Clinical Possibilities with Recent Technology

The recent technology explosion in diagnostic imaging has been partly driven by clinical requirements as well as competition between manufacturers and modalities. In order to justify the high cost of new technologies, it is necessary to show that they are of real benefit to patients. While this is easy to determine in regard to safety and comfort, the effect on outcome and quality of life is difficult to quantify. These later criteria are influenced by many factors including the need to obtain pathological proof, bias in case selection and imperfections in the existing gold standard. Examples are given of the clinical application of new techniques, some of which illustrate unequivocal and quantifiable benefits while others are more difficult to justify on the available evidence.