Guest Editorial: Listen to the passion

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I came into the medical imaging business during the birth of computed tomography as the marketing director of a major imaging company. One rule I learned during those days, which I never forgot, is to listen to the passion of potential customers.

As my group showed 3-dimensional (3D) images to doctors from around the world, some of whom visited us at University of California San Francisco, the neuroradiologists clearly had a passion for what we were working on. Perhaps it was due to a “recognized need” that they had been trying to address — to visualize tortuous vessels in the brain and distinguish them from pathology. The rest is history. Our company focused on neuroradiology, the market segment that represented early adopters, and we rose to become the established leader in the technology.

Today, there is a significant need, which is expressed passionately by many radiologists, cardiologists, and surgeons, which is overcoming the challenge of visualizing “objects” while studying “images.” Most physicians using imaging diagnosis exist in a 2D world, but, in some cases, when viewing 3D images on a flat screen (2.5D) they can “get a feel” for the 3D aspects of the image. What’s lacking is the ability to visualize with “depth perception,” the ability to “look around” objects and to “interact” with them. This is what we might refer to as a “complete 3D” experience. This characteristic allows radiologists to more effectively communicate with surgeons who live in a 3D world. As one surgeon stated, “I’ve never opened up a patient and seen a 2D view.”

Several imaging vendors have already responded to the needs expressed above with several more complete 3D devices, as shown at RSNA 2013. It is expected that as more companies listen to the passion, the technology and its utilization will grow rapidly. At RSNA 2013, a team from Stanford University presented results from a study that focused on the very complex problem of visualizing major aortopulmonary collateral arteries in pediatric patients. The results showed an improvement in workflow with higher sensitivity and comparable specificity and diagnostic accuracy as compared to 2D/2.5D visualization devices.

What are some of the likely reasons that complete 3D technology is receiving greater interest than in the past? Among them are that the combination of depth perception and motor inputs to interact with patient-specific data, which significantly improves the intuition of the user; an increased ability to balance germane from extraneous content, which increases the efficiency and effectiveness of the user; specialized tools that facilitate the user’s ability to produce increased benefits in clinical efficacy and workflow; and the accumulation and distribution of knowledge made possible with a richer level of content than heretofore available.

As noted in “A tipping point for visualization-driven knowledge,”1 the key to success in all modalities has been based on clinically derived protocols. Listen to the passion of potential customers. When you find it, listen even more carefully. Therein lie the carefully conceived design requirements, capabilities, and protocols needed to satisfy the clinical need. It’s free advice that’s priceless.


  1. Schilling RB. A tipping point for visualization-driven knowledge. App Radiol. 2012;10:4.
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Guest Editorial: Listen to the passion.  Appl Radiol. 

By Ronald B. Schilling, PhD| May 01, 2014

About the Author

Ronald B. Schilling, PhD

Ronald B. Schilling, PhD

Ronald B. Schilling, PhD, is Executive Chairman of EchPixel. He is also a member of the Editorial Advisory Board of Applied Radiology.

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