Cancer Imaging Training in the 21st Century: An Overview of Where We Are, and Where We Need To Be.
Advances in cancer care over the past decade have significantly changed treatment algorithms and life expectancies. Time from cancer diagnosis to death is rapidly increasing, as new, targeted therapies are developed, many prolonging life even in advanced disease. Tumors are now genotyped at diagnosis, allowing personalization of treatment. The FDA is continually approving new drugs that quickly become the standard of care for common tumors; the impact of these drugs and their side effects is monitored with imaging, and accurate interpretation of imaging studies has become essential as these patients live longer. Oncologists rely on radiologists to understand new patterns of treatment response and novel drug side effects that are associated with new drug classes, increasing the knowledge required for accurate image interpretation. These factors have led to the demand for dedicated cancer imaging training for radiologists, who can integrate findings throughout the body on various imaging modalities. In addition, we need to expand radiology's focus beyond diagnosis, staging, and restaging of tumors, and include education about the influence of genomics on tumor characterization and guidance for cancer care, the spectrum of treatment response, and the imaging characteristics of adverse events associated with various therapies. The time has come, therefore, to formally incorporate, as part of radiology residency, a distinct cancer imaging curriculum that is standardized, tested, and will allow the new generation of radiologists to effectively communicate with and assist their oncologic colleagues and optimally contribute to the care of patients with cancer.