25 Most Influential

1. Society of Nuclear Medicine
Leading a revolution

By planning strategically, SNM continues to grow and adapt to meet the changing needs of patients, healthcare, its members and the profession. For more than 50 years, SNM and its 16,000 physician, technologist and scientist members have been well known for excellence in the nuclear medicine profession.

Their work has expanded into the rapidly emerging – potentially revolutionizing – field of molecular imaging. Nuclear medicine imaging has always contributed functional assessment to the anatomical definition of the presence or absence of disease. The new tools made available through molecular imaging and PET have great potential to contribute to the personalized medicine revolution – and SNM is leading the way.

Validating the Field

Molecular imaging may revolutionize patient care – by integrating information about location, structure, function and biology – leading to a package of non-invasive, in vivo imaging tools with enormous potential for improving patient care and outcomes. It will provide an essential key to the future of high-quality personalized medicine, which involves diagnosing, treating and monitoring patients based on their individual makeup.

SNM is assisting in translating multimodality breakthroughs from the lab into practical tools for physicians, thus expanding treatment options for patients. The society is reaching out to experts in related fields and facilitating the movement of molecularly guided discoveries from bench to bedside.

SNM’s “Bench to Bedside” campaign has raised nearly $4 million in its first year to develop educational tools for radiologists, primary-care physicians and patients; to support advocacy for molecular imaging; and to train the current imaging workforce.

The society is addressing the technological, regulatory, financial, business development and evidence-based requirements to successfully integrate molecular imaging into medical care and the evolving field of personalized medicine by proving that it makes a difference to patients.

SNM is also working with national groups to develop meaningful clinical studies data so that these new imaging tests can be introduced as fast as possible into clinical practice, and also to ensure that current PET indications can be expanded.

This will lead to the practical clinical use of imaging biomarkers, offering tremendous potential for accelerating the development of pharmaceuticals and therapeutic devices, and ensuring that the best treatment is given to the right patient at the right time. And, SNM’s Clinical Trials Group is facilitating the development of imaging biomarkers and new probes.

Driving Research and Education

SNM’s Molecular Imaging Center of Excellence, the driving force for research, education, advocacy and innovation in the field of molecular imaging, has successfully completed a number of activities, positioning SNM as a central resource.

Center members have developed standard definitions and terminology; created a new Web site to provide online information, education and training in molecular imaging; established a dialogue with funding agencies; hosted an expert/industry summit; initiated outreach to referring physicians, patient groups, federal agencies, regulators and the public; and launched proactive lobbying for reimbursement, research funding and related issues.

The society is recognized, and strongly represented, as a vital and influential leader and innovator in advancing molecular imaging and therapy and supporting nuclear medicine. During a year-long rebranding process, SNM reviewed all of the elements of its brand and considered options and suggestions to strengthen and broaden its image, creating a unified organizational identity with the development of the Molecular Imaging Center of Excellence, the redesign of its main Web site and logo.

By all these actions – and continuing to collaborate with those in related professional and patient associations – SNM is leading the molecular imaging revolution.

— Alexander J. McEwan, MD, is president of the Society of Nuclear Medicine.




2. Newt Gingrich
Building an intelligent health system

As the founder of the Center for Health Transformation (CHT), former Speaker [of the House] Newt Gingrich is having a monumental impact on creating what the center calls “a 21st century intelligent health system.”

Through our center, Newt has brought together an unparalleled collaboration of high-impact leaders from both the public and private sector, who are working together to replace the current paper-based, bureaucratic system with a new system of health – one that is centered on the individual, IT-rich and focuses on early detection, prevention and wellness. The increased creation and adoption of diagnostic tools, such as diagnostic imaging, are key to the future being advocated and created by the center.

The mission of the CHT is to support a movement that will accelerate the adoption of transformational health solutions and policies that create better health with more choices at lower cost. With Newt Gingrich, the center acts as a catalyst to accelerate transformational change by sharing those solutions, technologies and policies with a wide array of policy-makers, opinion leaders and decision-makers. 

With cancer, Alzheimer’s, diabetes and health information technology as four of our key projects, the center advocates the creation and adoption of diagnostic tools to help advance personalized medicine and targeted treatments for various conditions, recognizing that patients who begin therapy earlier have better outcomes. 

