November 8, 2013 marks the International Day of Radiology, commemorating the discovery of x-rays 118 years ago by Wilhelm Conrad Rӧntgen, in Germany. He used the symbol “X” to denote the unknown, as he was unsure of the source of his discovery, speculating that the “new rays may be due to longitudinal vibrations in the ether.”
Although this was not the source of the mysterious rays, Rӧntgen’s discovery did set in motion true vibrations throughout the world that sparked the imagination of scientists, businessmen, charlatans, the public and press who were fascinated with an apparatus that could reveal what was hidden from view. The history of x-ray use after 1895 is fascinating. It is a cautionary and optimistic story that also parallels the story of the developing medical field of radiology.
One of the early pioneers of x-rays in the United States was Thomas Edison, who scoffed at men like Rӧntgen as “pure scientists” who “would never earn a single dollar on their discoveries.” In 1896, Edison staged expositions using a fluoroscope – a portable x-ray device – to allow people to look inside their own bodies. A correspondent for the British medical journal, The Lancet, reported in October 1896: “A fearful mother asked to find out whether her son had actually swallowed a missing three-penny piece. A young maid, on the other hand, wanted to have her fiancé x-rayed without his knowledge, so to determine whether his innards were healthy.”
Edison finally terminated his shows in 1904 after his chief assistant, Clarence Dally, died from excessive x-ray exposure. Juxtaposed against the tales of inventions of this age, such as “x-ray proof underwear” and the “pedoscope” (a device utilizing x-rays to assess shoe fit), are stories of heroes like Dr. Walter Dodd and Dr. Lawrie Byron Morrison, both graduates of the University of Vermont, who helped develop the emerging field of medical imaging, and both of whom also succumbed to radiation injuries in the course of their work.
The theme of this year’s International Day of Radiology is chest imaging, and I am proud to be a part of the chest radiology department at the University of Vermont Medical Center with my colleagues Peter Dietrich, MD, Jeffrey Klein, MD, Curtis Green, MD and Ryan Walsh, MD.
In addition to Rӧntgen’s x-rays, which are now captured digitally, we can see inside the body and diagnose cardiac and chest diseases using CT scans, MRI, ultrasound and nuclear medicine with amazing detail. Since 2005, we have introduced cardiac MRI, cardiac CT and PET/CT imaging, and the pace of discovery and technical innovation in imaging and information technology continue to accelerate.
November 8 will be a typical, busy day in our reading room, interpreting studies and consulting with our clinical colleagues, but I will take a moment to reflect on another significant aspect of the birth of this specialty; we have learned the lessons of the past and practice this art SAFELY to protect our patients. Administrative staff process thousands of requests daily, ensuring timely scheduling of exams and archiving and displaying of images, well trained technologists acquire images and ensure patient comfort and safety, physicists and engineers calibrate and test equipment so that it is in perfect working order and manage radiation safety, and physicians, nurses and physicians assistants safely treat and diagnose patients directly in interventional radiology.
Our equipment is the best in the world, and while routinely performing low-dose CT scans, we are experimenting with new technology to lower CT radiation dose even further. Today, we understand and know how to respect and use x-rays cautiously, but more importantly we have learned how to take care of our patients and ourselves to ensure safe and accurate diagnosis. That is really something to celebrate.
To learn more about the International Day of Radiology and the history of radiology, please visit internationaldayofradiology.com. (Historical references above are quoted from the “Story of Radiology” published by the European Society of Radiology.)
George Gentchos, MD, is Director of Thoracic Radiology at the University of Vermont Medical Center and Associate Professor at the Larner College of Medicine at UVM.