‘More than 1,000 words’: AI models could be used to communicate procedures to cancer patients

When Adina Isenberg was diagnosed with breast cancer nine years ago, it came as a shock.

“You think, like, how is this real? This must be some sort of joke.”

But when she woke up from her lumpectomy procedure, she was faced with a whole new host of feelings with how the surgery changed her body.

“When I woke up from my surgery, I couldn’t believe that in addition to the scar that I had prepared for on my breast, I had a second scar in my armpit, which is for when they take out what they call the sentinel node,” she said.

Researchers at the University Health Network in Toronto are now leveraging AI to help create a 3D picture of what tumours look like. Using this technology could better prepare patients for the procedures they are about to undergo.

Isenberg has joined the team to help communicate what this new technology could mean for patients.

“We can’t help if someone has gotten cancer. We can’t know how their body is going to respond to treatment. That’s out of our control,” she told Global News. “What we can do is make the entire rest of the experience better. And we must.”

Researchers are using AI technology to create what they call a “digital twin” of the patient’s anatomy to better understand the tumour and its effect on the patient.

“Instead of being 2D, just a flat image on a screen, it becomes this interactive model that is not just a recreation of what could be, but it’s an image of you,” Wagner Souza, a staff scientist at UHN and assistant professor at the University of Toronto, told Global News. “It’s you cloned in 3D, and we can play around from different angles so we can show depth, where the lesion is, how it could potentially look after it’s removed.”

Isenberg said that being able to show the model to patients and explain the process of what they are about to undergo could reduce unnecessary medical trauma.

Souza said it allows patients to become part of the conversation.

“It’s empowering, because you know where you’re fighting,” he said.

“People say that an image is worth 1,000 words. Maybe a live image that is not just a model, but it’s you … maybe that will be worth way more than 1,000 words and give you the power that you need to make a decision that you are satisfied with.”

The technology still has to go through clinical trials, but early use suggests there may also be benefits in the operating room.

Amin Madani, an endocrine and acute care surgeon at UHN, said typically surgeons have to look at two-dimensional images, and build in their head what the anatomy might look like.

“For us surgeons, you have to look at an imaging, like an MRI, a CT scan, and then memorize it in your head and say ‘okay, let’s just go for it’,” he said.

He said having this kind of technology allows the surgeon to build an understanding and expectations of the patient’s body ahead of time, allowing for better planning and strategizing.

While researchers say the technology is a huge advancement, there are still some unknowns.

“There are some things we can still not do, but we’re working towards being able to achieve,” Souza said.

When patients have their images taken, they are lying on their front, but they are often on their backs for surgery.

“That alone changes the structure of the body, the breast, the tissue. And this is something that we are wondering, can we potentially implement in the model?” Souza said. “Can we integrate physical properties so that when we’re showing the image, we can actually predict that in this position, at this height, with these variables playing all together, the lesion will actually move from this point to that point and we can be so precise?”

These are applications that may be explored as the technology goes through clinical trials, but the promise of what the modelling can do is exciting for surgeons looking to change the game.

“I think machine learning, AI, algorithms that can see what’s happening in surgery for added intelligence in the OR is going to be the next frontier in my opinion,” Madani said.