Future Developments in Digital Radiography

Date
Thursday 28 September 2000

Venue:
The Board Room, Moorfields Eye Hospital, City Road, London, EC1V 2CD

Speaker:

Professor Andrew Todd Popropek, University College, London

Introduction

Professor Todd-Popropek began by stating that radiology in the future would encompass three things:

  • intelligent acquisition and display;
  • handling, processing and interpretation;
  • the impact of digital methods.

The future is hard to predict

The future, as ever, is hard to predict so the exact extent of each of these features may vary but the challenges remain the same:

  • How to acquire images?
  • How to use the images?
  • What technological influences will affect these issues?

He amplified the third point with examples:

  • new detectors;
  • PACS (Picture Communication and Archiving Systems);
  • techniques of image processing;
  • multiple imaging modes;
  • interventional techniques (e.g. computer assisted surgery);
  • tele-radiology and medicine;
  • computer aided diagnosis;

The future for radiology

Will radiology continue to exist as a clinical specialty or be subsumed into other areas of medicine? Ensure best application of the techniques by identifying user requirements and not imposing a 'toy' application. Tools must be developed and users must accept that there will be changes to working practice.

Back to basics

An image is an essential aid for interpretation to extract clinically useful information. 'Visualisation' of the image takes underlying 'image data' and makes it visible to users.

The advantages of digital images are that:

1) they can be processed to make significant data more accessible;
2) quantitative information can be extracted, thus making the interpretation more robust;
3) the process can be automated and be made more reliable;
4) the process can be standardised and so enable comparisons.

What about x-rays?

Will we continue to use x-rays? MR and Ultrasound will increase in use, the use of light and the near infrared may well come along. However the actual demise of x-rays is not predicted.

Detection techniques

Professor Todd-Popropek then reviewed the available detection techniques and issues:

  • computerised radiology
  • digital radiology
  • PACS
  • the DICOM standard

Practical changes

Increasing use of speech recognition, multi-media and tele-medicine - and tele-radiology.
Speed of connection, image quality, user interaction and legal responsibility. Interventional radiology already takes place in Angioplasty, biopsies, computer-aided surgery and micro-video capsules.

Advanced methods

Image processing and multiple modalities -

Detection of an image, its measurement and description. For example in MRI for cardiology, functional MRI to study brain activity and testing to find the significant parts of an image which at present is a research issue.

Computer aided diagnosis -

The use of image processing and information and knowledge held on the processing system will support identification of the organ(s) involved, arriving at a diagnosis and identifying the disease.

Requests may be generated electronically with a link to EPR; expert vetting can take place to verify that the test is appropriate, with links to clinical protocols and diagnostic strategies.

Reporting tools will facilitate interpretation, assist in defining terminology, include image processing, analysis and measurement, and suggest diagnoses.

Such a system may be a learning system - updating its own knowledge base.

Radiology will change

In summary, the combined impact of all these is that radiology will change!

Andrew Capey, Secretary
October 2000