When it comes to getting the message out, there are few as compelling as Newt Gingrich. Along with the hundreds of health speeches he gives each year, he and the rest of our center team are featured regularly in the news media. They are making the case for health transformation in Congressional testimony, in training and educational briefings for key public- and private-sector decision-makers and through CHT Press, the center’s new publishing arm.

While many ask if Newt plans to run for office, he consistently asserts that his focus is not on running for office, but on getting America and our leaders to adopt 21st century transformational solutions for a better future, with a primary emphasis on health transformation.

Both Newt and CHT are committed to the fact that, whatever the future holds, we will continue to serve as a key catalyst for the creation of a 21st century intelligent health system that saves lives and saves money for every American.       

— Nancy Desmond is president and CEO of the Center for Health Transformation and co-author with Newt Gingrich of The Art of Transformation.




3. Breast MRI
New advances, new options

In 2007, the number of breast MRI examinations continued to skyrocket, propelled by studies performed within the past year that substantiate the clinical indications for the examination. For instance, MRI screening of the contralateral breast in women with recently diagnosed unilateral breast cancer was evaluated at 25 clinical sites in the United States and Canada in a study conducted by the American College of Radiology Imaging Network (ACRIN).

Mammographically occult breast cancer was found in 3.1 percent (30 of 969 women). These findings are consistent with those of five previous smaller studies from 1997-2003, which, on average, found cancer in 5.1 percent (40 of 792 women) contralateral breasts.

In another study, 195 genetically high-risk women, defined as BRCA1/BRCA2 carriers or with at least a 20 percent probability of carrying a BRCA1/BRCA2 mutation, were screened with mammography, MRI and ultrasound at six facilities throughout the United States. The cancer yield was 3.5 percent percent for MRI, 1.2 percent for mammography and 0.6 percent for ultrasound in this trial conducted by the International Breast MRI Consortium and supported by ACRIN.

These results are consistent with those from nine previous high-risk screening studies performed in North America and Europe from 2000-2007, which found an average 3.9 percent detection rate for mammographically occult tumors.

On the basis of such high-risk screening studies, the American Cancer Society (ACS), in early 2007, published “Guidelines for Breast Screening with MRI as an Adjunct to Mammography.”
Screening MRI is recommended for women with an approximately 20 percent to 25 percent or greater lifetime risk of breast cancer, including women with a strong family history of breast or ovarian cancer and women treated for Hodgkin’s disease. Approximately 1 to 1.5 million women in the United States fall into these extremely high-risk categories.

ACS concluded that available data are currently insufficient to recommend for or against MRI screening for women with a personal history of breast cancer, carcinoma in situ, atypical hyperplasia and extremely dense breasts on mammography. Further studies are needed to determine the detection rates, false positive biopsy rates and cost-effectiveness of MRI screening of such women who may have a less than 20 percent lifetime risk of breast cancer.

Although breast MRI has an increasingly better defined list of screening and diagnostic indications, it is important to realize that clinical results will depend on the technical quality and the level of interpretive expertise. With this in mind, the ACR will initiate a voluntary breast MRI accreditation program by the end of 2007.
   
— Stephen A. Feig, MD, FACR, is chair of the American College of Radiology Breast Imaging Communications Committee.




4. Arl Van Moore Jr., MD, FACR
Radiology’s frontman

As chair of the American College of Radiology (ACR) – one of the largest medical specialty organizations in the world – Arl Van Moore Jr., MD, FACR, is among the nation’s foremost respected leaders in the field of radiology and an important resource for the entire medical community.

Dr. Moore is the central figure in the ACR’s efforts to ensure appropriate reimbursement for imaging and radiation oncology services based on medical fact and quality patient care. He tirelessly argues before Congress and other bodies regarding the value of appropriate medical imaging performed by a highly trained radiologist.

Furthermore, he emphasizes the need to protect patients’ access to care as private-payers, Medicare and state agencies frequently revise their imaging policies. In his role as chair of the ACR’s board of chancellors, Dr. Moore delivers outstanding leadership to a host of issues, ranging from quality and safety to the development of the new ACR Education Center – a national, cutting-edge training facility for radiologists, which opens in early 2008.

