In a few years we are likely to see 3D images generated instantly, and with comparable resolution to today’s 2D views. Inclusion of functional information, possibly at the molecular level, could also assist in clinical decision-making. Some specialist clinicians with intimate knowledge of their fi eld of interest are likely to have a better understanding of the pathology and physiology of an organ system than a general radiologist. So given that the images will be presented in a more familiar format, why should clinicians and surgeons wait for a general radiologist to read them? If radiologists wish to retain their role as the experts in image interpretation, they will not only need a thorough understanding of imaging and radiological anatomy, but also a detailed understanding of pathology and physiology. It is clearly unrealistic to expect most people to gain that knowledge across a range of fi elds, hence the need for subspecialisation. There are already commercial moves to harness the expertise of superspecialist radiologists, using teleradiology, to provide expert opinions in particularly diffi cult cases. This is just the beginning of a major shift in the pattern of practice in radiology. The radiology community cannot ignore impending technological developments. If radiologists take no interest in the emergence of highly detailed, user-friendly images, then the clinicians and surgeons will organise their own department-based image interpretation. However, radiologists are very good at adapting to technological change and are very likely to rise to these challenges. Far from having a sell-by date, radiology has a bright future.
Radiology is riding the crest of a wave. We have superb images, available immediately in all parts of the hospital. Fusion of functional and structural imaging modalities is a reality and molecular imaging is developing fast. Modern radiology increases the effectiveness of treatment, reduces the length of hospital stay and, appropriately used, allows the most efficient use of the healthcare budget. Radiologists see their specialty as a paragon of virtue and they are sometimes surprised when others take a different view. However, the reasons for this discrepancy are obvious: the high capital costs of radiology are all too visible, whereas its benefits are less easily apparent. Furthermore, the lack of patient contact results in the credit for the benefits of radiology accruing to the doctor treating the patient rather than to the specialist interpreting the images.
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