Radiology in 2040 | Dr. Meinal Chaudhry | TEDxNaduvilal Junction
Radiology in 2040 promises instant, portable diagnostics that revolutionize healthcare delivery, allowing advanced imaging and treatments anywhere, such as in the Himalayas, through technologies like AI, functional MRI, and 3D bioprinting. The talk covers a journey from current slow diagnostics (4-6 hour waits) to future instant digital workflows, addressing global challenges from remote medical access to organ shortages. The speaker concludes by showcasing *theranostics*, a highly targeted cancer treatment, and foreshadowing a future where understanding and manipulation of biology—like reading thoughts via MRI—will be commonplace. ## Speakers & Context - Speaker who presents a vision of radiology in 2040. - Initial premise establishing a high-performing athlete undergoing cancer therapy, linking modern medicine to futuristic possibilities. - Discussion structure: Current diagnostics $\rightarrow$ 2040 diagnostics $\rightarrow$ Remote diagnostics (Himalayas) $\rightarrow$ Functional imaging $\rightarrow$ 3D printing $\rightarrow$ Targeted therapy (Theranostics). ## Theses & Positions - The current diagnostic pathway is severely inefficient, involving multiple waiting periods (appointment, fasting, scan wait, report wait, treatment start). - Future radiology will be defined by portability, instant digital workflow (images to phone, prescription to phone), and autonomous monitoring (biomarker patch). - High-end diagnostics must be deployable at point-of-care in remote or risky terrains, independent of infrastructure. - Functional imaging and AI will allow for mapping and understanding of molecular function (e.g., brain activity, organ function) beyond simple structural imaging. - The ultimate goal of medical technology is to achieve molecular-level understanding and intervention, potentially leading to organ regeneration (*kidney printing*). ## Concepts & Definitions - **Radiology:** Branch of medicine dealing with Imaging Technologies. - **Imaging Technologies:** Including X-ray, CT (Computed Tomography), Ultrasound, and MRI (Magnetic Resonance Imaging). - **Functional Imaging:** Technique to understand the *function* of an organ at a molecular level, as opposed to just its structure. - **BOLD Imaging (Blood Oxygen Level Dependent Imaging):** Acronym for the technique used in functional MRI; detects changes in oxygen consumption in active brain centers. - **Neuromarketing:** Using functional MRI to test promotional materials by observing which areas of the brain are evoked (e.g., happiness, desire). - **Theranostics:** A combination of *therapy plus Diagnostics*; utilizes a therapeutic biomarker piggybacking on a diagnostic biomarker. - **Biomarker Patch:** Small skin patch that monitors medication levels and reminds the user to take medicine. ## Mechanisms & Processes - **Modern Diagnostic Workflow (Current):** Appointment $\rightarrow$ 4-6 hours fasting/waiting $\rightarrow$ Scan $\rightarrow$ Wait 4-6 hours (or days) for report $\rightarrow$ Treatment starts. - **2040 Diagnostic Workflow:** Scan $\rightarrow$ Images instantly to phone/radiologist/doctor phone $\rightarrow$ Tailor-made prescription lands on phone $\rightarrow$ Medicine automatically delivered $\rightarrow$ Phone reminds user $\rightarrow$ Biomarker patch monitors adherence. - **Remote Diagnostics (Himalayas example):** Complex diagnostics would function like *"switching off or on a fan"* using portable diagnostics and AI, enabling image acquisition and reporting in place. - **Brain Mapping:** During surgery, the functional MRI maps active areas (e.g., language, motor activities) to ensure post-operative function retention. - **Cancer Diagnosis Improvement:** Transitioning from viewing anatomy via standard MRI to physical, understandable models using 3D printing. - **Organ Regeneration:** The process involves printing the structure, seeding it with patient stem cells, and growing a functional organ *in vitro* (e.g., kidney). - **Theranostics Function:** A diagnostic particle attaches to a wall protein unique to cancer cells, causing targeted death, leaving normal cells unharmed. ## Timeline & Sequence - **Past:** Professional trekkers in the Himalayas in **July 2019** experienced a failure of high-end diagnostics at the point of care. - **Near Future (Projection):** Within the coming years, portable diagnostics coupled with AI will enable high-end imaging in risky terrains. - **2040 (Projection):** The realization of instant digital medical workflows, miniaturized hardware (X-ray size of SLR cameras, MRI size of front-loading washing machine). ## Named Entities - Bollywood actor (unnamed, shown in cancer treatment segment). ## Numbers & Data - Waiting time for current CT scan report: **4 to 6 hours** or sometimes **a couple of days**. - Ideal X-ray machine size: size of **SLR cameras**. - Ideal MRI magnet size: size of