As former chair of the ACR Task Force on International Teleradiology and primary author of the “ACR Whitepaper on International Teleradiology,” Dr. Moore serves as a leading authority on patient safety and quality-of-care issues associated with this ever-increasing practice within the radiology community.

Dr. Moore is also chair of the ACR Task Force on Disaster Preparedness and primary author of the primer, “Disaster Preparedness for Radiology Professionals.” He is a leading expert in efforts to enable the radiology community, first-responders and the rest of medicine to proceed effectively in the event of a nuclear accident or terrorist attack.

In private practice, Dr. Moore is an active interventional radiologist and president of Charlotte Radiology, one of the largest radiology groups in the South. Additionally, he is medical director at the Carolinas Medical Center School of Radiologic Technology.

Dr. Moore is also an interventional radiology CAQ examiner for the American Board of Radiology and a clinical assistant professor at the Duke University Medical Center department of radiology. He will be a key figure in radiology for many years to come.

— Harvey L. Neiman, MD, FACR, is the executive director of the American College of Radiology.




5. Claudia Henschke, MD, PhD
Innovation in lung cancer detection

At a recent conference at the Center for Disease Control and Prevention (CDC), the topic was spiral CT screening for lung cancer. The bulwark of the center’s efforts on lung cancer have focused on tobacco control, but Dr. Claudia Henschke’s landmark paper on lung cancer screening appearing last October in the New England Journal of Medicine has caused many, including the CDC, to reconsider this thorny topic. The story of how this paper came to be reveals much about the determination and drive of Dr. Henschke.

In 1999, the main thrust of innovation for finding early lung cancer was directed at employing new molecular diagnostic approaches, so that there was considerable skepticism about the robustness of Dr. Henschke’s first screening paper in the Lancet, suggesting that spiral CT could be effective in consistently finding early lung cancer.

Furthermore, when the seed money allowing this initial research dried up, Dr. Henschke developed an innovative Web-based study management system with a collaborator, Dr. Anthony Reeves. This tool enabled the economical, but massive, growth of collaborators, allowing for the 2006 New England Journal report, which included more than 31,000 study participants.

Along the way, Dr. Henschke, with a large and loyal band of collaborators, redefined the approach to diagnostic work-up in the screening setting and redefined the surgical approach for screen-detected cancer. They pioneered the use of image processing to detect nodule growth as a tool to reduce over-treatment in the clinical management of screen-detected cancers.

The flow of innovative tools to meet specific management needs has not stopped as new biopsy catheter-guidance devices and other tools are moving forward. This work has had such impact, that Senators Feinstein and Brownback, in a joint resolution called the National Cancer Act of 2007, have proposed that the CDC initiate demonstration projects to follow up on the research findings of Dr. Henschke’s group.

While lung cancer screening remains an evolving field, the breathtaking pace of progress in this field has been unquestionably driven by a very resourceful radiologist from Cornell. 

— James L. Mulshine, MD, is professor of internal medicine and associate provost for research at Rush University Medical Center.




6. St. Jude Children’s Research Hospital
Giving children hope

Radiological Sciences is a major clinical and research department at St. Jude Children’s Research Hospital in Memphis, Tenn., which is focused on improving the diagnosis and care of children with cancer and related catastrophic diseases. Diagnostic imaging is the department’s largest division, incorporating routine and cross-sectional imaging modalities in radiography, MR and nuclear medicine.

Faculty members are responsible for clinical investigations that have focused on advancing diagnostic techniques and measures of tumor response, as well as the treatment-related changes in major programmatic areas, including neuroimaging and bone integrity. Recently, molecular imaging research has been initiated with the installation of a dedicated cyclotron facility and nuclear chemistry.

An active translational imaging research effort includes quantitative and functional neuroimaging, as well as technical development and clinical investigation related to vascular imaging in both neuro-oncology and sickle cell disease. In the fall, the department will move into new quarters, nearly tripling its space to provide both expansion and modernization to optimize diagnostic imaging and radiation oncology with enhanced technologies and a dedicated staff.

