There was a familiar cast at the annual meeting of the Society for Imaging informatics in Medicine in Orlando, Fla. As in previous years, Katherine Andriole, Paul Chang, Keith Dreyer, Ramin Khorasani and Eliot Siegel and other imaging informatics giants shared their knowledge with an eager audience. This year, the statesmen (or statespeople) of SIIM shared the stage with a group of newcomersthe millennials, who offered a fresh and futuristic perspective.