MAY 2006 ■ VO LU M E 16, NUMBER 5

Also Inside:■ Study Shows Small MR-Detected Breast Lesions Do Not Require Biopsy ■ Radiographer Shortage Continues as Programs Turn Away Qualified Candidates■ Imaging Reimbursement Cuts May Harm Rural Practices, Patients■ RSNA Grant Leads to Novel Molecular Imaging Agents

Register Now for RSNA 2006

RSNA.org/register

Lung Cancer RevolutionImminent, Researcher Says

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MAY 2006

E D I T O RBruce L. McClennan, M.D.

C O N T R I B U T I N G E D I T O RRobert E. Campbell, M.D.

M A N A G I N G E D I T O RLynn Tefft Melton

E X E C U T I V E E D I T O RNatalie Olinger Boden

E D I T O R I A L A D V I S O R SDave Fellers, C.A.E.

Executive DirectorRoberta E. Arnold, M.A., M.H.P.E.

Assistant Executive DirectorPublications and Communications

E D I T O R I A L B O A R DBruce L. McClennan, M.D.,

ChairSilvia D. Chang, M.D.Richard T. Hoppe, M.D.David M. Hovsepian, M.D.Valerie P. Jackson, M.D.Jonathan B. Kruskal, M.D., Ph.D.Steven M. Larson, M.D.Hedvig Hricak, M.D., Ph.D.,

Board Liaison

C O N T R I B U T I N G W R I T E R SNicole Grasse, M.A.Amy Jenkins, M.S.C.Marilyn Idelman SoglinLydia Steck, M.S.

G R A P H I C D E S I G N E RAdam Indyk

W E B D E S I G N E RKathryn McElherne

2 0 0 6 R S N A B O A R D O F D I R E C T O R STheresa C. McLoud, M.D.,

ChairGary J. Becker, M.D.,

Liaison for ScienceHedvig Hricak, M.D., Ph.D.,

Liaison for Publications andCommunications

Burton P. Drayer, M.D., Liaison for Annual Meeting and Technology

George S. Bisset III, M.D., Liaison for Education

Sarah S. Donaldson, M.D., Liaison-designate for Science

Robert R. Hattery, M.D., President

R. Gilbert Jost, M.D., President-elect

RSNA NewsMay 2006 • Volume 16, Number 5

Published monthly by the Radiological Societyof North America, Inc., at 820 Jorie Blvd., Oak Brook, IL 60523-2251. Printed in the USA.

POSTMASTER: Send address correction“changes” to: RSNA News, 820 Jorie Blvd., Oak Brook, IL 60523-2251.

Nonmember subscription rate is $20 per year;$10 of active members’ dues is allocated to asubscription of RSNA News.

Contents of RSNA News copyrighted ©2006 bythe Radiological Society of North America, Inc.

Letters to the EditorE-mail: rsnanews@rsna.orgFax: 1-630-571-7837RSNA News820 Jorie Blvd.Oak Brook, IL 60523

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1 Announcements

2 People in the News

4 Board of Directors Report

Feature Articles

6 Lung Cancer Revolution Imminent, Researcher Says

8 Study Shows Small MR-Detected Breast Lesions Do Not Require Biopsy

10 Imaging Reimbursement Cuts May Harm RuralPractices, Patients

12 Radiographer Shortage Continues as Programs Turn Away Qualified Candidates

Funding Radiology’s Future®

19 RSNA Grant Leads to Novel Molecular ImagingAgents

20 R&E Foundation Donors

14 Journal Highlights

16 Radiology in Public Focus

17 RSNA: Working for You

18 Program and Grant Announcements

21 Meeting Watch

22 Exhibitor News

23 Product News

25 RSNA.org

1R S N A N E W SR S N A N E W S . O R G

ANNOUNCEMENTS

NINETY-THREE percent ofrespondents to a shortsurvey about their experi-

ences with RadiologyInfo.orgindicated they had found theinformation they sought.Nearly 50,000 visitorsresponded to the surveybetween December 20, 2004and December 31, 2005.

RadiologyInfo.org is thepublic information Web sitedeveloped and funded byRSNA and the American Col-lege of Radiology (ACR).More than 14,000 visitors in that same timeperiod also participated in a more detailedevaluation of the material on the Web sitewith more than 80 percentindicating that the amount ofinformation was “just right.”About 55 percent said the same about theamount of graphic art and photos. An over-whelming majority of visitors—almost 82percent—said they found the site through anInternet search engine.

About two-thirds of survey respondents

were female and over age 46. Most respon-dents were patients (57 percent) or apatient’s friend or family member (16 per-

cent). More than 80 percentof respondents had somecollege education.

RadiologyInfo™ provides simple, yet thor-ough, descriptions of diagnostic imaging,interventional radiology and radiation ther-apy procedures and treatments. In September2005, a Spanish version of the site wasadded.

RadiologyInfo™ Users Satisfied

Three UK Radiology Academies Open

THE Royal College of Radiolo-gists, in collaboration with the

UK Department of Health andNational Health Service, hasestablished the Leeds and WestYorkshire, Norfolk & Norwich

and Peninsula radiology acade-mies. The academies are part ofthe Radiology-Integrated TrainingInitiative, a new national programto increase the number of radiolo-gists in training.

Top 10 Procedures Visitedon RadiologyInfo™

English language(January–December 2005)PETCT BodyChest RadiographyMR AngiographyMammographyUltrasound AbdomenUltrasound PelvicGeneral UltrasoundCT HeadCT Abdomen

Spanish language (September–December 2005)Chest RadiographyBone RadiographyHysterosalpingographyHead CTLung CancerUltrasound ScrotalMammographyFunctional MR Imaging (fMRI)Ultrasound ObstetricHead & Neck Cancer

MEDICAL IMAGING COMPANY NEWS:

IBA to Build Center in Vietnam■ Ion Beam Applications (IBA), of Louvain-La-Neuve,Belgium, has announced a contract with several Viet-namese agencies to develop and supply equipment foran integrated National Cyclotron Center in Hanoi, Viet-nam. The center will produce SPECT and PET radioiso-topes for medical imaging purposes and serve as a sci-entific research and education center. Tran Hung DaoHospital will operate the center jointly with the VietnamAtomic Energy Commission (VAEC), the Vietnam Acad-emy of Science and Technology, Hanoi University ofTechnology and Hanoi University of Natural Science.

