The New Year is shaping up as make-or-break time in radiology's five-year effort to create a separate institute for imaging research at the National Institutes of Health (NIH). Legislation has been introduced in both the U.S. House of Representatives (H.R. 1795) and Senate (S. 1110) supporting the formation of a National Institute of Biomedical Imaging and Engineering.
Prospects look good in the Senate, with Majority Leader Trent Lott (R-MS) serving as the bill's chief sponsor. Momentum is building in the House, too, with senior Reps. Anna Eshoo (D-CA) and Richard Burr (R-NC) sharing the role of chief sponsor.
So far more than 110 representatives have signed on as co-sponsors of the legislation. Supporters hope to bring the number of House co-sponsors to 150 by the end of January, according to Dr. C. Douglas Maynard, chairman of the department of radiology at Wake Forest University School of Medicine.
Dr. Maynard currently serves as president of both the Radiological Society of North America and the Academy of Radiology Research. The latter group was established in 1995 by major radiology organizations in order to build support for imaging research in Washington and, specifically, prepare the way for a dedicated institute at the NIH, said Edward C. Nagy, executive director of the academy. Further information may be obtained at the academy's Web site (www.acadrad.org) or via e-mail at [email protected].
With support for the institute effort growing in Congress, now is the time to intensify lobbying by radiologists, Maynard said.
"We feel this is our best chance of getting this (legislation) through," he told AuntMinnie.com. "That is why we are putting on a no-holds-barred campaign to reach all of radiology and have them write letters of support."
A focus on basic research
Advocates say the new institute is needed because today at the NIH, imaging is studied largely in an applied sense, as it relates to specific organs or disease states researched by existing centers such as the National Cancer Institute (NCI). They believe a concentrated focus on basic imaging research is needed to make quantum technological leaps and propel imaging technology into new directions.
"The issues and subjects that this separate institute would study have evolved to the point where a separate institute is needed to give the (necessary) attention to these issues," said John Flaherty, chief of staff for Eshoo.
Along with stimulating basic research in imaging technology, the proposed institute would also fund and coordinate technology assessment and outcomes research efforts, Nagy said. Creating a separate imaging institute would also provide a platform for professional input into both internal and external decisions at the NIH, according to Maynard.
"We feel it is very important for radiology and the whole imaging community to have a presence at the NIH, from a pure standpoint as well from a standpoint of supporting research around the rest of the country," Maynard said.
An imaging institute would also help focus and coordinate existing research efforts throughout the government, according to Nagy. Imaging research is currently undertaken by a wide variety of federal agencies, both within and outside the NIH, with little coordination, he said. These include the Defense and Commerce departments, The National Science Foundation, NASA and intelligence agencies.
The Department of Defense, for example, has received significant funding from Congress for research in mammography, Maynard said.
"There are two reasons I think why money has been going into the Defense Department for mammography," he said. "One is that Defense wants to keep its budget up. But also there has not been a really good home for that research at the NIH, so a home was found for it somewhere else."
Creating a new institute would not take research money away from existing efforts, though, Nagy said.
"We are not talking about taking their budgets away, but rather providing a forum where they can share information," he said.
The NIH has actually increased its support dramatically for imaging research over recent years, particularly at the NCI, Maynard said. Without a structure to advocate for imaging research, however, this support depends on the views of individuals within the NIH, which change over time.
One tough opponent
While there does not appear to be significant organized opposition to the idea of a new imaging and bioengineering institute, one naysayer is a very important player indeed: The NIH itself.
"NIH does not support the creation of an Institute for bioengineering/bioimaging," said Dr. Wendy Baldwin, deputy director for extramural research at the NIH. "The Institutes and Centers have rich portfolios of research already; BECON (the Bioengineering Consortium at the NIH) is providing a mechanism to address cross-cutting issues or research that is early enough in development that it doesn't have a clear disease relationship. It is preferable to keep the bioengineering/bioimaging research closer to the basic biology and the clinical problems rather than in an independent institute. It (a separate institute) is not needed."
Alternative legislative language has been introduced in Congress that would set up an office of bioimaging/bioengineering within the office of the director of the NIH, Nagy said. This wording, wrapped into a large omnibus appropriations bill, would also require the NIH to study the feasibility of setting up a separate Institute of Biomedical Imaging and Engineering and report back to Congress by June 30.
This potential move could be viewed as an interim step toward a separate institute, or as an alternative to a full-blown institute for imaging, depending on your point of view.
Although the Academy of Radiology Research has not taken a formal position on the alternative language, it is not enthusiastic about the idea.
"We don't think it is necessary," Nagy said. "If seen as the end of the process, then it falls far short of solving the problem."
The NIH, on the other hand, doesn't consider an office of bioimaging/bioengineering to be a good idea in and of itself.
"The creation of an office in the office of the director for bioengineering/bioimaging is not envisioned as a step toward an institute," Baldwin said. "Rather, it is a way to institutionalize BECON and bring in a senior bioengineer. We will be moving ahead on this office after the first of the year."
By Roger LindahlAuntMinnie.com contributing writer
January 11, 2000
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