themantalope

Not to mention shoulder MRs can be hard to read. Findings can be subtle and have to be interpreted in context with the exam, symptoms etc.

lol yea I wasn’t going to put in a full dictation on the internet but clearly a lot of misinterpretations from the AI

That’s a good question.

My understanding is that medical images are part of a patients record (so they must be available for the patient or other docs at the request of the patient) but whoever has collected the images does have some form of ownership. I’m not a lawyer and I have a cursory understanding of this. I believe it would be possible for an AI company to lease or get access to the data through a transaction but I suspect that it hasn’t happened (or happened publicly) due to fear of backlash.

For example I know that some companies like Tempus had access to imaging that corresponded to tumors which had been biopsies for sequencing and they were developing models in house.

Somewhat. During residency I developed models for detecting liver tumors in MRI imaging. Like you said, highly specialized and a lot of manual work developing the dataset.

There are now open source open weight “foundation models” coming out of labs that are transformer or mamba based architectures. These will accelerate development.

I mostly do interventional radiology, which is more similar to a surgical specialty than a diagnostic radiology practice. We do a lot of procedures , see patients in our clinic, have a service that rounds on and follows up on patients etc. I don’t think AI will affect my job much in the next 10-20 years. Advancements in AI and robotics could potentially offload some of our work, but most of what’s out there is underwhelming, but we all know that can change fast.

Even for diagnostic, I’m not totally convinced AI is going to cause a lot of issues. From a medical-legal perspective I doubt AI companies are willing to take on the risk of misdiagnosis . When that happens, human rads will start to get phased out.

In the interim, I think the next 10 years could be a golden period for diagnostic rads. Rads will still be the ones doing the work and signing reports, but people who learn how to use the right combination of tools will become very productive and can make a great living. Eventually payers will re-align but early adopters who figure it out will have a leg up.

Radiologist. I don’t read MR shoulder exams in my day to day practice, but from the few pictures shown , I can’t conclusively disagree with the original report.

These models are generally terrible at reading medical images. The amount of public training data on the internet compared to the number of scans a radiologist reads in training is minuscule. There’s obviously a ton of medical images in general but very few, and even fewer along with a report are available on the internet publicly for download.

There are vision language models coming out of research labs that are excellent in describing and localizing findings. Still at the level of a 1st or 2nd year radiology resident, but as we all say - this is the worst the models will ever be.

Not sure. Image reconstruction/generation is a computationally intensive process, and in recent years DL based methods for improve image reconstruction have advanced fields like musculoskeletal MRI imaging. The physics behind this idea are interesting, but will have to wait to see if they produce images with high anatomic detail.

MRI uses EM radiation in the radiowave frequency band. This is using sound.

If you could obtain volumetric/3D ultrasound data that was not operator dependent, that would be great.

US is a good diagnostic tool, but it can be challenging to read because obtaining good images is very operator dependent. You need to have a good sonographer that can get the right views, knows how to adjust the imaging parameters to produce high quality images. It's not like CT or MR where the tech just sets a few basic scanning parameters and let the machine do its job.

However, see my other comment, the example images they provide on the page do not look great, very limited organ detail.

edit: clarification

Other than the shapes of the tissues in the images, there is no anatomic detail. Wouldn't be useful for diagnostics. It's substantially worse than conventional ultrasound.

radiologist here - example images don't look great

I’ve switched to open code and openrouter.

I only did the $20/month subscription since 9/2025

It was great for about 5 months, amazing in fact. I under utilized it.

For the past month, it’s basically unusable, both Claude code and just Claude chat. 1-2 prompts and I’m out. Last week I prob sent a total of 15 messages to Claude and was out of daily and weekly usage each day.

I get that the $20/month subscription isn’t a money maker for them, and they probably lose money. But the experience of using Claude has been ruined

There is a lot in this comment I agree with, however I think may universities have backed themselves into a corner with the degree of tuition inflation that has taken place over the last 20+ years.

I graduated from a SUNY school in 2012. At the time, you could still actually go to school and work part time and get through it. Not saying it was easy by any stretch but it was possible. Tuition + living expenses were about $17/year on campus , less expensive housing was available off campus.

