Adding Prudence to Our Appetite for Progress Can Deliver Innovation that Benefits All
From x-ray hype to AI black boxes, progress works best when curiosity is paired with caution.
Throughout history, our enthusiasm for new technology has often outpaced our ability to fully comprehend its risks. From the industrial revolution to the digital age, we have repeatedly embraced innovations with excitement while ignoring caution, sometimes overlooking potential hazards in our eagerness to advance. In healthcare, where technological breakthroughs promise transformative benefits, new capabilities can come with severe risks that demand careful scrutiny.
The early 20th century witnessed widespread adoption of radioactivity in consumer products and medical devices, long before its dangers were understood. Luminous watch faces and the health problems experienced by workers painting the dials by hand provide an example. Similarly, x-rays, discovered in 1895, quickly became a marvel for clinicians and the public alike. However, the excitement led to routine, unshielded exposure for patients and practitioners, resulting in severe health consequences for both groups.
The shoe-fitting fluoroscope is a striking example. A popular feature in shoe stores in the US and Europe from the 1920s, these devices used x-rays to reveal how shoes fit on children’s feet. There were various brands – the Foot-O-Scope, or the British-made Pedoscope – often housed in nothing more substantial than a wooden enclosure. Marketed as a modern convenience, they were later recognized as hazardous, earning a place among Time Magazine’s “Worst Ideas of the 20th Century.” Its popularity persisted for decades, despite the radiation risks posed to all in the vicinity. Clearly, concern began to mount as investigations from the late 1940s documented dosages both within the machine and at various distances above and around it. The results are startling, noting accumulated doses of up to 140mSv to the foot during a 20-second exposure. That’s about six times today’s typical annual occupational exposure limits for radiographers, clinicians and industry workers.
Despite such purely novel applications, the evolution of x-ray systems has delivered extremely valuable benefits across industries as well as in the medical field. As the dangers of radioactivity became clear, the medical community began to recognize and mitigate the risks associated with imaging technologies, prioritizing safety alongside innovation. Protective measures, such as lead shielding and regulated exposure times, were introduced to safeguard both patients and healthcare workers.
As other imaging modalities have emerged, such as computed tomography (CT), magnetic resonance imaging (MRI) and positron emission tomography (PET) using injected radioactive tracers, development has continued to reduce doses while simultaneously improving image quality. Ongoing innovation in x-ray equipment has included improvements in source and beam control to reduce scattering and to sharpen focusing and steering. In this way, ensuring that more of the beam’s energy reaches the target tissue reduces the transmitted energy. It shows how risk-aware innovation can realize the benefits of technological progress without compromising safety. We have also seen digital detectors replace traditional chemically based film, which converts only a small fraction of incoming x‑ray photons into a usable image. These are more efficient, with better low-dose performance, lower noise and greater dynamic range, producing not only high-quality images from reduced dosages but also reducing retakes.
There’s a democratizing benefit here as well, as these advancements have enabled equipment to become smaller and more lightweight, and more affordable to acquire and operate, due to reduced shielding, lower transmitter power, and reduced reliance on photographic plates and film, which are consumable and inconvenient. It’s making high-quality healthcare more accessible to more people. Today, over 2 million scans are performed every day in the US alone, including some 1.5 million x-rays and 250,000 CT scans.
Right now, AI is arguably the most influential technology transforming medical imaging. Deep learning models are also driving further dose minimization by enabling high-quality image reconstruction from lower radiation exposures. These innovations improve both patient outcomes and operational efficiency, demonstrating the positive potential of technology when thoughtfully applied.
It’s also helping to increase the speed and efficiency with which healthcare services are delivered. Using AI algorithms to assist in triage is already an established practice, reducing clinicians’ fatigue and helping identify urgent cases more rapidly. By automating routine tasks and flagging anomalies, AI reduces the likelihood of human error and streamlines diagnostic workflows.
As the world’s population grows and ages, demanding more medical assistance, capturing these benefits is imperative. On the other hand, the rise of AI brings new challenges, such as the “black box” problem. This is a key concern as algorithms grow more complex and their decision-making processes become increasingly opaque, even to expert users. This lack of transparency raises concerns about accountability, trust, and the potential for unintended consequences in diagnostics.
Healthcare professionals must grapple with the reality that, while AI can outperform humans in certain tasks, our understanding of how these systems arrive at conclusions could become increasingly limited. We need to address this issue if we are to continue directing and driving innovation. Ongoing collaboration among technologists, clinicians and ethicists is vital to ensure that AI remains a tool for empowerment, not confusion.
I often talk about lessons from history, and there’s an important one here. Technological progress comes with risks, and we must balance our excitement with a commitment to identify these as early as possible and prioritize mitigation. It’s easier said than done, as we are dealing with many unknowns as we try to move forward. Could early scientists have understood the health risks from radiation with little to no data – anecdotal or empirical? Today, as we contemplate the risks posed by AI, opinions are polarized, although a consensus has not been established.
In medical technology, and beyond, responsible innovation that benefits us all lies not in unchecked adoption, but in thoughtful advancement. By recognizing past missteps and proactively addressing emerging challenges, we can harness the power of new technologies to serve humanity’s best interests.End of article content
Alun Morgan is technology ambassador at Ventec International Group (venteclaminates.com); alun.morgan@ventec-europe.com. He is presenting at the PCEA PCB Management Symposium, “Strategic Leadership in the Age of AI, New Technology Adoption, and Talent Scarcity,” taking place April 28 at PCB East. His column runs monthly.