An Introduction to Diagnostic Radiology from the Chief Censor in Radiology

The discovery of x-rays in 1895 by Wilhelm Roentgen heralded the arrival of a totally new method of medical diagnosis. The past century has witnessed an explosion in the increasingly sophisticated utilisation of x-rays and other energy sources such as radioisotopes (nuclear medicine), ultrasound and magnetic resonance imaging to enable us to provide a very accurate display of human anatomy, pathology and physiology. Modern diagnostic imaging methods clearly define a huge variety of disease processes, and also allow evaluation of the effects of treatment. The newer imaging modalities also enable the diagnostic radiologist to undertake sophisticated interventional and therapeutic procedures.

Radiology is now central to the clinical practice of medicine across a wide range of disciplines. It is the best practical way to diagnose, monitor treatment and detect progression or relapse of many important and common diseases in a minimally invasive and anatomically precise manner. As a consequence of the increasing sophistication and accuracy of clinical imaging, the utilisation and importance of radiology has increased dramatically and consistently over the last 20 years. There is a greater and greater need for more radiologists of increasingly better quality and skills, and this shows no sign of abating. It is also a highly portable profession, specific national and state regulations notwithstanding.
The aim of the College is to produce highly competent clinical radiologists with a wide range of expert diagnostic and interventional skills, as well as medical professionals who are able to participate in management, collaborative research, team-based medical care, and keep up with the new developments in imaging for the benefit of patients in Australia and New Zealand. The RANZCR has long had an unenviable reputation worldwide for producing excellent radiologists. However, the current approach is being revamped, and new trainees from 2010 onwards will be trained and assessed under a modernised curriculum that has been under development since 2006, in partnership with the Australian Medical Council. We anticipate this will result in better training, supervision, learning opportunities, research training and assessment than the current program allows. Full details will be released later in 2009.

As mentioned earlier, diagnostic radiology is a speciality that is primarily used in the diagnosis of disease processes. However, in the last 20 years, accurate anatomical depiction of disease processes has enabled radiologists to develop the subspeciality of Vascular and Interventional Radiology. The utilisation of these techniques is already well established, and continues to expand with new methods of minimally invasively treating medical diseases and inserting medical devices. Such conditions include but are not limited to treating vascular pathology such as vascular occlusions, stenoses, malformations and aneurysms; unresectable tumours using transarterial or percutaneous approaches; injection of various substances for management of fractures, tumours, and painful conditions; stoppage of uncontrollable bleeding; drainage of deeply placed infected or neoplastic collections; and placement of intravascular or intracavitary catheters for therapy or repeated drainage. Newer technologies on the horizon promise even more roles for interventional radiologists in the future.
More research into clinical utility, outcomes and the impact of radiology is being actively sought by all governments, and the value of imaging education and research has been elevated in most Universities. There is thus a rapidly growing potential for academic development in Medical Imaging across Australia. Fulfilling careers in private and public practice, management and academia are all possible in Radiology. The RANZCR recognises that research has an important role to play in advancing the science of radiology. In 1982 the RANZCR established a Research Fund to help encourage research by trainees and Fellows of the College.

Prof. Shih-chang Wang
Chief Censor in Radiology
The Royal Australian and New Zealand College of Radiologists