"I think it's an unstoppable train [AI in medicine], in a...

"I think it's an unstoppable train [AI in medicine], in a specific area of medicine – showing true expert level performance – and that's image recognition.)

Isaac Kohane, Professor of Biomedical Informatics, Harvard

My friends,

It's been some time since Tiresias has spoken of artificial intelligence and Optiscan’s real-time digital confocal laser endomicroscopy (CLE). Artificial intelligence in healthcare is growing but has not reached a critical mass or momentum yet. The key area, where AI will make a real difference is in image recognition and image diagnosis. The radiologists have been at the forefront, whereas the pathologist have been great laggards. This is not unexpected given the nature of the fields and the nature of the people who go into these two subspecialties. Before the medical Imaging revolution which started with the invention of the CT Scanners, radiologists and pathologists were similar characters; introverted nerds working in darkened rooms somewhere in the bowels of hospitals. Failed clinicians frightened of patients and real medicine. However, radiologists’ work, since the invention of the CT scanner and subsequent other imaging has been essentially computer-generated, and the next natural step is to have computers interpreting these computer-generated images. Radiology and as importantly, radiologists, have been transformed. Radiologists are the BSD’s of medicine, entrepreneurial, corporatized, big money earners, and at the forefront of the whole digital revolution. The pathologists, on the other hand, are where the radiologists were in the 1950’s and 1960’s; backward, introverted, slow and isolated beings, staring at pink and blue images through their microscopes, happily far removed from real medicine and the real world, stubbornly reliant on their traditional methods. They have ventured into the operating rooms for their frozen section interpretation, albeit reluctantly and with great discomfort, and in considerable fear, being demanded of making snap diagnosis which matter to the actual surgery being done in their presence. The gods forbid. These are the very reasons they ran away from clinical medicine and surgery. They know that they don't belong in the presence of patients and a presence of real medicine or surgery. But the clinic and the operating room is exactly where the new developments must take place to make a difference in the diagnosis and treatment of cancer. The development of real-time digital microscopy, combined with artificial intelligence in image processing providing real-time cellular level histopathological diagnoses is inevitable and is imminent. The current pathological images, which pathologists examines are analogue. This is of course after the excision, preparation, slicing, staining, processing and then examining. Optiscan of course leapfrogs all of this and generates instantaneous digital images, in as many repetitions as necessary, in matters of seconds, in the clinic and in the operating room which can be immediately analysed by deep artificial intelligence to assist histopathologist, who does not need to be in the clinic or the operating room, to then guide the actions of the clinician and surgeon, all in real time. This is the future, and the rest is just noise of those left behind as the train gathers speed.