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The American College of Radiology Imaging Network and the Mission of Radiologists¹

¹ From the American College of Radiology Imaging Network, ACR Research Offices, Philadelphia, Pa. Received December 26, 2001; accepted January 2, 2002. Address correspondence to the author, Department of Radiology, University of Virginia Health Sciences Center, Box 800170, Charlottesville, VA 22908-0170 (e-mail: bjh8a@virginia.edu).

Index terms: Editorials • Radiology and radiologists • Radiology and radiologists, research

The primary mission of clinical radiologists—like that of all physicians—is to improve the length and quality of life for the individuals to whom they provide their services. However, current radiologic practice is based on a mixture of individual experience, habit, and potentially nongeneralizable information gained at meetings or from journals reflecting traditional single-institutional imaging investigations. As a result, radiologists doubtlessly employ practices that may fail to achieve their desired goal for patient care. Thus, despite our best intentions, radiologists may fail to fulfill their mission as well as we might like.

This is not very different from the situation with other medical specialties. However, there is one major difference: For some years, many of these specialties have relied on consortia of institutions, methodological resources, and administrative centers to develop and conduct multiinstitutional clinical trials, the results of which can be used to better advise their physicians on what are the best medical practices for their patients. The advantage of these consortia is that they bring together the most capable researchers with community and academic practitioners to conduct multidisciplinary multiinstitutional clinical research that provides more valid, more reliable, and—most critically—more generalizable studies than is possible with traditional single-institutional research. The outcome of all of this is better clinical practice.

In 1999, the National Cancer Institute provided initial funding for the establishment of a clinical trials consortium devoted to medical imaging that bears the potential to provide for radiologists the same evidence basis for practice that similar consortia have provided for other specialties. The new organization was named the American College of Radiology Imaging Network (ACRIN), with its headquarters located at the American College of Radiology research offices in Philadelphia, Pa. The expressed mission of ACRIN is purposely akin to the primary mission of radiologists: to improve the length and quality of lives of cancer patients through the conduct of clinical trials of diagnostic imaging and image-guided therapeutic technologies. ACRIN expects to accomplish its mission by addressing a number of objectives, of which the following are among the most important:

1. Evaluate innovative emerging methods of diagnostic imaging and image-guided treatment that have the potential to improve survival and the quality of life for cancer patients.

2. Compare established patterns of imaging diagnosis, staging, and palliative or curative image-guided treatment with alternative approaches to improve the effectiveness of care for patients with cancer and reduce the costs of this care.

3. Examine diagnostic and therapeutic strategies that combine imaging procedures with each other and with other (nonimaging) technologies to improve the efficiency of cancer detection and treatment.

4. Assess the value of the use of imaging examinations for detection of cancer in high-risk patient populations (ie, screening).

5. Determine the value of imaging in reducing the anxiety of individuals who have symptoms suggestive of cancer but who eventually are found to be free of malignancy.

6. Assess imaging technologies beyond the evaluation of accuracy to include such end points as the influence of imaging examination results on medical diagnosis and treatment and on health care outcomes, including quality of life and health care costs.

7. Through clinical trials, increase the early availability of new potentially valuable technologies to a broader range of patients, including special populations such as women, minorities, and economically disadvantaged patients, and to study the effect of using the technologies in these populations.

8. Develop new methods and improve existing methods for evaluation of the effect of using medical imaging technologies on the care of patients.

9. Attract the best scientists and clinicians to participate in ACRIN activities.

10. Educate radiologists in how to conduct high-quality clinical research.

11. Collaborate with existing cooperative groups to share protocols and patients to make the best use of ACRIN resources and speed patient accrual.

12. Collaborate with industry and payers to gain early access to emerging technologies for clinical trials, diffuse the cost of conducting trials, and hasten the diffusion of valuable technologies into clinical practice.

In subsequent contributions to Radiology, I and others involved in ACRIN will address how ACRIN has already begun to achieve success in accomplishing these objectives. Specifically, we will detail why multidisciplinary multiinstitutional research provides better information about the appropriateness of clinical practices than conventional research, what trials are underway and what considerations went into their design, and how readers of Radiology can participate in ACRIN activities.

I am indebted to Radiology and its editor, Dr Proto, for affording ACRIN the opportunity to make the readers of the Journal more aware of the importance of the ACRIN trials to the future of our specialty and, I hope, to enlist radiologists’ support for and participation in ACRIN’s activities.

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