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 with dense, fibroglandular breasts who were at high risk of developing breast cancer.

The problem these women have with mammography is contrast. A cancer appears as a white splotch, and fibroglandular tissue looks white on mammograms, making it harder to see the cancer.

Dr. Berg marshaled the evidence supporting a trial that included bilateral screening ultrasound performed and interpreted separately from mammography, developed a protocol and sought approval from ACRIN and the National Cancer Institute for the study and gratefully accepted generous funding from the Avon Foundation.

Recruiting 21 teams of expert breast imagers from the United States, Canada and Argentina as principal investigators of this study, Dr. Berg oversaw the enrollment of 2,809 women whose risk of breast cancer and breast density met the study’s eligibility criteria.

The study, now closed to accrual, called for three annual rounds of mammography and bilateral breast sonography. During the long gestational period of this excellent research endeavor – and during the study itself – Wendie has distinguished herself as an outstanding thinker, leader and scientist.

— Ellen B. Mendelson, MD, FACR, is co-investigator of ACRIN 6666.




10. Carmine Valente, PhD, CAE
Ultrasound’s advocate

The American Institute of Ultrasound in Medicine (AIUM) operates at the forefront of the ultrasound community under the leadership of a dedicated and diverse group of volunteers. The constant element in this equation is the guidance provided by AIUM CEO, Carmine Valente, PhD, CAE.

Dr. Valente received his public health training from Johns Hopkins University and his doctorate from the University of Maryland. He is also designated a certified association executive by the American Society of Association Executives.

“For the past 10 years, I have had the honor and privilege of serving as the CEO of the AIUM. As a multidisciplinary medical association of [more than] 7,000 physicians, scientists and sonographers, we have had access to the collective knowledge and expertise of our volunteer officers, leaders, dedicated staff and members to promote and advance the field of medical ultrasound,” Dr. Valente says.

This is an exciting time for the AIUM. Most recently, the AIUM has campaigned for the approval of the use of contrast-enhanced ultrasound (CEUS) in the United States. The lack of CEUS potentially hinders the delivery of optimal diagnostic imaging, resulting in an adverse impact on patient care.

Perhaps one of the most important efforts of the AIUM is the work of its Bioeffects Committee, charged with evaluating research on the biological effects of ultrasound. The government, manufacturers and other world ultrasound bodies look to the AIUM on matters related to the safety of clinical ultrasound.

Dr. Valente has been a key element in facilitating and coordinating these and other important activities that continue to grow both the AIUM and interest in the ultrasound arena.

— Joshua Copel, MD, is president of the AIUM.




11. Edward “Ned” Patz Jr., MD
Thinking outside the box

Edward “Ned” Patz Jr., MD, has clearly established himself as one of the most influential radiologists in the country. Over the past decade, Dr. Patz has proven to be an innovative, productive and influential visionary in the field of tumor diagnostics, particularly focusing on the early detection of lung cancer. His observations, writings and teachings have significantly impacted the current practice of medicine.

Dr. Patz has an amazing ability to think “outside the box.” He has created a true paradigm shift in diagnostics, stressing that imaging should provide a spectrum of noninvasive information, accurately reflecting the underlying biology. No one has a better appreciation of this novel approach and of the necessities of molecular diagnostics in clinical medicine than Dr. Patz.

His initial research efforts were focused on PET imaging, and he was among the first in the world to apply this technique to the analysis of solitary pulmonary nodules. His work was rapidly integrated into worldwide clinical practice.

Dr. Patz’s unique understanding of tumor biology led him to explore alternative diagnostic strategies, which resulted in a number of pioneering contributions in early detection strategies, and in the development of tumor-specific imaging probes and biomarkers. It is this latter work that holds enormous promise for the future. 

Dr. Patz is a unique and creative individual. His contributions to diagnostic imaging and translational medicine are outstanding. He will, undoubtedly, continue to contribute to significant advances in diagnostic radiology and molecular diagnostics.

— Carl Ravin, MD, is professor and chairman of the department of radiology at Duke University Medical Center.




12. Memorial Sloan-Kettering Cancer Center
Cancer’s greatest foe

Advances in imaging technology – and in the ways we apply it – are having a major impact on cancer care. We are able to detect cancer at increasingly smaller sizes. Imaging findings frequently provide crucial information for treatment selection, treatment planning and assessment of response. And imaging is increasingly being used to guide minimally invasive procedures, changing the nature of surgical practice.

