[hef19898]

Yeah, that's where the serious business and online culture meet. And I know which one I prefer. That being said, with diagnostics becoming better each and every year, it is less straight forward to know which, if any treatment, to use against which tumor at a given time.

Generally, I do very much oreder if projects like this, regardless of the field, do include a healthy number of very experienced people in the actual domain, here that would be oncologists and radiologists specialized in oncology. Otherwise, I always assume it is some potentially dangerous almost-right first principle thinking at play. IMHO there is not a lot that is more dangerous than this.

[medimikka]

Not so much business, as real medicine. The reason people get pissed at medicine is that it moves "slow" by their standards. But Jason M Somebody in his garage already built a cryo scalpel, why are you not using it?

Well, Thalidomide, the aforementioned cryo scalpel, Paolo Macchiarini, and others have taught us, that that's never a good idea.

It's 2024. We're throwing our lot in with serodiagnostics over anatomical localization, a PET scan being the only thing we need these days. If we know it's a lesion and we can FNA it, we will, else there's enough serodiagnostically we can do, to build individualized treatment plans (or determine if there's even a reason to use them).

It's pretty fun to see the computer draw little circles around lesions. The Bruker solution (also Open Source and free, by the by) does this admirably well. But it's neither useful in diagnostics nor in therapy, since both don't really hinge on a circle around a lesion.

[alwa]

Out of curiosity- the blog leans heavily on examples of clinicians operating in the developing world. Would the same lines of serodiagnostic techniques tend to be realistic in lower-resourced settings like that?

It seems plausible to argue that if you can afford a CT and a radiation therapy machine, then you probably meet the resource bar for the new family of techniques, but I just don’t have much of a reference point to judge.

[medimikka]

> It seems plausible to argue that if you can afford a CT and a radiation therapy machine, then you probably meet the resource bar for the new family of techniques

Pretty much. The thing, though, is that places like Ghana (were I worked, I am a bit less educated about other places) get second hand machines from the US, Israel, UK, and Russia, so it'll take a few years until serodiagnostic and serotherapy labs "trickle down." So here he's right, not everyone has those resources.

However, the _imaging_ and _localization_ of lesions was never the issue.

Neither is the radiotherapeutic treatment. If you don't have enough power to do both at the same time, you won't have enough power to do his approach, since neither AI nor human eye can see through tissues. Humans move. Humans breathe. Either you take those movements as given, and live with the wider consequences, or you spend millions of cyber knives (https://med.stanford.edu/neurosurgery/divisions/radiosurgery...) that detect movement and counteract it. Having a more colorful version of the initial imaging won't change that. A radiologist's eye can do the same, and unless I see compelling evidence that the AI can do it better, something I have not seen, yet, any of the now 30+ solutions for AI analysis (as I said, Bruker and others are also offering theirs for free and open, and behind them stand massive research apparatuses) should especially not be used in developing countries.

Seriously, finding tumors and staging them is the easiest part of this job. And the rest can't be done by AI (yet.)

[coolwulf]

Thanks for your comment. However I don't think finding lesions is trivia especially if you are dealing with a patient with multiple brain Metastasis of more than 10 or even 20, 30 in counts.

For SRS, accurate localization and contour, label are crucial for the better outcome.

[hef19898]

But is an AI-generated circle! For sure there is a billion dollar start-up in there somewhere, right? /s

I see a lot of parallels between what you just wrote and big data and AI applications in a field I know a thing or two about: Logistics and Supply Chains. Same things happen there, a smart system highlighting a problematic order or time period. Great, but identifying those never was the real problem to begin with. At the same time, all the potential of using better planning tools to enable people or to automate repetitice tasks to free up peoples time get somewhat ignored because those use cases are less sexy than automating, and solving, all those "problems" using AI... But tjis hype cycle will ultimately be replaced with new one, like those before it. And I will yell at some other hype cloud!