ART Buys Alerion■ ART Advanced Research Technologies Inc. (ART), ofSaint-Laurent, Quebec, has acquired Alerion Biomed-ical, Inc., of San Diego. ART provides optical molecularimaging products for the healthcare and pharmaceuti-cal industries. Alerion developed and manufacturedbiomarkers and contrast media, including the Fenestra™

line, for preclinical and clinical imaging devices.

VIEWING TECHNOLOGY

Tip of the MonthNormal office light levels are too high for readingdigital mammograms. Reflections and glare reducethe eye’s ability to detect low-contrast lesions.

American Association of Physicists in Medicine

2 R S N A N E W S M A Y 2 0 0 6

AUR Presents AwardsThe Association of University Radiologists (AUR)has awarded gold medals to Wilbur L. Smith Jr.,M.D., and Kay H. Vydareny, M.D. Dr. Smith ischair of the Department of Radiology at Wayne StateUniversity and Detroit Medical Center. Dr. Vydarenyis a professor of radiology at Emory University.

Also at the AUR annual meeting last month inAustin, Texas, the Association of Program Directorsin Radiology (APDR) presented its achievementaward to Vijay M. Rao, M.D. Dr. Rao is chair of theDepartment of Radiology at Thomas Jefferson University.

PEOPLE IN THE NEWS

Lee Named to “40 UnderForty”Vivian Lee, M.D., Ph.D., professorand vice-chair of research in theDepartment of Radiology at theNew York University School ofMedicine, has been named toCrain’s New York Business “40Under Forty” list. The list is billedas an annual compilation of “risingstars” in medicine, business, enter-tainment, sports and the arts.

Hailed by Crain’s as a “multitasker in medicine,” Leehas developed new MR imaging techniques. Her focus hasbeen using MR imaging to identify causes of kidney dys-function in transplant recipients, as well as to understandthe connection between high blood pressure and renalartery stenosis.

IN MEMORIAM:

Frederic N. Silverman, M.D.

Frederic N. Silverman,M.D., considered afounding father of

pediatric radiology, diedMarch 15 in Palo Alto,Calif., at the age of 91.

Dr. Silverman was a pio-neer in alerting the medicalcommunity and public tothe use of radiology todetect child abuse. He grad-uated from Syracuse Uni-versity School of Medicinein 1939 and, after complet-

ing internships at Yale andJohns Hopkins, served atour in the South Pacificwith the U.S. Army MedicalCorps.

In 1947, Dr. Silvermanbecame the first full-timedirector of the Division ofRoentgenology at theCincinnati Children’s Hos-pital Medical Center(CCHMC), a position heheld until 1975. He was acharter member of the Soci-

ety for Pediatric Radiology(SPR) and served as its sec-ond president.

Dr. Silverman’s 1953landmark article, “TheRoentgen Manifestations ofUnrecognized SkeletalTrauma in Infants,” pub-lished in the AmericanJournal of Roentgenology,defined inflicted trauma asthe etiology of what is nowknown as child abuse.

Emageon Has New COOEmageon Inc. has announced that Grady Floyd has joinedthe company as Chief Operating Officer. Floyd has 20years of leadership experience in companies specializing invisual medical imaging. Most recently, he was co-founderand COO of Vasant, L.L.C.., a consulting firm specializingin healthcare technology business development.

Kay H. Vydareny, M.D. Vijay M. Rao, M.D.

Vivian Lee, M.D.,Ph.D.

Wilbur L. Smith Jr.,M.D.

Frederic N. Silverman,M.D.

CIR Names Honorary MemberCésar Sánchez Pedrosa, M.D., will be named an honorarymember of the InterAmerican Congress of Radiology(CIR) for outstanding work in promoting radiology andcontinuing education.

Also at the CIR Congress this month in Spain, CIR willaward gold medals posthumously to Luis Karpovas, ofBrazil, CIR president from 2004–2006, and Luis Romero,of Argentina, CIR President from 1992–1994.

ACR Gold MedalistsDURING ITS annual meeting last month in Washing-

ton, the American College of Radiology (ACR)awarded gold medals to the following:• Robert E. Campbell, M.D., clinical professor of

radiology at the University of Pennsylvania Schoolof Medicine. Dr. Campbell was 1989 RSNA presi-dent and is a contributing editor of RSNA News.

• David C. Levin, M.D., professor emeritus of radi-ology at Thomas Jefferson University

• J. Frank Wilson, M.D., professor of radiationoncology, chair of the Department of Radiation Oncology at Medical College of Wis-consin (MCW) and director emeritus of the MCW Cancer Center

ACR also named Ann Barrett, M.D., Guo-Liang Jiang, M.D., and Man ChungHan, M.D., as honorary members.

3R S N A N E W SR S N A N E W S . O R G

PEOPLE IN THE NEWS

Send news about yourself, a colleague or your department to rsnanews@rsna.org, 1-630-571-7837 fax, or RSNA News, 820 JorieBlvd., Oak Brook, IL 60523. Please include your full name and telephone number. You may also include a non-returnable color

photo, 3x5 or larger, or electronic photo in high-resolution (300 dpi or higher) TIFF or JPEG format (not embedded in a document). RSNA News maintainsthe right to accept information for print based on membership status, newsworthiness and available print space.

Robert E. Campbell,M.D.

David C. Levin, M.D. J. Frank Wilson, M.D.

RSNA Scholar Receives Komen GrantRSNA Research & EducationFoundation Bracco DiagnosticsResearch Scholar Jingfei Ma,Ph.D., has received a $225,000grant from the Susan G. KomenBreast Cancer Foundation for“Whole Body MRI for Detect-ing Breast Cancer Metastases.”