Furthermore, imaging is accelerating our understanding of the biology of cancer and hastening the development of new drugs.

Testifying to the increasing importance of imaging in cancer care, Memorial Sloan-Kettering Cancer Center’s (MSKCC) department of radiology has grown dramatically in recent years. The number of faculty members has doubled, while the total staff has grown to more than 550 members.

Going forward, MSKCC’s Breast and Imaging Center, which is currently under construction, will be able to accommodate an increasing number of breast cancer patients, while also expanding services for cancer screening and diagnostic services. The facility will offer patients minimally invasive treatment options – high-frequency ultrasound, for example – that work together to optimize care.

The future of cancer care lies in minimally invasive, image-guided approaches to diagnosis and treatment. Ultimately, we want to be able to diagnose, treat and follow patients without ever having to cut into the skin.

— Hedvig Hricak, MD, PhD, is chairman of Memorial Sloan-Kettering Cancer Center’s department of radiology.




13. American College of Radiology
Imaging’s mission control

The American College of Radiology (ACR) is proud to serve a leadership role in radiology. As medical imaging and radiation oncology procedures replace more invasive techniques, the ACR will meet the challenges presented by advancing technology and a shifting medical landscape.

The ACR spearheaded the introduction of the Access to Medicare Imaging Act of 2007, which seeks a two-year delay to Deficit Reduction Act imaging cuts, pending a study of their effect on care. The ACR was instrumental in convincing the Centers for Medicare and Medicaid Services (CMS) and many private insurers to scrap plans for an additional 25 percent reduction on contiguous imaging payments.

And, we will continue to oppose congressional efforts to impose further cuts. The ACR worked with CIGNA to get the insurer to reprocess previously denied computer-aided detection mammography claims – months before a settlement obligating them to pay these codes became effective.

The ACR is a leader in radiology research. The American College of Radiology Imaging Network (ACRIN®) “MRI of the Contralateral Breast Trial” may very well change clinical practice by showing that breast MRI, in addition to mammography, detected more cancers in the opposite breast of newly diagnosed patients. This could reduce unnecessary surgeries and chemotherapy.

The ACR recently launched the National Carotid Artery Stent Registry, the first of six voluntary registries comprising the National Radiology Data Registry, whose evidence-based benchmarks will aid quality improvement in imaging facilities nationwide, potentially increase CMS reimbursement and guide future research.

And in January 2008, the association will launch the ACR Education Center. This “mini-university” will offer hands-on refresher courses and new techniques, including simulation, for practicing physicians and house multimedia facilities for interaction between doctors and educational material.

— Arl Van Moore Jr., MD, FACR, is chair of the ACR board of chancellors.




14. University of Michigan Health System
Multifaceted to serve the field

As one of the nation’s top academic medical centers, the University of Michigan Health System (UMHS) cares for some of the most severely ill patients across the spectrum of human disease, and performs advanced research and training in many fields.

Accordingly, the 130 physicians and hundreds of nurses, technologists and staff of the U-M department of radiology have developed a broad range of specialty imaging programs using the latest imaging technology, from 64-slice CT and 3-Tesla MRI to PET/CT, SPECT/CT, biplane digital fluoroscopy and color Doppler ultrasound.

The department’s major subspecialties are abdominal, angiography-interventional, breast imaging, cardiothoracic, cross-sectional interventional, emergency, interventional neuroradiology, MRI, musculoskeletal, general neuroradiology, nuclear medicine, pediatric radiology and ultrasound.

The department’s main base is a rapidly growing imaging department, serving the main UMHS medical center complex, including University Hospital, C.S. Mott Children’s Hospital, Women’s Hospital, the Taubman Outpatient Center, the Cardiovascular Center and the Comprehensive Cancer Center. The department also operates four satellite locations in surrounding communities, and staffs the VA Ann Arbor Healthcare System.

In addition to dedicated research, MRI and PET equipment at the main complex, the department has animal-imaging facilities where molecular and structural imaging techniques are being developed. Several advances have already been spun off to industry, including companies begun by UMHS physicians.

The department’s educational programs are equally extensive. Forty-four radiology residents and 30 fellows are in training at any one time, as are dozens of technologists-in-training studying at two community colleges.

