January 2020 Spotlight Newsletter

 

Scott Reeder, MD, PhD, FSCBTMR
Professor and Vice Chair of Research
Chief of MRI, Department of Radiology
University of Wisconsin, Madison
 

 

 

 

Dear Members, Fellows, and Friends of the Society for Advanced Body Imaging (SABI),

 

It is with great humility and honor that I write to you in my capacity as President of the Society for Advanced Body Imaging. This has been a year of transformation, as the SCBT/MR has grown beyond its name, leading to our new identity – SABI - that captures the evolving talent, culture, and energy of our society. Our society’s new motto, “Leading Innovation Into Practice”, embodies our innovative spirit, taking us beyond CT and MRI, to include emerging and unimagined technologies, such as artificial intelligence and much more.

 

I am still settling in after “Mile High Innovation” and an exhilarating meeting this October in Denver. I wish to convey my heartfelt gratitude to the Program and Research committees, and to all of the hard work that the volunteers of our society put into making the Denver meeting a success.

 

With that energy I now look forward to our next annual meeting in New Orleans, to be held on 10-14 October, 2020. The Program Committee, led by Dr. Beth McFarland, our President elect, is already hard at work designing an exciting program for SABI 2020. Highlights include an exciting pre-meeting workshop on artificial intelligence, the Presidential Lecture, and an outstanding set of plenary and scientific sessions on the latest in CT, MRI, artificial intelligence, and much more.

 

I also wish to express my heartfelt gratitude to the Board of Directors who have been working tirelessly behind the scenes to transform our society with a renewed and forward-looking culture of mentorship, engagement, and personal connections. Several new committees have been formed or reinvigorated including Communications, Education, Publications, and Technology Assessment, as well as an exciting new Mentoring program led by Drs. Neil Rofsky and Carolyn Wang. Never has there been a better time to get involved in our society!!

 

Finally, I would encourage all of you to check out the Journal of Computer Assisted Tomography (JCAT), the flagship journal of the SABI. There are excellent opportunities to publish your work in JCAT, learn about the latest in body imaging, and to get involved with a leading medical imaging journal. Many thanks to Dr. Eric Tamm for his hard work as he integrates SABI and JCAT.

 

There is much work to do as we accelerate down this new fork in the journey of our society, and I look forward to continued collaborations and friendship as we lead innovation into practice in 2020.

 

 

With warmest regards,

 

 

Scott B. Reeder, MD, PhD, FSABI

 

 

 

 

 

 

 



Susan Ascher, MD, FSABI

Co-Director Abdominal Imaging
Medstar Georgetown University Hospital
 
 

Catastrophizing is what I was doing moments before the Fellow’s luncheon at this year’s annual meeting in Denver.  I was set to announce that the Board had decided to rebrand the society and change its name to the Society for Advanced Body Imaging (SABI). Our goal was to better reflect who we are and where we are going. My heart was beating fast and my thoughts were racing: “What if our rebranding efforts and the Society’s new name are rejected?  What if folks walk out in protest?  What if the change is viewed as being disrespectful of our storied past?”

Thankfully, none of these irrational thoughts came to fruition and SABI was roundly embraced.  In fact, the changes were met with a standing ovation!  The point is, change is scary, but necessary.  I bet anyone reading this newsletter practices differently today, then say they did a year ago.  Maybe you changed a protocol, or began offering active surveillance for prostate cancer, or increased your patient engagement or bought AI software.  Whatever changes you and your colleagues made in your daily practice, I bet SABI was there to help.  We are, and want to be your go-to society for innovations in the practice of body imaging—not only current modalities (e.g., CT, MR, PET, US), but those on the horizon, and here-to-for unimagined. We welcome a diverse membership and are committed to innovating, mentoring and educating in an inclusive and respectful environment.

It was privilege to be President during the transition and I owe a debt of gratitude to fellow Board members, active members, and administrative staff who worked tirelessly to make SABI a reality. Under President Scott Reeder’s leadership, we will refine the changes we embarked upon with rebranding. I am confident we are on the right path.

