In 2016, I stood on a stage at the American College of Radiology’s Moreton Lecture and told a room full of radiologists they had 10 years.

Ten years until the culture, the technology, and the imperative aligned to allow us to deliver healthcare at the N of 1—the single, unique patient.

I challenged them to stop hiding behind the "interpretation of images" and start owning the fact that their words build worlds. I challenged them to connect, to be human, and to recognize that for the patient on the other side of that scan, the only thing that matters is their specific, unique life—the N of 1.

Well, here we are. It is 2025. Nine years later. And as I read the highlights from Dr. Umar Mahmood’s RSNA 2025 keynote address, the prophecy isn't just coming true—it’s the headline.

Imaging the Individual

The theme of RSNA 2025 is "Imaging the Individual." Dr. Mahmood’s message was clear: "We help to heal all of us by focusing on each of us."

We are finally moving away from the industrial assembly line of medicine, where we treat the "average" patient, to a world where we tailor imaging to illuminate a patient’s unique characteristics.

This is the N of 1 reality I spoke about almost a decade ago.

Back in 2016, the barrier was often culture and connection. Today, the bridge is being built by technology.

• We have high-fidelity imaging at speeds we couldn't imagine a few years ago.
• We have AI that doesn't just "read" but integrates—combining the EMR, tumor genetics, and targeted therapies into a coherent, personalized battle plan.

We are moving from simply identifying risk to intervening before the disease even progresses.

The tools are finally here; technology is enabling us to truly deliver care at the N of 1.

But technology is just a tool. It is a connection engine that "flattens the world," but it cannot replace the pilot.

The Two Paths for Precision Care

Dr. Mahmood noted that radiologists are "not just at the center of this transformation... we are helping to create and image it."

This brings me back to my challenge from 2016. The technology can generate the data, but you must be the quarterback.

Precision care requires a leader. It requires a physician who is willing to own their words and drive the strategy for the patient. Radiologists can choose one of two paths:

1. Remain in the Dark: Let the AI generate the report and the oncologist tell the story. You are merely a spectator in the connection economy.
2. Step Into the Light: Use these tools to craft a manageable, optimized, and deeply personal treatment plan. You move from a doctor who interprets images to a healer who guides the journey.

The Final Mile

We are at a critical inflection point. The timeline was accurate; the technology has caught up to the vision. The ability to image the individual is no longer science fiction—it is the standard we are setting right now.

But the machine cannot own the story. Only you can do that.

So, my message to the world of Radiology remains the same as it was in 2016, but with a new urgency: Own your words. Be the quarterback of precision care. Because when you focus on the N of 1, you don't just change a diagnosis—you change a life. And that is what scales.

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