William
R. Brody,
MD,
Academic A Fresh
T
PhD
Radiology Approach’
idea that research in imaging has not kept pace with that in oth-
HE
er fields
is a commonplace.
Far less apit. Certainly,
parent is what to do about the point of departure must be awareness of the reasons why research has been problematic in a field in which new
modalities
offer
myriad
possibili-
and
years
to increase the magnitude and of research performed. Their efforts have begun to pay off. Largely as a result of their work, mi-
on
quality
sources. It would be interesting tam additional data comparing gy and other clinical departments,
tiativ#{233}shave been undertaken national level to correct the
as internal
years,
fects
awards
of budget
cuts.
Against a backdrop it is easy for the particular concerns of diagnostic radiobogy to be subsumed; it is crucial they
cutbacks,
are not. Whereas medical imaging shares the general problems caused decreased funding, other problems perienced
by radiologists
port are unique these that must dressed. A paradox
seeking
funding
has
the
total
Cancer
these
is
re-
the conjoint to increase
The
ologists, gy
and
departmental
From
the
Radiology Hopkins
University
Wolfe
St. Baltimore,
ary
11, 1990;
print requests c
RSNA,
H.
Morgan
Radiological School
The
of Medicine,
MD 21205.
accepted January to the author.
of
15. Address
Janure-
1990
See also the article 247-251) in this issue.
by
Virapongse
et a! (pp
Diagnostic Raof a radiobo-
board
committee the allocation
at the NC!.
in their efforts of research
to diagnostic
undertaken invaluable, as suggested
imaging.
at the national are only part of earlier, the
N
partments. Not surprisingly, they found that the level of funded research correlates with the level of these resources, which include such key vanables as the amount of research space, the number of engineers on staff, the amount of time dedicated to research performed on imaging equipment, and
the availability of lectures to educate people in research methods. The predictabibity
of these
trasts
the somewhat
with
finding that undertaking
correlations
departmental research
con-
surprising had
interest in little effect
of research
medicine
departments precious
re-
to obradiobosuch
or surgery,
are resources
commitments
derpinnings
with
reluctant to to research.
are the un-
of successful
research,
pan-
ticulanly in an increasingly competitive funding environment. Enough has been written recently about the difficulties
to
low level of research resources that currently exists in academic radiology de-
Johns 600
Received
of which
amounted
problem itself is twofold, dictating a solution with corresponding scope. In this issue of Radiology, an article by Virapongse et a! (1) focuses on the
and radi-
Department
Science,
out
funded,
bevel
But these
$35.6
of these
devoted
Still, actions level, while the solution;
175:37-38
Russell
and
was
actual
diobogy commit
measures underhow important it is for the leadin academic radiology to support
dollars
research
1990;
success
ership
#{149} Radiolo-
management
radiologists,
Radiology
I
#{149}
3
of grant
imaging
Committee on and the addition
scores
research, howto question
Radiology
Editorials
seif-ex-
the past
amount
(NCI),
were
gist to the advisory
costs. Thus, the major barrier to imaging research has been neither lack of interest nor imagination, but the far more prosaic lack of funds. This fact has not gone unnoticed by leaders in the field of radiology, many of whom have gone to great lengths in recent
terms:
are
Over
The measures adopted to address these discrepancies include congressional approval to fund a laboratory for diagnostic imaging at the NIH, an initiative put forth through the efforts of the
when ever,
Index
dollar
Institute
grants
Conjoint diobogy,
has been has been
numbers
stark:
in diagnostic
mained relatively unchanged. But the areas of diagnostic radiology that have pushed the field to new limits are costly to explore. If the investment has been the means to a clinical end, the cost has been perceived as justified; the end the trend
the
even
$1.6 billion, while the budget for the entire National Institutes of Health (NIH) totaled approximately $7 billion.
sup-
that as the field has broadened in scope-even to the point of redefining its identity-research
imbalance,
planatory,
be $38.4 million in fiscal 1989. For fiscal 1989, the budget of the National
by ex-
radiology
the
the
respect to research productivity-defined as research funding per clinical faculty member-and research resources. Whatever the outcome of comparison data, the implication is that ra-
million in fiscal 1987, fell to $32.6 mulion in fiscal 1988, and was projected to
to their field, and it is be identified and ad-
of diagnostic
at the imbalance
of research funds awarded to diagnostic imaging as compared with other clinical specialties. As to the extent of
ties. The importance of identifying problem areas of imaging research is underscored by the fact that all medical specialties are now dealing with the efof universal
Research:
of getting
a grant;
what
was
once a relatively cess now invites
straightforward procomparison with The Perils of Pauline. Suffice it to summarize that the NIH is currently funding about
17%
of applications.
This
not
only means that the process is more competitive-a fact that everyone recognizes-but that the process itself has changed intrinsically, a fact that has been slower to gain acceptance. But the changes are as certain as they are thoroughgoing.
when
Gone
a single
NIH
individual
funding
are the
could
by him-
days
obtain
or herself.
