History Of Radiology

A Brief History of Radiology
Radiography and Fluoroscopy
Figure Legend: R and F Room completed during the Good Samaritan Hospital Radiology Department renovation 2006.
Wilhelm Roentgen discovered x-rays on 8 November1895 at the Physical Institute of Würzburg University in Germany. Only a month after Roentgen invented the first x-ray machine and showed the world an x-ray of his wife’s hand, doctors in Europe and North America obtained x-ray machines of their own and began making x-ray images to look for “bullets, bones, and kidney stones.” Those that did it were self-taught. Over the ensuing decades, afew young doctors decided to concentrate on interpreting x-rays and fluoroscopic images.
The use of x-rays to assist in the diagnosis of fractures, tuberculosis, kidney stones, and fetal positioning was tremendously important, and utilization skyrocketted. Soon there were not enough x-ray specialists tocomplete the rapidly growing number of x-ray examinations requested.This rapid growth in medical x-rayutilizationcoincided withthe creation of medical specialties in America. The American Board of Radiology was established in 1934 by a group of academic radiologists who felt that self-taught x-ray uses had grownsufficiently to become an independentmedical specialty. They felt that a specialty board in radiology should be formed tohelp set standards for the training of x-ray doctors, set standards for x-ray uses in the hospital departments, and help set standardsfor radiation units and measurements. Their concepts were comparable to other newly created self-defining medical specialty groups including ophthalmologists, obstetricians, surgeons, and urologists.
Before 1960, most radiologists worked in hospitals under contract with the hospitalsin which the hospitals set the terms, fixed the prices, billed and collected the fees, and paid the radiologists according to their contract agreements. With the enactment of Medicare in 1965, a legislative definition of radiology as an independent medical specialty was first established. Thereby, radiologists began being paid for their services directly by Medicare and other private insurance companies in the same manner asall other doctors were. Medicare would separately reimburse the hospital for the technical fee and reimburse the radiologist for the professional fee. As a result, in the late 1960′s, many radiologists at private hospitalssuccessfully negotiated with the hospital administrationand were able to form highly efficient and effectiveprivate practice radiology groupswhich began billing Medicare and insurance companies directly for their services.
With these agreements, radiology groups continued to contract with hospitals to help manage, and to provide radiology services for,the radiology departments, butprivate practice radiologistsbecame largely financially independent from the hospitals. Many of these private practice radiology groups were also able to accept supplemental work from outside the hospital from private doctors offices, private multispecialty groups, private subspecialty physician and surgeon groups, government agencies and clinics, and even other hospitals. Radiologists in academic centers and in newly forming large multispecialty groups mostly remained under contract with the hospital or clinic, allowed the institution to bill globally, and accepted an annual salary and termsthat they negotiated individually.
Figure Legend: Mrs. Vance, Good Samaritan Hospital Radiology Department Nurse instructing students 1965
Figure Legend: Elaine Banzhaf and Patricia Schlosser (behind glass) circa 1965.
Figure Legend: Sister Mary Alice,Good Sam Radiology Department Manager in the 1950′s and 60′s.
Figure Legend: Patricia Schlosser and Earl Carrico, Good Sam Radiology Technologists circa 1965.
Figure Legend: Good Samaritan Hospital Radiology Technology Graduating Class. Kathy Doherty-Fries top left and Denise Vocke (current Radiology Department Manager) bottom left.
Figure Legend: R and FRoom completed during the Good Samaritan Hospital Radiology Department renovation 2006.