Dr. Ma, of the University of

Texas M.D. Anderson CancerCenter, received the RSNA grantin 2004 for “Differentiationbetween Benign and MalignantVertebral Compression Fractureswith Quantitative Diffusion andFat MR Imaging.”

More information about theRSNA Research & EducationFoundation (R&E) ResearchResident/Fellow and ResearchScholar grants, as well asother R&E grant and awardprograms, can be accessed atRSNA.org/Foundation/programs.cfm.

New ECR PresidentChristian J. Herold, M.D., is the firstAustrian president of the EuropeanCongress of Radiology (ECR). Dr.Herold is a professor and director of theDepartment of Diagnostic Radiology atthe Medical University of Vienna andits University Hospital, AllgemeinesKrankenhaus. Dr. Herold also is a part-time faculty member in the Departmentof Radiology at the Johns HopkinsMedical Institutions.

Dr. Herold served as a Radiology associate editor from1995 to 1999, has been a Radiology reviewer since 1993, andwas presented the Radiology Editor’s Award for Distinction inReviewing in 1994.

Chicago Radiological Society Honors MossThe Chicago Radiological Soci-ety has presented its Distin-guished Service Award to Gre-gory D. Moss, M.D., chair of theDepartment of Radiology andImaging at Resurrection MedicalCenter in Chicago. Affiliatedwith Resurrection Medical Cen-ter since 1984, Dr. Moss wasnamed to his current position in 1995.

Dr. Moss has been a leader in many radiology organi-zations, including the Chicago Radiological Society, theIllinois Radiological Society, the Society of InterventionalRadiology and the American College of Radiology.

Christian J. Herold,M.D.

Jingfei Ma, Ph.D.

Gregory D. Moss, M.D.

4 R S N A N E W S M A Y 2 0 0 6

THE RSNA Board of Directors metin Chicago in late March, approv-ing the 2006-2009 Strategic Plan

and several proposals in the areas ofcontinuous quality improvement,enhancing the educational experience atthe RSNA annual meeting, increasinginternational outreach and raising aware-ness about the RSNA Research & Edu-cation Foundation.

Meeting with LeadershipPrior to the Board meeting, Boardmembers met with the chairs and vice-chairs of RSNA committees and theeditors of RSNA journals.

Committee leadership heardupdates from the Board on the RSNAStrategic Plan, five-year vision and newinitiatives such as the RSNA Highlightsconference and the Continuous QualityImprovement Initiative (CQI2). Thecore of the meeting featured discussionabout the committee appointmentsprocess, new member and chair orien-tations, communication with the Boardand among committees, meeting sched-ules and the committees’ role in RSNAstrategic planning.

The assembled leadership alsooffered ideas on involving residents,junior faculty and corresponding mem-bers in RSNA activities and governance.

Strategic PlanThe Board approved a revised strategicplan that includes updated objectivesand strategies to support the Society’smission to be the “premier professionalassociation dedicated to science andeducation in radiology.” The Board alsorefined its five-year vision, concentrat-ing on topics including radiologic edu-cation, maintenance of certification, avirtual annual meeting, electronic

educational materials and molecularimaging.

Continuous Quality Improvement The Board approved a 12-month actionplan under the new CQI2. An RSNAcommittee, chaired by Steven J.Swensen, M.D., developed the actionplan, which includes:• Opening session and focus sessions

on quality at RSNA 2006• Refresher course series on quality at

RSNA 2007, focusing on hot topicssuch as pay per performance andpractice metrics

• Section on quality in RadioGraphicsbeginning in 2007

The CQI2 committee is also devel-oping a model for a longitudinal work-shop on continuous quality improve-ment (CQI) that will train participantsto design and implement CQI projectsin their own practices or departments.

A content code for Quality Assur-ance/Quality Improvement (includingradiation and general safety issues) wasapproved at the September Board meet-ing. For those of you looking toquickly find these course offerings atRSNA 2006, look forthe QA symbol onrsna2006.rsna.org whenthe meeting programbecomes available inOctober. Click on thesubspecialty content tabat the top of the page.

RSNA 2006One of the most notice-able changes at the upcoming annualmeeting will be reconfiguration of thehall in the Lakeside Center ofMcCormick Place that houses scientificposters, education exhibits, infoRAD®

exhibits, informatics demonstrations,company-sponsored hands-on work-shops, and the RSNA journal editorialoffices.

Beginning at RSNA 2006, the hallwill be called Lakeside Learning.While it will still contain the traditionaldisplays, the big difference will be totalcontent integration by subspecialty in anew hub-and-spoke format.

For example, those interested incardiac imaging will findall of the scientific postersand education exhibits incardiac imaging groupedtogether as a spoke with agathering area at the out-ermost edge of the spoke.The gathering area—called a community—willfeature lounge seating and42-inch plasma monitors

on which some of the cardiac educationexhibits and scientific posters will beshown. The community will also be theplace where lunchtime poster andexhibit discussion with authors will

RSNA Board of Directors Report

RSNA NEWS

Theresa C. McLoud, M.D.Chair, 2006 RSNA Board of Directors

92nd Scientific Assembly and Annual Meeting

November 26–December 1, 2006

McCormick Place, Chicago

5R S N A N E W SR S N A N E W S . O R G

occur. Seventeen subspecialties will berepresented, including informatics (for-merly known as infoRAD) applications.

The Board believes attendees withsimilar practices will have an increasedopportunity for social interaction and vig-orous discussion with colleagues in thecommunities. A feature article on the newLakeside Learning hall will be includedin the June issue of RSNA News.

International attendees of RSNA2006 may have an easier time navigatingthe McCormick Place convention centerby taking advantage of interpretationservices. In addition to Chinese, French,German, Japanese, Korean and Spanish,Dutch translation services will be avail-able this year at the Help Centers.

