Artikel
How artificial intelligence and technical development could change neurooncological treatment in 2030 – Are we too skeptical towards inevitable changes?
Wie künstliche Intelligenz und technische Entwicklung die neuroonkologische Behandlung revolutionieren könnten – Sind wir zu skeptisch im Hinblick auf unaufhaltsame Veränderungen?
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Autoren
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Christian von der Brelie
- Georg August Universität Göttingen, Neurochirurgie, Göttingen, Deutschland
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Veit Rohde
- Georg August Universität Göttingen, Neurochirurgie, Göttingen, Deutschland
| Veröffentlicht: | 8. Mai 2019 |
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Gliederung
Text
Objective: Due to the exorable changes of the medical world by technological progress and artificial intelligence (AI), the whole clinical setting will change. This study is a thought experiment envisioning a neurooncological case setting in 2030.
Methods: The envisioned scenario was categorized: diagnostics, therapy, follow up. Recent developments in AI / medical technology were reviewed and applied. 15 neurosurgeons (ns; experienced>10 ys), 2 AI developers (AID) and a future scientist (FS) were interviewed whether they think this vision is likely.
Results: Diagnostics: A symptomatic patient will consult an APP, which will recommend a MRI. The data will be transferred to an MRI-company. MRI centers (hosted by agents, run by MRI-robots) will be open 24 hours making a prompt scan possible. Techniques like arterial spin labeling will replace contrast-agent imaging. AI-based MRI analyses will make a precise diagnosis. Diagnostic neuroradiologists or biopsies will be dispensable. 7/15 NS think this scenario will be likely.
Therapy: Decision making where be treated will be triggered by transparent webpages of neurooncological centers and influenced by patient reviews. Counseling will be a time-consuming part. A liquid biopsy will reveal genetic details of the tumour. Functional-MRI will set the limitations of resection. Resection will be carried out via endoscopy-assisted microcraniotomies by a robot-human interface. Coagulation will be done via uv-light triggered excitation of soluble hemostatic agents. Radiating nanoparticles being coated with targeted therapeutics will be placed. The situs will be glued. The tumour tissue will be used to create a vaccination. 4/15 NS believe this scenario will be likely.
Follow up: Postop-deficits will be treated with transcranial magnetic stimulation or functional modulation by implanted electrodes. The impact of psychological support will decrease since the prognosis will be favourable. Radiation therapy will be obsolete. Liquid biopsy results will individualize immuno-/chemotherapy in case of recurrence. MRI-robots will perform f/up imaging, by such tumour recurrence will be seen earlier and with greater precision. 3/15 NS believe this scenario will be likely.
Both of the AID and the FS believe that all scenarios are likely in 2030.
Conclusion: The majority of NS were skeptical towards the scenario. Technological revolution by AI is a great chance and we need to bridge the gap to AI development in order to get access to the complete potential of AI.