 

Congratulations to the 2019 - 2020 Board of Directors!

 


PRESIDENT
Scott Reeder, MD, PhD, FSABI
University of Wisconsin - Madison


 

PRESIDENT ELECT
Beth McFarland, MD, FSABI
SSM St. Joseph Health Center


 

VICE PRESIDENT
Joel Platt, MD, FSABI
University of Michigan
Medical Center

 

TREASURER
Brian Herts, MD, FSABI
Cleveland Clinic


 

CHIEF MEMBERSHIP OFFICER
Ivan Pedrosa, MD, PhD, FSABI
University of Texas SW
Medical Campus

SECRETARY
Desiree Morgan, MD, FSABI
University of Alabama
 at Birmingham

IMMEDIATE PAST PRESIDENT
Susan Ascher, MD, FSABI
Medstar Georgetown
University Hospital

MEMBER AT LARGE
Aarti Sekhar, MD
Emory University

 

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Congratulations to Dr. Reed Dunnick and Dr. Jeffrey Weinreb!  (Click on photos to learn more)

2019 Scientific Session Winners

 

LAUTERBUR

Named in honor of Paul Lauterbur, PhD, who first described the basic MRI technique in 1972 and published his first MR images in 1973, this award is presented to the best MR oral presentation.
Direct Radiologic-Pathologic Correlation of Liver Lesions with an MR-Compatible Localization Device    
Dr. Victoria Rendell    

HOUNSFIELD

Named in honor of Sir Godfrey Hounsfield, a 1979 Nobel Prize winner for the development of computer-assisted tomography, this award is presented to the best CT oral presentation.
Vascular Deformation Mapping: A New Technique for Three-dimensional Growth Mapping in Thoracic Aortic Aneurysm    
Dr. Nicholas Burris  

RESOUNDANT® INNOVATION AWARD

Sponsored by Resoundant, this award is presented to the most innovative technology or contrast Oral Presentation from the Scientific Session. 
GagCEST as a Viable Tool for Detecting Differences in Healthy and Osteoarthritic Cartilage at 3T    
Dr. Elka Rubin    

MONCADA

Named in honor of Rogelio Moncada, MD, a member of SCBT-MR who was instrumental in establishing our research awards program, this award is presented to the best oral presentation for a contrast media-related topic.    
Reproducibility of Radiomics Features Using Single-Energy Dual-Source CT:  Influence of Radiation Dose and CT Reconstruction Settings Within the Same Patient    
Dr. Mathias Meyer 
   
YOUNG INVESTIGATOR

This award is presented to the best Oral Presentation by a medical student, resident or fellow.
Body composition change measured by CT imaging and survival in patients with pancreatic cancer    
Dr. Lei yu    

MORE SCIENCE-HCC SESSION    
Publicly Transparent Outcome Data for CT Guided Lung Biopsies; a Patient Centered Approach
Dr. Geoffrey Miller


EVEN MORE SCIENCE - RESPONSE TO THERAPY SESSION   
Repeatability and Reproducibility of Confounder-Corrected R2* as a Biomarker of Liver Iron Concentration: Interim Results from a Multi-Center, Multi-Vendor Study at 1.5T and 3T
Dr. Diego Hernando 

MAGNA CUM LAUDE
Reference Atlas of Power Injectable Medical Access Ports on Chest X-Ray: A Supplemental Guide to Successful Identification at Referral Centers   Dr.Huy Do    

MAGNA CUM LAUDE 
Accurate diagnosis in prostate mp-MRI: Know your pitfalls and avoid unnecessary biopsies!    
Dr. Vlad Bura  

MAGNA CUM LAUDE
ntraductal Papillary Neoplasm of the Bile Duct: Radiology-Pathology correlation    
Dr. Jack Conner 