Ultrasound
Ultrasonic energy was first applied to the human body for medical purposes by Dr. George Ludwig at the Naval Medical Research Institute, Bethesda, Maryland in the late 1940s. In 1962, after about two years of work, Joseph Holmes, William Wright, and Ralph Meyerdirk developed the first compound contact B-mode scanner. Their work had been supported by U.S. Public Health Services and the University of Colorado . Wright and Meyerdirk left the University to form Physionic Engineering Inc., which launched the first commercial hand-held articulated arm compound contact B-mode scanner in 1963. This was the start of the most popular design in the history of ultrasound scanners. The first demonstration of color Doppler was by Geoff Stevenson, who was involved in the early developments and medical use of Doppler shifted ultrasonic energy. [20]
Computed Tomography
Figure Legend: 64-slice CT scanner installed in the Good Samaritan Hospital Radiology Department during the 2006 department renovation.
The first commercially viable CT scanner was invented by Sir Godfrey Hounsfield at EMI Central Research Labs, Great Britain in 1972. EMI owned the distribution rights to The Beatles music, and it was their profits which funded the research. Sir Hounsfield and Alan McLeod McCormick shared the Nobel Prize for Medicine in 1979 for the invention of CT scanning. The first CT scanner in North America was installed at the Mayo Clinic in Rochester, MN in 1972.

MRI
Figure Legend: 1.5 TeslaMRI machine in the Good Samaritan Hospital Radiology Department 2006.
Magnetic Resonance Imaging is a relatively new technology. The first MR image was published in 1973and the first cross-sectional image of a living mouse was published in January 1974. The first studies performed on humans were published in 1977.
Nuclear Medicine
Figure Legend: Nuclear Medicine gamma SPECT scanner installed in the Good Samaritan Hospital Radiology Department during the 2006renovation.
The history of Nuclear Medicine is rich with contributions from gifted scientists across different disciplines in physics, chemistry, engineering, and medicine. The multidisciplinary nature of Nuclear Medicine makes it difficult for medical historians to determine the birthdate of Nuclear Medicine. This can probably be best placed between the discovery of artificial radioactivity in 1934 and the production of radionuclides by Oak Ridge National Laboratory for medicine related use, in 1946.Many historians consider the discovery of artificially produced radioisotopes by Frederic Joliot-Curie and Irene Joliot-Curie in 1934 as the most significant milestone in Nuclear Medicine.
Nuclear Medicine gained public recognition as a potential specialty on December 7, 1946 when an article was published in the Journal of the American Medical Association by Sam Seidlin. The article described a successful treatment of a patient with thyroid cancer metastases using radioiodine (I-131).
Widespread clinical use of Nuclear Medicine began in the early 1950s, as knowledge expanded about radionuclides, detection of radioactivity, and using certain radionuclides to trace biochemical processes. Pioneering works by Benedict Cassen in developing the first rectilinear scanner and Hal O. Anger’s scintillation camera (Anger camera) broadened the young discipline of Nuclear Medicine into a full-fledged medical imaging specialty.
In these years of Nuclear Medicine, the growth was phenomenal. The Society of Nuclear Medicine was formed in 1954 in the United States. The development of generator system to produce Technetium-99m in the 1960s became a practical method for medical use. Today, Technetium-99m is the most utilized element in Nuclear Medicine and is employed in a wide variety of Nuclear Medicine imaging studies.
By the 1970s most organs of the body could be visualized using Nuclear Medicine procedures. In 1971, American Medical Association officially recognized nuclear medicine as a medical specialty. [1] In 1972, the American Board of Nuclear Medicine was established, cementing Nuclear Medicine as a medical specialty.
In the 1980s, radiopharmaceuticals were designed for use in diagnosis of heart disease. The development of single photon emission tomography, around the same time, led to three-dimensional reconstruction of the heart and establishment of the field of Nuclear Cardiology.
More recent developments in Nuclear Medicine include the invention of the first positron emission tomography scanner (PET). The concept of emission and transmission tomography was introduced by David Kuhl and Roy Edwards in the late 1950s. Their work led to the design and construction of several tomographic instruments at the University of Pennsylvania. Tomographic imaging techniques were further developed at the Washington University School of Medicine. These innovations led to fusion imaging with SPECT and CT by Bruce Hasegawa from University of California San Francisco (UCSF), and the first PET/CT prototype by D. W. Townsend from University of Pittsburgh in 1998.
PET and PET/CT imaging experienced slower growth in its early years owing to the cost of the modality and the requirement for an on-site or nearby cyclotron. However, an administrative decision to approve medical reimbursement of limited PET and PET/CT applications in oncology has lead to phenomenal growth and widespread acceptance over the last few years. PET/CT imaging is now an integral part of oncology for diagnosis, staging and treatment monitoring.

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