The need for radiologic services has continued to grow; many radiologists have worked very hard and many have been well rewarded. There are job opportunities for young radiologists, particularly those with subspecialty fellowship training. In the background there is concern about the growth of offshore radiology supplied by radiologists in India, Australia and doubtless elsewhere. Whenever there is a gap in coverage, there is the possibility of the gap being closed by offshore radiologists or, using the same well developed electronic transmission modalities, by onshore talent.
The cost of healthcare continues to rise faster than the rate of inflation. Manufacturers providing retiree and employee healthcare as part of compensation find themselves disadvantaged in comparison to the competition from elsewhere.
Computed tomography (CT) examinations can now be done using instruments having as many as 64 detector rows. Demonstration of small vessels such as coronary arteries is enhanced and shows promise of becoming definitive. High-resolution CT angiography has enhanced examination of the brain. Removal of emboli and stenting of vessels has been more frequently done.
The combined use of positron emission tomography (PET) with CT is expanding with several new applications. Staging and restaging of lymphomas, characterization of lung nodules and staging of lung and breast cancers are probably the most frequent applications now. There are also applications for Alzheimer's disease and other head and neck problems.
Magnetic resonance (MR) and MR guided biopsy of the breast are proving useful. Computer-aided diagnostic programs are being applied.
Interventionalists are employing retrievable inferior vena caval filters. Bland embolic materials have proved useful in therapy of hepatoma.
The availability of radiologic and general medical information through the Internet has expanded remarkably. Many journals and other information services are readily accessed online. Search engines have improved to the extent that RSNA will discontinue the production of the Index to Imaging Literature at the end of 2004. RSNA is also following another major trend in medical education with the presentation of many of the scientific exhibits only in electronic form.
William R. Eyler, M.D.Historian
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