Advances in imaging

Radiology is constantly evolving in its clinical application, playing a central role in numerous patient pathways in health care. Advances in sophisticated technologies have extended the scope of its application to every organ, offering not only essential services in diagnosis, monitoring treatment, and predicting outcomes but more recently therapy in the form of interventional radiology. The result of these developments is that the volume of activity is continuing to grow in all imaging techniques (often referred to as imaging modalities). The term “imaging” encompasses a number of diagnostic tests, some of which may be performed outside a radiology department. There is great variation among countries and by specialty in how these processes are undertaken and where. Imaging was originally founded on the plain X-ray. Despite the development of newer techniques towards the latter part of the 20th century, the plain X-ray still plays an important role in diagnosis (although its role is often to rule out pathology, rather than for primary diagnosis) and its uses continue to grow. However, the newer modalities of ultrasound, CT and MRI are increasing at a more rapid rate. Figure 9.1 shows the increased activity in England in the last 20 years. This demonstrates a 3.6% compound growth in the last five years. Major growth can be observed in the more complex cross-sectional imaging techniques, with compound annual growth rates (CAGR) in the last 10 years of 10% for CT and 12.3% for MRI (see Table 9.1). There is slightly less growth recorded in ultrasound at 5.3%, but this may be an underestimate as a significant amount of ultrasound is now performed outside imaging departments and would therefore not be recorded in these figures. Although these figures are specific for England, a similar picture is seen throughout Europe and internationally. This growth is significantly in excess of that expected by demographic drivers and is predominantly