CUM LAUDE
Estimating Quantitative Lobar and Zonal Pulmonary Perfusion from Dual Energy CT Pulmonary Angiography:  Accuracy and Applications in Pulmonary Embolism     
Dr. Ramandeep Singh 

CUM LAUDE
Assessment of Liver Surface Nodularity, Sarcopenia and Visceral Obesity as Predictors of Cardiometabolic Risk Factors in African Americans    
Dr. Elliot Varney 

CUM LAUDE 
Renal Mass Characterization with Dual-Energy CT using the Iodine Quantification Technique from a Dual-Layer Spectral CT Platform
Dr. Sherry Wang 

CUM LAUDE
Evaluating for primary malignancy in patients with solitary and multiple brain lesions: the diagnostic value of CT chest, abdomen, and pelvis    
Dr. Richard Rothman

 

 

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We are excited to announce that the 2020 SABI Annual Meeting will be held in New Orleans at the Ritz Carlton on October 10 - 14. The Program Committee, led by Dr. Beth McFarland, our President elect, is already hard at work designing an exciting program for SABI 2020. Highlights include an exciting pre-meeting workshop on artificial intelligence, the Presidential Lecture, and an outstanding set of plenary and scientific sessions on the latest in CT, MRI, artificial intelligence, and much more.

Ghaneh Fananapazir, MD

Associate Professor - Ultrasound

UC Davis Health

 

 

Guarav Khatri, MD

Associate Professor - Radiology

UT Southwestern Medical Center

 

 

Sadhna Nandwana, MD

Assistant Professor of Radiology and Imaging Science

Emory University

 

 

 

 

 


"Information Overload"
The ability to instantly connect has benefits for radiologists -
but also inevitable distractions.
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Smartphones are an important aspect of modern life, especially for professionals. According to the Pew Research Center, 81% of adults — and 91% of U.S. adults who have a college degree — own smartphones.1 Recently, I had a conversation with a friend and discovered that between various social media networks, email, and traditional phone call and text messaging, I could privately contact them through 14 different ways — just from my smartphone.

Information has never been more accessible and the ability to instantly connect with another person has its benefits. However, the constant barrage of alerts and notifications that ease of connectivity entails brings with it inevitable digital distractions. A changing digital landscape has meant that discussions are shifting to social media platforms. Social media has completely changed the way information is disseminated. Now, texts, emails, and social media notifications follow many radiologists home, and these alerts affect neural networks that regulate attention.2 This leads to a constant state of alertness, awaiting the next notification or ping. This heightened level of alertness is not sustainable forever, and it can lead to what has been described as “techno-brain burnout.”3 In fact, a recent survey by the ACR Commission on Human Resources found that 77% of radiology practice leaders report burnout as a “very significant” or “significant” workplace problem.4 Requirements for emailing for work and, more recently, social media have contributed to burnout.5

Our connection to digital media has crept into off-hours as well. According to a recent study, Americans check their phones on average 80 times per day while on vacation.6

Between balancing work requirements with personal priorities such as family, friends, exercise, and personal time, what is a busy professional to do? Here are a few specific steps individuals can take:

1. Realize you have control. Radiologists want more control over their time, and modern smartphones allow the user to have a fair degree of it. Notifications and alerts for specific apps and programs can be turned off, as can, if needed, the entire smartphone. These settings are present, and users should take some time familiarizing themselves with and making use of those settings.

2. Exercise email discipline. A recent study found that limiting how often you check email to three times a day leads to decreased overall stress.7 Turn off or limit new email notifications and alerts and set aside specific intervals during the day to check it as opposed to checking every time you get a new email. During those five to ten minutes of emailing, take an action with each new email: delete, save, or archive; respond in two or three sentences; or flag when it warrants a more detailed response and more time is available.

3. Be judicious with notifications. When an app requests to send notifications and alerts, I almost always decline. I am an avid social media user, and yet I do not have Twitter or Facebook notifications or alerts enabled on my devices.

4. Create digital-free time. Set aside time every day to disconnect completely from email and social media to focus on friends and family. If possible, attempt to occasionally have extended time logged off completely from digital life — perhaps except for voicemail or emergencies.

