RSNA 2014: 5 takeaways

 - Cheryl Proval
Cheryl Proval, Editor

Here is the undeniable truth: RSNA is a marathon, a long-distance race that requires strategy, stamina and will. From the session rooms to the exhibit floor to the many fine restaurants in the magnificent city of Chicago, there is no better place to go hunting and gathering for domain-specific knowledge in radiology.

Here are a few takeaways from the meeting:

Partnerships are de rigueur. This was a key takeaway from last year’s meeting, but it bears repeating: Partnerships are an increasingly important strategy in a healthcare environment that demands better outcomes for fewer dollars. Your ability to forge those partnerships with a wide variety of partners will not only enable your practice to remain competitive in the evolving healthcare landscape, it also will help build a rising tide that will raise all boats. RSNA President N. Reed Dunnick, MD, quoted RSNA Past President Eugene P. Pendergrass, MD, when he urged radiologists to partner with industry to accelerate the specialty’s move into the era of personalized medicine.

It was ultrasound’s year. From Jonathan M. Rubin, MD, PhD’s plenary session on The Future of Ultrasound to evidence of the modality’s rapid advances on the exhibit hall floor, ultrasound took center stage. Rubin focused on volume blood flow and elasticity imaging to demonstrate how the increasingly sophisticated modality is being used to answer questions in less invasive ways. How long will it be before shear wave elastography makes liver biopsy obsolete? Investigational just a few years ago, shear wave elastography was a standard application on Toshiba’s top-of-the-line ultrasound systems this year. Rubin also described ultrasound’s ability to visualize reverse flow in a blood vessel—the jet effect of stenosis. How many catheter placements will be averted in the future?

Radiology has graduated from data digitization to information processing. Congratulations, medical imaging has successfully completed the transition from an analog to a digital specialty. Now what? Just last week, I noted that after ten years in development (still ongoing), RadLex found its first major use case in the ACR’s Dose Index Registry, but that was before I read my colleague Dave Pearson’s article on the RSNA report templates. An initiative is underway to backload RadLex terminology into each template, making the reports that result eminently more mineable.

Yes, there are important economic and operational implications for RadLex, but when these reports bearing common terms are viewed in the context of emerging big data sources—such as The Cancer Genome Atlas that NIH director Francis Collins said is producing 20 TB of information each month—it is clear that the effort spent on standardization is bringing the entire specialty tantalizingly near to the Holy Grail—measuring outcomes.

Big iron mash-ups. Several new hybrid modalities worth mentioning appeared this year on the exhibit floor. GE Healthcare showed the 510K-cleared SIGNA MR/PET scanner, which merges PET and 3T MR and is described as the first time-of-flight-capable PET/MR. Toshiba introduced a hybrid angio-CT system called Infinix 4D CT Prime that pairs its Infinix vascular imaging system with the company’s 320-slice Aquilion CT scanner—upgradable to 640—on rails, for a 50% to 75% reduction in some procedure times, according to a company representative.

These are not one-size-fits all modalities, but if our healthcare delivery system evolves to include the focused factories once predicted by Regina Herzlinger, PhD, a modality configuration that can save an interventional radiologist or a trauma surgeon valuable time could find a receptive market.

Most peaceful exhibit floor oasis. Restroom breaks are hurried and daytime meals are taken mainly on the run, so when a reporter is taken to a quiet place in the mini-city that is the RSNA exhibits, it feels a lot like an oasis. Best oasis of 2014? It was Barco’s cave-like reading room, in which its new Uniti 12MP 33-in display emitted a soft ambient light. When radiologists put heads on pillows on Christmas Eve, it will not be sugar plums they dream about but this new tricked-out, one-size-holds-all grayscale and color diagnostic imaging monitor.

No other meeting can come close to the quantity and variety of information sources offered by the RSNA, and it will take us months to download all that we found for our readers. 

Stay tuned!

Cheryl Proval