When more than 200 experts in medical imaging gather in Memphis starting today, they'll indulge their passion for peering deep inside of human bodies.

But the overall theme is on making imaging technology more useful at a time when the cost of imaging seems, to some, to be exorbitant compared to the benefits.

The gathering is the fourth annual Memphis BioImaging Symposium today and Friday at the Fogelman Executive Conference Center at the University of Memphis. Today's presentations begin at noon. Friday's events start at 7 a.m.

The conference attracts some of the biggest names in imaging and organizers expect a record turnout this year thanks to a focus on bioinformatics, or turning visual images into digital information that can be transmitted, shared and interpreted over the Internet.

"The use of digital electronic-based medical imaging has clearly demonstrated significant improvements in efficiency, accuracy and clinical value to the patient," said physician Paul Chang, one of this year's presenters. "We have clearly moved from early-adopter to early-majority with respect to digital imaging."

Technology in tough times

Chang is a professor and vice chairman of radiology informatics and medical director of pathology informatics at the University of Chicago, Pritzker School of Medicine. He's sensitive to the fact that medical imaging is under greater scrutiny, as providers deal with costs and falling reimbursements.

Hospitals now struggle with the capital costs of new machinery; Memphis internist Scott Morris, founder of the Church Health Center, concedes the value of imaging for individual patients but is fond of pointing out that the average cost of an MRI, about $2,000, would buy a year's worth of blood pressure medicine for 200 people.

"It's a very valid point," Chang said.

His presentation, in tandem with physician Steven Horii, a professor of radiology and clinical director of medical informatics at the University of Pennsylvania, will concentrate on integrating imaging and informatics. The goal is to lower the cost while squeezing more information out of every image. Though simple in concept, it requires systems that can handle massive amounts of data, and a "willingness for physicians to re-engineer themselves to fully leverage this technology," he said.

The Memphis conference, Chang said, highlights how medical imaging is coming out of its two decades of growing pains and working to make itself relevant and accessible.

A pragmatic approach

While sexy technology like PET scans get lots of attention, Horii's presentation will be on the practical side. The two major information systems of today are the Radiology Information System, which manages patient information, scheduling and reports, and the Picture Archiving and Communication System, which stores and retrieves images.

Horii will talk about the evolution of these systems and how they can be used more effectively in accurate records and billing. With improved sharing of images, he said, it is possible to reduce costs by eliminating duplication. But costs, he contends, ought to be considered in context.

"No question about it, modern medical technology and not just imaging is expensive," Horii said. "It is also well documented that medical imaging is the most rapidly rising diagnostic cost area."

But for the money, patients get much greater accuracy in diagnosis, which leads to the correct treatment the first time. That's not only a quality of care issue, he said, but a genuine savings in length of hospital stays and a quicker return to work.

Just 20 years ago brain tumors were diagnosed indirectly by looking for blood vessel displacements, but thanks to CT scanners those masses can be identified and targeted, Horii said. Another archaic procedure involved draining a bit of spinal fluid to diagnose a brain tumor indirectly, leading to excruciating headaches and long hospital stays. That procedure disappeared within weeks once patients had access to CT.

Imaging tomorrow

The tone of the conference will be set tonight by physician Eliot Siegel, a professor of radiology at the Veterans Affairs Maryland Health Care System in Baltimore, who will paint an image of the future of imaging. His example is caBIG: cancer Biomedical Informatics Grid.

It's an initiative of the National Cancer Institute of the National Institutes of Health to connect cancer centers across the United States with common information systems. With dozens of vendors producing hundreds of imaging systems, a major cost issue is the inability of one technology to connect to another. Overcoming this, Siegel said, will be a quantum leap forward to creating customized medicine.

"During the next 10 years, a revolution in cancer treatment will occur with the introduction of personalized medicine in which treatments will be tailored to individual patients and their tumors rather than to general categories of disease," Siegel said.

The current approach is closer to trial-and-error - if the most likely treatment does not work, doctors regroup and try something else. But a convergence of imaging, communications and DNA analysis will allow clinicians to design a chemotherapy drug lethal to individual cancer cells that also will be compatible with a patient's own immune system.

That form of treatment will emerge much faster, Siegel said, if researchers around the world could share their findings more effectively.

Emerging bioscience contender

Memphis is the natural place for this conference, given the city's leadership position in biomedical science, said physicist Gary Keyes, an event organizer and interim chair of the Department of Biomedical Engineering at the University of Tennessee Health Science Center. Biotech in Memphis is often thought of as drug and product development, he said, but it has two other components. There's logistics, exemplified by Medtronic Spinal and Biologics and by Smith & Nephew Orthopedics. And bioinformatics, the information systems that tie it all together.

"When we chose this year's theme of bioinformatics, we wanted to provide a strong foundation for attendees in reach of the technical fields, and give them a picture of where things are going in the future," Keyes said. "This is aimed at a mixed audience of students, professionals, researchers in the field and physicians - plus people working in the bioimaging industry."

The lead sponsor again this year is Memphis-based Luminetx, maker of the VeinViewer system. Other key sponsors are Siemens, GE Healthcare and the National Cancer Institute.

The University of Memphis is a new host this year, joining the perennials Memphis Bioworks Foundation, UTHSC and St. Jude Children's Research Hospital.

For more information on the symposium, visit www.membis.org or call Linda Taylor at 495-2235.