UBC KGH Interventional Radiology #IRad

Kelowna, British Columbia
Joined March 2017
Nevin de Korompay retweeted
AI will not automate radiologists like you think We have been talking for years now about AI automating jobs. Radiology has been a prime target, with Geoff Hinton once claiming, “people should stop training radiologists now, it’s just completely obvious that within five years, deep learning is going to do better than radiologists”, which is funny since he said that in 2016. There is now more demand for radiologists than ever, so clearly things did not turn out the way many thought. Here I will make a prediction that while radiology will change in the coming decade, radiologists will not be automated away any time soon. I will use radiology as an example but I think these principles will broadly apply to any field where demand can be elastic and quality can scale with increased intelligence. First of all, we have seen in the short history of language models that there is a “jagged edge of intelligence”, where AI excels at verifiable tasks with a lot of data but is underwhelming on less common tasks. One thing most AI researchers underestimate about radiology is that it is actually extremely multi-task. There are at least a hundred conditions that can be diagnosed from x-rays alone, and thousands using CT and MRI. AI will first master common and easy-to-see conditions and it will not be as good as experts at less-common diseases just because there is less data for that. This jagged edge will certainly improve over time but this means that AI will certainly be used as a triage tool at first, rather than full automation in one go. I would guess that this process from solid triage tool to full automation would take 3-5 years in the best case scenario, because training AI to get all the edge cases right will be bottlenecked by data collection of rare diseases, and also because radiology isn’t currently a focus for frontier labs. Second, there will be elastic demand for radiology as it gets cheaper per unit. I think elastic demand (“Jevons paradox”) is the most underrated phenomenon when people think about AI automation. In software, it is obvious that I have way more demand than before because Claude Code makes it so easy. These days I ask Claude Code to build a custom three-thousand line html viewer to help me visualize every little RL run that I do. The same thing will happen in radiology. If there is essentially no cost or latency of interpreting an MRI, a physician can order many scans preemptively to better diagnose a case. So with AI tools, a radiologist might have to read only 20% of inbound scans, but there might be 5x more scans inbound. Many developing countries have fewer than one radiologist per million people and they will also want to send a lot of radiology to be interpreted. Longer term, cheap and fast radiology interpretation will also drive incentives to build cheaper radiology scanners. If an MRI had essentially no latency for interpretation, medical devices companies will want to build much cheaper MRI machines that can be used more frequently, perhaps even in the middle of a surgery. AI will accelerate the development of scanning technology, too. If a full body MRI was only $100 dollars I would totally want to get one every month instead of every two years. I can imagine a world where people get 10 or 100x the number of scans they do today, largely for preventative care, if radiology were 10-100x cheaper. Third, even if we did have a model that could outperform the world’s best radiologists today, that would not be the end of all work on radiology. Medicine is a field of change. We may develop new treatment protocols that require reading radiology images in a way that radiologists currently aren’t used to. New scanners may reveal diseases that we cannot currently diagnose today with radiology alone. Some radiologists will change their work from reading scans to doing frontier research to advance our understanding of radiology and translate new knowledge into updated models. Moreover, I am sure that we will ask for more out of our AI models than ever before. With a good flywheel, we may one day train AI models that can use radiology images to predict disease probabilities far into the future. With good prediction algorithms, cancer may be detected months earlier than we can detect it now. Society will invest a lot into this research and this will contribute even more to increased demand for radiology and the best AI around it. On top of all of this, the medical system is typically slower to adopt new technology and has more regulation compared to technology companies. There is legacy infrastructure and medical centers need to constantly support patients which makes it hard to integrate new technology. This is even more true in developing countries. Moreover data access tends to be limited due to HIPAA, deidentification, IRBs, etc. So I think radiologists will be in demand for a while. While some worry about radiology being totally automated, I think there is a more exciting future for radiology than ever before—one where there is more demand and we ask for more predictive power from our intelligence. This is similar to how many of us feel that programming will thrive more than ever before despite drastic change in the field. More generally, any domain where demand can be elastic and quality can scale with increased intelligence will, like radiology, similarly flourish with the development of AI. This is certainly a more exciting and nuanced future than what Hinton described in 2016! (Finally, to be fair to Hinton, he did acknowledge in a recent podcast that he was wrong and also agrees with the elastic demand argument.) Thanks @JayRothschild and @engyziedan for feedback on this post.
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Nevin de Korompay retweeted
Fun case showing a combo of PARTO/CARTO techniques with a bunch of little tips on the way (fyi, I am usually a PARTO person when dealing with these).
How do you approach managing gastric varices in patients with cirrhosis? This week’s Case Highlight features Drs. Sabeen Dhand (@SDhandMD) and Aparna Baheti (@bahetimd) discussing treatment strategies for gastric varices in patients with cirrhosis, including the role of embolization. Explore this case and more clinical discussions in the BackTable App: backtable.com/shows/vi/cases… #InterventionalRadiology #GastricVarices #Cirrhosis #Embolization @HarborUCLA @beckcj
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Nevin de Korompay retweeted
AI is doing great in radiology. Just replace us already. All clear.
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Nevin de Korompay retweeted
What is the most likely diagnosis, based on this image, which is commonly misdiagnosed (as on this webpage!) as Chiari 1 malformation? radsource.us/chiari-i-malfor…
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Nevin de Korompay retweeted
I am thrilled to share that the SPIDER-WEB study comparing carotid revasc vs. medical tx in patients with symptomatic carotid webs is complete. The results will be submitted to ISC 2027. We are grateful for the contributing sites. Do you think we have a winner? #stroke #ISC27
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Nevin de Korompay retweeted
Quick summary of the data (and our experience) with sedation in PE. The sicker the patient, the lighter the sedation.
