Education and Instruction in Roentgenology

Abstract

To introduce the presentations of the evening I have taken as my subject “Education and Instruction in Roentgenology,” feeling that here is a topic of immediate interest to us all. The title may be somewhat misleading as to its intent, since “education and instruction in roentgenology” applies not alone to the roentgenologist, the fact being that enlightenment is required in many other directions. The need of under-graduate instruction requires as much consideration as post-graduate. Furthermore, there is but little doubt that hospital executives and boards require much authentic information concerning our aims and needs so that there may be better understanding and more co-operative regulation. The lay public also requires education so as to correct some of its ill-conceived ideas concerning the modalities and significance of roentgen diagnosis and therapy. The manufacturers' and salesmen's ideas might also be subject to some revision or regulation, to say nothing of the ever-variable legal aspect brought about by the more common use of radiant energy. Remarkable as the advancement of roentgenology has been since the discovery of the X-rays thirty-three years ago, most of us know that we are but at the threshold of development as regards both the methods of application and means of interpretation; therefore, none of us is exempt from further learning. Of the roentgenologist of to-day is required no mean knowledge of the electronic theory, electrophysics, mathematics, photography, etc., if the control of his equipment is to be on an intelligent and satisfactory basis. Interpretation begins with the application of the physical factors involved, in which the laws of light, divergence, distortion, and absorption, as well as hydrostatics and gravity, play important rôles. Interpretation continues with the avoidance of misinterpretation of normal variations, requiring a thorough study, not alone of normal roentgen antomy but of development as well. The roentgen aspect of physiological function has its own peculiar application, especially in the study of intrathoracic and abdominal lesions. Correct interpretation in conjunction with the foregoing data being finally dependent upon gross pathological change, a careful review of clinical, operative, biopsy, and autopsy findings rounds out the fund of knowledge required. With regard to pathological data, the roentgenologist's viewpoint is not always fully comprehended. The latter rarely knows aught of color, consistency, cell type, or organisms represented in a given lesion. Furthermore, immediate ante- or postmortem changes may have added to the findings conditions that previously did not exist. Again, excepting in a confirmatory way, microscopy is of but little direct value in roentgen interpretation, for what cannot be determined by gross pathological examination can hardly be discovered by means of the X-ray.