The recipients of 2006 special hon-ors have been notified. The names ofthe RSNA Gold Medalists, HonoraryMembers, Special Presidential Awardrecipient and honored lecturers will beannounced in the June issue of RSNANews.

Educational Courses at RSNA HQIf you are among the members who haveparticipated in committee meetings andeducational courses offered at RSNAHeadquarters in Oak Brook, Ill., youmay have noticed that the first-floor con-ference room is not always conducive toholding large meetings, particularly whenbreakout sessions are needed.

In an effort to accommodate largergatherings and to host more interactivecourses, the Board has approved a planto revamp the conference center. Con-struction should be completed by fall2006.

Similarly, the annual Integrating theHealthcare Enterprise (IHE®) Connec-tathon has outgrown its meeting spaceon the lower level of RSNA Headquar-ters. Beginning next year, the Connec-tathon will be held at a hotel conferencecenter, and, for the first time, willinclude educational sessions in additionto the opportunity for manufacturers totest equipment for interoperability withother systems. Nearly 400 systemsengineers from about 60 healthcare

information technology companies fromaround the world participated in the2006 Connectathon.

Course content is still in develop-ment, but will include topics such as theelectronic health record.

Oncologic Imaging and TherapiesThe Board approved the formation of anew Taskforce on Oncologic Imaging andTherapies that will help formulate pro-grams and initiatives of interest to bothdiagnostic radiologists, interventionalradiologists and radiation oncologists.

An RSNA staff taskforce has alsobeen formed to investigate ways toincrease the number of radiation oncol-ogists who are RSNA members andwho participate in the RSNA annualmeeting.

Imaging as a BiomarkerRSNA will cosponsor the U.S. Measure-ment System Workshop, Imaging as aBiomarker: Standards for Change Mea-surements in Therapy, that will be heldSeptember 14–15, 2006, in Gaithers-burg, Maryland. The major sponsors arethe National Institutes of Health,National Cancer Institute, NationalInstitute of Standards Technology andthe Food and Drug Administration.

RSNA Research & Education FoundationAs the RSNA Research & EducationFoundation continues its SilverAnniversary Campaignto raise $15 million byits 25th anniversary in2009, the RSNA Boardhas approved new bene-fits for Foundationdonors. These benefitswill be outlined overthe next few months in RSNA News andwill be listed on the Foundation’s Website (RSNA.org/foundation).

By raising the additional $15 mil-lion, it is estimated that the Foundationwill be able to fund 25 percent of theworthy grant applications submittedeach year.

THERESA C. MCLOUD, M.D.CHAIR, 2006 RSNA BOARD OF

DIRECTORS

■ Note: In our continuing efforts to keepRSNA members informed, the chair of theRSNA Board of Directors will provide a briefreport in RSNA News following each boardmeeting. The next RSNA Board meeting isin June 2006.

The hall in Lakeside Center of McCormick Place housing scientific posters, educa-tional exhibits, informatics demonstrations and other exhibits has been redesignedand renamed Lakeside Learning. This photo shows the previous arrangement.

6 R S N A N E W S M A Y 2 0 0 6

FOR AN idea of how lung cancerdiagnosis and treatment are beingtransformed, look at the dramatic

changes in approaches to breast cancerover the last several years, said theauthor of a recently released study onearly lung cancer screening.

“A whole revolution will happen inlung cancer,” said Claudia I. Hen-schke, Ph.D., M.D. “There was a timewhen radical mastectomy was the stan-dard therapy for breast cancer. Now,it’s much less common. Women nowhave much less extensive surgery suchas a lumpectomy. The same thing willhappen with lung cancer.”

Dr. Henschke, along with col-leagues from the International EarlyLung Cancer Action Program (I-ELCAP), recently released a studysuggesting that early screening may beuseful in detecting lung cancers thatare still curable. “Why should I take awhole lobe of the lung for somethingthat is 5 or 6 mm?”

Dr. Henschke, of New York Pres-byterian Hospital–Weill Cornell Med-ical Center, and colleagues publishedtheir article, “Computed TomographicScreening for Lung Cancer: The Rela-tionship of Disease Stage to TumorSize,” in the February 13 issue of theArchives of Internal Medicine. It iswell known, Dr. Henschke said, thatlung cancers without evidence oflymph node metastases are more cur-able, with the curability rate beinghigher with smaller sizes.

The team noted that tumor size has,in the past, been identified as a prog-nostic indicator for stage I lung canceras it was used to divide stage I intostages IA and IB. Their study, theauthors wrote, provides direct evidence

of a stage-size relationship in screeningcases.

“The smaller they are, the morelikely it is that they’re early and themore likely they can be cured,” addedDr. Henschke.

Screened Population Versus Registry DataLung cancer remains a leading causeof cancer deathworldwide. In theU.S., it causes moredeaths than breast,prostate, cervical andcolon cancers com-bined. In spite ofrecent advances insurgical techniques,as well as inchemotherapy andradiation therapy, theoverall survival ratehas not improvedappreciably in the past 40 years. Theoverall 5-year survival rate in the U.S.is only 14 percent and worldwide it is

even lower.In the Archives of Internal Medi-

cine, Dr. Henschke and colleaguesreported studying 28,689 asymptomaticmen and women who underwent base-line CT screening, with 22,991 receiv-ing repeat screening. The median ageof enrollees was 61 and men made up58 percent of the study participants.

The median pack-yearsof smoking was 30.

A total of 464 lungcancer cases werediagnosed, 376 on ini-tial screening and 88on repeat screening.Grouping the 436 non-small cell carcinomacases according totumor diameter, theteam found that 91 per-cent of tumors 15 mmor less had no metas-

tases. Eighty-three percent of tumors16 to 25 mm had no metastases, while68 percent of tumors 26 to 35 mm had

Lung Cancer RevolutionImminent, Researcher Says

Claudia I. Henschke, Ph.D., M.D. Stephen J. Swensen, M.D.

It is frustrating that the

high percentage of stage I

cases is not given sufficient

recognition in terms of the

number of lives that could

be saved, because people

are dying everyday.