St. Jude is internationally recognized for its pioneering work in finding cures and saving children with cancer and other catastrophic diseases.

Founded by the late entertainer Danny Thomas, St. Jude freely shares its discoveries with scientific and medical communities around the world. No family ever pays for treatments not covered by insurance, and families without insurance are never asked to pay. St. Jude is financially supported by ALSAC, its fundraising organization.
   
— Larry Kun, MD, is chair of the St. Jude Children’s Research Hospital department of radiological sciences.




7. Linda K. Holden, MS, RT(R)(QM)(RDMS)
The liaison

American Society of Radiologic Technologists (ASRT) President-elect Linda K. Holden, MS, RT(R)(QM), RDMS, is the sonography program director and a radiography faculty member at the Laramie County Community College in Cheyenne, Wyo. But, according to Christine Lung, director of government relations for the ASRT, “She is a [also] wonderful person.”

Lung has worked with Holden for several years on the passage of the Consistency, Accuracy, Responsibility and Excellence in Medical Imaging and Radiation Therapy (CARE) bill. “[Holden] is a strong advocate for federal minimum standards,” Lung says. “She served on ASRT’s Committee for R.T. Advocacy before being elected to the ASRT Board. Linda has [also] consistently participated in the R.T. in D.C. advocacy event.”

And it was Holden who finally convinced Rep. Barbara Cubin, R-Wyo., who has been in office since 1994, to sign on as a co-sponsor of the CARE bill this year during the annual R.T. in D.C. event.

Holden was also instrumental in gaining CARE bill support from Sen. Mike Enzi, R-Wyo., who is chairman of the Committee on Health, Education, Labor and Pensions. “Linda and Sen. Enzi are both from Wyoming,” Lung says. “[So,] she felt comfortable going to him and asking to co-sponsor the bill.”

Today, Holden is one of the main constituent contacts for Sen. Enzi. According to Lung, “When we need that personal constituent touch, we go to Linda.”

“In addition to being a great advocate for the RT profession,” Lung says, “Linda is a great educator. She has a very friendly and collegial rapport with her students. She is truly an influential person within the profession.”

— Michelle Stephens is the corporate writer for the ASRT.




8. American Board of Imaging Informatics
Certifying the IIP

The American Board of Imaging Informatics Inc. (ABII) is the nonprofit organization that sponsors the Imaging Informatics Professional Certification Program and awards the Certified Imaging Informatics Professional (CIIP) designation to qualified candidates.

Founded by the Society for Imaging Informatics in Medicine (SIIM) and the American Registry of Radiologic Technologists (ARRT), ABII offers a national certification program that defines the standard for demonstrated knowledge and competence in medical imaging informatics.

Initial exam development and design began in 2003, and it has been supported through the process over the last four years by the founding organizations. Collaboration between the two organizations allowed each to contribute its unique expertise and resources. SIIM brings a wealth of content-specific expertise, while the ARRT has extensive experience in the policies and procedures of certification.

The ABII seven-member board of trustees consists of three members nominated by SIIM, three members nominated by the ARRT and a public member who is not employed in the field of imaging informatics. ABII’s mission is to enhance patient care, professionalism and provide a measure of competence for those practicing in the field of imaging informatics.  

The IIP certification program has been developed to be consistent with the standards of the National Commission for Certifying Agencies (NCCA). The program will be submitted for accreditation to the NCCA.

Anyone interested in learning more about ABII and certification should visit www.abii.org or contact ABII at 651-994-6410.
   
— Chuck Socia, RT(R)(CT)(QM)/CIIP, is with the American Board of Imaging Informatics.




9. Wendie Berg, MD, PhD
Ultrasound meets breast imaging

One of the most important contributions to women’s health that radiologists can make is the early detection of breast cancers when they are small, early-stage and more successfully treatable.

For many years before the American College of Radiology Imaging Network (ACRIN) 6666 multicenter trial opened for patient participation, Dr. Wendie A. Berg, MD, PhD, understood the need for a large study that would investigate the role of supplemental ultrasound for a special group of women for whom mammography had some limitations in detecting breast cancer: women w