Industry will shape medical practice

In the rah-rah days of the 1980s, radiologists were insatiable. Perceiving a threat to their turf, they claimed any medical technology that involved imaging. They clamored for MR scanners, fought cardiologists and vascular surgeons for control of x-ray angiography, even battled urologists for lithotripters. Times have definitely changed.

Radiologists today appear barely interested in the only new game to come to town for more than a decade: molecular imaging. This apathy, along with technological developments and a maturing of the installed base of current imaging equipment, has brought our industry to a crossroads.

Radiology has been the cornerstone of medical imaging for the better part of a century. Much of the technological development we now take for granted has come from input provided by leaders in this medical specialty. The disease-centric model of imaging and radiology's unwillingness to push itself forward, however, are shunting industry to other medical disciplines, which are becoming increasingly interested in what imaging can do for them.

This turn of events may have a technological base. In an effort to boost productivity and reduce user error, engineers have made equipment ever simpler to operate and images ever easier to interpret. Computer-assisted diagnosis, 3D imaging, and smart algorithms—some of which propose the actual phrases to use in radiology reports—will further reduce the importance of radiological expertise.

The implications for industry are profound. On the one hand, the path now appears clear for equipment developers to craft equipment suited specifically to the way other disciplines practice medicine, which is markedly different from that of radiologists. Any rebuke from radiology to industry for following this path will likely be modest, especially if vendors use already established marketing tracks to practitioners outside radiology.

On the other hand, by openly courting nonradiologists, industry risks alienating the very people who brought equipment vendors to their current pinnacle of success. Luminaries in radiology understand imaging and will be essential to the continued evolution of individual modalities and image quality. It will be a delicate balancing act, therefore, but ideally industry must try to focus radiologists' expertise on the development of core technologies, while tapping the expertise of nonradiologists when designing productivity tools and medical protocols.

Most sobering, perhaps, is the realization that industry strategy for future equipment development and marketing, regardless of what it is, will shape the next century of medical imaging, just as it has the last.

—Greg Freiherr, gfreiherr@cmp.com