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Radiologists are increasingly using radiation dose reduction strategies, which minimise the potential risks of radiation in x-ray-based imaging modalities without compromising image quality. Computer-aided detection and diagnosis systems can reduce the rate of missed cancers and may also help to characterise early lesions. Researchers are also working on ways to identify high-risk subjects, based on molecular or genetic studies, which may enhance screening effectiveness. Cooperation with other medical specialties is key to these achievements. Radiologists already work in multidisciplinary teams to treat cancer patients. Close collaboration with other specialists, for instance biologists, physicists and doctors of nuclear medicine is fundamental to the development of new screening tools. As is the case in many other areas of medicine, the current trend in screening is toward personalisation, to find out the individual’s risk of cancer, based on very specific biological tests. “We all know that some people are more predisposed to some cancers, and we should maintain our progress in the ability to propose to the individual a screening programme that is tailored, rather than a ‘mass product’.” In addition to the benefits brought by imaging, diet and obesity management, as well as environmental and lifestyle modifications, may also help to prevent cancer in the future.
Imaging plays a major role in the detection of cancer as it provides a detailed insight into the exact location and extent of the disease. It can also provide detailed information about structural or cancer-related changes. Emerging methods of molecular imaging, which combine traditional imaging technology and nuclear medicine techniques, can also be used to obtain more detailed information about abnormalities, including their distinct metabolism. There are various ways to detect cancer using imaging methods. Cancer may be detected incidentally, when an examination is carried out for other reasons, or there may be clear symptoms and the patient may undergo imaging to confirm, locate, and determine the extent of the disease. Another possibility is of course the detection of a malignancy while participating in a screening programme. “Certainly radiology is by far the best method for cancer detection in the majority of cancers. However, the vast majority of tumours are only apparent with an advanced test, especially at the initial stage, and radiology is certainly the major player.” Modern medical technology offers a wide range of imaging methods to imaging specialists. Well known methods used for the detection of cancer are ultrasound (US), computed tomography (CT), magnetic resonance imaging (MRI) and mammography, the latter being used specifically to detect breast cancer. “The technique of choice depends on the type and site of the cancer. All of these modalities provide cross-sectional anatomical images. US and CT are generally less expensive and more widely available than MRI and are therefore used more frequently around the world.”
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