X-Ray Vision

Seeing the future through our crystal ball
Emerging trends could create a growing role for imaging in the healthcare delivery system of the future

By John C. Hayes, editor

Gazing into a crystal ball and predicting our professional future is something few of us have time to do. It’s not that thinking about the future isn’t important; it’s just that the pressures of the day always seem to interfere. In this special edition of Diagnostic Imaging, we’ve done some of the gazing for you. Here you’ll find interviews with, and articles by, key figures in medical imaging who have some intriguing ideas about where the profession is going.

You may disagree with some of their prognostications, but I’m betting you’ll agree more often than not. Although predicting the future is difficult, if not outright risky, many of the trends that will shape medical imaging are already in place and evident to the serious observer. Here are a few of the common threads:

There will be a new language to describe what medical imagers do. The term “radiology” is ingrained in medical imaging and will persevere for many years, but other terms could disappear fairly quickly. My candidate for the first extinctions are “filmless” and “film libraries.” Others on the way out, as suggested by writers elsewhere in this issue, include “PACS” and “teleradiology.” The terms and concepts that will replace them include digital archives (where your priors will come from), optical imaging, and molecular imaging.

Where you practice will become less important than how you practice. Twenty-four/seven radiology is fast becoming a fact of life, but in a digital world that may not be as serious an issue as it is sometimes considered now. A New York radiologist, for example, might read images during normal working hours that were collected from a night admission in Budapest, half a world away. We’re already hearing from radiologists who see wired and wireless digital imaging networks as a way to provide their expertise from a villa in Greece or a beach in the south of France.

Patients and physicians alike will have it their way. Imaging and treatment regimens will become more specific and customized. Therapies may be based on an individual’s specific genetic makeup. Physicians will customize how they receive patient information through terminals, personal digital assistants, or workstations. This tailored information will allow them to make the most of their diagnostic strengths.

How you learn will change. Big conferences such as the RSNA meeting will continue, but more and more imagers will turn to individualized instruction over the Internet. New technologies will even allow some of them to go through surgical training at a distance.

Think fusion. The first fusion PET/CT images that appeared about three years ago were a revelation to both radiologists and nuclear medicine physicians and a harbinger of medical imaging’s future. Images and sequences of images that capture physiological processes as they occur will become the way medicine views and understands pathology. Bringing radiology into these processes will also move medical imaging much closer to therapy; the sometimes strict lines between diagnosis and therapy will begin to blur.

All in all, it will be very different from today’s world. Radiologists will need to learn new skills to cope, and some of them will be threatened by the changes. Others will embrace those changes and make the most of them, moving easily into the digitized-molecular-biological world of medical imaging.

One thing is certain: The shift will help keep medical imaging at or near the center of the medical universe. Those who can make the transition will find it a very exciting place to be.

What are your thoughts on this topic? Please e-mail me at jhayes@cmp.com