The department also annually sponsors eight major CME courses that are taught by physicians and technologists. For staff technologists, a system of career ladders in various subspecialties allows for continuous growth and training.

— N. Reed Dunnick, MD, is the Fred Jenner Hodges Professor and chair of the department of radiology at the University of Michigan.




15. Richard G. Barr, MD, PhD
Early detection with elasticity imaging

Richard Barr, MD, PhD, is conducting research to help lower the number of breast biopsies by employing elasticity imaging in a clinical setting.

Dr. Barr is a professor of radiology at the Northeastern Ohio Universities Colleges of Medicine and Pharmacy in Rootstown, Ohio, and a radiologist in Southwoods X-Ray and MRI in Youngstown. He reported his findings at the annual meeting of the Radiological Society of North America in November.

Dr. Barr and his colleagues used the Siemens Antares ultrasound system in their work. Siemens Medical Systems was the first to obtain clearance from the U.S. FDA to do elasticity imaging.

Elasticity imaging is a modified ultrasound examination, in which the stiffness of a mass is gauged (malignant breast tissue stiffens). Two simultaneous images are taken, one in a normal state and one in a slightly compressed state. The images are then compared using proprietary software.

Early detection of malignancies is vital to successful treatment, but the process is just as important for patients who have masses determined to be benign. By showing that tumors are likely to be benign and placed in a “we’ll just watch it” category, the process could reduce the number of biopsies performed. More than 75 percent of biopsies are negative, so the number of unnecessary procedures could drop.

According to Barr, the learning curve for doing elastograms is about 30 minutes. He adds that the process could be used on other soft-tissue cancers, such as liver, thyroid and prostate cancers.

— Jim Szatkowski is the public relations coordinator for Northeastern Ohio Universities Colleges of Medicine and Pharmacy.



16. American College of Cardiology 
Taking it to heart

As the radiology field continues to seek out best practices, it’s fortunate that they have an ally in the American College of Cardiology (ACC). In June, the ACC partnered with the American Society of Echocardiography (ASE) – in conjunction with a variety of other cardiovascular organizations – to develop “Appropriateness Criteria” for two cardiac ultrasound practices, transthoracic (TTE) and transesophageal (TEE) echocardiography.

The ACC developed the criteria to help guide doctors in determining the proper times to utilize TTE and TEE. According to the ACC, in general, use of TTE/TEE for the initial evaluation of structure and function was viewed positively, while routine repeat testing and general screening uses in certain clinical scenarios were viewed less positively.

“For the very first time, we are formally addressing the appropriate use of one of the earliest and most commonly used imaging technologies. Although the concept of proper use of technology is not new, providing physicians with the tools to assess our own practice patterns is a critically important and new undertaking. It gives real meaning to our efforts to promote quality in cardiovascular care,” says Pamela S. Douglas, MD, MACC, FASE, chair of the TTE/TEE Appropriateness Criteria Writing Group and a past president of the ACC.

In addition, be on the lookout for the ACC to make its voice heard in the radiology community in 2008. With the advent of advanced imaging technology with cardiac implications, such as Toshiba America Medical Systems’ 256-slice CT scanner, the ACC will likely take center stage once again.

— RT Image Staff




17. Kerry Link, MD
A visionary in cardiac imaging

A classically trained cardiovascular radiologist, Kerry Link, MD, joined the faculty at Wake Forest University School of Medicine in 1987. He worked primarily in coronary angiography, pediatric heart catheterizations and cardiac MRI.

In 1995, Dr. Link won the Fulbright Fellowship in Medicine for his work in coronary artery flow measurements and studied coronary artery physiology at the Royal Brompton Cardiac MRI Center in London.

A visionary clinician and educator in cardiac imaging, Dr. Link recognized the tremendous importance of imaging – not just in clinical diagnosis, but also in clinical and basic science research. He mustered the resources to put in place a dedicated imaging research facility that has grown into the world-renowned Center for Biomolecular Imaging at Wake Forest University Health Sciences.

Dedicated in 2003, the center comprises more than a dozen MRI, PET, PET/CT, multislice CT, ultrasound and optical scanners. Also encompassing biomarker development, including nanotechnology, the center has worked on more than 70 funded imaging grants from more than 20 medical and basic science departments, resulting in more than 150 publications.