5. Respect others’ off-time. If writing work emails during the weekend, consider pre-scheduling them or saving them as drafts to be sent on Monday morning.

One of the greatest assets of a smartphone is the ability to connect with family, friends, and colleagues. However, the pressure to stay perpetually up to date can have insidious consequences for radiologists attempting to balance the never-ending stream of technological advancements, their daily work, and their personal well-being. While we may have more resources vying for our attention, we still only have a limited number of hours in the day — this places a premium on our ability to discern what is really worth knowing. In the digital age, we think our most important sources of knowledge are our smartphones or access to the internet. In fact, what we need now more than ever are connections with our mentors and professional role models, relationships with our families and friends, and time to ourselves.


Tirath Y. Patel, MD, is a radiologist at Houston Radiological Associates.

ENDNOTES
1. Pew Research Center. Mobile fact sheet. Published June 12, 2019. Accessed September 13, 2019.
2. Small G, Vorgan G. iBrain: Surviving the Technological Alteration of the Modern Mind. New York: Harper; 2009.
3. Small G. Brains on overdrive: am I thinking too fast for my own good? Psychology Today Web site. Published October 4, 2009. Accessed September 13, 2019.
4. Parikh JR, Wolfman D, Bender CE, Arleo E. Radiologist burnout according to surveyed radiology practice leaders. J Am Coll Radiol. Published August 6, 2019. S1546-1440(19)30828-2. Accessed September 13, 2019.
5. Tso HH, Parikh JR. Embracing social media in the era of work-life integration. Clin Imag. Published November – December 2019. (58)191-3. Accessed September 13, 2019.
6. SWNS. Americans check their phones 80 times a day: study. New York Post Web site. Published November 8, 2017. Accessed September 13, 2019.
7. Coryell C. Finding a balance. ACR Bulletin. Published May 2019. Accessed September 13, 2019.
8. Kushlev K, Dunn EW. Checking email less frequently reduces stress. Comput Human Behav. Published February 2015. (43)220-8. Accessed September 13, 2019.


 

The Time is Now
Paid parental leave is an important mechanism for preventing
burnout and addressing diversity in radiology

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It’s no secret that the United States lags far behind other developed nations on parental leave. While many countries offer between 12 and 52 weeks of paid parental leave, the U.S. remains the only developed country without a national policy on the issue.1 Only 19% of
private sector employees have access to paid parental leave of any length.2 Perhaps not by coincidence, the U.S. also sees a higher level of maternal and infant complications and mortality than other developed countries.3

An increasing number of physicians — and radiologists specifically — say that it’s time for medicine to lead by example, offering paid parental leave in residency, academia, and private practice. This is more than a women’s issue or a family issue, they say. It’s a health issue and fits squarely with the emphasis on health outcomes.4 

Proponents of parental leave also believe that taking a lead on this issue can help address some of the challenges facing radiology. This includes attracting and retaining talent, preventing burnout, and increasing diversity — including increasing the percentage of women entering the field.

In the past year, individuals and organizations within medicine and radiology have taken a stand on the issue, including the American Academy of Pediatrics, the AMA, the Society of Chairs of Academic Radiology Departments (SCARD), the American Association for Women in Radiology (AAWR), the Association of Program Directors in Radiology (APDR), and the ACR.5 

Katarzyna J. Macura, MD, PhD, FACR, ACR vice president, believes innovation and forward-thinking about parental leave can positively affect the future of radiology and radiologists. According to Macura, “Family- friendly policies and well-being plans have potential to positively impact all radiologists, not just women and their families.” Flexible leave plans can also help people of all genders caring for parents or spouses or those who want to work reduced hours without fully retiring.

Elizabeth K. Arleo, MD, president of AAWR and a leading voice on the topic, agrees. Arleo says the AAWR has been taking a three-pronged approach to advocate for paid parental leave in the field of radiology. The initial step focused on advocating for 12 weeks paid parental leave for attendings in academia, the second stage focused on trying to improve parental leave in residency, and recent efforts have included addressing the issue in private practice.

