The future of radiology is mobile and consumer-driven. 14

Radiology future is mobile and consumer-driven. Ultrasound scans are pocket-size. MRI and CT services are marketed directly to consumers. Leading MRI and CT radiologist answers key radiology-related questions in extensive video interview. What will future medical technology advances bring to radiology? What are implications of training needs and communication trends for the future of radiology?

Radiology future. It is mobile and consumer-driven. Pocket ultrasound scanners have very good quality (GE Healthcare Vscan). But doctors have to learn how to use pocket ultrasound devices properly. Video interview with leading expert in radiology, CT and MRI specialist. Dr. Kent Yucel, MD. Radiologists and cardiologists have best training to interpret results of ultrasound scans. They can decide what is important and what is not. The risk is that poorly trained doctor can miss important findings on ultrasound results. Doctor can also attribute too much meaning to benign findings of pocket ultrasound. Medical Second Opinion on any cardiac ultrasound or abdominal ultrasound confirms that findings are correct and meaningful. Dr. Anton Titov, MD. Medical Second Opinion also helps to choose the best treatment strategy for patient’s problem identified on ultrasound. Seek medical Second Opinion on cancer and heart disease and be confident that your treatment is the best. Dr. Kent Yucel, MD. Radiologists are also pushed to interact with patients more directly. This can confuse patients because radiologist does not have all inputs into the patient’s situation. Radiologists best serve patients by communicating more with physicians who order radiology tests. Dr. Anton Titov, MD. We had a very thorough discussion about advanced imaging technologies for patients with many health conditions. Let this be a concluding topic of our conversation today. What is your view on the impact that mobile devices have on practice and training in such visually oriented field as radiology? Dr. Anton Titov, MD. Dr. Kent Yucel, MD (MRI and CT Specialist, Tufts Medical Center): When we talk about mobile imaging devices, we are talking primarily about mobile ultrasound. Ultrasound miniaturization of ultrasound devices has progressed very far. Now there are ultrasound machines that have very good quality of ultrasound pictures. Doctors can carry these devices around with them from one place to the other. They can use portable ultrasound devices at the bedside. Dr. Kent Yucel, MD. their risk of that is (in a human factor). While the imaging may be high quality there is still a tremendous need for doctors who are using this equipment to have adequate training in evaluating the pictures. Otherwise they may think that nothing is wrong with the patient when the patient has a serious condition that they failed to find. Or, equally concerning, they may see something on the picture they don’t understand. And that finding is not a problem. Maybe it is a benign finding. And they misinterpreted it as a significant finding. Dr. Kent Yucel, MD. So the equipment issue is solved effectively with ultrasound. There are small devices that are very mobile. That is true. The real problem is making sure the doctors were using these devices are adequately trained. They don’t necessarily have to be radiologists. But radiologist as an example, or cardiologist – they are very well trained at doing ultrasound exams. They are trained in deciding what’s important and what’s not important. They know what the ultrasound may have failed to detect. So then patients need further imaging based on the findings of ultrasound. Dr. Kent Yucel, MD. I am not saying only the radiologist or cardiologist have to do ultrasound. But I am saying that doctors who are going to be doing ultrasound, must have the extra training needed to interpret the pictures. Dr. Anton Titov, MD. As a follow-up question, MRIs and CTs are becoming widely available to patients and marketed to consumers. So does that bring an opportunity for more direct consultations of patients to radiologists? Dr. Anton Titov, MD. Maybe radiologists should now bypass a number of physicians that are traditionally inserted along the value chain for somebody who is scheduled to do CT or MRI? Dr. Anton Titov, MD. This is the consumer-driven healthcare culture. Can direct contact between radiologists and patients be beneficial for the practice of radiology? Dr. Anton Titov, MD. Dr. Kent Yucel, MD. That is a very hot topic in the United States right now. Radiologists are talking about getting more involved in direct patient communication. Radiologists historically communicated directly with patients in mammography field. So with mammography the decision of “do nothing” or to get further evaluation of patient’s breast, is up to the radiologist. The radiologist is responsible for communicating that decision to the patient. So that there has been a lot of talk about extending direct communication between radiologists and patients to other areas. Dr. Kent Yucel, MD. I have a problem with that strategy. Many radiologic findings need to be placed in the overall clinical context of the patient. Only then doctors know how to manage patients. So the lab tests, the physical exam, the presenting symptoms – all need to be taken into the account to decide what to do about the radiology finding. Perfect example is MRI of the spine for back disease back pain. MRI of the spine detects all kinds of abnormalities, many of them not related to the patient’s symptoms. So that is where the careful physical examination is required. Talking to the patient is mandatory to know whether these MRI findings in the back, in the discs, or in the nerves need to be treated or not. It is a great idea theoretically. But the way radiologist can add most to the value chain is by talking more directly to doctors who are ordering the exam. Radiologist can help ordering doctors to put the findings in context. Sometimes the ordering doctors may have difficulty interpreting the reports. And that is where radiologists can add value to that patient’s care. Radiologists should communicate directly, verbally with the patient’s doctors. The problem communicating with the patients directly is it can create more confusion than clarity in their mind. Dr. Anton Titov, MD. So the traditional way of team interaction in patient care remains the golden standard and would be so in the foreseeable future. Dr. Kent Yucel, MD. Exactly. Dr. Anton Titov, MD. Professor Yucel, thank you very much for this extensive discussion today about advanced imaging of various organ systems. It is been very helpful to learn a lot of new insights. Dr. Kent Yucel, MD. I’m sure that it will be very helpful for all those who see this interview and this video. Dr. Kent Yucel, MD. Dr. Anton Titov, MD. You are very welcome! Thank you!  Thank you very much! Radiology future. It is mobile and consumer-driven. Video interview with leading expert in radiology. How mobile technology pushes and changes radiology field.