Claudia I. Henschke, Ph.D., M.D.

RSNA HOT TOPIC

7R S N A N E W SR S N A N E W S . O R G

no metastases. Of tumors 36 mm orgreater, 55 percent had no metastases.

“The percentages of N0 M0 (nometastases) cases in screen-diagnosedlung cancers are much higher than pre-viously reported in the Surveillance,Epidemiology and End Results (SEER)registry,” the authors wrote. “Theseresults provide direct evidence of astage-size relationship in a screenedpopulation.”

Debate Continues Over Benefit of EarlyScreening Dr. Henschke said the results justifythe benefit of early screening amongpopulations at risk for developing lungcancer. Early stage I lung cancer has acurability rate of almost 70 percent,she explained, with some studiesreporting much higher rates for smallercancers. However, most cancers arenot identified until the disease has pro-gressed and symptoms become morepronounced. Lung cancer has nosymptoms in its early stages, sheadded, which is another argument forthe necessity of early screening. A per-son’s risk, she said, depends on howmuch he or she smoked, the person’sage and, if the person has quit, howlong it has been.

Stephen J. Swensen, M.D., profes-sor of radiology at the Mayo Clinic inRochester, Minn., disagreed that thestudy conclusions constitute a call forearly screening. The results are inter-esting, he said, but they won’t changeradiologists’ day-to-day practices.“There’s no clear evidence that screen-ing will save lives when you look at allpopulations with lung cancer,” he said.

The study is another small step inthe accumulation of data and opinionregarding the utility and feasibility oflung cancer screening, said Eric J.Stern, M.D., professor of radiologyand medicine at the University ofWashington Harborview Medical Cen-ter in Seattle.

“At this time, I do not think therewill be a great immediate clinical

impact, as the screening trials are stillunder way,” said Dr. Stern, a chestradiologist. “This is not to say the con-clusions of the study might not have animpact in the future, as they could leadto continued refinement of the interna-tional system for staging lung cancerclassification.”

Dr. Henschke said she anticipatesjust such a stage shift, pointing againto recent changes in the staging ofbreast cancer as an example. However,because staging recommendations arejust being considered by the Interna-tional Association for the Study ofLung Cancer (IASLC) Staging Com-mittee, changes could be three to fouryears away, she said.

“It is frustrating that the high per-centage of stage I cases is not givensufficient recognition in terms of thenumber of lives that could be saved,

because people are dying everyday,”she said.

Other Studies ContinueDr. Swensen added that while “inter-esting and worthwhile” lung cancerstudies are being conducted, “all willbe overshadowed” when results arereleased from the National LungScreening Trial (NLST), for which heis a principal investigator at Mayo. TheNLST, sponsored by the National Can-cer Institute (NCI), is a longitudinalrandomized trial of subjects at highrisk of developing lung cancer. Resultsare expected as soon as 2008.

“No one knows right now if we’redoing more harm than good by per-forming screenings,” Dr. Swensensaid.

Dr. Henschke disagreed. She said

A small adenocarcinoma presenting as a solid nodule. Just behind the descendingthoracic aorta, it would be obscured on the chest x-ray. The radiologic-pathologiccorrelation is good as it shows the tumor abutting the pleura and the high-powered view shows that it is an adenocarcinoma.Images courtesy of Claudia I. Henschke, Ph.D., M.D.

Continued on page 11

8 R S N A N E W S M A Y 2 0 0 6

LARGER MR imaging-detected breastlesions are more likely to be malignant than small lesions of

5 mm or less, according to a recentlypublished study.

In the February 2006 issue of theAmerican Journal of Roentgenology(AJR), Laura Liberman, M.D., and col-leagues from Memorial Sloan-Ketter-ing Cancer Center reported that thepositive predictive value for lesionsidentified with MR imaging using a1.5 Tesla magnet rose significantlywith increasing lesion size.

“Biopsy is rarely necessary forlesions smaller than 5 mm because oftheir low—3 percent—likelihood ofcancer,” the team wrote in their study,“Does Size Matter? Positive PredictiveValue of MRI-Detected Breast Lesionsas a Function of Lesion Size.”

Co-author D. David Dershaw,M.D., offered two explanations for thestudy findings. “It is not uncommon tosee small areas of enhancement in anormal breast with MR,” said Dr. Der-shaw, director of the breast imagingsection in the Department of Radiol-ogy at Memorial Sloan-Kettering and apresenter at the RSNA 2005 Categori-cal Course in Diagnostic Radiology:Breast Imaging.

“The smallest of these small areasof enhancement is a single pixel,” Dr. Dershaw said. “In the Breast Imag-ing Reporting and Data System (BI-RADS®) lexicon for MR, radiologistsare supposed to ignore them becausethey are common and of no impor-tance. The single pixel enhancement isanother manifestation of the fact that

small enhancements in the breast arerarely of importance.”

Another explanation, he said, isthat small findings frequently representa physiologic pattern in the breast. Headded that MR resolution makes italmost impossible to determine thetrue configuration of those small find-ings. Unlike larger areas of enhance-ment, he said, where inhomogeneity orspiculation in the pattern of the lesionor nonenhancing fibrous bands may beevident, small areas do not allow theluxury of resolution for such identifi-cations.

“We are a little more blind withsmaller things than we are with largerthings, so I think we tend to biopsythem more often,” explained Dr. Der-shaw.

Findings Clinically SignificantFor the study, researchers reviewed

records for 666 consecutive nonpalpa-ble, mammographically occult lesionsthat had MRI-guided localization. Themedian MR-detected lesion size was 1 cm. Twenty-two percent of thelesions were malignant. Fifty-four per-cent of the malignancies were ductalcarcinoma in situ (DCIS), 44 percentwere invasive cancers and 2 percentwere lymphoma. The frequency ofmalignancy increased significantly withlesion size. Malignancies were found in3 percent of lesions less than 5 mm, 17percent of lesions 5 to 9 mm, 25 per-cent of lesions 10 to 14 mm, 28 percentof lesions 15 to 19 mm and 31 percentof lesions 20 mm or larger.

