The plenary session of the Friday Imaging Symposium at the 1999 Scientific Assembly and Annual Meeting of the Radiological Society of North America was entitled "Algorithmic Controversies." The program for this session was initially conceived to demonstrate the confrontation between functional imaging and anatomic imaging. However, as the program developed, it became clear that the main focus of the session should be integration of the functional and anatomic aspects of the various imaging modalities featured in the session. The utility of integrating both functional and anatomic imaging for a relatively diverse set of clinical problems was shown by the excellent presentations of the panelists Drs Lawrence E. Holder, Geoffrey S. Hastings, Heber MacMahon, Stephen J. Swensen, Edward F. Patz, Jr, Hirsch Handmaker (written account presented in this issue by Jay E. Blum and Dr Handmaker), Damian E. Dupuy, Alexander Gottschalk, and Lawrence R. Goodman. Although the panelists discussed areas at the leading edge of radiology, these areas involve techniques that can be, or soon will be, used by practicing radiologists. The session emphasized that in this new millennium the fusion of functional imaging and anatomic imaging will become both commonplace in radiologic practice and an important aspect of patient care. The articles that follow illustrate this concept in four areas. The first area concerns the impact of radionuclide cine imaging of radiolabeled red blood cells on the diagnosis of gastrointestinal bleeding and how this affects angiography. The next area deals with how the techniques of computer-aided diagnosis can be used to improve detection of solitary pulmonary nodules at plain radiography; use of new spiral computed tomographic (CT) techniques to improve diagnosis and use of positron emission tomography to clearly characterize most lesions are also discussed. These efforts indicate we are entering into an era in which we will both detect solitary pulmonary nodules better and characterize them with noninvasive techniques. The third area focuses on the use of a newly approved receptor tracer for detection of acute deep venous thrombosis in the lower extremities. This application illustrates the potential of this type of polypeptide in nuclear medicine imaging, and the way in which it was used with ultrasonography, which is the conventional method for detecting deep venous thrombosis, is a good example of the integration of functional and anatomic imaging techniques. Finally, rethinking the proper use of ventilation-perfusion scintigraphy in centers in which helical CT, pulmonary angiography, and ventilation-perfusion scanning are available is discussed in the last two reports. I believe the 1999 Imaging Symposium illustrates that when you extract the best that each modality has to offer, the patient is the ultimate beneficiary. The fusion of functional and anatomic imaging is certain to be a new area of major development in the years to come. The following articles provide examples of how this fusion can be successfully performed.
