X-ray Day and the Evolution of Diagnostic Imaging

John Cronan, MD

Few know today is X-ray Day. On November 8, 1895, a man named Wilhelm Roentgen invented what became known as X-rays.

Fast forward to today, and X-rays, as well as all forms of diagnostic imaging, are at the core of medicine. The specialty has changed dramatically in the past 25 years. It has clearly revolutionized patient care to the extent that many refer to the CT scanner as “truth.”  CT, or computerized tomography, was invented in 1971 by Godfrey Hounsfield, who won the Nobel Prize in 1979. It is now used to evaluate trauma patients, assess patients with acute and chronic complaints, and diagnose and then monitor cancer during treatment. 

While the physical exam has not changed much in 300 years, imaging has changed dramatically in just a quarter century. In fact, it can be said that diagnostic imaging has revolutionized medicine. The concept of a radiologist sitting in a dark room reading “films” should have disappeared in the 80s. Yet, it is amazing how many people still think this is the life of a radiologist. 

Today, this is reality:

  • The radiologist is often the first physician meeting the stroke patient who is transferred from another hospital. 
  • The neurointerventional radiologist takes the patient to the “angio” (angioplasty) room and quickly threads a catheter into the brain, removing the clot that is causing the stroke, and allowing the patient to leave the hospital in a few days.
  • The mammographer, another radiology specialist, is comforting the woman and taking her through the process of diagnosing a mass in her breast.  Using ultrasound, MRI, mammography and biopsy, the radiologist can determine if a mass in the breast is cancerous and the extent and stage of the cancer. 
  • Radiologists who specialize in a procedure known as ablation treatment can place specialized needles through the skin into tumors and burn or freeze the cancer cells. 
  • A radiologist can use ultrasound guidance to place a tube into the diseased gallbladder of an elderly patient too sick to go through surgery to control a condition.  This type of interventional radiology is often surgery without the need for an operating room.
  • Cancer patients undergo chemotherapy, immunotherapy or radiation to treat their tumors.  The progress and success of these treatments is gauged by nuclear medicine and the positron emission tomography (PET) scan. PET scans offer a look into the field of “functional imaging” – looking at metabolic activity rather than the size of the cancer to see if the tumor is alive or dead. Small lymph nodes, which appear normal to the eye under other imaging may actually contain disease. The PET scan can more accurately determine this, and even determine if leftover masses after chemotherapy require more treatment, or if a tumor has been completely sterilized.

Thanks to diagnostic imaging, we are now even capable of seeing images of the body in 3-D.  When disease is found, imaging allows us to more safely place a needle for a biopsy or place a catheter.  Because imaging is integrated into nearly every component of medicine, we have extensive sub-specialization within the department of diagnostic imaging at Lifespan. 

The department has 13 different sections, including pediatric radiologists who focus on children, and neuroradiologists who work on the brain and the spine. Our specialists can also interpret images for other physicians’ patients even when we are not on site, through our Picture Archiving Communication System (PACS). 

In 1895, Roentgen discovered the X-ray. It was the beginning of diagnostic imaging. Today, hardly any diagnosis is made without imaging.  X-Ray Day, more aptly called Imaging Day, is a short moment to appreciate the magnitude of this great specialty.

Visit our website for more information on Lifespan Medical Imaging.

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