From Bertha Roentgen's hand to current medical imaging: one century of radiological progress

From 1896 to 1996 radiology progressed at an amazing and unforeseen pace. The analysis of a few examples shows that these developments were due to a few groups and were enhanced by a close interaction between radiologists, physicists, engineers and manufacturers. Radiologists emphasize needs and are often able to suggest avenues for research; engineers exploit the basic discoveries of physicists and find new technologies. Manufacturers proceed from prototypes to instruments that can be built on an industrial scale at an affordable price. This system works efficiently only in a few developed countries. The gap between developing and developed countries is not narrowing and a large proportion of the world population has no access to adequate medical imaging. Very sophisticated imaging technologies used in industrialized countries are costly in terms of both money and human resources and in developing countries may usurp the limited assets that are needed for public health. Thus, the current challenge facing radiology is to take advantage of technological progress, firstly for building affordable and easy to maintain equipment giving images of sufficient quality, and secondly, through progress in telecommunications and computers, to improve medical education, telemedicine and build hospital networks. These networks will enable easier access to consultations with specialized radiologists and will give physicians the means of sharing their medical expertise. The aim is not only to narrow the gap but to provide a sufficient level of care in imaging medicine and radiotherapy throughout the world. This will only be achieved through a clear strategy and adequate human, technical and financial resources. The role of the radiological community, in particular ISR, RSNA and EAR, shall be crucial in this endeavour.