In a few years we are likely to see 3D images generated instantly, and with comparable resolution to today's 2D views. Inclusion of functional information, possibly at the molecular level, could also assist in clinical decision-making. Some specialist clinicians with intimate knowledge of their field of interest are likely to have a better understanding of the pathology and physiology of an organ system than a general radiologist. So given that the images will be presented in a more familiar format, why should clinicians and surgeons wait for a general radiologist to read them? If radiologists wish to retain their role as the experts in image interpretation, they will not only need a thorough understanding of imaging and radiological anatomy, but also a detailed understanding of pathology and physiology. It is clearly unrealistic to expect most people to gain that knowledge across a range of fields, hence the need for subspecialization. There are already commercial moves to harness the expertise of superspecialist radiologists, using teleradiology, to provide expert opinions in particularly difficult cases. This is just the beginning of a major shift in the pattern of practice in radiology. The radiology community cannot ignore impending technological developments. If radiologists take no interest in the emergence of highly detailed, user-friendly images, then the clinicians and surgeons will organise their own department-based image interpretation. However, radiologists are very good at adapting to technological change and are very likely to rise to these challenges. Far from having a sell-by date, radiology has a bright future.
Radiology ; standards ; trends ; Time Factors

Digital Image Communication in Medicine (DICOM) defines a standard method to store and transmit digital medical image information, in which there is a piece of implemented protocol named DICOM-RT that specially addresses both the transmission of radiation therapy image data and the ancillary data. In this paper, we firstly introduce the DICOM-RT with the emphases on its components, relationship with radiotherapy and how to produce the DICOM-RT object that refer to some certain radiotherapy information. Then we expatiate on the impact that benefits from applying DICOM-RT to radiotherapy, with an aid to accelerate its application in China.
Automatic Data Processing ; Computer Communication Networks ; Humans ; Radiology Information Systems ; standards ; Radiotherapy ; standards ; trends ; Radiotherapy, Computer-Assisted ; methods ; Tomography, X-Ray Computed

Tumor response may be assessed readily by the use of Response Evaluation Criteria in Solid Tumor version 1.1. However, the criteria mainly depend on tumor size changes. These criteria do not reflect other morphologic (tumor necrosis, hemorrhage, and cavitation), functional, or metabolic changes that may occur with targeted chemotherapy or even with conventional chemotherapy. The state-of-the-art multidetector CT is still playing an important role, by showing high-quality, high-resolution images that are appropriate enough to measure tumor size and its changes. Additional imaging biomarker devices such as dual energy CT, positron emission tomography, MRI including diffusion-weighted MRI shall be more frequently used for tumor response evaluation, because they provide detailed anatomic, and functional or metabolic change information during tumor treatment, particularly during targeted chemotherapy. This review elucidates morphologic and functional or metabolic approaches, and new concepts in the evaluation of tumor response in the era of personalized medicine (targeted chemotherapy).
Antineoplastic Agents/*therapeutic use ; *Diagnostic Imaging/standards/trends ; Forecasting ; Humans ; Individualized Medicine ; Neoplasms/*drug therapy/*pathology ; *Outcome Assessment (Health Care) ; Practice Guidelines as Topic ; Radiology/standards/trends ; World Health Organization