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Diagnostic imaging: developing new roles.

It is 1992 and the medical imagologist Dr. Kay Jones, is sitting in front of a high resolution CRT monitor in the diagnostic imaging department of a large metropolitan hospital, her monitor one of a bank of 12 that circle the laboratory. In the centre are three computer terminals and a technician-operator who has just received the written system-order Dr. Jones must supply in accordance with requirements safeguarding the confidentiality of medical records. A green "operative" light appears on the console of Dr. Jones' monitor. She presses a combination of keys and the monitor is filled with data about the patient under study, a 29-year-old female with suspected breast cancer. A complete record of previous examinations is presented by date, image-type, anatomical subject and reference number. The most recent entries include digital radiographs and an ultrasound study related to a pregnancy 3 years earlier. The patient's radiation exposure is shown for each of the radiologic examinations and cumulative exposure totals for each of the past 5 years are presented as part of the summary of tests. Using the appropriate reference numbers, Dr. Jones brings each of the radiologic images to the screen in turn. Manipulation of the console controls enlists computer assistance to remove the ribs from the image being viewed, permitting a closer look at a portion of lung. A further adjustment changes the image contrast to her satisfaction, for better analysis of the image. As she studies the screen, Dr. Jones wonders if a three-dimension-