We consider it timely for an in-depth analysis of the relative efficacy and definition of usefulness and limitations of ultrasound, nuclear medicine, computed transmission tomography (CT), and recently magnetic resonance imaging (MRI). Furthermore, positron emission tomography (PET) until recently purely experimental is finding its way into diagnosis and patient management. The initiative of federal government to introduce a system of prospective payments based on diagnostic related groups (DRGs) for in-patients, has had already a significant impact on radiological procedures performed on hospitalized patients. In this important group two phenomena are becoming evident: 1. Medical referring community is utilizing less these expensive imaging procedures for both diagnostic and followup purposes. 2. There is a premium placed on radiological services for an improved utilization of these imaging modalities in order to define protocols that may lead to shorter periods of hospitalization and increased utilization of out-patient facilities. Both pathways lead towards cost containment of the spiralling increasing health national budget. While there has been a decline in utilization of radiological imaging procedures in many medical centers throughout the nation, it is not clear that there is a consensus with regards toits proper and most efficiency utilization. Thus, the need for definition of criteria that will avoid duplication. The use of unnecessary gathering of complementary data that may improve of marginally, but not significantly diagnostic accuracy, is a situation likely to become difficult to justify in many cases.
