Prospects for progress in diagnostic imaging

Abstract

Abstract. Potchen EJ (Michigan State University, Michigan, USA). Prospects for progress in diagnostic imaging (Internal Medicine in the 21st Century). J Intern Med 2000; 247: 411±424.New fast-imaging MRI systems designed specifically for cardiac magnetic resonance enable new applications of noninvasive vascular imaging. The use of functional MRI and diffusion tensor imaging to map brain function and structure offers a new dimension to an understanding of the human condition. Clinical applications of functional MRI will influence many specialties including surgery, education, and rehabilitation. Functional imaging has the potential to visualize the regional concentration of specific proteins. This imaging at the level of molecules may be possible by use of a contrast material whose signal is changed by local enzymatic activity. The three-dimensional digital data collected in modern imaging techniques allow for virtual endoscopy in the respiratory, alimentary, and cardiovascular systems. Virtual endoscopy may replace many of the more invasive diagnostic methods in the near future. The measurement of clinical decision-making through observer performance studies better informs both the physician and the patient on how to improve upon the quality of clinical practice. These prospects for progress reinforce diagnostic imaging as a cornerstone in medical informatics. The history of creating images used in medicine reveals the invention of diagnostic tools which may provide new information but premature use can result in improper application of a poorly understood technology. Research into the use of new technology may be as important as the technology itself in improving the human condition.

Request form history, clinical indication, and yield of brain magnetic resonance studies

“…Over the course of the past decade, several important developments have occurred within the field of MRI that underscore the importance of its effective use and financial impact. Clinicians from a wide variety of specialties are now utilizing MRI to replace more traditional diagnostic techniques, and MRI is now being applied to arenas previously unseen (1–4). It is often difficult, however, for requesting physicians to understand fully the rapidly progressing modality and expanding clinical indications for these new options, particularly when most referring physicians are now working harder than ever to take care of the increasing patient load (6, 7).…”

“…THE RELATIVELY HIGH cost and increased use of magnetic resonance imaging (MRI) have caused some to regard this important imaging procedure as a significant contributor to America's rising health care expenditures (1–5). Efforts to control these rising costs have resulted in several health care reforms, many of which have included insurance companies and other third‐party payers as gatekeepers (6, 7).…”

Exosomes and ultrasound: The future of theranostic applications

“…Among the imaging modalities Magnetic resonance imaging (MRI), Computed tomography (CT) and Ultrasound provide significant insights on the disease status with minimal invasiveness [ 188 ]. Conclusive evidences were provided by these imaging methods without any contrast enhancing agents, hence clinical diagnosis and decisions regarding therapeutic management are successful most of the times [ 189 ]. However, there are some exceptions, where contrast agents are needed to differentiate overlapping symptoms of different pathological conditions in the same organ or to define the disease stages [ 190 , 191 ].…”

Future prospects in cardiac magnetic resonance imaging

“…To some extent, these viewing approaches are based on the radiographic angiography paradigm and reveal the relative size and relationship between vessel segments. Recently, with renewed interest in the status of the vascular wall, virtual endoscopic viewing software has been applied to MRA data [47]. By interactively adjusting thresholds of intensities and edge contrast, it is possible to navigate through the data set, viewing the condition of the vascular wall and relative size of the lumen in a manner similar to intravascular ultrasound.…”