News articles describe unnecessary and duplicate imaging procedures when patients go from one institution to another. Articles published in the medical literature document unnecessary imaging performed when physicians refer their patients to facilities in which they have ownership interest.

Meanwhile, radiology has not adequately documented the value of imaging studies. Imaging reimbursement will continue to decrease if we cannot demonstrate that imaging makes a significant difference in patient outcomes.

We have been very successful in promoting the apparent benefits of new technology and techniques to our referring colleagues. While some publications demonstrate the valuable impact of imaging on patient outcomes, many commonly used imaging studies have not been subjected to such analysis. For example, CT for pulmonary embolus and single photon emission CT (SPECT) for cardiac perfusion were widely used long before those techniques were critically analyzed for effectiveness.

The problem is twofold: well controlled studies to determine the value of imaging are costly and difficult to perform and, perhaps as importantly, there are not enough academic radiologists trained in health services research to perform these types of technology assessment and outcomes studies.

With regard to funding, increased support is needed not only from existing sources, such as the National Institutes of Health and Agency for Healthcare Research and Quality, but also from new governmental sources such as the Centers for Medicare & Medicaid Services and non-governmental agencies as well. Continuing to garner industry support for the RSNA Research & Education Foundation and greater collaboration with the American College of Radiology Imaging Network (ACRIN) can also help.

As for training researchers, the GE–Association of University Radiologists Radiology Research Academic Fellowship develops young academics suited to the role. RSNA, through its R&E Foundation, as well as ACRIN and other professional societies, currently fund similar positions, but overall, only a limited number of researchers are trained each year.

This should change. Academic departments should train more researchers and practicing radiologists should realize the importance of—and contribute funds to—this worthy cause.

Ronald L. Arenson, M.D., is RSNA Liaison for Annual Meeting and Technology. He is chair and the Alexander R. Margulis Distinguished Professor of Radiology at the University of California, San Francisco.