Adnkronos Rome, November 8 (Adnkronos Salute) – Today, radiology turns 130: from November 8, 1895 – when physics professor Wilhelm Conrad Röntgen discovered, through experiments, the existence of X-rays (which he called X precisely because they were unknown) and subsequently performed the first X-ray of his wife's hand – to today, with radiology representing one of the most important medical specialties, integral to the diagnostic and therapeutic processes of most pathologies, the evolution of the discipline has been long and rich in innovations.
"Since then, we've moved from images exposed on X-ray films to today's digital ones, visible on special monitors and archived on dedicated computer systems, but the physical principle of X-rays has remained the same. Innovation has a particular impact on our discipline," Nicoletta Gandolfo, president of Sirm, the Italian Society of Medical and Interventional Radiology, explained to Adnkronos Salute. "And over time, other sources of physical energy have been added: ultrasound from ultrasound, magnetic fields from MRI, and the ionizing radiation used in conventional radiology, CT scans, and interventional radiology. These technologies allow us to look inside the human body with ever-increasing precision, distinguishing normal from pathological and contributing decisively to increasingly targeted and personalized treatments."
Every year in Italy, 70 million diagnostic imaging procedures are performed, numbers that demonstrate the importance of the radiologist's role and dedicated technologies: from the first ones that use X-rays, such as conventional radiology, CT scans, and angiography, to those that rely on other energy sources, such as magnetic resonance imaging and ultrasound. "While we were once considered primarily technology experts," Gandolfo emphasizes, "today the radiologist has a full-fledged clinical role. We are present in every diagnostic and therapeutic pathway and treat most pathologies across the board, from cardiovascular and oncological diseases to inflammatory/degenerative and traumatic conditions, from fractures to oncological conditions, and even neurological or pediatric diseases. Our images are used to make a diagnosis, evaluate response to treatments, and guide surgical or pharmacological decisions."
Furthermore, the SIRM president continues, "interventional radiology has opened up extraordinary possibilities: through minimally invasive procedures, under radiological guidance, we can stop a bleeding vessel, unblock a blocked artery, embolize tumor neoangiogenesis, or directly treat certain lesions with ablative cooling or heating techniques. These are minimally invasive procedures," she specifies, "that often avoid, or sometimes prepare for, complex and risky surgical procedures, speeding up the patient's recovery. Today, the radiologist is a doctor who constantly communicates with other specialists—surgeons, oncologists, internists, orthopedic radiation oncologists, neurologists, pediatricians, and pathologists—to develop personalized treatment plans. They are not only clinical, but also ethical and educational: we have the role of ensuring appropriate prescriptions, so we must help choose the right test for the right patient, reducing waste and ensuring quality and safety."
Regarding the issue of appropriate central prescribing, including reducing waiting lists, Gandolfo has no doubts about the contribution of radiology: "Radiologists—as provided for by Ministerial Decree 77 of 2022, which redefines community care—have a crucial role in guiding colleagues in choosing the most useful tests and discouraging unnecessary ones, with the aim of improving the quality of diagnostic and therapeutic pathways and contributing to the sustainability of the National Health System. It often happens that tests are requested out of an excess of caution, but every unnecessary test takes away time and resources from those who truly need them. For this reason, we should increasingly network, especially with general practitioners and specialists in other disciplines. Improved communication can significantly contribute to reducing waiting lists for a more efficient system. We also have an educational role for patients, explaining when a test is truly unnecessary and why. This is part of our ethical responsibility, along with ensuring their safety by controlling the dose of radiation administered. and constantly checking the quality of the equipment."
Speaking of machinery and technology, how much are things changing with artificial intelligence, and what role does radiomics play? "AI is an extraordinary tool that helps us improve the quality of work and diagnostic accuracy," Gandolfio remarks. "It can optimize images, reduce radiation doses, standardize diagnostic protocols, and improve the organizational management of a department. Thanks to its implementation, we can now rely on radiomics, a new frontier in radiology that allows quantitative image analysis to gain insights into tumor behavior, predict more effective treatment, and monitor response to therapy by building personalized pathways. It is now a cornerstone of precision oncology radiology. Technological innovation is also having an impact on interventional radiology: image-guided procedures offer less invasive and safer alternatives. However, it is important to remember that artificial intelligence can support physicians, but not replace them: human judgment, communication skills, and the responsibility of the radiologist remain at the core."
"Alongside the radiologist," Gandolfo continues, "other key figures work to ensure the department's smooth operation: the medical physicist, who monitors the quality of the equipment, the dose delivered, and exposure, ensuring the safety of patients and staff; the radiology technician, who collaborates with the physician and performs various diagnostic tests; and the radiology nurses, highly specialized professionals in the management of sophisticated medical devices and specific medications, such as contrast media, which are completely different from those used in traditional departments. Today, we advocate for the enhancement of the role of the radiology nurse, because where there are specifically trained and stable professionals, the system is more efficient, procedures are safer, and the quality of work is higher. In medicine, quality comes from the team: a strong and cohesive team, patient care is more effective."
"SIRM," concludes the president, "is one of the major internationally recognized scientific societies and a member of Fism (Italian Federation of Medical Scientific Societies). It promotes the growth of radiological sciences through training and dissemination of the various diagnostic potentials, technological innovation, the appropriateness of the requested tests, and ethical access to tests. It also collaborates with institutions and numerous other scientific societies to develop guidelines, organizational models, and diagnostic-therapeutic pathways that are applicable and sustainable throughout the country. One of the themes it has always supported is the promotion of all forms of prevention of oncological and non-oncological diseases. We actively participated by supporting Fism and AIOM (Italian Association of Medical Oncology) in numerous initiatives promoted, which were brought to the attention of the institutions at the General States of Prevention in Naples in June. Finally, we collaborated with AIOM on the Tour Vespucci project, promoted by the Ministry of Defense and supported by 12 ministries: a ship that, passing through various Italian ports, brought the topic of cancer prevention to the entire population, providing citizens with information on the healthy lifestyles and screening campaigns. Primary prevention and early diagnosis can truly save lives, and this is a concept we believe is important to convey to the entire population."