Portal de Periódicos da CAPES

A Critique of Roentgen Interpretation

1959; Radiological Society of North America; Volume: 72; Issue: 3 Linguagem: Inglês

10.1148/72.3.431

1527-1315

Leo G. Rigler,

Paranormal Experiences and Beliefs

Presumably, the President of the Radiological Society of North America should be old and wise, and thus able to give advice to his colleagues. This responsibility has weighed heavily on my conscience, for I do not consider myself very old as yet, and certainly I cannot lay claim to wisdom with any feeling of confidence. Nevertheless, I would take this opportunity to re-evaluate some ideas concerning the practice of roentgen diagnosis, and particularly our procedures of interpretation. That roentgen diagnosis is still a dynamic expanding field of endeavor, a productive outlet for brains and energy, is attested by the last Program of the Radiological Society of North America, and by many others offered in this division of Radiology. The opportunity to improve our diagnostic resources is still with us to a superlative degree. Spectacular new developments occur almost from day to day, so rapidly indeed that it is difficult to keep abreast of the new procedures. Much still remains to be done so to improve our methods that the most minimal disease process will be detectable, and those segments of the anatomy now relatively inaccessible to roentgen methods will be made visible. But diagnosis can be improved in many respects without any additions to our armamentarium, with the conventional, presently available roentgenogram itself. Ours is a technological age, in which the physical sciences have advanced so much more rapidly than our thinking processes that many serious students of philosophy are greatly concerned about the possibility of imminent disaster. This trend is best exemplified by the development of new and more terrifying weapons without a corresponding development in brain power, vision, and the understanding of how to use our technological power for the benefit, rather than for the destruction, of mankind. In a small way, a somewhat similar situation exists in the field of radiology. All around us are new technics, more and more complex, and at the same time more and more revealing of the anatomical, pathological, and physiological constitution of the body. We are now able to see structures, to delineate pathological processes never before exhibited in the living individual. I wonder, however, whether these superb technics do not tend to minimize, or even to nullify, the importance of our thought processes, of our imagination, of our brains. Do we resort too quickly to our hands without first using our heads? Basically, there are three major steps in roentgen interpretation. The first is the distinction of one structure from another, a process affected in part by radiographic technic and by optics physiology. It has been dealt with extensively in recent years, notably by Tuddenham and his associates. The second is the determination whether a shadow represents a normal structure, a normal variation, or a real abnormality; that is, the detection of a disease process.