Editor's E-Note
Informatics is the backbone of modern medical imaging, and radiology has been at the forefront of changes that have facilitated the shift from film to digital and the ability to share images throughout the health care enterprise. But as image volumes have increased and workflows have become more complicated, it’s time for radiology to reconsider how work gets done. This month’s exclusive outlines the challenges of redesigning radiology workflow.
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— Dave Yeager, editor |
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Radiology’s Digital Head Start Is Forcing a Reckoning
By Nicholas Galante, MD, and Rish Seth, MD, CIIP
In the mid-2000s, radiology was technologically ahead of the rest of health care, and not just incrementally but structurally, in terms of how the work got done. Entering radiology at that time meant stepping into a specialty that had already solved problems the rest of medicine hadn’t yet acknowledged. The transition from film to digital imaging wasn’t simply an upgrade in tools. It was a fundamental shift in how radiology operated.
When the Baltimore VA Medical Center became the first filmless facility in 1993, it demonstrated that an entire specialty could reorganize around a new technological foundation. By the early 2010s, PACS had been deployed in nearly 90% of hospitals, effectively closing the chapter on physical film.
That transformation required solving interoperability. The adoption of DICOM created a common language for imaging data that allowed systems from different vendors to communicate reliably, years before the rest of health care. Around the same time, radiology embraced voice recognition more completely than any other area of medicine, with most practices migrating from transcription to speech-to-text by the mid-to-late 2000s. Together, these developments made radiology the first digitally native specialty in medicine.
While radiology continued to build on what it had already built. Each new capability, whether advanced visualization, AI-assisted triage, enterprise imaging, or structured reporting, was introduced into an environment designed for an era with lower imaging volumes, less data complexity, and fewer interoperability demands.
The systems weren’t designed wrong. They just weren’t designed for what came next. This is what we think of as digital rot, or the gradual degradation that occurs when new capabilities are layered on an outdated infrastructure, creating a system that becomes more fragmented and more difficult to maintain.
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Handheld Device Identifies Cancerous Breast Tissue
Researchers in Australia have developed a handheld device that uses sterotactic optical palpitation to differentitate healthy tissue from cancerous tissue. They believe the device could be useful during breast surgery.
Blast Exposure Linked to Brain Aneurysms
A recent study from Massachusetts General Hospital in Boston found that repeated low-level blast exposure led to structural brain MRI findings in US Special Forces personnel. The study of 564 participants used 3 T brain MRI with time-of-flight MR angiography. The study found that intracranial aneurysms were common in people with higher levels of blast exposure. The findings suggest a long-term vascular effect in people who have experienced repeated low-level blast exposure during military service.
Radiation With Immunotherapy Improves Disease-Free Survival in Prostate Cancer Patients
A multicenter trial found that adding immunotherapy to standard radiation therapy improved disease-free survival in patients with intermediate- or high-risk localized prostate cancer. The study evaluated 745 men with localized prostate cancers at 51 medical centers in the United States and Puerto Rico.
Ultrasound Pacemaker Stimulates the Heart Noninvasively
Researchers at MIT and the University of Southern California have developed an ultrasound pacemaker that is applied with a sticker and stimulates the heart noninvasively. The pacemaker works in conjunction with gene therapy to help cardiac cells better “hear” the ultrasonic vibrations.
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“Just as pediatric growth charts help clinicians determine whether a child’s height or weight is developing as expected, these brain charts provide a reference for how the brain’s neural pathways typically change over the lifespan. That gives us a powerful new way to identify when an individual’s brain wiring falls outside the expected range.”
— Julio E. Villalón-Reina, MD, PhD, a postdoctoral researcher at the University of Southern California Mark and Mary Stevens Neuroimaging and Informatics Institute and the first author of a study that used diffusion MRI to map the white matter structure of 21 major brain regions to create a reference map of the brain
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COVER STORY
Lending a Hand
Handheld ultrasound offers access and speed with improving quality, and the technology is being adopted in an ever-growing variety of clinical scenarios.
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Whole-Body Makeover
Ultrahigh gradient whole-body MRI is gaining attention among MRI experts.
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