Proven Benefits

Research has shown that paid leave of 12 weeks or more increases immunization rates, extends the length of breastfeeding, and improves bonding between parent and child.6 Paid leave has also been found to decrease rates of post-partum depression.7 These benefits lead to better health outcomes for both parent and child — as well as the health of the community.8

According to Arleo, physicians are well aware of these health benefits and rightfully want them for their own families. “You have young people who love their careers and taking care of patients and who also love their families,” says Arleo. “They shouldn’t have to choose between the two.”

Especially in a tight labor market, employee benefits such as parental leave can make the difference in attracting and retaining talent, and increasing profitability, productivity, and employee morale.9 Research shows that 57% of jobseekers report that benefits and perks are among their top considerations for accepting a job.10 Extending parental leave options is a tactic successfully employed by the IT industry, with companies like Google, Amazon, and Facebook leading the way. Google reported that after implementing a policy of 18 weeks of paid parental leave, new mothers were twice as likely to stay on the job after welcoming a new child. Many top companies offer much longer leaves — up to a year in some cases.11

Reduced Burnout

These statistics and outcomes speak directly to the field of radiology, where women make up less than one-quarter of the profession — a percentage that hasn’t changed significantly in decades, Arleo points out.12

That’s why the SCARD and APDR positions on the topic are so important, she says. The APDR statement affirms that residents are considered employees and have a right to family leave of 12 weeks under the Family and Medical Leave Act and empowers residents to exercise that option.13 In addition, a new policy from the ABR now allows radiologists to sit for their core exams after 32 months of residency instead of 36 — and residents can take their full 12 weeks of leave and still take their exam at the same time as their class.14 “This has the potential to change the gender landscape in the profession,” Arleo says.

Monica J. Wood, MD, a fourth-year radiology resident at Massachusetts General Hospital, agrees. Although she had already decided on a career in radiology, the fact that her residency program offered a generous paid leave policy has helped her feel supported professionally and personally as she welcomed a new baby during her residency. “It makes a difference in my ability to complete training and also be able to start a family,” Wood says.

Parental leave can also help address the rates of burnout that affect 45% of radiologists.15 Kamran Ali, MD, FACR, a radiologist with Wichita Radiological Group, says he has prioritized physician wellness, work-life balance, and preventing burnout since becoming president of his private practice that employs 20 radiologists and includes a small residency program. Even so, parental leave was not a top concern for him until Amy K. Patel, MD, a former resident at his practice, and Arleo approached him at ACR 2019. Ali quickly saw the connection. “If we really care about value and resilience, then we should take a look at implementing a parental leave policy at our practices,” he says. “It goes a long way in mitigating burnout and making a more resilient and inclusive workforce.”  Read Full Article


 

A Collaborative Resource
A roadmap on gadolinium indentifies knowlege
gaps about its retention

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Gadolinium-based contrast agents (GBCAs) have revolutionized MRI, enabling physicians to obtain crucial life-saving medical information that often cannot be obtained with other imaging modalities. Since initial approval by the FDA in 1988, more than 450 million intravenous GBCA doses have been administered worldwide, with an extremely favorable pharmacologic safety profile.1 However, recent information has raised new concerns about the safety of GBCAs.

 

On Feb. 15, 2018, the National Institute of Biomedical Imaging and Bioengineering (NIBIB) convened an international meeting in Bethesda, Md., to identify and prioritize future research initiatives regarding the mechanisms, biological importance, and clinical implications of gadolinium retention. The research roadmap resulting from this workshop identifies knowledge gaps about gadolinium retention and prioritizes directions for needed research. The Bulletin recently spoke with Herbert Y. Kressel, MD, FACR, co-author of the roadmap, and Deborah Levine, MD, FACR, also a co-author of the report, to discuss their efforts to shed light on this tool in diagnostic imaging.

