Choices - indications

In 1994 - and perhaps for a few years to come - true "global imaging", available to all who need it, is a goal towards which WHO and organized radiology must strive. Quality, safety and availability for the majority must be the criteria: all are met by the WHO Imaging System. Too many governments, hospitals and clinics buy their equipment because a persuasive salesman has convinced them of their need. Radiology is expensive, and the selection and purchase of imaging equipment should, and indeed can, only be properly made knowing the answers to these questions: who needs to be imaged, why is the imaging necessary, how many will need each type of imaging, who will produce the image, and who will interpret the image?

These decisions will be based not only on patient need, but also on the treatment which is available. An MRI scan of a brain tumour serves little purpose if there is no neurosurgeon or oncologist to whom the patient may be easily referred. Fortunately, for both ourselves and our health service budget, few of us will develop brain tumours! But we are all, at all ages, at considerable risk of trauma and chest disease.

WHO efforts to provide "Health for All" should be used to guide the choice and distribution of imaging facilities in every health care system. For the majority of imaging examinations, the WHIS (WHO Imaging System) will more than satisfy the needs of the majority of patients. It is the responsibility of radiologists to en sure that these essential patient needs are met everywhere.

Philip E.S. Palmer, Thure Holm and Gerald P. Hanson