When I was a kid I could buy 10 baseball cards plus a piece of bubble gum for a dime. Now, many years later, $4.95 buys 11 cards with no gum. A similar situation seems to exist with PACS and teleradiology at the RSNA meeting this year. A few great cards still exist, but I already have most of them.

The Mickey Mantles and Don Drysdales of PACS are out in force this year, in the form of major modality companies and film vendors. But while they are busy informing the world about their record-breaking statistics, I can't help wondering about the products that never left the bench. Software upgrades and updates are nice, but they are a small part of the bigger PACS picture. It is great to finally see alliances with RIS vendors become a reality, but the costs of the PACS/RIS interfaces remain exceedingly high.

Teleradiology as stand-alone technology has all but evaporated. A few players still compete in this market (Images-on-Call, Line Imaging Systems, DataView, MedPACS, and others), but the days of market dominance by any one company are gone.

In the CR market, prices broke the $100,000 barrier this year, but are expected to be halved again once newcomers Phormax and Digident receive Food and Drug Administration clearance to market their desktop CR products.

Digital Radiography still generates interest and has attracted a few new players, but lacks significant advances in technology or pricing.

Independent companies actually seem to be stronger at this year's show than in years past. The user interface demonstrated by DR Systems is challenged only by Cemax-Icon's AutoRad in terms of best GUI (graphic user interface) design. Overall, however, GUIs from all the vendors have become so straightforward that they are almost radiologist-proof at this point.