A battle is taking shape in computed tomography (CT), one that pits the tubes that deliver X-rays against the detectors that record them. It is a fight over how to use X-rays of different energies — variations on the decades-old concept of selective energy CT (SECT), which promise to make diagnoses more accurate and patient management more effective. 

In a rare showing of bipartisan support, on April 14, 2015, Congress repealed the sustainable growth rate (SGR) and approved a new framework to allow Medicare to transition from its current fee-for-service payment system to a value-based reimbursement system. The legislation (H.R. 2) eliminates the threat of annual cuts in Medicare payments to providers that were required under the SGR, which was approved more than a decade ago to control skyrocketing Medicare costs.

As the saying goes, sometimes less is more — a maxim that is proving true in the world of medical imaging as remote viewing systems continue to advance. While some manufacturers are still utilizing software-based systems for reading and sharing imaging data, many are embracing browser-based models, otherwise known as zero-footprint viewers.

Proton therapy has been on the rise in recent years, both in the United States and abroad, with more and more proton centers opening their doors to cancer patients around the globe. It provides an attractive alternative to conventional radiation therapy, as the directed beam more intensely attacks cancerous tissue while sparing surrounding healthy tissue and organs. In addition, radiation oncologists can control the depth to which the proton beam penetrates, and the beam will not travel any further, unlike traditional X-ray-based radiation therapy.

It’s the invisible elephant in radiology — radiation exposure. As physicians, we know all too well that exposure to radiation should be limited to the least amount possible. We have all learned about the ALARA principle for keeping exposure low. We also take precautions on our patients’ behalf and educate them. But what about us? The physicians and technical staff who treat patients every day cannot avoid radiation exposure entirely. However, there is growing evidence that not only is radiation exposure detrimental to our health, but also many long-term cumulative effects are still unknown.