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Thursday, March 28 2024
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The X-Ray is dead; here comes the new X-Ray

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As kids we have played, tripped, and twisted or sprained our limbs. Or we may have had a cough and cold, with or without fever, or displayed asthma-like symptoms. In either case, when we have visited a doctor or have been taken to one for diagnosis and treatment, we would have been advised to take an x-ray.

We then waited in a queue for the x-ray, were asked to or been twisted and turned on the x-ray table despite the pain, and then with bated breath waited to see if indeed it was a fracture, a dislocation, or just a tear of the muscle; and in case of the lungs or other organs – mainly the lungs – how deep-seated the infection was.

We have all seen the doctor examine our x-rays in the backdrop of a tube lit box that spread its rays of bright white light through the x-ray film to enable the Doctor to see the imperfections in our bodies and limbs. He compares what he sees with several similar x-ray films he has seen in the past from memory, looking for similarities and variations. He then relates them to his physical and diagnostic examination before he concludes a diagnosis and treatment protocol.

But there is no accurate method to compare similar x-rays, no data bank of x-rays to compare against except those in the mind of the Doctor, and it is quite possible, the human mind being what it is, he might miss out on an important clue for the right diagnosis because presenting symptoms, etc can be very similar and confusing.

Now-a-days there is one more complication – COVID19 which affects the lungs in its advanced stages – its effect on the lungs is similar to pneumonia, but it’s not – there are variations and the lung x-ray is supposed to reveal that – but given the data bank of x-rays of Covid19 patients being limited – surely there is scope for misdiagnosis and treatment? Especially as the virus mutates and its effect on the lungs changes.

The doctor has no choice but to make a considered decision based on clinical inputs and the lone x-ray. And in most cases, he does the right thing giving us cause for immense gratitude for saving our lives or at least improving the quality of our life.

But what if technology can help you compare that x-ray with a thousand others from around the world and give you feedback on yours from that comparison based on artificial intelligence or what they call machine learning? And that too within five minutes?

That would be like how calculator changed the way we do math or deal with figures – we know what we need to do, and how to do it, but we are concerned about accuracy and that is where the calculator helps. Then along came computers which would give you ‘scenarios’ to choose from.

And today, there are software programs that are addressing diagnostic issues Doctors face – from the laboratory to the imaging room

But Technology is taking it one step further into the cloud, enabling Doctors to, at the click of a button compare x-rays in real-time with a thousand others and get an indicative diagnosis scenario within minutes – this is not to say, his clinical skills are redundant – but it is just a tool to improve diagnostic accuracy!

Today several technology companies are working on this technology. One of them is Cognex.

When the Covid-19 pandemic started raising alarms around the world, the deep learning experts at Cognex started wondering if their technology could help healthcare professionals mount an effective defence.

The alarm proved justified: As of mid-September 2020, Covid-19 had infected nearly 30 million people worldwide and claimed almost a million lives. Clinicians everywhere faced similar challenges: Depending on laboratory tests to confirm COVID cases was time-consuming, potentially delaying diagnosis and treatment. X-rays and other medical imaging technologies could provide rapid confirmation of a COVID diagnosis, but it was easy to misinterpret the meaning of these images.

Cognex’s deep learning team looked at these challenges and realized that a software package they built for automating and optimizing production lines might provide a solution to the medical-imaging component of pandemic response.

Instead of comparing in real-time, they are building a Computer Software which is being continuously fed with different images and different inferences till a point is reached when the Software is sufficiently equipped to make an inference or prediction when a new sample is provided to it. Engineers and Computer Scientists call this Machine Learning. Instead of a programmer writing hundreds of conditions, a simple self-learning code is planted inside the software, which accepts thousands of samples and inferences and starts building an algorithm all by itself. The higher the number of samples, the better is the accuracy of the model. We have perhaps reached a stage where the algorithm is in an advanced stage where it can become an additional tool for the doctors before they conclude their investigation.

So, who makes this X-Ray Analysis and Inference Software? How can doctors request for this service? How much will it cost? What is the equipment required? How long will the doctor need to wait for the report to come?

With the advancement in technology and cloud computing becoming the order of the day, the doctor need not invest in any Hardware or Software or Server. He just needs 5 seconds of computing time from a central powerful server somewhere in the cloud. The X-Ray is sent in real-time to this Central Server and outcomes the  Inference within 5 seconds. An accomplished team of doctors working for Amazon or Google or Microsoft or IBM or Apple or Cognex will write down all the possible medical conclusions and include it within the software, such that the most appropriate inference is sent as a response to the sample submitted.

So, X-rays will continue but the tube lit box might be passe. Instead, the digital X-Ray will travel through a network into a Cloud Computing Machine having an X-Ray Analysis and Inference Software. This software will provide a near accurate report to the doctor. Now, the doctor can make his diagnosis within the overall context reassured that he has all the information at his command to make an informed decision.

Doctors and Engineers will be working hard to save a life or improve the quality of life. That will be the new normal, a healthy normal!

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