In an era where medical imaging is at the forefront of diagnostic innovation, the field of radiology is evolving rapidly, shaped by technological advancements and groundbreaking research. To navigate the complexities and opportunities within this dynamic discipline, we turned to some of the brightest minds in radiology. In this special feature, thought leaders share their insights on pressing questions facing radiology today. From the integration of AI in diagnostic imaging to the future of patient-centered care, these expert answers offer a glimpse into the challenges, innovations, and transformative shifts shaping the future of radiology. Join us as we dive into the perspectives of pioneers who are redefining the way we look at health, technology, and patient outcomes.
With the rise of personalized medicine, how do you see radiology evolving to provide more tailored diagnostic and treatment plans for patients?
Medical imaging occupies a keystone role with personalized medicine, with many advanced imaging modalities, such as functional MRI and molecular imaging, already helping us characterize disease activity at the cellular level and direct therapy. Most importantly, medical imaging is uniquely positioned to offer these diagnostic and therapeutic capabilities in a non-invasive and continuous fashion in follow-up, which differs from the work of other fields. In the near term, efforts will focus on validating and experimenting with these new imaging techniques to determine their value in patient care while addressing their limitations and ensuring judicious use in resource-limited healthcare systems.
– Dr. Jaron Chong – Chair, CAR AI Standing Co
How have advancements in artificial intelligence and machine learning impacted the field of radiology, and what do you foresee as the next major innovation?
Artificial intelligence (AI) and machine learning (ML) have significantly enhanced the field of radiology by improving the speed and accuracy of image analysis. As these two fields continue to progress, the very latest technologies in Large Language Models (LLM’s) and Vision Language Models (VLM’s) will offer the next round of capabilities to further advance radiologist analysis and accelerate efficient and accurate workflow. These techniques are generalized enough that the impact of tools could be broad, from mundane tasks like proof-reading reports, to executing population based screening and preventative recommendations, and begin to impact administrative burdens in the medical imaging workflow.
– Dr. Jaron Chong – Chair, CAR AI Standing Co
As imaging techniques continue to improve, how do you think radiology will influence early detection and prevention of diseases, particularly cancers or neurological disorders?
Improved imaging techniques are continuously revolutionizing the early detection and prevention of diseases. High-resolution imaging and advanced modalities like PET/MRI are making it possible to identify precancerous lesions and early-stage cancers with remarkable precision. Similarly, advanced neuroimaging techniques are helping to detect biomarkers of neurological disorders like Alzheimer’s disease, oftentimes well before symptoms appear. By identifying diseases at an earlier stage, radiology is empowering clinicians to intervene sooner, improve patient outcomes, and even prevent disease progression through early lifestyle or therapeutic interventions. With the proliferation of AI/ML tools, we may now also begin to offer these functions at a greater volume and on a wider scale than previously attainable.
– Dr. Jaron Chong – Chair, CAR AI Standing Co
How do you see the role of radiologists evolving in multidisciplinary care teams, especially with the growing focus on collaborative healthcare models and integrated patient care?
The role of radiologists is evolving from traditional image interpreters to pivotal collaborators in multidisciplinary care teams. As healthcare shifts towards integrated patient care, radiologists are uniquely positioned to serve as information curators and
clinical consultants.
In multidisciplinary care, radiologists will provide real-time insights, integrating imaging data with clinical, genomic, and pathology information to guide diagnostic and therapeutic decisions. Their expertise combined with advanced imaging techniques, such as AI-powered radiomics and 3D/4D imaging, will enable more personalized and precise care.
Radiologists will also take on a leadership role in managing and interpreting aggregated patient data. With platforms like Sectra’s “Pixel EMR” approach – where imaging data from various specialties is centralized – radiologists can contextualize findings across disciplines, fostering a comprehensive understanding of a patient’s condition.
Technology will further amplify the impact of radiologists, requiring them to adapt and expand their expertise. As AI and deep learning (DL) become integral to imaging workflows, radiologists must understand these technologies to ensure their safe application. Familiarity with DL algorithms will be essential for providing critical clinical oversight, validating AI outputs, ensuring accuracy, mitigating biases, and integrating AI-generated insights into comprehensive clinical interpretations. By combining their expertise with AI, radiologists can enhance diagnostic precision while maintaining the human touch in patient care.