Among lesions less than 10 mm,the likelihood of cancer was highest inpostmenopausal women. The likeli-hood of cancer was lowest in pre-menopausal women and in the high-risk screening setting.

Study Shows Small MR-Detected Breast Lesions Do Not Require Biopsy

FEATURE SCIENCE

D. David Dershaw, M.D. Stephen A. Feig, M.D.

9R S N A N E W SR S N A N E W S . O R G

The conclusion that MR-detectedbreast lesions of 5 mm or less do notrequire biopsy is clinically significant,said Stephen A. Feig, M.D., professorof radiologic sciences at the Universityof California Irvine (UCI) School ofMedicine and director of breast imag-ing at UCI Medical Center.

“Obviously, the findings will haveto be confirmed by additional studiesto see if the results hold,” said Dr.Feig, director of the RSNA 2005 breastimaging categorical course in whichDr. Dershaw was a presenter. “Weneed to know if the results can be gen-eralized.”

Dr. Feig said the study’s positivepredictive value for MR imaging-detected lesions was lower than thepredictive value of mammography inlarge academic centers, even thoughmany patients studied with MR imag-ing were high-risk and a number ofexams were performed to determinethe disease extent. In a normal popula-tion, he speculated, the likelihood ofmalignancy for MR imaging-detectedlesions of similar size and appearancewould be much lowerthan reported in theMemorial Sloan-Ketteringstudy.

In this context, thedetailed information aboutlesion size and character-istics of patients in thisstudy is very helpful, Dr.Feig said. He noted that inlesions of less than 5 mm,about 12 percent of studylesions biopsied, the likelihood ofmalignancy was only 3 percent.

A mammographic lesion having a2–3 percent likelihood of malignancy,he said, is usually classified as BI-RADS 3, or probably benign. “Thelesion would be recommended forshort-term follow-up rather thanbiopsy,” he said.

Noting that the study detectedDCIS in more than half of the lesions,Dr. Feig said reports on MR detection

of DCIS have been mixed. “The morerecent reports suggest MR may bemore effective than previous studiesreported, and the AJR article is encour-aging because it backs up MR’s abilityto detect DCIS lesions,” he said.

MR Versus Mammography and SonographyRadiologists reading breast MR imagesneed to understand they are not seeingthe same phenomena they see on mam-mography and sonography, said Dr.Dershaw.

“Sometimes it is more difficult tointerpret MR examinations,” he said.“MR shows an active process blood-flow pattern, rather than a lump or abump or calcifications.”

MR resolution also does not allowdiscrimination based on criteria used inmammography and sonography, headded. “We have to think about what itis that we are seeing on MR from asomewhat different perspective thanthe way we think about what we areseeing on sonography and mammogra-phy,” he said.

Dr. Feig noted that extremely high-risk women, suchas those with BRCA-1and BRCA-2 muta-tions, should considerhaving breast MR as asupplementary screen-ing modality to mam-mography.

“The research thatwe have been doing inMR is part of ourlearning curve in read-

ing MR studies of the breast. I expectthat our research has impacted the waywe read our examinations at SloanKettering,” Dr. Dershaw concluded.

AHRQ Report Challenges Effectiveness of TestsThe same month the AJR study wasreleased, the Agency for HealthcareResearch and Quality (AHRQ)released a study concluding that MRimaging, positron emission tomogra-

phy (PET), scintimammography andultrasound are not sufficiently accurateto replace biopsy of suspicious breastabnormalities.

Dr. Feig disputed the report. Hesaid some of the modalities, such asscintimammography and PET, are notcurrently used to exclude the need tobiopsy a suspicious mammographiclesion. Ultrasound, on the other hand,can virtually always rule out the needto aspirate simple cysts, he said.

In its report, “Effectiveness ofNoninvasive Diagnostic Tests forBreast Abnormalities,” AHRQ statedthat its goal was to “help patients, pol-icy makers, and clinicians determinewhether these noninvasive tests aresufficiently accurate to be appropriatefor evaluation of average risk womenwith an abnormal mammogram orexam finding.” One of the 12 agencieswithin the Department of Health andHuman Services, AHRQ supportshealth services research with the goalof improving healthcare quality andpromoting evidence-based decision-making.

AHRQ reached its conclusionsafter reviewing 69 publications to eval-uate sensitivity, specificity, and posi-tive and negative predictive value of

We are a little more

blind with smaller

things than we are with

larger things, so I think

we tend to biopsy them

more often.

D. David Dershaw, M.D.

Though not from the Liberman et. al.study, this image is similar to recordsreviewed for the study. It shows a smallenhancing mass in the subareolarregion of the breast. It turned out tobe fat necrosis. Image courtesy of D. David Dershaw, M.D.

Continued on page 11

10 R S N A N E W S M A Y 2 0 0 6

RECENT reductions in Medicarereimbursement rates for outpatientimaging procedures will jeopardize

patient care, warn some private practiceradiologists and industry advocates.

“If you look at what happened inhome health and diabetes and otherareas that have had cuts like this, it’sbeen a disaster,” said CherrillFarnsworth, executive director of theNational Coalition for Quality Diagnos-tic Imaging Services (NCQDIS), anadvocacy group representing outpatientdiagnostic imaging centers. She saidshe believes many facilities will closetheir doors in the face of cuts as high as25 to 30 percent.

Totaling $2.8 billion over the nextfive years, the imaging cuts are part ofthe Deficit Reduction Act (DRA) of2005. The DRA was signed into law byPresident Bush in February 2006 and isintended to cut $39 billion in federalspending. Effectively equalizingMedicare reimburse-ment rates for outpa-tient and hospital imag-ing procedures, theDRA provision cappedreimbursement for thetechnical component ofphysician office imag-ing to the lesser of theHospital Outpatient Prospective Pay-ment System (HOPPS) or MedicareFee Schedule (MPFS) payment.