Dr. Link serves as director, overseeing all institutional clinical, animal and molecular imaging research. He also has served or is currently serving as principal or co-investigator on more than two dozen grant-funded research projects.

Although he spends the bulk of his time with the Center for Biomolecular Imaging, Dr. Link continues to be actively involved in clinical cardiac imaging and teaching. He believes imaging is poised to help medicine transition from a traditionally reactive, symptom-based approach to disease to a more proactive, preventive or early interventional approach.

Dr. Link also was invited to give the Oral Presentation at the 2006 annual scientific meeting of the Radiological Society of North America.

— Jonnie Rohrer is the senior public relations manager at Wake Forest University School of Medicine.




18. Midwestern State University’s MSRS Program
Raising the bar for education

The exceptional faculty and staff at Wichita Falls, Texas-based Midwestern State University (MWSU) leads a Master of Science in Radiologic Sciences (MSRS) program designed to prepare master’s candidates in the field of radiologic technology. This hybrid distance program opens the door for busy radiologic technology professionals to continue their education. The program prepares its graduate students to be leaders in the field of education, research and administration within radiologic technology.

The graduate faculty is dedicated to the success of the hybrid distance learning program. To this end, they tirelessly give up many weekends to make themselves available to the graduate student classes.

In addition to their extremely heavy undergraduate teaching workloads, the incredibly dedicated faculty members sacrifice several weekends a semester to ensure the ongoing success of this program. The MWSU MSRS program focuses on “raising the bar” within the field of radiologic technology.

Students are encouraged to publish papers and to contribute to the body of knowledge within the field. MWSU faculty also supports the radiologist assistant program, which is also set up as a hybrid distance learning program. The students are the faculty’s biggest fans and supporters.

The faculty includes Nadia Bugg, PhD, Donna Wright, PhD, Jeff Killion, PhD, and James Johnston, PhD. All of these educators go above and beyond the call of duty to make sure students are prepared to be successful contributors within the field.

In addition to their full-time roles as educators, they hold leadership roles within the radiologic technology community, and have encouraged all of us to continue to “raise the bar” as educators, administrators, and researchers within our field.

MWSU recently enjoyed the distinction of being awarded No. 1 in the “Top Value” category among public institutions based upon a variety of factors by Consumers Digest.

This excellent university, along with its dedicated and involved faculty, deserves recognition for the role they play in contributing to the ongoing excellence within the field of radiologic technology.

— John Colang is an alumnus of the MSRS program at Midwestern State University.




19. R. Gilbert Jost, MD
Tech-savvy leadership

As president of the Radiological Society of North America (RSNA) board of directors, R. Gilbert Jost, MD, is recognized globally for using IT to improve diagnostic radiology practice.

In addition, Jost also holds the titles of Elizabeth Mallinckrodt Professor of Radiology, chair of the department of radiology at Washington University School of Medicine, director of the Mallinckrodt Institute of Radiology and radiologist-in-chief at Barnes-Jewish Hospital in St. Louis. Additionally, Jost is a fellow of the American College of Radiology and has the distinction of being named an inaugural fellow of the Society for Computer Applications in Radiology (now the Society for Imaging Informatics in Medicine.)

Jost leads the charge in many radiologic pursuits. He was an early participant in the Integrating the Healthcare Enterprise (IHE) Planning Committee and the IHE Strategic Committee. He was also very influential in the adoption of the DICOM standard and an early promoter of the IHE movement, which has since gained increasing acceptance throughout the world as a methodology that allows medical computer systems from different manufacturers to communicate with one another.

In addition, Jost is a firm believer in advancing research and education through the synergy of science, technology, ingenuity and patient care. He remains committed to the application of digital information systems to enhance radiology practice.

“These are exciting times, and times of great change for our specialty,” Jost says. “The challenge is to stay abreast of the changes and help to keep radiologists at the forefront of the rapid developments in the field of medical imaging.”

— Gary J. Becker, MD, is chairman of RSNA’s board of directors for 2007.




20. The Children’s Hospital of Philadelphia
Always on the cutting edge

The radiology department at The Children’s Hospital of Philadelphia showcases a new facility and the arrival of two cutting-edge diagnostic tools this year as one of the world’s largest and most advanced centers for pediatric imaging and diagnosis. 

