The task for the neuroradiologists of this decade, those who are now the actors and directors of this “story,” is to complete the long march toward the specialty board certification and also to be leaders in the practice and teaching of diagnostic and interventional neuroradiology and in research in the field of neurosciences.

The scenario in which they are asked to act, however, is changing at a spectacular and unexpected speed.

From 1895, the year of the discovery of X-rays by Wilhelm Conrad Roentgen, the major steps of our disciplines in the past century have been in the 1920s, the introduction of contrast studies, followed by the advent of CT in 1972 and of MRI in the early eighties. We are now, almost 40 years later, probably facing a new revolution or significant step forward with the pervasive advent of AI and radiomics.

The “explosion” of artificial intelligence (AI) and its generative side will dramatically change not only the medical practice, especially in its diagnostic aspect, but also the modality of training future doctors and, in particular, specialists in neuroimaging, that is, the neuroradiologist.

Nobody has a crystal ball to look into the future, so we cannot know whether the prophecy of Jacques Attali that envisages that medicine in 2050 will mainly be “auto diagnosis” will come true. We definitely know that the gloomy prediction of Geoffrey Hinton, who back in 2016 stated that “artificial intelligence will do better than radiologists and for this reason we should stop forming radiologists now,” was wrong. We prefer to quote Curtis Langlotz, Professor of Radiology and Biomedical Informatics, who has said: “Will AI ever replace radiologists? No, but radiologists who use AI will replace radiologists who don’t.”

The role of the neuroradiologist will, however, definitely change and we must be ready to be leaders in the field and continue to value our role as physicians who not only do not lose contact with the patient but also increase our role of being an inevitable interface between diagnostic data, their interpretation, and use, to give the best advice and help to the patients. We must also be in a strict relationship with biomedical engineers, neuroscientists, and clinicians.

The inevitable progress and increase in complexity of the interactions in the field of neurosciences will probably lead and determine the relationship with the radiological family and be a further factor, together with the growth of neuro intervention, to push toward the definitive recognition of neuroradiology as a medical specialty.