Recently an article was published in the New England Journal of Medicine entitled “Imaging the Brain” (1). The article, written by a neurologist, summarized the topic in 20 pages. A neurologist was the sole author; no neuroradiologists were coauthors. More recently an article was published in the Journal of the American Medical Association (JAMA) entitled “Cranial Computed Tomography Interpretaion in Acute Stroke” (2). Again, no neuroradiologists were involved in the study.
Should neuroradiologists be concerned about not being primarily involved in articles about two core neuroradiology subjects such as brain imaging and CT interpretations? Some would answer, “No, don't bother. Dissemination of information about our specialty to the readership of two major U.S. nonspecialty journals is commendable, and it doesn't matter who the authors are.”
The editor of a journal is not concerned about the author's specialty, but is primarily concerned about a topic's scientific content, validity, accuracy, applicability, and appropriateness for the journal's readers. Some journal editors may invite such papers from nonneuroradiologists. The editors of the New England Journal of Medicine and JAMA no doubt had little or no concern about the lack of neuroradiologist authors of the two articles. That lack, however, should be our concern. Our image as the prime directors of neuroimaging has been compromised by the absence of a neuroradiologist as author.
Many articles published in neurology and neurosurgery journals are of neuroradiologic interest but are often published without a neuroradiologist as author or coauthor. I agree that the lack of neuroradiologist contributions in articles in these journals is not as harmful to our image as the lack of neuroradiologist contributions in articles read by the general medical public.
Why is this so? Neurologists and neurosurgeons are aware of our value as neuroimagers, and will continue to consult us, as always, whether or not we are coauthors or authors of papers published in their journals. Nonetheless, when a neuroradiologic topic, written by a neurologist, is published in journals directed at the general medical community such as the New England Journal of Medicine or JAMA, that community may identify that topic with the authors. Then they may turn to the neurologist for help when in need of neuroimaging to solve a clinical problem.
What can we do about this? It is our role to inform our nonneurologic and nonneurosurgical colleagues about our specialty's clinical applicability. Neuroradiologic content, as published in the leading neuroradiologic and radiologic journals in the U.S., centers on applied technology to image quality and our consequent ability to image different diseases. Increasingly we have been encouraged to carry out cost-analysis studies, and publication of such studies has begun to appear slowly in our journals. Such research is commendable, and while state-of-the-art neuroradiology papers should continue to be published in journals such as the AJNR, we must not forget the need to inform our clinical colleagues of our specialty through reviews in clinical publications such as the New England Journal of Medicine and JAMA. Because subjects as general as “Imaging the Brain” have been accepted by general medical journals, the editors of these journals believe that there is a need to disseminate this information to their readers. If that is so, let us be aware of this need and be the leaders in educating our colleagues.
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