Demand for a new main speciality in image-guided therapy.

As image-guided and minimally invasive therapy advances in complexity and volume, it becomes more obvious that none of the existing main specialities in medicine offer the ideal clinical or technological training for the responsible physicians at this time. The radiologists lack a clinical basis, and do not have adequate opportunities for proper pre- and post-procedural follow-up of their patients. The clinical doctors, i.e. cardiologists or vascular surgeons, do not have the proper technological background, or the training in 2D/3D imaging diagnostics or radiation hygiene. Radiology ‘possesses’ the technology, while the clinical specialities ‘possess’ the patients. Integrated use of various imaging modalities (fluoroscopy, computed tomography, ultrasound, magnetic resonance imaging, endoscopy or video-assisted techniques) may also be exploited more effectively for guidance and control of surgical or minimally invasive intervention. To pursue the progress and secure the quality and efficiency of future medical developments in the field, a fusion of clinical medicine and radiology into a new speciality is proposed. A basic training of 2 years in surgery or internal medicine, and 2 years of radiology can be followed by organ-wise (gastrointestinal, vascular, cardiology, etc.) subspecialisation. In this way, devastating turf battles and conflicts of interests in the hospital system may be neutralised and the traditional specialities join forces to the best of patients. Proposed terms for this new kind of specialist could be ‘Clinical Surgical Radiologist’, ‘Clinical Cardiological Radiologist’, etc., or simply ‘Image-guided Therapist’.