Advances in medical imaging for cancer diagnosis and treatment

Article Abstract:

It seems that medical imaging technology will continue to advance as long as there is more to be seen and more information to be extracted. Computed tomography (CT) uses X-rays to reconstruct the three-dimensional relationships of structures, and is a vast improvement over the shadow-casting of conventional radiographic plates. The fact that CT scanning uses X-rays means that radiologists can rely upon a vast storehouse of experience in the interpretation of what CT images actually reflect. This is not true of magnetic resonance imaging (MRI), which is already replacing CT for many applications. The resolution of MRI results in images far sharper than can be achieved with CT. The images reflect variations in the magnetic environment of hydrogen atoms in water, and thus the appearance of lesions on MRI is different from imaging systems based upon X-rays. Lesions may fail to appear on MRI, and lesions of disparate pathology may appear similar on MRI. Furthermore, the sum total of experience on the interpretation of MR images is, at present, still relatively small. The superior image quality, however, ensures that the experience will be sought and that MRI will find increasing use. Attempts have been made to use magnetic resonance for other atoms besides hydrogen. Unfortunately, only water is present in large enough amounts to render a good image in a reasonable time. Therefore, the magnetic resonance of atoms such as phosphorus serves only as a tool for spectroscopy. Nuclear magnetic resonance spectroscopy can observe the ratio of phosphates in different stages of cellular energy metabolism, and thus provide information on the chemical functioning of the brain. More precise data in the biochemical function of the brain can be provided by positron emission tomography (PET) and single photon emission tomography (SPECT), which use emissions from radioactive tracers to construct an image of where the tracers are concentrated in living tissue. Through the appropriate tracer, detailed information about the location of key biochemical processes may be obtained. These imaging technologies, used to complement one another, will yield information about cancer in its living, dynamic state, and complement the pathological analysis of processed tissue specimens. (Consumer Summary produced by Reliance Medical Information, Inc.)

Usage, History, Cancer, Diagnostic imaging, Medical imaging equipment, Radioactive tracers, SPECT imaging, Single photon emission computed tomography

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Changing cancer care in the 1990s and the cost

Article Abstract:

It is estimated that health care in the United States will cost $1.5 trillion annually by the year 2000. As of yet, there have been no successful efforts to contain the growing costs of medical care, and there are some who suggest that technological innovations are no longer appropriate in a climate of shrinking fiscal resources. However, it is both unethical and short-sighted to reject new technology a priori without considering the long-term consequences. The introduction of a new technology may be costly in the short run, but may indeed save considerable amounts of money over a longer time span. This is especially true for technology that leads to early detection or even prevention; monies spent on early detection and prevention may result in enormous savings by eliminating the need for more intensive treatment, which would have been otherwise necessary. The author discusses the fact that the American health care system is the most costly in the world, yet Americans are far from the best cared for, do not enjoy as long a life expectancy as people in most developed nations, and have a higher rate of infant mortality. Potential solutions to the health care crisis, such as the rationing of health care, are discussed. The most important aspect of dealing with the dilemma seems to be avoiding the tendency to shift blame for the situation to some particular group. The solution will only come when a set of rational priorities are established and the means to achieve these goals is objectively evaluated. (Consumer Summary produced by Reliance Medical Information, Inc.)

Economic aspects, Laws, regulations and rules, Medical care, Cost of, Health care costs, Medical technology, editorial

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