AI’s influence is pervasive in both healthcare and radiology

The 8th edition of the ‘Textbook of Radiology & Imaging’, curated by Dr Bharat Aggarwal, Director-Radiology Services, Max Healthcare was recently launched. In an interaction with Kalyani Sharma, Dr Aggarwal talks about various elements of the book and how it documents advancements in the field of radiology, especially in terms of technology and patient care

Can you tell us about the journey of launching this new edition of Sutton’s Textbook of Radiology?

The new edition was conceptualised in late 2019, when Elsevier approached me to edit this edition. The first task was to create a strong structured team, for which I reached out to three young and distinguished radiologists – Dr Amit Sahu from Delhi, Dr Akshay Baheti from Mumbai and Dr Varsha Joshi from Hyderabad, to join as associate editors. Since this book was read by all radiologists of our generation, we then travelled to the US for RSNA, the largest radiology conference globally, to seek the support of top sub-speciality radiologists from some of the best academic and clinical radiology departments of the world. This helped build a strong sectional editorial team, from hospitals such as the Harvard medical system. Collectively we then identified the contributors to author the chapters and set the production in motion.

The book was put together in the COVID pandemic and all authors diligently stuck to their commitment despite being pulled into the frontlines, and we put together a high quality, up to date book that will lay the foundation for the radiologists of the future.

What elements of the previous editions have been preserved in this new edition, and why were they considered relevant even after two decades?

General radiology procedures such as chest x-ray interpretation continue to be extremely relevant in modern medicine. Understanding of basic x-ray and other image guided also lays the foundation of more advances techniques which have evolved in the last two decades. As a result, the book continues to retain most of the material pertaining to chest xrays and basics of other imaging modalities such as CT, ultrasound and MRI. Images of some classical x-ray diagnoses were also retained.

You mentioned that new sections have been added, such as radiology physics, pediatric radiology, interventional radiology, and emergency radiology. How do these additions make the textbook more comprehensive for today’s radiologists?

The first section introduced the audience to research techniques, information technology and artificial intelligence, along with methods of quality control & assurance in the radiology department – these are relevant to the entire spectrum of staff in radiology departments. The clinical sections of the book are comprehensively written covering all current methods – from basic radiography to advanced procedures, to help the radiologists better understand how to use the available techniques in their ecosystem; to provide the appropriate diagnosis in enabling patient care. The illustrations and images typify different diseases so that the readers can not only learn different patterns of disease, but also use the book as a ready reference in their day to day life.

Separate sections on paediatrics, emergency radiology and interventional radiology highlight the importance of these in todays’ radiology practice – the radiologists will not only be able to do contextual on the job learning on an ongoing case based approach but also understand the spectrum of conditions which are closely inter-related in these sub-specialities.

The field of radiology has seen significant advancements over the years. How does this new edition of the textbook reflect these changes, especially in terms of technology and patient care?

The book has been kept updated with all new imaging technique including the role of Artificial Intelligence (AI) in radiology today – this is not only captured within the various chapters, but a separate chapter to make the radiologist understand how artificial intelligence works is included. This will enable the intersection of medicine and engineering to improve enhance the clinical applications of emerging technology. The book also captures the changing lexicons of communication and explains the impact of radiology techniques on treatment strategies. There has been an advancement of surgical techniques and medical management of disease- the role of the radiologist in this new ecosystem is emphasised in the book, enabling them to participate proactively in clinical decision making.

The book has new chapters on quality assurance and patient safety – all of which are extremely important contributors to improved patient experience, safety and outcomes. The chapter on research methodologies introduces the radiologist to a very important aspect of medicine which will contribute to further improvements in radiology technology and medical information.

The book addresses the importance of AI in radiology. How critical is AI knowledge for practicing radiologists today, and how does the textbook prepare them in this regard?

AI’s influence is pervasive in both healthcare and radiology. The majority of radiology equipment now incorporates AI to enhance quality and efficiency. This includes tasks ranging from positioning patients in CT and MRI scanners to optimising radiation dosages through AI-driven reconstruction algorithms, which have become standard features in modern scanners. Automated image reconstruction algorithms, powered by AI, deliver immediate high-resolution 3D and 4D advanced visualisation of organs and diseases, thereby expediting the diagnostic process. AI is being used for pattern identification on imaging techniques and contributes to disease prognostication – this has contributed to improved detection rates and the quality of report generation, pointing out abnormalities that could potentially be missed. Relevant sections of the book incorporate this ubiquitous presence of AI in modern radiology practice.

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