COVID-19: Radiologists are at the pulse of medicine & innovation

Radiology has been a cornerstone of medical care for over a century. COVID-19 once again illustrates how indispensable it is. As Managing Board Member at Siemens Healthineers and a medical doctor with long experience working in surgery, I would like to share my view on how modern technology in radiology can aid in combating COVID-19 – and what COVID-19 patient management might or might not tell us about the future of radiology.

Let me start by sharing my perspective on some recurring questions from radiologists.

“Hospitals all over the world are overwhelmed with COVID-19 patients. Will we be able to keep radiology services going in the months ahead?”

First of all, I am deeply impressed by what healthcare workers all over the globe do for their patients in very challenging and difficult times. To me, it is a great honor that we as a MedTech company are able to help our customers who are at the forefront – and ultimately also help patients. Alongside critical care physicians, nurses, and general practitioners, radiologists belong to the most essential healthcare professionals fighting the COVID-19 pandemic. It is they who can detect signs of COVID-19 pneumonia much more accurately than anyone else, given a characteristic imaging impression in chest x-ray and an even clearer signature on chest CT data. Additionally, there are early signs that the demand for imaging services in COVID-19 patients might increase, as other organs seem to be affected, such as the heart, kidney, liver, as well as the brain.

Radiologists and their teams, especially radiographers and nurses, are providing an important service, but they are as susceptible as anyone else to catching a COVID-19 infection. How to minimize the risk of exposure for their team and how to keep the service running with a reduced workforce are therefore the main concerns currently keeping our customers awake at night. Digital imaging technology can be of help here.

Remote scanning solutions mean patients can be examined without the physical presence of imaging personnel. Thus, without sacrificing the service being delivered, fewer professionals need to have direct patient contact. Additionally, remote scanning supports radiologists and radiographers who are quarantined, enabling them to continue working from home.

On the other hand, modern technology helps staff operating the scanners keep a safe distance and reduces the patient set-up time. It is much easier to keep a distance of 1.5 meters when scanners can be operated via mobile devices and provide automated positioning, thanks to AI and automation. Protective gear will still be needed, of course. But technology makes radiology as safe as possible in these times of COVID-19.

So, yes, with the appropriate measures, I think it will be possible to keep radiology services going throughout the crisis and they will continue to play a key role for clinicians and patients.

“Talking about AI: Is there a role for diagnostic AI in COVID-19?”

Chest x-ray and CT imaging are a cornerstone of COVID-19 patient management. This means that in highly affected institutions, there will be an increased chest CT workload connected with detecting and monitoring COVID-19 disease progression and therapy response. Clinical Decision Support systems, like the AI-Rad Companion Chest CT, provide numerous features that aid radiologists in coping with increased workloads, for example tools that assist in lobe segmentation or lung lesion and emphysema detection. We are also working 24/7 with hospitals worldwide to develop specific AI algorithms intended to help detect signs of atypical pneumonia and quantify the extent of infection. A prototype is already available and clinical validation is underway.

“How can we make sure that radiologists get all the information they need on Covid-19?”

Communicating and sharing experience is crucial during such a crisis. There is a vast amount of information on COVID-19 in medical literature by now, and much of it is publicly accessible. But there is also a need to communicate knowledge and experience within medical institutions or care networks – ideally without meeting in person to minimize risk of infection. Telecare platforms can be extremely helpful here. Digital collaboration platforms are highly suitable for sharing cases, for example. We have amended our existing online education platform by providing free access to general information on COVID-19 related to imaging protocols and examination workflows.

“Beyond COVID-19, will radiology be the same in a few years or will AI take over imaging?”

I believe that after COVID-19, we will not ‘return-to-normal’ but ‘return-to-a-NEW-normal’ where many of the topics previously discussed will gain even more ground. Healthcare will be more broadly provided through remote services, not only to reduce the risk of infectious diseases or to be more efficient, but also for the patient’s convenience. In the long term, with AI-assisted image analysis improving by the day, radiology as we traditionally know it will cease to exist. This doesn’t mean that it will go away: it will be significantly different, and at the same time more important than ever. It will help to center and integrate data from various sources (e.g., Pathology, Lab, Genetics, Imaging) in order to best navigate and stratify patients for their personalized therapy.

AI will not reduce the need for imaging but will decrease the need for specialization and sub-specialization in image interpretation. AI will make it much easier to interpret imaging findings for radiologists with different levels of expertise, or even non-radiologists. Imaging training for clinical specialists will increasingly be integrated into the various clinical disciplines and will be able to help the daily imaging needs of their departments – something that could, incidentally, be extremely helpful in pandemics, where there is an incredibly high number of patients that need healthcare services in a short period of time.

“So, would you advise a young doctor to specialize in radiology?”

Of course, I would, now more than ever! AI is starting to pervade radiology. Radiology is an important discipline which embraces new technology early on, thinks about how to use it for the benefit of patients, and – by being open-minded and open to technological innovation – is driving change across disciplines.

Thanks to digitalization and the increasing use of AI, radiology will become more attractive to young doctors and students. Radiologists will be less prone to burnout than they are today. There will be less routine reporting. They will be able to spend more time with patients and focus on complex cases not amenable to AI. They will do less operating of diagnostic machines and focus on collaborating with other disciplines. Based on this, radiology will also become more interventional, combining diagnostic information with more personalized, image-guided therapy.

In short: Within the healthcare system, radiologists will be the catalysts of the digital and personalized medicine transformation. So, my answer is a clear ‘yes’; go for radiology to stay at the pulse of medicine and innovation!

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In my next articles, I will elaborate further on COVID-19 management in radiology from the perspective of the patient and hospital executives.