Moreover, radiologists will play a critical role in patient-facing care. With seamless integration into EMRs – like Epic, radiologists’ insights will be readily accessible to the broader care team. As imaging findings increasingly inform treatment plans, radiologists will directly engage more with patient care teams to explain results and options, build trust, and enhance patient outcomes. The future radiologist will be central to integrated care, leveraging technology, data, and collaboration to deliver precise, patient-centered outcomes. This evolution elevates their role and aligns radiology with the overarching goals of multidisciplinary, value-based healthcare.
– Stephen Harrold, Director, Strategy & Innovation, Sectra Canada Inc.
Imaging plays a central part in the health care journey of most patients, including diagnosis, interventions, and follow-up during and after therapy. Radiologists’ interpretations of images affects other physician and surgeon decision-making, as well as allied health providers. Thus, the role of radiologisst in multidisciplinary care will continue to grow given the increasing needs for effective communication between various health professionals to coordinate care of patients in a health care system which has limited resources.
– Dr. Ania Kielar – CAR President
What are some of the most exciting or under appreciated areas of research in medical imaging that could significantly change the way we approach diagnosis in the near future?
It’s remarkable to see how far we’ve come through innovation, developing new equipment, new techniques, and doing things that were certainly unimaginable for Roentgen, the father of X-rays. And as we see advanced modalities gaining more and more features, it is sometimes underappreciated that plain old X-ray or as it is now called, Digital Radiography (DR) itself still has room for improvement and innovation that can lead to better outcomes. DR or Digital X-ray is the first step in the diagnostic process – and sometimes the only one available, especially in low-resource settings.
Improving Digital X-ray, therefore, is paramount. The rise of new technologies that make Digital X-ray better – such as quantitative single-exposure dual-energy subtraction – can add significant value. When you can better detect and quantify diseases right from the start, in both fixed and mobile settings, you can optimize the entire chain of hospital care. When you can offer more insights at the bedside, in emergency rooms, in outpatient clinics, it’s one less patient you have to move around the hospital for follow-up imaging and improve time to diagnosis and intervention. The impact can be huge.
Let’s take the example of the ICU: what is the burden of advanced imaging on staff and hospital operations? If you can alleviate the need to move patients for a CT scan with something as simple as a spectral digital bedside X-ray, the difference can be significant. As another example, let’s talk about remote or low-resource areas that might not even have advanced equipment available. There is a gap in healthcare and the very foundation of radiology, DR, through spectral imaging, might be the missing piece in this puzzle.
– Amol Karnick, President and CEO, www.kaimaging.com
Radiology is a critical part of many medical diagnoses, but there are concerns around radiation exposure. How do you balance the need for diagnostic imaging with minimizing risks to patients?
Radiologists, like other physicians, follow guidelines and evidence-based practice to determine the best imaging for the question at hand, based on the patient’s symptoms and past medical history. The Canadian Association of Radiologists publishes various practice guidelines which are created and updated by experts in the field. This includes radiologists as well as physicians who are involved in the care of patients related to a particular guideline. Radiologists follow the ALARA principle with regards to radiation exposure (As Low as Reasonably Achievable) for patients, choosing imaging tests such as ultrasound and magnetic resonance imaging (MRi) when appropriate. When x-ray, computed tomography (CT) and Positron Emission Tomography (PET) is the most appropriate imaging test to perform, we work to perform the test using the lowest radiation dose possible, while maintaining high quality images.
– Dr Ania Kielar, CAR President
How has the role of radiologists changed with the increased use of remote imaging and teleradiology, especially in underserved or rural areas?
Regardless where radiologists report a study, they are responsible to ensure highest quality imaging for each patient. The Canadian Association of Radiologists is working to expand accreditation of imaging facilities across the country to help ensure best practices and protocols are available for all types of patient imaging. Radiologists are key members of multidisciplinary case conferences ()MDC), where physicians caring for patients with specific conditions can discuss cases in an environment with key experts in the field to ensure best care for each individual; this can include certain types of cancers, endometriosis and other non-cancerous conditions. Since COVID, these MDC are increasingly taking place in a virtual format, thereby allowing specialists from many different disciplines to participate without having to travel, and thus, allow improved access to expert discussions and consensus building.
– Dr Ania Kielar, CAR President