Prospects for progress in diagnostic imaging (Reprinted from Journal of Internal Medicine, vol 247, pg 411-424, 2000)

New fast-imaging MRI systems designed specifically for cardiac magnetic res onance enable new applications of noninvasive vascular imaging. The use of functional MRI and diffusion tensor imaging to map brain function and struc ture offers a new dimension to an understanding of the human condition. Cli nical applications of functional MRI will influence many specialties includ ing surgery, education, and rehabilitation. Functional imaging has the pote ntial to visualize the regional concentration of specific proteins. This im aging at the level of molecules may be possible by use of a contrast materi al whose signal is changed by local enzymatic activity. The three-dimensional digital data collected in modern imaging techniques a llow for virtual endoscopy in the respiratory, alimentary, and cardiovascul ar systems. Virtual endoscopy may replace many of the more invasive diagnos tic methods in the near future. The measurement of clinical decision-making through observer performance studies better informs both the physician and the patient on how to improve upon the quality of clinical practice. These prospects for progress reinforce diagnostic imaging as a cornerstone in me dical informatics. The history of creating images used in medicine reveals the invention of diagnostic tools which may provide new information but pre mature use can result in improper application of a poorly understood techno logy. Research into the use of new technology may be as important as the te chnology itself in improving the human condition.