The doors to radiology’s new facility opened within Children’s Hospital’s new West Tower in March, offering expanded services and amenities. This includes a state-of-the-art sedation suite with 21 private rooms, seven ultrasound suites, four fluoroscopy suites, two 64-slice CT suites, a PET/CT center, three interventional radiology suites, five nuclear medicine suites, two diagnostic X-ray suites, a new reading room, a larger waiting area comprising private registration booths and changing booths, family counseling rooms and a child play area.

Children’s Hospital’s first PET/CT center opened in March and is the only facility in Northeastern United States that has a PET/CT scanner dedicated solely to children. Children’s Hospital can now offer better detection of a variety of cancers, treatment response, neurological disorders and non-urinary tract focal infection/inflammation. The PET/CT center will also provide many research opportunities focusing on imaging biochemical activity.

Children’s Hospital also unveiled its new magnetoencephalography (MEG) facility this year. The hospital is one of a few pediatric institutions with MEG, which measures brain waves and produces maps and movies of brain function and abnormalities.  Physicians and researchers at Children’s Hospital have begun to use MEG to characterize and localize the brain origins of autism and epilepsy, among other disorders. 

— Diego Jaramillo, MD, MPH, is radiologist-in-chief at The Children’s Hospital of Philadelphia.




21. Shehnaz Pancholi
Telemedicine’s first lady

As the CEO and founder of Teleradiology America (TA) and Pediatric Radiology of America (PRA), Ms. Shehnaz Pancholi draws upon her extensive experience in the teleradiology domain. Prior to launching SRS, she was instrumental in the success of American Teleradiology Network (ATN). At ATN, as director/vice president of sales, Ms. Pancholi was instrumental in starting and training the sales team.

Under her leadership, the revenues grew 500 percent within two years. She also was pivotal in building the credentialing and licensing team, which accelerated the start of clients’ services after the initial sales closing.

After the acquisition of ATN by Nighthawk Radiology Services, Ms. Pancholi realized the need to create a teleradiology company that not only addressed the adult domain, but the enormously large and untapped field of pediatric teleradiology. Currently, she oversees the only teleradiology company that caters to both the pediatric and adult markets.

She has assembled a robust faculty that is dedicated to the growth of the company. The radiologists that join the team are not only employees of SRS, but also become owners of the company, in that they all become stockowners. Ms. Pancholi understands the need for both the management and physicians to take pride in the continued growth of their company.

At the helm of TA/PRA, she stands out as the only female CEO in the growing teleradiology domain. As an immigrant to the United States, she is achieving the “American Dream.” Her successful track record and her expertise will ensure her place as a visionary in the domain of telemedicine.

— Rashid Taher, MD, is strategic advisor and a member of the board of directors for Teleradiology America.




22. Peter Kingma
Bearing international acclaim

At a global, multimodality medical imaging company, it is easy to lose sight of the big picture and focus too narrowly on one’s own product line.

What makes Peter Kingma so influential is that he never loses sight of the big picture: delivering the best possible healthcare to patients by giving physicians technology that improves quality and reduces their costs.

From that standpoint, Peter truly has a multimodality mindset. But it doesn’t end there; his 22-year career at Siemens Medical Solutions started in South Africa and, since then, he has had tremendous international success. So his thinking is not only multimodality, but also multinational.

This approach affects his team, and I’ve seen that firsthand. Working for the division’s global headquarters in Germany, Peter steered the CT business as the technology was just transitioning into a multislice environment. He ushered in the age of volumetric imaging that we see today.

Leaving his CT comfort zone, Peter established a Siemens business in Australia and New Zealand. He built these businesses from the ground up, and today they are enjoying a great deal of success.

Following that, we brought him back to the United States, where he led the U.S. sales force for our molecular imaging division.

Peter returned to CT this year, and he will drive the U.S. business moving forward. The Somatom Definition Dual Source scanner has already set a new standard in cardiac imaging. He will push the envelope even further as the scanner leverages its two X-ray tubes to provide dual-energy images that were never before possible on a CT scanner.

But, no one is better positioned to lead this business than my multitalented colleague and close friend, Peter Kingma.

— Markus B. Lusser is vice president of global sales and marketing at Siemens Medical Solutions’ Molecular Imaging Division.




23. Barry B. Goldberg, MD
The father of ultrasound

Click here to view an exclusive Webcast with Dr. Goldberg as he discusses the latest innovations in ultrasound.