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Today I learned that ovarian neuroendocrine tumors are the only intra-abdominal tumor location that can cause carcinoid syndrome without metastasizing to the liver because the ovaries drain directly into systemic circulation bypassing liver metabolism.
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Replying to @SABImaging
@SABImaging #SAR2026 Volume surge is absorbed entirely by top-quartile radiologists working both more days and higher daily output 😳🤔🤔🤔
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Nevin de Korompay retweeted
Rorschach radiology "Trigeminal Neuralgia" Left: Axial CISS-TOF MRA fusion image demonstrating AICA-right trigeminal n. neurovascular conflict Right: Flying Spaghetti Monster (Touched by His Noodly Appendage)
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Nevin de Korompay retweeted
Who else works in a system where you’ve become the regional dumping ground for everything? Complicated surgeries, weekend disasters, surgical complications, biopsies and every procedure smaller facilities supposedly can’t do or simply don’t want to do. We’re essentially the pop off valve for the entire region. In radiology that includes MSK ultrasound, lung biopsies, MRI patients with pacemakers and anything else that’s difficult, time consuming or unprofitable. And yes I’m talking to you smaller hospitals that cherry pick your work and private equity radiology groups that read outpatient imaging nonstop while dumping the difficult work on full service radiology groups. And we all know how it works. Your hospital system benefits from these patients and collects the downstream revenue and technical fees while radiology does the grunt work. Meanwhile the outpatient MRI group down the street cherry picks profitable studies right under your nose and laughs at you on Saturday afternoon while you’re taking call and they’re calling you a sucker. This has been going on for decades. I’m sure many know the drill. I’d love to hear how others have successfully pushed back against this and stopped being the default destination for everyone else’s unwanted work.
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Nevin de Korompay retweeted
The first guidelines on preventive care in cirrhosis
At the #ACG2026 Postgraduate Course, Dr. @ebtapper will discuss the brand new ACG Clinical Guideline on Preventive Care for Patients with Cirrhosis! Will you be there? 📕Read the guideline: bit.ly/acg-preventive-cirrho… 🗣️Register for the PG Course: bit.ly/acg-2026-register
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Nevin de Korompay retweeted
🧵OK, I'm doing a talk next week to a group that won't have any idea why I'm there, so I'm going to repost some of my older 🧵 This one is on the 'figure-of eight' and also the 'pursestring' sutures. We'll go over what they're for and some technical pointers and pitfalls.
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Nevin de Korompay retweeted
.@GBarnesMD updates that LMWH NOT IV UnFx heparin is now the class I recommended Rx for initial rx of acute #PE , even for pts undergoing intervention #VSS2026 . Spread the word!
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Nevin de Korompay retweeted
Jobs that are strong "bundles" of tasks are less susceptible to AI replacement. "Reading scans is a task. Radiology is a job. A radiologist does not only classify images. She triages cases, communicates with other physicians, trains residents, takes responsibility for difficult calls, and signs a diagnosis that others are willing to act on. What the market buys is not a classification exercise but a bundled service." cepr.org/system/files/public…
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Nevin de Korompay retweeted
Jensen Huang does highlight an important distinction between a task and a purpose. If your job is defined by a purpose (helping doctors diagnose disease using imaging) rather than simply a task (studying and describing scans), you will be able to leverage AI rather than be replaced by it.
I like Jensen Huang’s optimism about the future impact of AI on jobs but he keeps peddling this notion, this week on the Ezra Klein show, that “Every single radiology application has AI in it.” Radiologists are actually overworked today because AI has NOT made substantial productivity gains broadly. nytimes.com/2026/09/23/opini…
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Nevin de Korompay retweeted
In my opinion the problem in radiology is often not the uncertainty itself but the failure to clearly lay out the solution in the impression. If there is an evidence-based pathway to greater certainty through time or another imaging modality or ultimately tissue diagnosis that pathway should be clearly stated using a sensible scientific approach. The problem is the sloppy impression that simply says “likely this but cannot exclude that” and stops there. Uncertainty is unavoidable. The key is providing a rational path to resolve it.
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Nevin de Korompay retweeted
As more radiologist work goes tele- and work-from-home, what does this mean for interpretation quality and downstream patient care? A fascinating single-center study from South Korea just published in @AcadRadiol suggests that traditional onsite interpretations may be better: "Teleradiologists issued more follow-up examination recommendations than on-site radiologists for outpatient abdominopelvic CT examinations, with greater inter-radiologist variability." academicradiology.org/articl…
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Nevin de Korompay retweeted
The MEMBRANE trial randomized patient with chronic SDH (with or without surgical evacuation) to MMA symbolization versus standard care. The rate of recurrent SDH >10 mm or rescue surgery was basically half that in the MMA group compared to SOC Middle Meningeal Artery Embolization With n-Butyl Cyanoacrylate in Chronic Subdural Hematoma jamanetwork.com/journals/jam…
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Nevin de Korompay retweeted
#throwbackthursday Pregnancy and Uterine Artery Embolisation: Myth Busted link.springer.com/article/10…
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Nevin de Korompay retweeted
My beef with the term "chronic thrombus": it's misleading, and gives the wrong idea. Posthrombotic changes should be better thought of as *fibrosis*: scar tissue occluding the veins! (much tougher than some soft clot). Look at that intima: scar. This impacts treatment!
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