The University of Arizona Department of Radiology first considered establishing a photoelectronic radiology department in 1973. It seemed clear that the technology had progressed far enough for us to investigate the possibility of total film replacement.' Data from the space program in particular indicated at that time that sophisticated television images over 1000 x 1000 lines were approaching the detail seen on the traditional x-ray film. This technology has been known over many years of research and development as "photoelectronic imaging devices (PEID) ."14 However, at that time film replacement was out of the question. What was not out of the question was the consideration of using a subtraction technique, "digital video subtraction angiography." To this end, we, and independently the University of Wisconsin,314 proceeded to develop this technology.5'6 Our intravenous video subtraction images in patients started in our research laboratory in 1977 and in March of 1980 we opened a biplane special procedures room dedicated only to photoelectronic imaging (no film).7'8 Digital video subtraction angiography has been successful and is described in much greater detail in these Proceedings by other authors. Current efforts are under way toward total replacement of film. This is an immense problem, one that will require a much greater sophistication of computers, storage devices, system analysis, and cooperation from both the radiologist and the clinician.9'10 In a theoretical study we converted our 65,000 procedures-per-year department to complete photoelectronic imaging (no film) and estimated that we would save approximately five million dollars over ten years.15 Extrapolating this to the entire United States would result in a conservative estimate of saving one billion dollars per year. Not included in these mathematics are cost-effective savings of the physicians' time and effort.