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Computed and digital radiography systems that once cost in excess of US$150,000 can now be had for less than $50,000, and prices may decline further as manufacturing processes continue to improve and the lower prices attract more healthcare providers to buy the technology, whose benefits in terms of improved productivity in the radiology department, faster and ubiquitous availability of images to doctors, and improved diagnostics through manipulation of the digital images, are well established.

Radiologists and hospitals should worry that inexpensive digital image processing technology will eventually enable non-radiologist caregivers including orthopedists, podiatrists, and chiropractors to interpret their own radiographic images. “Hospital leaders,” write Glenn Crosse and Daniel J. Valentino in HealthLeaders, “would be wise to consider the potential implications for the providers they employ and those who have privileges, so that they are prepared for increased competition over use of the new equipment and reimbursement for procedures.”

While a complete transition to truly filmless digital radiology departments may still take the turnover of a generation of radiologists and referring physicians, “It is important to note that few healthcare industry experts are discussing ‘whether’ this transition will happen, but rather ‘when’ it will happen,” they write.

X-ray Vision Without Glasses

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British and Swiss researchers have found a way to see through rubble at earthquake sites, or look at parts of the body obscured by bone, using a new material that exploits the way atoms in matter move, to make them interact with a laser beam in an entirely new way. Professor Chris Phillips, of Imperial College London, says: “This real life ‘x-ray specs’ effect relies on a property of matter that is usually ignored – that the electrons it contains move in a wave-like way. What we have learnt is how to control these waves directly. The results can be pretty weird at times, but it’s very exciting and so fundamental. At the moment the effect can only be produced in a lab under specific conditions but it has the potential to lead to all sorts of new applications.”

Diffusion Tensor MRI a “Revolution”

Source: Advisory Board Daily Briefing (subscription service), March 15, 2006.

Diffusion Tensor Imaging (DTI) is an MRI-based procedure that produces colorful visual images of the brain’s white matter to determine the exact location of a tumor and determine its effect on surrounding areas. DTI is poised to “revolutionize[e] neurosurgery nationwide,” the Newark Star-Ledger reports. Compared with standard MRI techniques, which only identify functional areas on the surface of the brain in relation to the tumor, DTI creates computer-generated images that depict “bundles of colored wires extending out into the different parts of the brain” to help physicians determine which fiber tracts are affected by the presence of a brain tumor.

DTI helps surgeons to determine what fiber tracts a tumor has infiltrated or become connected to, and then to create an approach that will ensure they don’t “disconnect and injure those tracts,” as one surgeon put it. The director of neuroradiology at Johns Hopkins said there is “no question that DTI technology is improving outcomes by reducing the deficits seen in patients following brain surgery.”