What was the result of the workshop?

HK: In December of 2017, the FDA issued a communication about GBCAs as part of its post-market monitoring of drug safety — requiring a class-wide warning about gadolinium retention in the labeling of these agents, and additional studies by manufacturers to assess their safety.2 In 2018, the NIBIB workshop, sponsored by the ACR, NIH, and RSNA, was held to review what is known about gadolinium retention and its potential clinical significance. Most importantly, a major goal was to identify key gaps in current knowledge to form the basis of a prioritized research roadmap.

Two reports based on the workshop have been published (available at bit.ly/Gad_Roadmap). In May of 2018, at the request of the FDA, the four manufacturers of GBCAs — Bayer, Bracco, GE Healthcare, and Guerbet — co-authored a letter sent to all providers, alerting them that GBCAs may remain in the body months to years after injection. The letter noted that retention is highest with the linear agents and lower with the macrocyclics. The letter also clarified that no adverse clinical or pathological consequences of this retention have as yet been identified. To help educate patients, the FDA — in collaboration with the GBCA manufacturers — has created a medication guide specific to each agent for distribution prior to a contrast-enhanced MRI examination.

What led to the development of the resources?

DL: Both Dr. Kressel and I had been working in the editorial office of Radiology, and we had accepted for publication early reports of gadolinium deposition in the brain; we knew that this was a very important topic. And because we’re talking about a very low incidence — if any — of patients having symptoms, we needed large studies; we needed researchers to collaborate to answer this really important question. But as more papers came out, it seemed like different research groups were working in their own silos and doing their own studies differently — using different types of contrast, different concentrations, different techniques — not all of which were optimized for detecting gadolinium — so you couldn’t really compare or combine results. So the idea of bringing this scientific community together was to figure out where the research gaps were and to make a roadmap — to really talk about best practices for studies going forward so that hopefully we could generate interest from the research community to collaboratively come up with answers.

The important thing to understand about the controversy with gadolinium is that, historically, the safety profile is still there; it’s still an exceptionally safe contrast medium. We don’t want to scare people and have them not use gadolinium with contrast because it’s so helpful for so many different medical conditions. So we always talk about a cost-benefit ratio; the benefit is getting the right diagnosis, or helping with treatment or tailoring treatment in cancer patients, and the risk — right now — is still a theoretic risk.

How can the radiology community use these presentations as a resource?

HK: The slides of the entire workshop have been posted on the NIBIB website (available at acr.org/Clinical-Resources/Contrast-Manual). These include presentations on the chemical properties, stability, biodistribution, toxicology, and speciation of these agents — as well as on retention in central nervous system (CNS) and non-CNS tissues in animals and in humans.

DL: Having the slides available on the NIBIB website was something that we thought was very important because, again, there is only so much that you can put in print. By having the original agenda, the transcript of what was actually said at the meeting, and the slides available, we believe that anybody doing research in this area can use these resources. In addition, most of the general ACR community aren’t researchers, but if they do MR, they want to have a good understanding of contrast. This resource can help them understand the benefits and the risks of using GBCAs, as well as how to put those risks in context — because a lot of patients will come in and have questions, and rightly so.


ENDNOTES
1. Levine D, McDonald RJ, Kressel HY. Gadolinium Retention After Contrast-Enhanced MRI. JAMA. 2018;320(18):1853–54.
2. Brooks, M. FDA to Require Warning Labels on Gadolinium-Based Contrast Agents. Medscape. Published Dec. 19, 2017. Accessed Oct. 2, 2019.

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

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SABI is trying to increase the society's outreach and involve more members in society information. The communications committee hopes to use social media to create a space where members can stay up to date, and connect on society news. As well as learn from recent research and members can share and discuss relevant materials.  Follow us, and interact with the various posts. The more interaction on the social media pages, the broader the viewership.

 
    

 

 

 Chief Editor
Priya Bhosale, MD

Administrator Editor
Jennifer Sheehan