New diagnostic imaging technologies have borne unusual scrutiny in considerations of health care cost containment. This scrutiny derives from a history of relatively poor technologic assessment, questions about the extent to which technologic innovations promulgate improvements in patients' health, and observations that economic concerns often take precedence over medical ones in technology acquisition decisions. Current and future legislative and market-driven health care reform initiatives will require providers thinking of acquiring new imaging technologies to assess their costs and benefits more rigorously.