Key Radiology Research Milestones (1973-2013)
Indrajit
1970s
The development of real-time, gray-scale ultrasonography by numerous medical physicists and physicians.
1972
First CT scan performed in England (Godfrey Hounsfield, based on mathematical algorithms by Alan Cormack; Cormack and Hounsfield were awarded the 1979 Nobel Prize).
1973
Paul Lauterbur described in Nature how he generated images by nuclear magnetic resonance (NMR was first reported independently by Felix Bloch and Edward Purcell who shared the 1952 Nobel Prize for their discovery).
1975-1976
Early rigorous studies of cost-effectiveness of medical imaging using the diagnosis of renovascular hypertension as an example (Barbara McNeil, James Adelstein).
1976
David Kuhl describes computerized SPECT imaging, the basis for further development of nuclear imaging and ultimately PET imaging.
1979
Andreas Gruntzig describes a series of patients treated with his balloon catheter method for arterial dilatation (furthering Charles Dotter's work on angioplasty dating from 1964; Dotter also placed the first arterial stent in 1969).
1982-1983
James Hanley and Barbara McNeil publish their work using receiver operating characteristic (ROC) curves. ROC curve analysis has become the basis for evaluating the capacity of imaging technologies to detect abnormalities. Their articles in Radiology have become the all-time most cited for that journal.
Early 1980s
Work by Paul Lauterbur, Peter Mansfield, Raymond Damadian, and many others lead to clinical MRI. Lauterbur and Mansfield shared the 2005 Nobel Prize.
1987
Formation of the Radiology Diagnostic Oncology Group (RDOG), the first NCI-funded structure for conducting multi-center clinical trials of imaging (PI, Barbara McNeil). RDOG conducts five trials over the ensuing ten years.
1988
Elias Zerhouni and colleagues describe a method for MRI cardiac imaging
Late 1980s
Ferenc Jolesz et al describe early work on image-guided ultrasonic tissue ablation
1990
BOLD-contrast imaging — the primary functional MRI (fMRI) technique – was described by Ogawa, and applied by Belliveau the following year to visualize human visual cortical activation. As a relatively straightforward method for measuring brain activity with relatively high spatial resolution, it quickly became the imaging mainstay of cognitive neuroscience
1990
Bruce Hillman publishes in the New England Journal of Medicine how financial incentives increase imaging use by non-radiologists. This research, along with a study by Jean Mitchell, and a federal study of self-referral activity in Florida, forms the basis for the Stark Laws banning patient referrals to freestanding facilities in which they have an ownership interest.
1990
Willi Kalendar and colleagues publish in Radiology their work developing spiral CT; early applications include Geoffrey Rubin’s 1993 work with CT angiography of the abdomen published in Radiology
Early 1990s
The role of Diffusion-Weighted MRI in stroke was established by Denis Le Bihan, Michael Mosely, and others as a highly sensitive and specific method for the early detection and characterization of stroke.
Mid 1990s
Greg Sorensen and others describe the utility of diffusion-perfusion mismatch on MRI as an indicator of salvageable brain in the presence of acute stroke, for the first time providing a predictor for patients in whom thrombolysis therapy would be of benefit.
1997
NCI initiates the Diagnostic Imaging Program (DIP; later renamed the Cancer Imaging Program (CIP)), intended to enhance the role of imaging in cancer diagnosis. Daniel Sullivan is appointed its Director.
1999
CIP funds the American College of Radiology Imaging Network (ACRIN) and the Brown University statistics group to jointly conduct multi-center clinical trials of imaging technologies (PI, Bruce Hillman). The group conducts more than forty clinical trials, including large screening trials.
1999
Mori, van Zijl, and others describe the use of diffusion-tensor MR imaging to visualize the three-dimensional pathways of human brain fiber-tracts, for the first time allowing high-resolution non-invasive visualization of neuronal projections, increasing our understanding of neurocognitive networks.
2001
By act of Congress, the NIH adds a new institute, the National Institute of Biomedical Imaging and Bioengineering, to facilitate basic research and speed the progression of valuable imaging innovations into practice. Roderick Pettigrew is named its Director.
2004
David Brenner and others report concerns over the potential of increasing CT use to elevate the U.S. population’s risk of incurring cancer.
2005
ACRIN's Digital Mammographic Imaging Screening Trial (DMIST; PI, Etta Pisano) is published in the New England Journal of Medicine detailing the superiority of digital mammography over conventional screen-film mammography for certain groups of women. The trial results lead to additional payment for digital mammography and spur the virtually complete replacement of analog mammography systems with digital mammography.
2007
ACRIN’s MRI of the Contralateral Breast (PI, Constance Lehman) is published in NEJM.The trial shows that MRI can identify most contralateral cancers at initial breast cancer diagnosis and help avoid an additional second surgery or a second course of chemotherapy.
2008
The National Oncologic PET Registry (NOPR) publishes its initial data on the impact of PET on intended treatment for various cancers. Led by Bruce Hillner, Constantine Gatsonis, Barry Siegel, and Edward Coleman, the results convince the Centers for Medicare and Medicaid Services (CMS) to greatly expand insurance coverage for PET in cancer.
2008
ACRIN's National CT Colonography Trial (NCTCT; PI, Daniel Johnson) is published in the New England Journal of Medicine showing equivalence of CT colonography to colonoscopy. The data supports the current claim for insurance coverage for the procedure.
2011
ACRIN's National Lung Screening Trial (NLST; PI, Denise Aberle) is published in the New England Journal of Medicine. The trial shows a 20% reduction in lung cancer mortality in long term smokers attributable to annual CT screening and is the primary basis for the 2013 US Preventative Services Task Force (USPSTF) decision to mandate insurance coverage for the procedure.
2012
Having begun non-oncologic research in 2008, co-PIs, Harold Litt and Judd Hollander publish in NEJM ACRIN's first cardiovascular trial showing that coronary CT angiography can quickly determine which ED patients presenting with chest pain can safely be sent home. The results provide compelling data for broader insurance coverage of CCTA for ruling out ACS in the ED.
