This article is based on the New Horizons lecture delivered at the 2016 Radiological Society of North America Annual Meeting. It addresses looming changes for radiology, many of which stem from the disruptive effects of the Fourth Industrial Revolution. This is an emerging era of unprecedented rapid innovation marked by the integration of diverse disciplines and technologies, including data science, machine learning, and artificial intelligence-technologies that narrow the gap between man and machine. Technologic advances and the convergence of life sciences, physical sciences, and bioengineering are creating extraordinary opportunities in diagnostic radiology, image-guided therapy, targeted radionuclide therapy, and radiology informatics, including radiologic image analysis. This article uses the example of oncology to make the case that, if members in the field of radiology continue to be innovative and continuously reinvent themselves, radiology can play an ever-increasing role in both precision medicine and value-driven health care. © RSNA, 2018.