A picture is worth a thousand words — particularly the one Richard Barth, MD, has on his computer monitor. The charming 3-month-old baby represents a quiet triumph for Barth, the new radiologist-in-chief at Lucile Packard Children’s Hospital.

Because of an unfortunate match-up of her parents’ genes, the baby had a 25 percent chance of being born with a rare debilitating brain malformation undetectable by prenatal ultrasound. But a fetal MRI at Packard Children's Hospital reassured her anxious parents that she probably did not have the defect.

"This was a real win for imaging," said Barth. "People used to think of radiologists standing in dark rooms all day with capes over their heads, but today’s radiologists are very much on the front lines of health care, interacting with patients and their parents."

That interaction with patients and other physicians will continue to broaden as Packard Children’s Hospital, with aid from the Lucile Packard Foundation for Children’s Health, gears up over the next few months to become one of only about 15 full-service pediatric imaging centers in North America — a title earned by focusing exclusively on the diagnosis and treatment of children by pediatric radiology specialists employing state-of-the-art, child-friendly machines.

When it comes to medical imaging, children are often treated like miniature adults. Children require specialized care, however, to protect their growing bodies and diagnose child-specific diseases. The traditional imaging suite with its large and often noisy equipment can be frightening to a child, and standard procedures used on adults could expose a child to more radiation than is either healthy or necessary. In addition, many childhood diseases present diagnostic problems unfamiliar to a general radiologist.

The technology explosion of the past two decades has revolutionized medical imaging. Pediatric radiologists can non-invasively peer inside an unborn child’s brain, monitor the beating heart of a child with a congenital defect or map abnormal brain activity in a child with attention deficit/hyperactivity disorder.

Packard Children’s Hospital will also soon be one of the few children’s hospitals in North America with a 16-slice CT scanner. This latest in CT technology permits a head-to-toe scan in fewer than 30 seconds, frequently eliminating the need to sedate a child for the procedure. It also provides data that can be translated into a 3-D model for surgical planning.

Over the next five years, Barth plans to add nine pediatric radiology subspecialists to make best use of the sophisticated imaging machinery in the new center and to enhance relationships with other specialists in the hospital.

"A neuroradiologist specialist knowledgeable in the imaging of pediatric neurological diseases will serve as the most effective consultant for his colleagues in the neurosciences," Barth said.

Barth will also bring on board basic researchers to continue the tradition in radiology of quickly transferring new discoveries to the patient’s bedside. "In many cases, rapid advances are possible that can make a tremendously positive impact on pediatric care," said Barth. "The new program will encourage synergy between scientists and clinical investigators to create the necessary breakthroughs."

The new physicians will work closely with physicians at the hospital’s Johnson Center for Pregnancy and Newborn Services, using fetal MRI, ultrasound and other imaging techniques to advance the care of pregnant women and their fetuses.

Not even molecules will escape the investigative scrutiny of the researchers in this new effort. "We’re creating a new program in molecular imaging to image structure and function at the molecular and cellular level. Molecular imaging promises to enable early diagnosis of diseases and rapid assessment of the effectiveness of therapy such as chemotherapy for tumors," said Barth.

The center will also work to alleviate a severe worldwide shortage in pediatric radiology subspecialists by training future leaders in the field.

This comprehensive model of child-centered imaging will set Packard apart from most hospitals in the country. "Our program will have the opportunity to become a leader in pediatric imaging to the benefit of children in the local community and worldwide," said Barth.

Despite the center’s promise, Barth’s enthusiasm is generated as much by his participation in the incredible changes in radiology during his tenure. "I felt like radiology was a good specialty in the 1970s, but the rollercoaster ride since then has been nothing short of spectacular," he said.