This article discusses the strengths and weaknesses of technology assessment methods for the evaluation of novel and complex radiology systems, including picture archiving and communication systems (PACS), computed radiography (CR), teleradiology, and other new models for the delivery of radiology services. Using examples from PACS and CR, we review early economic assessments of PACS from the radiology department. We then broaden our perspective to discuss the analytic criteria that can be used to evaluate economic analyses of PACS as the health care delivery system shifts toward managed care. We close with a proposal for optimizing the integration of information technology into the clinical environment through ongoing target data collection during the implementation of new radiology systems.