Radiology in the Spotlight

November is radiology’s month. As radiologists and allied professionals around the world gear up for RSNA, we’re anticipating a great show. The RSNA 2010 theme—Personalized Medicine—speaks volumes about where radiology is headed. As personalized medicine inches into clinical practice, imaging will take center stage.

A radiologist friend recently told me he wished RSNA could last one month. Indeed, one might need a month to squeeze in every session on the must-see list, network with colleagues and thoroughly explore the show floor. RSNA committees have pulled out all the stops this year with former President Bill Clinton delivering a special address on November 30.

Although Clinton’s topic remains under wraps, other keynote lecturers—John Mendelsohn, MD, and Sanjiv S. Gambhir, MD—are sticking fairly close to the theme and exploring strategies for earlier detection of cancer and personalized cancer treatment.

In this brave new world, the lines between molecular imaging and molecular diagnostics will blur. Major imaging vendors are anteing up with new imaging systems as PET/MR emerges. And GE, Philips and Siemens have announced large investments in digital pathology initiatives in the last year. The College of American Pathologists (CAP) is on board and has contributed to the expansion of DICOM standards to accommodate digital pathology.

The integration of digital pathology and digital imaging will bring new challenges. The evolution will require not only a reframing of radiology, but also a re-engineering of IT. Digital pathology datasets are ridiculously large, even by radiology standards. Dataset sizes range from 15 GB to an enormous 3.75 TB and will continue to escalate. Thus, data storage challenges multiply. Cloud storage, explored in this month’s Technology Outlook section, seems to offer a viable solution by better leveraging IT infrastructure.

However, the value of information decreases when it is not readily accessible by the entire healthcare team. Mary Stevens, editor of our sister publication CMIO, provides a sneak peek into the future of health information exchanges (HIE) as she profiles groups that have successfully integrated images into the HIE. These pioneers are already considering the implications of digital pathology.

As some practices contemplate next-generation challenges, breast imagers wrangle with an ongoing crisis. Mammography has been through the ringer in the last year. You likely remember the gasp heard round the industry late last fall when USPSTF recommended women younger than age 40 and older than 74 forego screening exams and those between the ages of 50 and 74 cut to biannual screens. Clinical studies continue to cast doubt on the value of screening mammography. One year after USPSTF, we take a long hard look at the state of mammography.  The damage is significant. States are cutting funding, women are falling behind on mammograms and practice volumes are dropping.

Finally, although PACS is mature, it’s a business essential. We look at the new rules of PACS deployment in the following pages. We’re also asking about the role of iPads in radiology and detailing the latest on cardiac MR, business intelligence and the Moly shortage.

Read on, stay head of the curve and stay in touch.