The provision also cuts reimburse-ment for the technical portion of MRimaging, CT and ultrasound exams oncontiguous body parts by 25 percent in2006 and an additional 25 percent in2007.

Rural Practitioners Particularly ConcernedThe American College of Radiology

(ACR) has joined more than 30 othermedical organizations, patient advocacygroups and manufacturers in lobbyingCongress to oppose the law, claiming itwill restrict patient access and care, dis-courage research and lead to highercosts for Medicare beneficiaries.

ACR Senior Director of Govern-ment Relations Josh Cooper said hisorganization worries the cuts will forcephysicians in outpatient facilities tostop offering needed radiologic servicesand limit the number of Medicarepatients they accept. Most vulnerable,said Cooper, will be centers in ruralareas that have less volume to offsetthe cuts. “A lot of facilities are set up tobe a community service and if theirtechnical fees are cut, it’s going to beharder to maintain that type of service,”Cooper said.

Geoffrey G. Smith, M.D., operatesone such rural outpatient imaging cen-ter in Casper, Wyo. He said he feels the

cuts were madewithout proper con-sideration for theimpact they willhave. “Congressneeded to chop offsome amount ofmoney and imagingwas where they

placed the knife,” he said.Farnsworth and Cooper said they

envision other consequences for patientcare as well, including less frequentequipment upgrades, reductions in staffand increased demand, which couldresult in longer wait-times for patients.But most troubling, they said, are thedifficult economic decisions outpatientpractices will have to make regardingthe procedures they offer.

“It’s well known in the radiology

community that mammography—although an extremely valuable serv-ice—is not profitable, and we’ve beentold by our members that mammogra-phy may be one of the first things togo,” Cooper said. He noted that themajority of mammograms are per-formed in private offices as opposed tohospitals.

Self-Referrals Still An IssueMany imaging organizations agree thatsome cuts were necessary, particularlyto curb skyrocketing utilization. How-ever, leaders say the cuts included inthe DRA fail to address physician self-referral, which they consider the rootcause of increased Medicare imagingexpenditures.

Self-referral, said Dr. Smith, is “theelephant in the room” ignored by Con-gress. He said loopholes in the Starklaw, which governs physician self-referral for Medicare and Medicaidrecipients, actually encourage utiliza-tion and self-referral. He said that whilethe cuts included in the DRA maythwart some self-referrals by making it

Imaging Reimbursement Cuts MayHarm Rural Practices, Patients

Cherrill Farnsworth

Congress needed to chop off

some amount of money

and imaging was where

they placed the knife.

Geoffrey G. Smith, M.D.

RSNA HOT TOPIC

11R S N A N E W SR S N A N E W S . O R G

more difficult for physicians to buyimaging equipment for use in theiroffices, they also unfairly penalize peo-ple like him.

“The cuts hit the knuckles of peo-ple like me and our group and our hos-pital and the people we serve here,”said Dr. Smith. “I’m basically lumpedin with the exact same group of folksthat I feel had a great responsibility increating the problem.” He added thatphysicians who self-refer also canevade the regulations and make upwhat they might lose in volumebecause they control the patients andtheir ordering patterns.

Cuts Face Legal ChallengesACR leadership and others predict thatthe cuts ultimately will cost rather thansave money. Quality will deteriorate asremaining hospitals and remaining out-

patient centers are forced do morescans quickly, they said.

Industry leaders also decry thatthey were not consulted on the cuts,which were drafted late at night by asmall group of legislators who did notsolicit outside input. The cuts were notincluded in either the Senate- or House-passed versions of the DRA and wereneither the subject of a Congressionalcommittee hearing nor recommendedby the Medicare Payment AdvisoryCommission (MedPAC).

Others have challenged the law onlegal grounds. A lawsuit filed by anAlabama attorney and another by thepublic interest group Public Citizenclaim the bill is unconstitutional. Theconstitution requires that the Senateand House pass identical versions of a

bill before it can become law; however,Senate and House versions of the DRAdiffer regarding durable medical equip-ment reimbursement under Medicare.

Dr. Smith admitted he’d like to seethe law overturned but added he isn’toptimistic. He is doing next year’sfinancial planning assuming the lawwill be in place. Whether or not the lawis overturned, Smith said he doubtsmuch will change.

“After 2007, spending will level offfor a few months and then all of a sud-den it will start going up again. It’s acomplex topic, and I think this solutionwill be a transient blip that will makelife more difficult for a whole group ofpeople I don’t think they intended tomake life difficult for,” he said. ■■

■ For more information on the Deficit Reduction Act of 2005, go towww.whitehouse.gov/news/releases/2006/02/20060208-9.html.

the various diagnostic tests. In a news release, the American

College of Radiology (ACR) stated itwas not consulted on the AHRQ study,“Without adequate input by those actu-ally involved in the field being studied,reports such as this are vulnerable toerrors of methodology, emphasis, and

conclusions, all of which reduce theclinical relevance and have the poten-tial of being misleading, counterpro-

ductive, and ultimately to waste valu-able resources.” ACR stated. ■■

Study Shows Small MR-Detected Breast Lesions Do Not Require BiopsyContinued from page 9

that by following requisite screeningand workup guidelines, radiologists cando more good than harm with earlyscreening of high risk populations. Asfor NLST, she said a key drawback isthat results will not be reported for sev-eral years.

“We report semi-annually, andwe’re already reporting that if the can-cer is found early and it’s small youhave a high rate of cure—90 percent orbetter,” she said.

The effect of early screening will be

very slow to show up in national survivalrates, Dr. Henschke added, “A majorityof people still are not getting screenedbecause they have to pay for it.”

Dr. Henschke said she and her col-leagues will publish in the next year a10-year follow-up of cases in I-ELCAP.Other upcoming studies will look atcombination lung/heart scans and the“rational recommendations” for early

screening of people who never havesmoked, she said. Trials of the treat-ment of lung cancer with radiofre-quency ablation (RFA) and radio-surgery are also planned.

