So many things in radiology are vital: keen diagnoses, accurate reports, dedicated professionals, and the swift collection and transfer of information. But without the continual introduction of new technologies in radiology, the specialty would not be making the tremendous contributions to medicine that it is today. Several years ago, in a Health Affairs article,1 Fuchs and Sox surveyed general internists about the importance of various innovations to their patients. Of the 225 survey respondents, 75.6% chose MRI and CT scanning as the most important innovation. Other imaging technologies on the list included mammography (47.6%), ultrasonography (31.1%), and bone densitometry (4%).
These innovations have had a dramatic impact on radiology and medicine in general. They have changed the way that physicians diagnose and treat their patients. For example, breast MRI is impacting breast-cancer detection in high-risk women significantly. As Medical Imaging Editorial Advisory Board member Nancy Elliott, MD, FACS, told me once: “If a woman has a negative MR, it’s a 99% assurance that she doesn’t have breast cancer. It’s as close to a guarantee as we can get with any study, which is as good as it gets in 2004.”2
Recently, the Blue Shield of California Foundation (San Francisco) and the California HealthCare Foundation (Oakland, Calif) donated a combined $905,000 to fund what the two organizations are calling the nation’s first center devoted to studying the usefulness of emerging medical technologies. Called the Center for Medical Technology Policy (CMTP of San Francisco), this private, not-for-profit organization is focused on generating credible clinical evidence that will ensure that these technologies are developed and adopted rapidly, and then are used efficiently and appropriately. (Visit www.cmtpnet.org for more information.)
The Fuchs and Sox survey was taken in 2001, about the same year that many publications evaluated the millennium in medicine. With all of the recent advancements in imaging in the past 5 years, it would be interesting to see the results today. Please send me your top-five list of imaging innovations that you believe have impacted medicine. I would expect to see PET/CT near the top as well as MR-guided focused ultrasound. Send them to .
Operated under the auspices of the Health Technology Center (San Francisco), the CMTP provides a neutral forum for patients, clinicians, payors, and policy-makers to collaborate with manufacturers, researchers, and other stakeholders on new technologies. The group plans to incorporate health care decision-makers’ perspectives in research priorities. Also, the CMTP has established a Technology Policy Collaborative, which facilitates communication between these groups at the national level.
The CMTP is a great idea—and it’s nice to have one of America’s largest payor organizations supporting it. With so many different organizations working on new developments, we need a neutral source to help sort out the technologies’ usefulness—and to determine which ones are not worth pursuing. Another one of the CMTP’s goals is to limit the adoption and use of technologies that have limited or uncertain benefit. Only then will researchers and developers be able to further focus their attention on the most worthwhile projects.
New technologies are so important that we’ve dedicated one of the most valuable pages in the magazine to it—our back page. This month’s “Emerging Technology” is showcasing a 4D localization system that has the potential to revolutionize radiation therapy. The system provides objective, accurate, and continuous tumor-location information during external-beam radiation therapy without adding ionizing radiation. It is the only system that uses implanted transponders tracked by electromagnetic technology that continuously monitors prostate organ motion during radiation therapy, giving clinicians confidence that the radiation beam is always on target.
Still, although we have elected to highlight the emerging technologies in Medical Imaging, we will leave the job of validating them up to the medical professionals.
- Fuchs VR, Sox HC. Physicians? views of the relative importance of thirty medical innovations. Health Affairs. 2001;20(5):30?42. Available at: content.healthaffairs.org/cgi/content/abstract/20/5/30. Accessed September 17, 2006.
- Lucas A. Chatting with Nancy Elliott, MD, FACS. Medical Imaging. 2004;19:7. Available at: www.medicalimagingmag.com/issues/articles/2004-05_09.asp. Accessed September 17, 2006.
Andi Lucas, editor