RSNA 2014: Celebrating Innovation Past & Future

There’s a very important tradition that takes place in Chicago at the end of every November, and it doesn’t involve turkey or football—it’s the Radiological Society of North America’s Annual Meeting and Scientific Assembly. While each year’s show is a major event for radiologists across the world, this year marks the 100th annual meeting of RSNA, and attendees will have a chance  to reflect on radiology’s past  while they prepare  for its future.

From Nov. 30 through Dec. 5, more than 50,000 attendees will converge at McCormick Place in Chicago to hear from luminaries in the radiology community. Approximately 3,000 scientific presentations and posters will educate attendees on the latest trends and topics in radiology research, and about 2,000 education exhibits and informatics demonstrations will be on display.

As with every RSNA meeting, there will be a major focus on not only bringing attendees up to date on the latest technology, but also helping them navigate the issues of the moment. Improving the value of radiology is imperative in today’s environment, and a number of sessions will prepare attendees to become leaders in this area. The American College of Radiology’s Imaging 3.0 campaign—which is focused on broadening radiologists’ role in shaping America’s future healthcare system—will have a presence at the meeting. Attendees also will have the chance to learn about the changing economics of radiology brought on by recent reforms.

But among the highlights of RSNA 2014 will surely be the ongoing tribute to the first 100 years of the society and the last century of radiology in general. The Centennial Showcase, a free-flowing interactive exhibit open for the duration of the meeting, will look back at radiology’s achievements, including historic science and technology. Attendees will be able to try diagnosing vintage images using only the tools of early radiologists in the “Cases of the Century” exhibit. A virtual incarnation of Wilhelm Roentgen, the father of radiology, will be in attendance, and visitors will have a chance to explore a replica of his lab.

It’s a lot to take in, but Health Imaging will be on hand to cover the latest breaking news. We hope you enjoy our RSNA 2014 preview. We’ve got session recommendations, an interview with the RSNA 2014 president, and our own quick look at some of the biggest events in the history of radiology. See you in Chicago!

RSNA president for 2014, N. Reed Dunnick, MD, discusses the critical role of radiology in a Q&A with Health Imaging. Read on for his thoughts on radiologist value and visibility, as well as a sneak peek at the hot topics that will be discussed at this year’s meeting:

The RSNA 2014 theme is “A Century of Transforming Medicine.” What special programs or activities can attendees expect to see at this year’s conference to mark this milestone year?

The RSNA Centennial celebration begins at the 2014 annual meeting—the Society’s 100th meeting—extends through 2015, which is the 100th anniversary of the RSNA, and ends during RSNA’s 2015 annual meeting. At the 2014 meeting we will remember and honor the past, take stock of our present, and celebrate 100 years of achievements.

The Centennial Showcase will be located in Hall D, opens on Saturday afternoon, and will be open all week. It is a multimedia, interactive, experiential exhibit that features a video timeline of RSNA milestones, a special welcome from a virtual Professor Roentgen, a gallery area focusing on the values and mission of the RSNA—the RSNA Community, Research, Education, Innovation, and Patient Care—an opportunity for attendees to attempt diagnoses from classic images in “Cases of the Century,” a gallery of images  (“Art and Science”) of scientific and artistic interest, and a Memory Book for providing well wishes to and from the RSNA community. All this has been designed to not only commemorate the past and highlight how far radiology and the RSNA have come, but also impress upon the meeting attendees that they are an indispensable part of the RSNA community.

How can radiologists further demonstrate their value to the healthcare system, and how will RSNA 2014 help in this effort?

Radiologists value to healthcare lies in our being able to determine the right imaging study for the patient, to perform imaging so as to obtain optimal images with the lowest possible risk to the patient, to make and communicate an accurate diagnosis in a timely fashion, and to supply imaging to help follow the progress of treatment. We provide critical information in consultations with referring physicians and assist them and our patients in understanding what we have found on our imaging studies. In a sense you can say that all of the education and new science at our meeting helps radiologists in their effort to demonstrate their value to healthcare.

But, more specifically, there are a number of courses related to leadership in radiology, professional organization for career development, and health policy and practice that can be useful in conjunction with the more clinically oriented courses. I note that Francis Collins, MD, PhD, director of NIH, will give a special lecture on “Exceptional Opportunities in Biomedical Research,” and we radiologists know that our value to healthcare and our patients lies not just in today’s clinical practice but in the research we perform to create tomorrow’s clinical practice.

