by
Sean Ruck, Contributing Editor | February 28, 2017
At the same time, radiology is moving from anatomical to functional analysis of disease processes. Functional information is a very broad concept, and it comes in a variety of flavors. In brain imaging, which is my primary field of interest, the first one that comes to mind is fMRI, which is based on bold contrast. But there are other techniques to provide functional information, such as perfusion imaging, assessing CSF flow dynamics, brain and spinal cord motion, etc. The big caveat is that we often miss a yardstick by which to calibrate our measurements between patients, sequences and vendors. Therefore, I am a strong believer in the mandatory calibration of machines and equipment with phantoms.
In clinical terms, radiology must aspire to become a vertically integrated medical specialty, especially regarding interventional treatments. For example, in patients admitted with an acute stroke, the ‘chain of command’ should go through radiology: diagnosis, establishment of the core of the infarct versus the penumbra (for example, by perfusion imaging), mapping of collateral vessels, and then, immediately, interventional endovascular stroke treatment and follow-up of the patient by the (interventional) radiologist. Endovascular stroke treatment is having the biggest impact on lives and quality-adjusted life-years of our patients. Therefore, radiologists should aspire to be recognized as clinicians.
Finally, I believe that we need to improve how we communicate with clinicians and with patients. Structured reporting, using a standardized template and a fixed lexicon (RADLEX) are certainly the way forward if we want to prepare our output for the oncoming age of data mining and big data.
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