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During the past century, our ability to perform complex calculations massively increased, due to the availability of powerful processors, and diffuse, ubiquitious presence of personal computers for home and professional applications. Many physicians are worried by the application of Artificial Intelligence (AI) in medicine, envisioning an Asimov science-fiction scenario. But is this real? What the AI use in medicine and, particularly, ultrasonography actually entails? AI refers to systems with the ability to “reason”, discover meaning, generalize, or learn from past experience, thus able to perform tasks normally requiring human interaction. Well-known examples of AI applications are self-driving automobiles or speech-recognition softwares (that we all have embedded in our smartphones). According to a U.S. Food and Drug Administration statement, AI-based technologies have the potential to transform healthcare by deriving new and important insights from the vast amount of data generated during the delivery of healthcare every day. It is clear that one fundamental prerequisite is the availability of the so-called “big data” [1]: they may be derived from clinical knowledge (e. g., electronic health records), laboratory results, molecular data (e. g., OMICS data, such as genomics, trascriptomics, proteomics), imaging (PACS-derived data from different modalities), and their integration. In medical field, AI has already been used in drug discovery and design [2], drug interaction checks [3], molecular diagnostics, clinical decision support [4], and imaging [5]. The main novelty is the ability of AI applications of discerning patterns by scrutinizing and analyzing massive amounts of stored digital information. These patterns may remain unrecognized by the human reasoning and classical statistical analysis because may involve variables not yet considered to be of interest, and not usually considered in clinical reasoning or in statistical planning. While humans have abstract-thinking ability, they are not able to find and visualize patterns embedded into large quantities of multidimensional, apparently unrelated data. Even when humans do not apply personal experience, but knowledge gained by the use of conventional statistical test, they remain able to predict only outcomes that are well described by conventional mathematical formulas. In real life many events that happen do not follow mathematical rules, but are nonetheless not completely unpredictable. Rather, they cannot be predicted by pre-ordered formulas, but nonetheless sometimes can be anticipated by exceptionally intelligent persons or on other occasions by a “gut feeling”. However, also “gut feeling” is somehow primed by previous experiences and is thus in a way a modality of extended intelligence. Therefore, also some “gut feelings” can be potentially provided by tools able to consider previous massive amounts of data and to interconnect them at incredible speed. Potentially we will have no more the opinion of the “gut feelings” in the future, but thanks to the AI we could express the opinion of the “gut brain”. Vito Cantisani Giorgio Grani Francesco Tovoli Fabio Piscaglia Carlo Catalano Editorial

Artificial Intelligence: What Is It and How Can It Expand the Ultrasound Potential in the Future?