The Evolution of Radiology in Cancer Diagnosis and Management

The incidence of cancer detection world‐wide continues to rise. Diagnostic imaging is central to the diagnosis, management, and follow‐up of cancer patients. Currently, between 40% and 60% of curative surgical management began with an imaging procedure. General advances in radiology were the first images of lesions by plane film screen systems. Some of the first successful images were with the contrast medium barium, which was used for radiography of the GI tract. Chest radiography of the lung using planar systems developed in the 1940s and the accidental discovery of computed property of digital radiography eased the analogue to digital transition in mammography, which was the first radiological specialization. Since the first demonstration of mammography at a scientific meeting in 1960, the combination of film/screen film has had a major impact on the detection of early breast cancer. This is probably the most widely known example of radiology leading a successful public health campaign and demonstrators reductions in mortality of early diagnosis. Unfortunately, the limitations of mammography are also now well recognized as understanding of the biological behaviour of cancer improves. Expansion in the availability and quality of CT systems in the 1980s led to a dramatic increase in CT usage so that it is second only to conventional radiography as a diagnostic imaging tool. PET imaging of 18F-deoxyglucose began in the 1970s, with clinical application following developments in the late 1980s, resulting in a resurgence in nuclear medicine. Large field of view gamma cameras, attenuation correction software, and PET-TC integration have all contributed to its success in the assessment of a range of malignancies. Even more recent developments, such as MR mammography or MR lymphangiography, may be more applicable in selected cases than the routine clinical use. MRI is well-appreciated in the detection of brain tumours, but studies elsewhere in the body have lagged behind. Ultrasound has a number of potential clinical applications, although most work has been vascular or specific to fetal anatomy. Advances in all modalities can lead to a change in cost benefit implications. For example, faster imaging techniques could see an eventual change in.