New curriculum takes shape
Protecting turf will involve biochemists and
biologists
By C.P. Kaiser
A decade ago, radiology—except for nuclear medicine—would scarcely
have been able to participate in molecular medicine. But advances in PET, CT,
MRI, and optical imaging should enable radiologists to image the body’s
genotypic expressions.
Ancillary questions arise, however. How will the future genomics- and
molecular-based radiology curricula be developed and taught in medical schools,
in resident and fellowship training programs, and in CME courses? What new
technologies will need to be mastered?
According to Dr. Philip O. Alderson, chair of radiology at Columbia
University, the science of molecular imaging will probably advance faster than
its inclusion in any medical curriculum, and rightly so. The American College of
Radiology and the American Board of Radiology have already begun weighing the
issue, learning what they can and determining how to advise their
constituencies.
The development of tracer ligands is one of the key components to molecular
imaging, particularly MR- and ultrasound-related chemical compounds.
Consequently, biochemistry, pharmacology, and microbiology will become much more
important to general diagnostic radiology than they are today. Any future
curriculum must provide these new elements, Alderson said.
Molecular imaging will become an extension of diagnostic radiology, he said.
Many established guidance systems will be used for radiologic monitoring
of biologic vectors, including angiographic guidance of intra-arterial
vectors, ultrasound monitoring of echogenic vectors, stereotactically guided
radiation for radiation-induced gene expression, and guided tissue biopsy for
histopathologic analysis after gene delivery.
“At some point, the specialty boards will have to announce to candidates
that gene expression-related imaging is now a vital part of the residency review
committee,” Alderson said. “But that step is years away.”
Nevertheless, the timely introduction of molecular-based curricula could help
keep radiologists from getting stuck in an anatomic mindset. Organized radiology
must reserve a role in molecular imaging for itself, according to consultant
Philip Drew, Ph.D. Otherwise, it will be spirited off by another specialty.