Are there any trends or technologies that you think will make a big splash at this year’s RSNA?

Breast tomosynthesis and MR imaging are again hot topics and trends in this year’s abstracts. Some other clinical hot topics are lung cancer screening (appropriate in light of recent and developing actions by CMS), MR imaging in the ER setting, dual-energy spectral CT, quantification of prostate imaging, soft-tissue and bone tumor characterization with DWI and quantitative imaging, and studies of structural and functional brain connectivity for neuropsychiatric diseases. Some health policy topics include studies of cost and value, and the use of large databases (“big data”) to assess imaging outcomes. Among informatics hot topics are mobile devices and alternative user interfaces, and structured reporting.

Radiology Through the Years: As RSNA celebrates its 100th meeting, we wanted to take a look back at some of the biggest developments in the history of radiology. This list is by no means comprehensive, so if you want to learn more about the innovations that shaped medical imaging, be sure to check out the Centennial Showcase at RSNA 2014.

1895: Roentgen Discovers X-ray

Wilhelm Roentgen, PhD, was investigating the effects of vacuum tubes when an electrical discharge is passed through them when he inadvertently gave birth to radiology. Roentgen was conducting an experiment involving a tube with a thin aluminum window that permitted cathode rays to exit when the discovery was made. The tube had a protective cardboard covering that prevented light from escaping, but Roentgen noticed the rays still caused a fluorescent effect on a small cardboard screen painted with barium platinocyanide. He determined that a new type of ray was responsible, and after repeated experimentation in the following weeks, he took the first picture using x-ray: a image of his wife’s hand. Upon seeing her skeleton, Anna Bertha, Roentgen’s wife, said, “I have seen my death!”

1915: The beginnings of RSNA

When a group of Midwestern radiologists in these early years found it difficult to travel to conventions on the East Coast, they decided to have their own meeting. In St. Louis, at the office of Miles B. Titterington, MD, five radiologists founded the Western Roentgen Society. If that name doesn’t ring a bell, it’s because the Western Roentgen Society was renamed the Radiological Society of North America in 1919.

1972: CT makes its debut

CT, better known at the time as computed axial tomography (CAT), was invented by Godfrey Hounsfield, a British engineer working at EMI Laboratories, and Allan Cormack, a South African physicist at Tufts University. The pair later shared the Nobel Peace Prize for their accomplishments. Using Cormack’s theoretical calculations, Hounsfield and colleagues constructed the first CT scanner, and the technology took the 1972 RSNA meeting by storm. Clinical scanners were installed throughout the mid-1970s, dedicated at first to head imaging only, but with whole body systems becoming available in 1976.

1975: First PET scanner comes to medicine

With most developments in radiology or science in general, every great breakthrough is preceded by years of hard work from pioneers who came before. This was the case with PET imaging. Radioactive tracers were first examined in the 1930s, with scanning of radioactive substances occurring throughout the 1950s and 1960s, but it wasn’t until the 1970s that the practical use of PET imaging came to medicine. Michel Ter-Pogossian, PhD, of Washington University in St. Louis, and colleagues followed the lead of CT technology and developed the first computerized PET scanner in 1975.

1977: First human MRI scan

As with PET, there’s a long history of scientific breakthroughs that led to the development of MRI. The rotating magnetic field was first described by Nikola Tesla all the way back in 1882, and physicist Isidor Isaac Rabi, PhD, laid the foundations for MRI by developing a method of measuring magnetic properties of atomic nuclei in the 1930s. The “Tesla Unit,” which indicates the strength of a magnetic field, was defined in 1956. All of this work eventually led to the first MRI exam of a live human in 1977. Today, more than 130 years after the discovery of a rotating magnetic field, the strength of MRI scanners is still measured in Teslas.

1982: PACS changes how images are stored

Scanner technology had been advancing for years, but radiology would need a way to store and view the images being created. The now ubiquitous term PACS was coined in the early 1980s by André J. Duerinckx, MD, PhD, though Samuel J. Dwyer, III, PhD, is generally regarded as the “father of PACS.” Dwyer and Duerinckx held the first symposium on PACS in 1982, and the first large scale PACS installation took place that same year at the University of Kansas Medical Center in Kansas City.