Imaging innovations such as Magnetic Resonance Imaging (MRI), Computed Tomography (CT) and Positron Emission Tomography (PET) have brought new dimensions to the diagnosis and treatment of medical conditions. From detecting small, hard to discern tumours and lesions to providing guidance on interventional procedures, imaging technologies have enabled progress across different specialisations including cardiology and oncology.
Most importantly, the innovation in medical imaging has the potential to be part of the solution to many of today’s healthcare challenges. The rise of non-communicable diseases is one of the most prominent health issues today with rippling effects into the future.
It is predicted that by 2030, there will be 10.6 million cancer patients in Asia and 60 percent of all deaths from cardiovascular diseases will occur in Asia.1 These health trends are driving demand for healthcare services, leading to the upward spiral of medical costs.
While grappling with the economic implications, we also need to respond to the realities of the shortage of experienced medical professionals, disjointed workflows and increasing patient caseloads.
The silver lining is that integrated and advanced imaging modalities will streamline procedures, enable first-time-right diagnoses and improve patient outcomes. Looking ahead, here are three trends that will shape the future of imaging:
1. Hardware with the human touch
A diagnostic procedure can be an unnerving experience for patients, often fraught with apprehension about the results of their diagnosis. Nervous patients who do not know what to expect or who are unable to cooperate during a scan – having trouble lying still in an enclosed space or holding their breath for the required amount of time – may increase the need for repeat scans as the quality of the imaging results are compromised.
During these sessions, it is up to clinicians and radiologists to add a human touch to create a calm and comfortable environment. Encouragingly, we are now starting to see patient-centricity built into the medical equipment itself, to help patients feel at ease before and during the scan.
Just as virtual reality (VR) applications have pushed boundaries in clinical education and training, it can also be harnessed to improve patient experience in a safe, controlled setting. Using VR, patients can preview what their MRI experience will be like before they get into the scanner, helping to reduce anxiety about the unknown.
Increasingly, institutions are also exploring ways to improve patients’ experience in the MR bore. Philips is seeing the use of contactless sensing technology to intelligently detect a patient’s respiratory signals using sensors and algorithms, thereby eliminating the need to strap a respiratory belt on the patient. Immersive ambient experience such as music, lighting and video projection are also used to distract and entertain patients as they move into the bore. With patients being more relaxed, this can reduce motion-related imaging variables while improving efficiency as patients need not go through repeat scans.
2. MRI and CT are the future of radiotherapy planning
Cancer management is moving away from a ‘one-size fits all’ approach to more personalised and targeted treatment pathways such as radiation therapy, which uses high-energy particles to destroy cancer cells.
Radiation therapy has made great strides in recent years, as it integrates sophisticated imaging to delineate the anatomy for dose planning. This approach known as target delineation, allows radiation delivery to be tailored to the anatomy so that the dose can be directed to the tumour, and not the surrounding tissue, helping to preserve healthy tissue as much as possible.
Pivotal to starting radiation therapy is a CT scan, which is used to create a treatment plan such as dose distribution and treatment position. While CT has been the standard imaging modality thanks to its speed and accuracy, it is limited in providing good soft tissue contrast, especially at regions where soft tissue structures are in close proximity.2 In this context, the benefits of high contrast MRI images that differentiate soft tissues, organs and anatomical structures are especially important in complementing CT, and in some cases replacing.
Given the complexity of cancer treatment, MRI will be increasingly important in the future of radiotherapy planning.
3. Harnessing patient data for better clinical intelligence
At a time when the adoption of imaging technologies and software has resulted in an exponential growth in medical images and patient data, the use of AI and algorithms in providing clinical intelligence to make the right decision at the right time has never been more critical.
Applying AI to healthcare and personal health requires more than just machine learning, deep learning or other statistical methods. First and foremost, it requires a deep understanding of the clinical, operational, or personal context in which such methods are used. We call this ‘adaptive intelligence’ – combining the data-processing power of technology with the clinical, operational and contextual knowledge of human experts for smarter data analytics. This term underscores how clinical insights should augment as a smart “assistant” to radiologists, adapting to their needs and preferences.
In medical imaging, adaptive intelligence has the potential to speed-up time-consuming image processing tasks and unify data from disparate imaging sources to support diagnostic confidence, enabling first-time right diagnoses and personalised treatment pathways.
Beyond diagnostics and treatment, improved data processing can also be used to streamline the operational aspects of healthcare systems, from equipment maintenance to patient scheduling to post-imaging follow-up.
For example, from a scheduling standpoint, AI is able to help predict whether a particular patient is going to show up for his or her appointment with significant accuracy. With this type of intelligence, radiology departments can better anticipate and proactively call the anticipated no-show patients to provide reminders or double-book that time slot.
There is no question that imaging is the common thread throughout patient care from diagnosis to treatment. In fact, imaging is in the middle of a transition to value-based care. This presents a unique opportunity to improve patient outcomes with technologies and informatics solutions that aggregate data, accelerate workflows and facilitate informed decisions to give clinicians and radiologists the insights they need to work effectively and efficiently.
- Institute for Health Metrics and Evaluation. Available at: http://www.healthdata.org/news-release/deaths-heart-disease-and-stroke-could-rise-significantly-unless-countries-address-risk.
- Schmidt MA, Payne GS. Radiotherapy planning using MRI. Phys Med Biol 2015, 60: R323–361.
Dominique Oh is the vice-president of diagnostic imaging business at Philips ASEAN Pacific.