Foreword

The success of the fourth edition and the resulting undoubted clinical benefit to patients has led Professor Gillian Needham and her Steering Group and Project Team to produce a fifth edition of the Guidelines, which I am delighted to recommend.  The task of preparing such Guidelines becomes ever more demanding, particularly when it incorporates the ethos of evidence-based medicine, together with refining original suggestions and introducing new scientific evidence where appropriate.

I would like to thank the many individuals and organisations that have contributed to this fifth edition.  The contents will be of great benefit to the commissioning and the delivery of both the clinical and the managerial aspects of health care.

In producing Guidelines such as these there are always areas of contention, with difficult decisions having to be made in order to incorporate views that may be at variance with one another.  Levels of scientific evidence for the recommendations are included within the booklet to enable the reader to assess the form and robustness of the advice offered.

There appears to be a tendency for some authorities to use these Guidelines as a means of restricting the radiologist's role in the process of justification.  This is an abuse of the process, particularly as many of the Guidelines are based on expert opinion or case studies.  They are intended as a guide for referring clinicians; discussions between the radiologist and the clinician, particularly during multidisciplinary team meetings, must always take precedence.  To use these Guidelines in any other way is unacceptable.

Professor Gillian Needham and her colleagues have put enormous effort into producing this document, and the Faculty Board of Clinical Radiology together with Council wish to record their appreciation.  The introduction of such recommendations requires the co-operation of all concerned; their ultimate effectiveness relies on appropriate education and locally agreed implementation.  I hope they will engender a debate so that their development may continue towards their ultimate goal: better health care for individual patients.

Dr Mike Dean, Vice-President and Dean of the Faculty of Clinical Radiology, on behalf of the Board of the Faculty of Clinical Radiology and Council of The Royal College of Radiologists

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