Radiologist. Medical advisor. Author. Founder. Director. Honoree. President, past-president or chairman (or all of the above) of so many prestigious radiology organizations, including the World Federation of Ultrasound, the American Institute of Ultrasound in Medicine and the Thomas Jefferson University Hospital. The list of the affiliations and credentials alone of Barry B. Goldberg, MD, could easily fill this space – and several more pages to boot.

But a quick look at his CV should easily tell you how he earned the nickname, the “Father of Ultrasound.”

With his current position as director of the department of radiology, division of diagnostic ultrasound and radiologic imaging, and professor of radiology at Philadelphia-based Jefferson Medical College – a post he has held for 30 years – he has continued work begun in the 1960s in developing ultrasound education programs for physicians and technologists, as well as throughout the world.

Among his many research projects over the years, Dr. Goldberg has been a key force in developing improved Doppler ultrasound measurement techniques, improving 3-D ultrasound imaging, evaluating new techniques for more accurate noninvasive measurement of bloodflow and evaluating ultrasound-guided needles to increase the accuracy of ultrasound aspiration and biopsy techniques.

In 1998, at the annual scientific assembly of the Radiological Society of North America (RSNA), when Dr. Goldberg received the Outstanding Researcher Award, then RSNA President David B. Fraser, MD, called him “the embodiment of the physician-scientist, who not only has done key innovative work in his field, but has provided leadership and training to generations of ultrasound specialists worldwide.”
   
— Jacqueline Kozloski is the director of public relations at Thomas Jefferson University and Hospital.




24. The Blogosphere
Radiology enters the ‘Blogosphere’

Recently, there has been no escaping the mention of blogs in the media. Blogging has emerged as a social phenomenon, which has impacted politics, business and communication.

Blogging software has enabled people with limited knowledge of the Internet to publish their thoughts online and participate in a global conversation; whereas the Blogosphere has hyperaccelerated the spread of information. Blogging might well become an important means of information transfer in radiology, also.

As radiology is an image-based science, a blog is a satisfying endeavor in that you can share your experiences with others instantaneously. In this context, I would like to submit my experience with an easy method for building a Web site known as “blogging,” or maintaining a Web log.

As a radiologist, I use my blog to post interesting cases from my routine practice along with any interesting abstracts I come across during my day-to-day work.

The success of this project can be measured by the fact that in the last three years of ‘‘rad-blogging,’’ more than 100,500 visitors came to the site from all over the world, with thousands of queries from patients, colleagues and many interested students.

Rad-blogging might well become a new easy method of information exchange and opinion-building in radiology.
   
— Sumer K. Sethi, MD, is a consultant radiologist with VIMHANS and CEO of Teleradiology Providers.




25. Steve H. Rusckowski
The people’s CEO

In November 2006, Steve Rusckowski was appointed CEO of Philips Medical Systems – a position that Steve is well suited for, due to his extensive experience in the healthcare industry.

Steve has been involved in many facets of healthcare – especially radiology and diagnostics – throughout his more than 20 years in the industry. He possesses a long track record of running successful growth businesses, shaping strategy and managing businesses that enhance healthcare during his time at Agilent Technologies, Hewlett-Packard and Procter and Gamble.

In addition, Steve is also a board member of several organizations that aim to advance radiology and the healthcare field, including Project HOPE, the New England Healthcare Institute, Massachusetts High Technology Council and more. All this experience, knowledge and keen understanding of the various constituencies and key perspectives in the healthcare marketplace position Steve as a dynamic leader for not only Philips’ future, but also how healthcare is impacted globally.

As Steve builds and strengthens strategic initiatives to continue propelling Philips forward, he has implemented a people-focused approach by introducing cross-discipline plans to partner with customers for their valuable clinical perspectives, trigger innovation based on human insight and engage and empower employees. 

Steve has an ambitious vision to further his commitment to customers, including strengthening Philips’ presence and position in emerging markets; increasing Philips’ mid- to low-price product presence; increasing the speed of product innovation and focus on improving customer satisfaction.

And, be on the lookout for Steve to energize Philips toward continually developing advanced systems, designed around clinicians that focus on the care cycle and aim to improve the entire healthcare delivery system.

— Brent Shafer is CEO of global sales and service for North America at Philips Medical Systems.