A method, computer system, and a computer program product for dynamically altering at least one image is provided. The present invention may include receiving a plurality of data, wherein the received plurality of data includes at least one existing medical image. The present invention may also include determining that one or more user instructions for the received existing image were received. The present invention may then include implementing the one or more user instructions on the received existing medical image. The present invention may also include altering the received existing medical image based on the one or more implemented user instructions and a medical knowledge base.