Technology will drive medical imaging: Dr Bhargava

Though there is the fear that Radiologists could be replaced by computers, Dr Rajat Bhargava, Consultant Radiologist and Head - Radiology at Fortis Hospital, Mulund observes, “As of now, the fear is unfounded since most of the systems available are providing clinical decision support to the Radiologist, thus increasing his speed and accuracy.”

Dr. Bhargava, our readers shall be interested in knowing about your journey, so far, in the field of radiology and also brief us regarding your current responsibilities at Fortis Hospital, Mulund.

Being selected to do my Radiology Post Graduate training from AIIMS, New Delhi was a dream come true for me. AIIMS gave me the widest exposure of patients, equipment, good teachers and a highly stimulating environment to hone my skills as a Radiologist. I then trained for Fellowships in some of the best institutes in the United States of America. It expanded my horizons further and gave me an exposure to the western way of working. However, I must add, we must make the best possible use of Western education exposure by being focused on the specific aspects of training that we are going to use in our practice in India. Just getting trained in West does not assure you of being the best in your practice here; you do need a good background and continued learning exposure to stay ahead in your field. Currently at Fortis Hospital, Mulund, I head the Radiology Department with administrative responsibilities and clinical work, involving cross-sectional imaging. At Fortis Hospital, Mulund, the one thing that differentiates us from others is our focus on the clinical aspects of Radiology. We work very closely with the Clinicians and ensure that our scans and reports give a clear direction to the treating Physicians.

We are also eager in knowing what made you specialise in this promising field of Radiology, kindly do enlighten us regarding the same.

Radiology as a branch is for the knowledge-minded Doctors. We need to have a vast knowledge pool in all specialties. I always liked reading, and when I was weighing options for my specialisation, I came to realise the critical role Radiology plays in the care of patients, I was attracted to this field. This branch has perhaps contributed the most in the past 30 years, in the advancement of the medical field. I am very happy to have chosen Radiology.

Can you emphasise on the various advanced imaging and radiology facilities available at Fortis Hospital, Mulund? How do you think the facilities available at Fortis Hospital, Mulund differs from the imaging facilities available at other imaging centers?

Fortis Hospital, Mulund, has advanced imaging equipment, keeping in mind the clinical needs of the Physicians and the patients. We have Ultrasound machines from GE and Philips, with 3D Imaging. The Siemens CT Scanner is advanced 128 slice with 3D processing workstations available to each of the Radiologists. Superconducting MRI Scanner with a comprehensive set of applications enables high-quality imaging. A new Biplane Philips Cath-Lab and a Biograph PET Scanner are the newest additions. We are in the process of upgrading our MRI unit with the latest 3 Tesla (3T) unit.

Dr. Bhargava, you are known to have successfully performed more than 3,000 routine and difficult procedures focusing on CT- and USG-guided procedures. Our readers shall be quite fascinated to know about your experiences while performing the same.

I have been involved in many procedures, using crosssectional imaging. The Percutaneous Biopsy and Drainage Catheter placement service using imaging plays a key role in patient management. It is a challenge to maintain a high success rate and keep the complications to the minimum, which we have managed to do by being meticulous in planning and execution. We also spend a lot of time talking to the patient and their family, involving them in the decisionmaking process. The procedures also give us a break from the daily, sometimes tiresome routine of constantly reviewing of thousands of images.

What do you have to say regarding the standard and availability of imaging and radiology equipment in India? Do you think there is a need of standardisation of these equipment? What according to you should be the change in the manufacturing and availability of imaging and radiology equipment in our country?

The one drawback of Radiology in India is the prohibitive cost of the equipment. Most of the high-end imaging equipment is imported, thus putting a strain on the finances. But, I am happy that in the past 10 years the general standards of imaging equipment have improved and patients are getting the full benefit of the advancements. However, this is true for metros and the trend must catch up in smaller cities and towns.

There is great stress made regarding the accreditation of medical devices for improvement of Indian medical services. What are your views regarding the necessity of the same?

Accreditation of radiological equipment is good. Atomic Energy Regulatory Board (AERB) is now ensuring only approved imaging equipment is installed. It ensures patient safety, especially in regard to monitoring of radiation doses to the patients and associated healthcare workers. Now many hospitals are also National Accreditation Board for Hospitals (NABH) accredited, thus helping raise levels to minimum acceptable standards.

What according to you have been the most exciting and interesting advances in the field of automated diagnostic systems in the last 10 years?

If we talk on how computers aiding radiologists in diagnosis, of course this area has rapidly expanded – generating both excitement and fear amongst the Radiologists. The fear is whether computers will replace the Radiologists! As of now, the fear is unfounded since most of the systems available are providing clinical decision support to the Radiologist, thus increasing his speed and accuracy. Most of the computer-aided diagnosis is geared towards pre-screening the scans to flag suspicious findings, providing measurements and selecting regions of the image which appear diseased. But, work goes on in finding algorithms which can potentially provide a more accurate clinical diagnosis.

What are the further advancements you foresee in the field of radiology and imaging equipment in the next decade?

Technology will continue to drive improvement of imaging equipment in the foreseeable future. Computing power continues to improve, resulting in faster scanners. MRI is getting patient-friendly with silent and faster scans. Spectral CT has the potential of going beyond anatomy into tissue characterisation. Use of Big Data and Artificial Intelligence resulting in faster workflow will grow. Lower radiation doses with better detectors and better Reconstruction Algorithms in CT scans are some of the other areas which will see major changes.