Today
the unspoken rule is that an entire team of people is needed. Furthermore, the facilities and equipment required for diagnostic imaging studies are extremely costly. The net result is that institutions, even the very barge ones, must choose only a few well-defined areas in which to conduct research.
though love
at my institution to have
research
of the imaging other radiobogic
Al-
we would programs
modalities ideal?),
in each
(is there any we recognize
that such diversity we have decided
is not possible, and to restrict ourselves. Our rationale is that without focus, it is impossible to either build the critical mass or establish the resources needed
to make an institution competitive. Take positron emission tomography (PET) scanning, might be willing tron and clinical
petitive more:
and
PET research Physicists,
radiochemists
develop
full-scale
for example. A hospital to invest in a cycboscanners, but a com-
program
computer
requires scientists,
are all essential
innovative
PET research
PET
initiatives.
program
to A
easily 37
requires an initial investment of $4-$6 million for the PET and cyclotron facility, plus annual expenses of about $300,000-$500,000 per year, at least until sufficient research funds become available to offset operating costs, normably about 3 years. Any department
departments to imitate their successful counterparts. The requisite first step is to support the practice of converting some clinical income into a research development fund. This money can then be used to finance equipment as
that
Some
decides
ticipate
the
ment
and
to invest
magnitude be willing
The
commitment
both
in dollars
The hire
in
reality
must
of the to commit
must and
is that
clinical
PET
faculty,
investto it.
be measured
we can no longer give
them
a day
80%
time
substantial their
38
disposal.
#{149} Radiology
available
facilities,
for
and
It is time
of
that
research,
seed for
money
radiology
as
to
at
pay
funds
through
in people.
research time per week, and expect they can compete with others who have
well
an-
for
are
such
initial
already
programs
experiments.
available as
the
Radio-
logical Society of North America (RSNA), an extremely important of capital to allow young faculty tiate research. The RSNA should
source to inibe
seen
and
as a model,
to be
duplicated
expanded. In summary, the development of a research program hinges on the willingness of academic departments to invest in people and facilities. These in-
vestments are costly and not without risk. The tendency of radiologists has been to try to steer a course between the Scybla of costly, often one-time investments and the Charybdis of no investments at all. The course of avoidance has achieved little; the goal now must be to reorient ourselves to a middle course, the boundaries of which are determined by well-thought-out plans designed to bring us into the mainstream of scientific research. U Reference 1.
Virapongse neau
BS,
academic
C, Emerson Staab
EV.
radiology.
S. Li KCP, Research Radiology
Marti-
resources
in
1990;
175:247-251.
April
1990
R. Brody,
MD,
Academic A Fresh
T
PhD
Radiology Approach’
idea that research in imaging has not kept pace with that in oth-
HE
er fields
is a commonplace.
Far less apit. Certainly,
parent is what to do about the point of departure must be awareness of the reasons why research has been problematic in a field in which new
modalities
offer
myriad
possibili-
and
years
to increase the magnitude and of research performed. Their efforts have begun to pay off. Largely as a result of their work, mi-
on
quality
sources. It would be interesting tam additional data comparing gy and other clinical departments,
tiativ#{233}shave been undertaken national level to correct the
as internal
years,
fects
awards
of budget
cuts.
Against a backdrop it is easy for the particular concerns of diagnostic radiobogy to be subsumed; it is crucial they
cutbacks,
are not. Whereas medical imaging shares the general problems caused decreased funding, other problems perienced
by radiologists
port are unique these that must dressed. A paradox
seeking
funding
has
the
total
Cancer
these
is
re-
the conjoint to increase
The
ologists, gy
and
departmental
From
the
Radiology Hopkins
University
Wolfe
St. Baltimore,
ary
11, 1990;
print requests c
RSNA,
H.
Morgan
Radiological School
The
of Medicine,
MD 21205.
accepted January to the author.
of
15. Address
Janure-
1990
See also the article 247-251) in this issue.
by
Virapongse
et a! (pp
Diagnostic Raof a radiobo-
board
committee the allocation
at the NC!.
in their efforts of research
to diagnostic
undertaken invaluable, as suggested
imaging.
at the national are only part of earlier, the
N
partments. Not surprisingly, they found that the level of funded research correlates with the level of these resources, which include such key vanables as the amount of research space, the number of engineers on staff, the amount of time dedicated to research performed on imaging equipment, and
the availability of lectures to educate people in research methods. The predictabibity
of these
trasts
the somewhat
with
finding that undertaking
correlations
departmental research
con-
surprising had
interest in little effect
of research
medicine
departments precious
re-
to obradiobosuch
or surgery,
are resources
commitments
derpinnings
with
reluctant to to research.
