Radiology is a true multicultural environment. Anyone moving from show to show within the world of radiology during any given year will be struck by the cultural differences between the diagnostic radiologists (medicine’s detectives), the interventional radiologists (masters of reinvention), the nuclear medicine physicians (the alchemists), and the radiation oncologists (the compassionates), with whom radiologists share representation in the American College of Radiology (ACR) and at the American Medical Association. All come together once a year at the meeting of the Radiological Society of North America, the United States’ largest and arguably one of the most stimulating medical meetings. United by history, these diverse parts of the whole contribute a richness in perspective and scope that spans the spectrum of medicine from diagnosis to treatment, all linked by the field’s magic elixir: radiation.

There are times, however, when that link feels very tenuous indeed. Few practices include representatives from all disciplines. Those that do include representatives from other disciplines struggle with equitable compensation and workload issues. Along with the richness of diversity come the headaches in addressing the individual agendas of each part of the whole.

Over the years, this diversity has left a legacy of intramural spats. Just a few years back, the Society of Cardiovascular and Interventional Radiology considered distancing itself from radiology by excising the “r” word from its name. The specialty that gave us balloon angioplasty excised the “c” word instead and became the Society of Interventional Radiology. With the rise of CTA and MRA, many of those specialists are now investing in learning the techniques of 3D reconstruction and image navigation to prepare for a future with less traditional angiography.

Currently, a spat is brewing between nuclear medicine and diagnostic radiology over who should read PET/CT (see the feature article by George Wiley “Disruptive Technology“). A document that will be released later this summer and will reflect the interests of both nuclear medicine and diagnostic radiology in PET/CT fell short of the consensus that was hoped for, but the participants representing the ACR and the Society of Nuclear Medicine should be commended for investing time and energy in the tedious and sometimes painful communications and negotiations involved in arriving at consensus.

In negotiating an agreement, the more powerful party (diagnostic radiology) must put itself into the shoes of the less powerful party (nuclear medicine) and craft a solution that allows nuclear medicine to survive and even thrive. The extraordinary application of fluorine18-labled deoxyglucose in PET imaging is just the beginning of the molecular revolution in imaging, and as Abass Alavi, MD, the nuclear medicine physician who injected the first dose in a subject, says, “There is more where that came from.”

Cheryl Proval