The Radiology–Surgery Dynamic

March 28, 2018

As long as radiology and surgery continue to cross-pollinate, there will be continued growth and evolution of both.

Wayne Gretzky is often quoted with regard to his philosophy of, “Don’t chase the puck, go to where the puck is going.”

When reading recent articles about technology that will “overtake” radiology (e.g. artificial intelligence), it is clear that the authors are focused on the present location of the puck. Radiology, to the best of my knowledge, has never stood still for very long periods of time.

A case in point are recent statements by Jesse Courtier, MD, radiologist at University of California, San Francisco. “Within the past year, we have seen a tremendous increase in excitement about the potential for both augmented and virtual reality applications in the field of diagnostic imaging. The possibilities of moving from 2D representations to true 3D patient-specific holographic models are extremely exciting to many of us.

“To see the anatomy represented in a 3D way is more realistic and closer to what surgeons actually encounter when in the operating room,” Courtier adds. “The possibilities of superimposing patient-specific 3D medical objects onto a real-world background have generated new ideas for patient and trainee education, pre-surgical planning, and even intraoperative use.”

It is exciting to read about radiology being focused on the use of the latest technologies to bridge the radiology–surgery gap. Radiology is also being driven by the field of radiomics-where images are considered to be data as well as pictures-resulting in the field of computational imaging.

At the same time, surgery is becoming highly focused on computational anatomy, a discipline based on quantitative analysis of organ shape and the application to computer-aided diagnosis (CAD) and computer-aided surgery.

Both computational imaging and computational anatomy are aimed at having a significant impact on precision medicine. Bridging the radiology-surgery gap may therefore be carried out with a high degree of “precision.”

It doesn’t appear from the above directives that radiology is standing still. Bringing radiology and surgery closer together requires a common language-perhaps that will be accomplished with a combination of virtual and augmented reality.

This was made clear by a radiologist at RSNA, a few years ago, when seeing virtual reality for the first time, stated, “Now I can speak intelligently with surgeons.” A few months later, a surgeon pointed out that he doesn’t use present workstations since they are limited to 2D. He then nailed it with the comment, “I’ve never opened up a patient and seen a 2D view.”

So, what about the impact of artificial intelligence on radiology? Leonard D’Avolio, CEO of Cyft, explains it well by stating, “Big data, machine learning, and AI are not sentient beings, able to perceive and feel things. Technology is the enabler, but it’s people and process that improve care.”

As long as radiology and surgery continue to cross-pollinate, there will be continued growth and evolution of both. And, technology will be applied in the most effective manner to achieve higher levels of patient outcomes.

Ron Schilling, Ph. D., is the executive chairman of Santa Clara, Calif.-based EchoPixel