DOI:10.2214/AJR.07.6612
AJR 2007; 188:1439
© American Roentgen Ray Society
Our Practice of Radiology: Reflections on its Growth and Stature
Robert J. Stanley, Editor in Chief
rstanley{at}uabmc.edu
As a former chair of the ACR Commission on Standards and Accreditation,
which now is configured under the umbrella Commission on Quality and Safety, I
have taken a personal interest in the practice guidelines of the College. This
month's issue of AJR includes an expedited guidance document on the
safe practice of MR [1].
Because of some rapidly evolving safety issues, we felt it necessary to
publish the guideline before it had become official policy of the ACR,
following formal adoption by the entire ACR Council as a Resolution. This
current document is an updated version of the 2004 practice guideline, and it
represents the consensus of numerous experts on a Blue Ribbon Panel. But it
does not represent official ACR policy, since it has not yet gone through the
formal required vetting process.
Having just returned from the 2007 meeting of the Abdominal Radiology
Conference in Bonita Springs, Florida, I am impressed with the complexity of
the gadolinium MR contrast issue regarding the risks of developing nephrogenic
systemic fibrosis (NSF) [2].
The ongoing widespread analysis of cases reveals that not all of the data are
in to allow for hard and fast recommendations regarding the use of
gadolinium-based MR contrast agents as they relate to varying levels of renal
function. This is an evolving phenomenon, and numerous cofactors are under
study. Thus, the guidelines proposed by the Blue Ribbon Panel may undergo
further revision before they become ACR policy. Nonetheless, the information
contained in the ACR guidance document represents the best available up to the
present. The AJR editorial board is happy to assist in the
dissemination of this most helpful document.
Have we got a great new educational product for you! GoldMiner, created by
Charles Kahn and Cheng Thao and described in this issue, is a "web
crawler" search engine that uses keywords and concepts to find images
and accompanying legends from a half dozen peer-reviewed radiology journals
[3]. The images can be
downloaded for inclusion in lectures and other educational exercises. Close to
100,000 images from nearly 12,000 articles are included to date and the number
will continue to increase. You can access this tool from the AJR home
page
(www.ajronline.org)
and click "Try ARRS GoldMinerTM." You will love it.
As I review the content of this month's issue, I am once again impressed
with how much our specialty has changed in the past 10 to 15 years. We really
are becoming "hands-on doctors," dealing increasingly with direct
patient evaluation and care with each passing year. The depth and breadth of
the imaging information we can provide our referring clinicians, as well as
the direct therapeutic interventions radiologists now offer for a large
variety of oncologic indications, are simply astounding. Radiofrequency
ablation is changing the way many tumors are primarily treated. Dr. Zagoria
and his group [4,
5] have advanced the management
of renal tumors with this treatment technique, as seen in the two studies
reported in this issue.
Morton's neuroma is a common and difficult-to-manage problem, which rarely
has come to the attention of diagnostic radiologists in the past. Hughes et
al. [6] describe a
sonographically guided alcohol injection treatment of this lesion, with very
promising results. What next?
As a practicing radiologist for the past 37 years, not counting my
residency, I cannot help but feel a sense of pride in my specialty as it grows
in scope and stature. I hope you share my enthusiasm.
References
- Kanal E, Barkovich AJ, Bell C, et al. ACR guidance document for
safe MR practices: 2007. AJR 2007;188
:1447
–1474[Free Full Text]
- Broome DR, Girguis MS, Baron PW, et al. Gadodiamide-associated
nephrogenic systemic fibrosis: why radiologists should be concerned.
AJR 2007; 188:586
–592[Abstract/Free Full Text]
- Kahn CE Jr, Thao C. GoldMiner: a radiology image search engine.
AJR 2007; 188:1475
–1478[Abstract/Free Full Text]
- Heilbrun ME, Zagoria RJ, Garvin AJ, et al. CT-guided biopsy for the
diagnosis of renal tumors before treatment with percutaneous ablation.
AJR 2007; 188:1500
–1505[Abstract/Free Full Text]
- Syvanthong C, Wile GE, Zagoria RJ. Effect of radiofrequency
ablation of renal tumors on renal function in patients with a solitary kidney.
AJR 2007; 188:1619
–1621[Abstract/Free Full Text]
- Hughes RJ, Ali K, Jones H, Kendall S, Connell DA. Treatment of
Morton's neuroma with alcohol injection under sonographic guidance: follow-up
of 101 cases. AJR 2007;188
:1535
–1539[Abstract/Free Full Text]
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