Heading into the future, a symbiotic relationship

The role of radiology in biomedical research has changed drastically over the past 10 years. Radiology researchers traditionally focused on two key areas: technical development and clinical applications. Investigators were aware of the lack of cost-benefit studies for imaging procedures demonstrating therapeutic efficacy as well as technical robustness and diagnostic accuracy.¹ This absence of scientific endeavor, however, was blamed on the complex biases of treatment and sociology affecting examination outcomes.

A global trend is now emerging for medical schools to organize research in order to stimulate cooperative efforts and increase external funding. Universities are recognizing the worth of expertise that cuts across traditional departmental boundaries. Several virtual institutes are forming around key areas; for example, neuroscience, oncology, and cardiovascular diseases. We are also seeing modality-oriented centers focusing on IT in medicine, genetics/genomics, and biomedical imaging.

Two examples of physical centers engaging in state-of-the art biomedical imaging research are the Center for Medical Image Science and Visualization (CMIV) in Linköping, Sweden,^2-4 and the Center for Biomedical Imaging at Stanford University (CBIS). An example of a virtual facility is the European Institute for Biomedical Imaging Research (EIBIR).

Diagnostic and interventional radiology will continue to take a leading role in university-led imaging centers. The area of academic imaging and visualization is potentially much wider, however. Image guidance in cardiology and orthopedic surgery and image processing in ophthalmology are good examples. Engineering, physical, and mathematical research is relevant to all aspects of the imaging process.

Another obvious development is the need for biomedical researchers to visualize biological processes at a variety of different levels. Improvements to spatial and temporal resolution mean that imaging technologies can now contribute to basic scientific research.⁵

Functional and morphological imaging techniques that operate at a molecular and cellular level will obviously be of value here. So will a wide range of clinical radiology modalities, as results are translated not just from "bench to bench" but "bench to bedside" as well. There is also an important need for a "bedside to society" transition of biomedical and/or imaging technology (see table).

Radiologists with academic and/or research interests will find themselves working alongside investigators from medical and technical fields with whom they have previously had little contact.⁶ This should lead to many new and exciting applications within the radiological research arena. Most of these projects have not yet extended to personalized medicine or reached the bedside of patients. It remains to be seen whether future collaborative projects will do so.

PROF. RINGERTZ is chair of the board at the Center for Medical Image Science and Visualization at Linköping University Hospital in Sweden, and a visiting professor of radiology at the Lucile Packard Children's Hospital at Stanford University in the U.S. He is president of the International Society of Radiology.

References
1. Thornbury JR. Why should radiologists be interested in technology assessment and outcomes research? AJR 1994;163(5):1027-1030.
2. Bolger AF, Heiberg E, Karlsson M, et al. Transit of blood flow through the human left ventricle mapped by cardiovascular magnetic resonance. J Cardiovasc Magn Reson 2007;9(5):741-747.
3. Hope TA, Markl M, Wigstrom L, et al. Comparison of flow patterns in ascending aortic aneurysms and volunteers using four-dimensional magnetic resonance velocity mapping. J Magn Reson Imaging 2007;26(6):1471-1479.
4. Ljung P, Winskog C, Persson A, et al. Full body virtual autopsies using a state-of-the-art volume rendering pipeline. IEEE Trans Comput Graph 2006 12(5):869-876.
5. Ehman RL, Hendee WR, Welch MJ, et al. Blueprint for biomedical research. Radiology 2007;244(1)12-27.
6. Li KC. Biomedical imaging in the postgenomic era: opportunities and challenges. Acad Radiol 2002;9(9):999-1003.