Now, even state schools have tuition which is only affordable through family wealth or loans. Going to university is no longer a low stakes choice - if you flunk you’re stuck with that debt forever. Not to say students aren’t responsible for understanding that when signing up, but the stakes are just a lot higher than what it used to be.

Interesting but how would this prevent against “off-chain” collusion? A fraudulent seller captures brokers on the buy and sell side? Seller backs out of the deal unless they know who the brokers are?

I think this kind of behavior in principle would be detectable but in principle with enough concentration in the market, a fraudulent seller could in practice get brokers and jurors to collude with them.

你可以把中文版发到网上吧

A few points based on comments I’m seeing about the article.

This method of ultrasound treatment is called histotripsy. The underlying mechanism it uses to treat tumors is by focused ultrasound beams that mechanically disrupt cell membranes . It basically turns the lesion into soup. It does not treat the lesion by heating, although there are other techniques that do use ultrasound to ablate tissue with thermal energy.

Where I have seen it used and discussed is in the liver, whether that be metastatic disease to the liver or primary liver tumors.

One challenge is that in the liver you can’t use it for lesions that are near the capsule of the liver. It can also be difficult to keep the ultrasound beam focused on the lesion with respiration, especially if the tumor is small.

It’s an interesting technique and I think more people will use it over time. Whether it will be better than other established techniques like microwave ablation or radioembolization (for liver tumors) remains to be seen. I’m an interventional radiologist.

Haha, I’m also an IR with AI research experience.

My view is much more in line with yours and this interpretation.

Another point - I think many people (including other clinicians) have a sense that radiology is a practice of clear cut findings and descriptions, when in practice it’s anything but.

At another level beyond the imaging appearance and clinical interpretation is the fact that our reports are also interpreted at a professional and “political” level.

I can imagine a busy neurosurgeon running a good practice calling the hospital CEO to discuss unforgiving interpretations of post op scans from the AI bot……

I am an interventional radiologist. I’ve done procedures to embolize the prostate (helps shrink it), and gonadal vein embolization (for varices).

The gonadal veins are in a different vascular territory from the prostate. The prostates vascular territory is the anterior division of the internal iliac. The gonadal veins arise directly from the inferior vena cava.

I had not come across this research before it’s interesting because as mentioned above, these organs are in different vascular territories but when venous structures begin to reflux the blood may find other collateral routes through other territories.

I skeptical that this works, but it is really interesting.

GET A LAWYER

Now in my fifth year of residency after finishing medical school, the effects of sleep debt are astounding. It’s difficult to describe how much better I feel and energetic I am when I have at least 3-4 days off work and get several consecutive nights of adequate sleep .

I made an app for text and reverse image search. I’m a radiologist.

https://raddex.ai

That’s the basic idea. You’ll still get some heating of tissue as ultrasound waves pass through other tissue but won’t be destructive.

Radiation therapies use similar principles but non-target tissue is still exposed to ionizing radiation which causes collateral damage.

Saw some talks on this at the CIO meeting last month. Data so far is good but technique is limited to solid organs than can be targeted on ultrasound.

Regardless it’s an interesting treatment.

I made a search engine for radiologists (I’m also a radiologist). Have some articles indexed. Working on indexing videos and streamlining the backend processing. Front end is next js. Any feedback appreciated!

https://raddex.ai

This is cool. I’m a radiologist. Do you have PACS?

Weird way to say that people should talk to their doctors about how they want to die before the time is upon them.

Major problem in the US. See it every day at my job.

Working as a surgery resident and now in IR, I can tell you it’s much better to be a little overprescritvie in addressing post-op pain than to get behind and underdose.

Also opiates in a short term setting are good meds. Pain control is good and people are able to get moving faster.

I’ve used this repo. It’s ok. For very simple layouts, it probably works fine. For more complex layouts it fails miserably. I’ve also had cases where it didn’t detect half the text on the page (machine generated text).

The paddlepaddle project has nice models. Not well documented though and can be hard to use, so proceed at your own risk. But it is popular.

It’s interesting that the media is just picking up on this now. The first major trial results that showed benefits of thrombectomy was the DAWN trial and if I recall the data was first published in 2016-2017. The hospital I work at adjusted stroke treatment practices years ago to reflect this.