Daily Bulletin 2017

Tomorrow's Radiologist Must Tap into the Infinite Possibilities of Innovation, Technology and Teamwork — Today

Monday, Nov. 27, 2017

Roderic Pettigrew, PhD

Along with being persistent innovators, tomorrow's radiologists must work to establish themselves as imaging, information science and image-guided therapeutics experts who will play a vital role on healthcare teams, said Roderic I. Pettigrew, PhD, MD, in an opening session lecture on Sunday in Arie Crown Theater.

In his presentation, "Tomorrow's Radiology," Dr. Pettigrew, founding director of the National Institute of Biomedical Imaging and Bioengineering, stressed that the overall goal of today's healthcare enterprise is to achieve healthy longevity — to be born healthy, acquire no significant disease and to reach the end of life without pain or suffering from disease.

"That bold vision requires technological innovation for earlier precision diagnostics and therapeutics," Dr. Pettigrew said. "And tomorrow's radiology will play a critical role in achieving this goal.

"We emphasize innovation because we realize that like imagination, there is no end to innovation," Dr. Pettigrew said.

For example, he referred to Peter Basser, PhD, of the National Institutes of Health and a team of researchers who invented and developed MR diffusion-tensor imaging, which is now used to map the human connectome.

"His latest innovation actually quantifies neural conduction latency," Dr. Pettigrew said. "This has the potential to offer new insights into some of our most challenging healthcare conditions in the brain, such as mental health and psychiatric illness."

Dr. Pettigrew also discussed a 4-D motion compensation MRI technique that allows for the in-utero assessment of cerebral function.

"This technique is able to depict the functional neural network involved in inward thinking," Dr. Pettigrew said. "This is the so-called 'default' mode network believed to be disturbed in autism and related to emotional development."

A technique like this could allow for the evaluation of a number of factors related to development, ranging from something as simple as a person's diet to the impact of listening to music, Dr. Pettigrew said.

Other areas in which imaging innovations have had a significant effect on health outcomes include the use of CT to evaluate the risk for coronary artery disease, mixed-reality MRI-guided planning for breast conserving surgery and the potential of MRI-ultrasound (US) in treating prostate cancer via focal laser ablation.

Radiologic Innovations Critical to the Future

Radiologists are also demonstrated innovators. For example, Dr. Pettigrew referred to a program at Massachusetts General Hospital, Boston, called the Radiology Consultation Clinic in which patients meet directly with radiologists to review images with the idea of getting them to take more responsibility for their own health and to follow their physicians' advice.

"This is the kind of role and impact we can have," Dr. Pettigrew said, adding that this type of innovation is directly tied to the role radiologists will play going forward — that of imaging and data science experts who are active members of the healthcare team.

This shift is demonstrated by some of the themes highlighted in recent Radiology articles, such as integrated diagnostics, radiomics, machine learning and artificial intelligence.

"The key message here is that modern imaging science is information and data science," Dr. Pettigrew said. "Extracting the data from these images will improve the value proposition in imaging."

And to do so, he added, tomorrow's radiologists must follow a clear path.

"Radiologists must leverage the digital revolution, the state of hyperconnectivity we are in, big data science and artificial intelligence."

Tip of the day:

Increasing the SID for upright radiographic exposures from 40" to 72" improves image quality through reduced focal spot blur and reduces patient dose.

The RSNA 2017 Daily Bulletin is owned and published by the Radiological Society of North America, Inc., 820 Jorie Blvd., Oak Brook, IL 60523.