are the un-
of successful
research,
pan-
ticulanly in an increasingly competitive funding environment. Enough has been written recently about the difficulties
to
low level of research resources that currently exists in academic radiology de-
Johns 600
Received
of which
amounted
problem itself is twofold, dictating a solution with corresponding scope. In this issue of Radiology, an article by Virapongse et a! (1) focuses on the
and radi-
Department
Science,
out
funded,
bevel
But these
$35.6
of these
devoted
Still, actions level, while the solution;
175:37-38
Russell
and
was
actual
diobogy commit
measures underhow important it is for the leadin academic radiology to support
dollars
research
1990;
success
ership
#{149} Radiolo-
management
radiologists,
Radiology
I
#{149}
3
of grant
imaging
Committee on and the addition
scores
research, howto question
Radiology
Editorials
seif-ex-
the past
amount
(NCI),
were
gist to the advisory
costs. Thus, the major barrier to imaging research has been neither lack of interest nor imagination, but the far more prosaic lack of funds. This fact has not gone unnoticed by leaders in the field of radiology, many of whom have gone to great lengths in recent
terms:
are
Over
The measures adopted to address these discrepancies include congressional approval to fund a laboratory for diagnostic imaging at the NIH, an initiative put forth through the efforts of the
when ever,
Index
dollar
Institute
grants
Conjoint diobogy,
has been has been
numbers
stark:
in diagnostic
mained relatively unchanged. But the areas of diagnostic radiology that have pushed the field to new limits are costly to explore. If the investment has been the means to a clinical end, the cost has been perceived as justified; the end the trend
the
even
$1.6 billion, while the budget for the entire National Institutes of Health (NIH) totaled approximately $7 billion.
sup-
that as the field has broadened in scope-even to the point of redefining its identity-research
imbalance,
planatory,
be $38.4 million in fiscal 1989. For fiscal 1989, the budget of the National
by ex-
radiology
the
the
respect to research productivity-defined as research funding per clinical faculty member-and research resources. Whatever the outcome of comparison data, the implication is that ra-
million in fiscal 1987, fell to $32.6 mulion in fiscal 1988, and was projected to
to their field, and it is be identified and ad-
of diagnostic
at the imbalance
of research funds awarded to diagnostic imaging as compared with other clinical specialties. As to the extent of
ties. The importance of identifying problem areas of imaging research is underscored by the fact that all medical specialties are now dealing with the efof universal
Research:
of getting
a grant;
what
was
once a relatively cess now invites
straightforward procomparison with The Perils of Pauline. Suffice it to summarize that the NIH is currently funding about
17%
of applications.
This
not
only means that the process is more competitive-a fact that everyone recognizes-but that the process itself has changed intrinsically, a fact that has been slower to gain acceptance. But the changes are as certain as they are thoroughgoing.
when
Gone
a single
NIH
individual
funding
are the
could
by him-
days
obtain
or herself.
Today
the unspoken rule is that an entire team of people is needed. Furthermore, the facilities and equipment required for diagnostic imaging studies are extremely costly. The net result is that institutions, even the very barge ones, must choose only a few well-defined areas in which to conduct research.
though love
at my institution to have
research
of the imaging other radiobogic
Al-
we would programs
modalities ideal?),
in each
(is there any we recognize
that such diversity we have decided
is not possible, and to restrict ourselves. Our rationale is that without focus, it is impossible to either build the critical mass or establish the resources needed
to make an institution competitive. Take positron emission tomography (PET) scanning, might be willing tron and clinical
petitive more:
and
PET research Physicists,
radiochemists
develop
full-scale
for example. A hospital to invest in a cycboscanners, but a com-
program
computer
requires scientists,
are all essential
innovative
PET research
PET
initiatives.
program
to A
easily 37
requires an initial investment of $4-$6 million for the PET and cyclotron facility, plus annual expenses of about $300,000-$500,000 per year, at least until sufficient research funds become available to offset operating costs, normably about 3 years. Any department
departments to imitate their successful counterparts. The requisite first step is to support the practice of converting some clinical income into a research development fund. This money can then be used to finance equipment as
that
Some
decides
ticipate
the
ment
and
to invest
magnitude be willing
The
commitment
both
in dollars
The hire
in
reality
must
of the to commit
must and
is that
clinical
PET
faculty,
investto it.
be measured
we can no longer give
them
a day
80%
time
substantial their
38
disposal.
#{149} Radiology
available
facilities,
for
and
It is time
of
that
research,
seed for
money
radiology
as
to
at
pay
funds
through
in people.
research time per week, and expect they can compete with others who have
well
an-
for
are
such
initial
already
programs
experiments.
available as
the
Radio-
logical Society of North America (RSNA), an extremely important of capital to allow young faculty tiate research. The RSNA should
source to inibe
seen
and
as a model,
to be
duplicated
expanded. In summary, the development of a research program hinges on the willingness of academic departments to invest in people and facilities. These in-
vestments are costly and not without risk. The tendency of radiologists has been to try to steer a course between the Scybla of costly, often one-time investments and the Charybdis of no investments at all. The course of avoidance has achieved little; the goal now must be to reorient ourselves to a middle course, the boundaries of which are determined by well-thought-out plans designed to bring us into the mainstream of scientific research. U Reference 1.
Virapongse neau
BS,
academic
C, Emerson Staab
EV.
radiology.
S. Li KCP, Research Radiology
Marti-
resources
in
1990;
175:247-251.
April
1990
