A Generation of Change in Medical Imaging

When I started medical school in 1977, most U.S. hospitals didn't have their own CT scanner. I started off planning to become a surgeon and vividly remember one of the most common procedures in which I participated, an exploratory laparotomy. We zipped the patient open from xiphoid to pubic symphysis to "take a look." A few years later in my radiology residency, I learned to do a pneumoencephalogram. After doing a lumbar puncture with a 20-gauge needle, I asked my attending, John Benson (a name you know if you've ever used a Benson guidewire), how much cerebrospinal fluid to drain. His answer: "All of it." Gulp.

By the time I finished my radiology training nine years later, digital cross-sectional imaging was a thing. Modern ultrasound, computed radiography, computed tomography, magnetic resonance imaging, and positron emission tomography had all made their way into clinical practice. By that time, pioneers like my mentor, Grant Heishima, were floating detachable balloons into intracranial aneurysms, and we had the first steerable catheters and hydrophilic guidewires. Game on for modern interventional radiologists.

Suddenly, we could see inside people in many new ways and often treat them with imaging guidance. We take these innovations for granted today, but it was a revolution that changed healthcare and the world for the better. Believe me, there was resistance every step along the way. Each innovation threatened and ultimately destroyed a previously well-established practice. As we approach the U.S. Thanksgiving Holiday, one must feel grateful to the pioneers that made modern medical imaging happen. It was hard work, and they all paid a price. They gave those of us in the field great careers and benefited billions of patients.