By Aine Cryts

Ajay Kohli, MD, a radiology resident at the University of Pennsylvania School of Medicine in Philadelphia, is enthusiastic about the role of imaging on the future of medicine. For example, he points to the vital role imaging plays in tracking the response of patients to innovative, million-dollar treatments, such as CAR T-cell therapies.

Kohli insists that change within radiology is driven primarily by value-based care—rather than technologies such as artificial intelligence. “Payers are moving to value-based care, and that transforms how healthcare is delivered,” Kohli tells AXIS Imaging News.

“As a result, many patients are evaluating getting the right diagnosis before they launch a big therapeutic change in their treatment plan,” adds Kohli, who says he doesn’t speak on behalf of the University of Pennsylvania School of Medicine. “That’s also the case with surgical options. But whatever route they choose, imaging pays a huge role in their decision-making process.”

AXIS Imaging News recently discussed the changing role of radiologists and the impact of the specialty’s innovation on medicine with Kohli, who has been involved in clinical studies using technology platforms, such as wearable technology to apply real-time histopathologic analytics during surgical oncology cases. Here’s what he had to say.

AXIS Imaging News: Please give me an example of an innovation you’ve witnessed during your training to become a radiologist.

Kohli: When I was in medical school, there was no way to screen for lung cancer—unlike screening methods we have for breast cancer and colon cancer. Lung cancer is the biggest killer of patients across the country. During my residency, a clinical trial was launched for a low-dose CT scan to screen for lung cancer. The idea is to use a low-radiation screen among patients at the highest risk of lung cancer.

Through the screening, we’re preventing many deaths due to lung cancer; we’re catching the lung cancer before it metastasizes. That’s just one example of the way imaging innovation has been applied, and it’s phenomenal.

AXIS: What are some of the pressures radiologists contend with in their daily practice?

Kohli: Imaging innovation has led to increasing imaging volumes across the country. That’s everything from CTs to ultrasounds to MRIs to areas of nuclear medicine. Meanwhile, the radiologist workforce hasn’t increased that much. That means it’s harder for radiologists to maintain work-life balance.

Radiologists have had to deliver on turnaround times, as well as more patients [undergoing] imaging. Radiologists need to generate reports faster and faster—sometimes within 30 minutes or even within five minutes. We’ve had to get faster and faster, and the “hamster wheel” continues. It’s frustrating, especially amidst all of the complex imaging modalities.

AXIS: What impact is artificial intelligence having on radiologists’ daily work?

Kohli: So far, artificial intelligence hasn’t played a role in changing radiologists’ work lives. But in the second half of the next decade, artificial intelligence has the potential to automate a lot of the decisions we make on a daily basis. That could alleviate some of the stresses radiologists go through.

Aine Cryts is a contributing writer at AXIS Imaging News. Questions and comments can be directed to chief editor Keri Forsythe-Stephens at [email protected].