The 1987 Gordon Richards memorial lecture: the future of radiography--cassetteless or filmless?

A six-year experience of the first cassetteless radiology department has shown that it produces considerable improvement in speed and efficiency of patient handling, reduced physical labor for the technician, and substantial financial savings, amounting to approximately one third of the total non-medical budget. This is contrasted with the potential cost of a totally digital (filmless) department. The digital acquisition devices and their image processing systems are considerably more expensive. Image display comparable to conventional radiographys (for example the full-sized chest film) is markedly inferior in resolution and totally prohibitive in cost. Image storage and recall of the same amount of data as currently handled by the conventional department are presently beyond the capabilities of any commercial communications system, and the potential cost is completely unacceptable. Projections of the imminent advent of the filmless department are grossly over-optimistic, whereas the development of cassetteless systems offers an alternative route to improved patient handling and increased cost-efficiency.     

Preston M. Hickey memorial lecture. Ionic and nonionic iodinated contrast media: evolution and strategies for use

The search for better radiopaque iodinated contrast material for intravascular use is continuing, but the recent development of new lower osmolality contrast media (LOCM), both ionic and nonionic, has dramatically affected the practice of radiology. The major issue retarding the introduction of LOCM into clinical practice in this country has been the increased cost of the media. Numerous preliminary assumptions and probabilities about the tolerance, efficacy, and overall safety of LOCM have been documented in scientific studies. The lower osmolality, reduced chemotoxicity, and high hydrophilicity of new compounds, particularly the nonionic variety compared with conventional high osmolality ionic agents (HOCM), offer a significant margin of safety to patients with known risk factors. Mounting data suggest that low or no risk patients are benefited as well, perhaps to an even greater degree. Costly trade-offs to the universal use of LOCM exist, therefore careful consideration of the advantages and disadvantages of LOCM for intravascular administration is required. This article, presented as the Preston M. Hickey Memorial Lecture to the Michigan Radiological Society in March of 1990, explores the historical development of iodinated intravascular contrast media, especially LOCM, and cites existing data that form the basis for various strategies for their use, that is, selective, universal, or nonvascular use. Better, safer, and less expensive contrast media are a realistic expectation in this new decade of technological promise. Reducing adverse side effects from the use of any new drug or technology must be our continued, collective goal.     

Malcolm Hanson memorial lecture. MR of the heart: anatomy, physiology, and metabolism

During the initial years, the use of MR imaging focused on the display of normal and abnormal cardiac anatomy. ECG-gated spin-echo imaging provides high-quality static images that clearly depict cardiac anatomy and a variety of anatomic abnormalities. However, it is now becoming clear that, with the addition of recent innovations, MR also is capable of evaluating cardiovascular physiology. With the use of fast imaging techniques, we can acquire images with essentially high temporal resolution so that cardiac function can be quantitated. Moreover, the use of proton and 31P MR spectroscopy provides additional information, which should enable the sequential monitoring of both cardiac function and metabolism.