a **front-loading washing machine**. - Current brain usage estimate: Person uses only **5%** of brain capacity in routine activities. - Historical cancer complication side effects mentioned: **baldness, tiredness, fatigue, anemia, infection, nausea, loss of appetite, feeling of sickness, bleeding, bruising**. ## Examples & Cases - **Himalayas Trekking Incident:** Four out of six professional trekkers injured during a heavy snowfall thunderstorm in the Himalayas; initial care limited by lack of high-end diagnostics. - **Brain Tumor Mapping:** Functional MRI used to map areas critical for walking (activated area shown in the lit-up region) before surgery. - **Cancer Tumor Visualization:** Showing a patient's foot tumor via a physical 3D-printed model on a table, allowing patient and doctors to understand the relationship with blood vessels/nerves. - **Kidney Failure Waiting List:** The current reality of waiting for a donor kidney, contrasted with the future ability to print a kidney in the lab using the patient's own stem cells. - **Cancer Treatment Comparison:** Traditional chemotherapy killing fast-growing normal cells (like hair follicles, intestinal mucosa) alongside cancer cells, leading to side effects. ## Tools, Tech & Products - **X-ray Machine:** Shrinking down to the size of **SLR cameras**. - **MRI Magnet:** Shrinking down to the size of a **front-loading washing machine**. - **Portable Diagnostics:** General category for advanced, miniaturized, field-deployable imaging units. - **Functional MRI:** Technology for mapping brain activity (BOLD Imaging). - **Biomarker Patch:** Device for monitoring medication adherence at the skin level. - **3D Printing Technology:** Used for printing anatomical structures and diseases for visualization and dummy surgeries. - **Theranostics:** Combination diagnostic/therapy agent. ## References Cited - None explicitly cited. ## Trade-offs & Alternatives - **Diagnosis:** Contrast between slow, multi-stage current hospital process versus instant, digital, point-of-care future workflow. - **Biopsy/Visualization:** Alternative to physical model vs. the printed anatomical model (3D printing). - **Kidney Treatment:** Waiting for scarce donor organs vs. printing functional organs *in vitro*. ## Counterarguments & Caveats - The speaker acknowledges that current high-end diagnostics often require complex facilities, creating a gap in deployment to risky terrains. - The discussion of functional MRI uses a simplified model (finger tapping) to explain the concept of localized activation. ## Methodology - Showcasing the concept via a predictive presentation, moving through historical limitations to technological breakthroughs. - Employing *visual comparisons* (e.g., old X-ray vs. new image quality; MRI size comparison; 2D scan vs. 3D print). - Using a hypothetical *"functional MRI of myself"* to demonstrate the potential for reading thoughts. ## Conclusions & Recommendations - The overall trajectory of radiology is towards extreme portability, artificial intelligence integration, and molecular precision. - Implementing portable, AI-driven diagnostics is crucial for improving healthcare delivery in resource-poor or inaccessible areas. - Future research focus must include printing functional human organs to eliminate organ transplant waiting lists. ## Implications & Consequences - **Healthcare Access:** High-end care becomes globally accessible, regardless of physical infrastructure (e.g., Himalayas). - **Medical Practice:** Changes from retrospective diagnosis to proactive, molecular-level preemptive intervention (e.g., pre-surgery mapping, printing models). - **Data Privacy/Autonomy:** The development of mind-reading technology via functional MRI necessitates extreme awareness of one's thoughts, as technology may render private thought visible and transmissible. ## Verbatim Moments - *"how will you feel if I tell you that I can read your mind and print your exact thoughts on paper"* - *"Welcome to Radiology in 2040"* - *"zoom your images come to your phone your radiologist phone and your treating doctor's phone"* - *"The medicine will automatically delivered to you and since you have prescription in your phone your phone will remind you to take those medicines at the desired time"* - *"the huge MRI magnet which engulfs a human being inside when it takes the images is shrinking down to the size of a frontloading washing machine"* - *"what is the question that you are left with? What is it that you want to know?"* (Implied question guiding the discussion towards functional questions). - *"the area which L lights up when a person does finger tapping"* - *"This technology my dear friends is called 3D printing technology"* - *"no more cues for kidney transplantation that's the magic of 3D printing technology"* - *"This is a combination of therapy plus Diagnostics"* - *"I might just can read it and tell you and print it on paper"*