I-ELCAP is an international collab-orative group created by a group oflung cancer experts. Screening sites forcollaborative I-ELCAP projects arelocated worldwide. ■■

Lung Cancer Revolution Imminent, Researcher SaysContinued from page 7

■ To view the abstract for “Does Size Matter? Positive Predictive Value of MRI-DetectedBreast Lesions as a Function of Lesion Size,” go to www.ajronline.org/cgi/content/abstract/186/2/426.■ To read the AHRQ report “Effectiveness of Noninvasive Diagnostic Tests for Breast Abnor-malities,” go to effectivehealthcare.ahrq.gov/repFiles/BrCADx%20Final%20Report.pdf.

■ To read the abstract for “Computed Tomographic Screening for Lung Cancer: The Rela-tionship of Disease Stage to Tumor Size,” go to: archinte.ama-assn.org/cgi/content/abstract/166/3/321.

12 R S N A N E W S M A Y 2 0 0 6

RADIOLOGISTS looking to hire moreradiographers into their practicesmay see fewer qualified candidates

and be forced to pay higher salaries,because of a continued shortage due tolack of space in training programs.

A study recently released by theAmerican Society of Radiologic Tech-nologists (ASRT) shows almost 32,000qualified students were unable to enrollin educational programs in the radio-logic sciences in 2005.

While the market doesn’t demandthat every would-be radiologic technol-ogist (R.T.) be accepted into a program,ASRT Research Director Richard Har-ris, Ph.D., said that if the current trendsin enrollment and graduation and reten-tion rates continue, there will be almost7 percent fewer radiographers than thegovernment-projected demand of76,000 additional through 2014. “Whilethe figure is down from our 2002-2012projections showing a 14 percent short-age, and a 30 percent deficitthe year before, we still needto figure out how to fix theshortage,” Dr. Harris said.

The news from the study,“2005 Enrollment Snapshotof Radiography, RadiationTherapy and Nuclear Medi-cine Programs,” is not allnegative. While radiographers may bein somewhat short supply, ASRT didfind radiation therapy programs areproducing new technologists at a ratemuch higher than the Bureau of LaborStatistics (BLS) estimated demand andthe number of nuclear medicine tech-nology graduates will be more thandouble the estimated need.

Applicants Not EvenlyDistributedPart of the reason R.T.programs end up turn-ing away qualified stu-dents, said Dr. Harris,is an uneven geo-graphic distribution ofapplicants. In therecent study, forexample, some pro-grams turned away atotal of 31,800 quali-fied students, while1,419 positions were available at otherinstitutions. Almost 33,000 qualifiedstudents were turned down from someprograms in 2004, yet nearly 1,600openings remained elsewhere.

By making application data avail-able annually, Dr. Harris said, ASRThopes program directors will alert eachother—and the qualified applicantsthey have to turn away—when there is

space available.However, even

with differences inapplication vol-umes—and the factthat some of the32,000 candidatesrejected last year werein fact students ulti-

mately accepted to a program afterbeing turned away from others—Dr.Harris said more spaces still need to becreated if the BLS-estimated need is tobe met.

According to the ASRT survey, partof the training space deficit stems fromtoo few clinical sites and too few med-ical professionals to staff those pro-

grams. ASRT leaders said increasingthe number of sites will bedifficult,because a facility serving as aclinical site must commit significantequipment and staff time. Dr. Harrisnoted that this is somewhat of a Catch-22—with radiographers in short supply,it’s all the more difficult for those inthe workforce to allocate time to educa-tion.

Faculty Recruitment and Student Retention Survey results also indicated that R.T.training programs need more fundingand equipment and have difficultyrecruiting faculty and retaining stu-dents. Recruiting faculty is indeed chal-lenging, Dr. Harris said, as salaries forradiologic technology faculty are lowerthan those available in clinical practice.

“This issue is endemic to highereducation rather than being unique toradiologic technology,” Dr. Harrisadded.

Now that unmet capacity hasreached such high levels, he said,ASRT plans to ask program directors innext fall’s enrollment survey to share

Radiographer Shortage Continues as Programs Turn AwayQualified Candidates

Two years ago, we

couldn’t get people to

apply to radiologic

technologist programs.

Stephen R. Baker, M.D.

Richard Harris, Ph.D. Stephen R. Baker, M.D.

FEATURE WORKFORCE

13R S N A N E W SR S N A N E W S . O R G

approaches they have used to success-fully address funding and facultyrecruitment issues.

As for retaining students in pro-grams—and graduates in the work-force—Dr. Harris said ASRT hopes thecreation of radiologist assistant (R.A.)programs (see RSNA News, May 2005)will encourage R.T.s to stay in the fieldand move ahead. R.A.s receive higherpay, have more responsibilities and gar-ner greater professional recognition.

Stephen R. Baker, M.D., chair ofthe Department of Radiology and asso-ciate dean at the University of Medi-cine and Dentistry of New Jersey, saidhe’s surprised by the results of theASRT survey. “Two years ago, wecouldn’t get people to apply to radio-logic technologist programs,” he said.

Dr. Baker said a radiographer short-age means private practice radiologistsmay see less qualified candidates downthe road. Those who are well qualified,especially those working in high-endCT and MR imaging, will be able to bid

up the price of their services, he said.Dr. Baker added that he does not

see the R.A. program as a solution. Inan April 2005 Emergency Radiologyeditorial, he and Alex Merkulov, M.D.,raised doubts about the value R.A.s canbring to radiology practices and specu-lated about longterm encroachmentissues.

In late 2005, RSNA began accept-

ing R.A.s as members. At RSNA 2006,a new educational track for R.A.s willbe offered. For more information, go torsna2006.rsna.org. ■■

AVETERAN RADIOLOGIST and anotherat the beginning of his career wereboth surprised by a recent survey

showing more than a quarter of respondingradiologists wouldn’t choose medicine as acareer if they had the choice to make overagain.

Physician recruiter LocumTenens.com sur-veyed 1,400 radiologists late last year. While49 percent of radiologists said they had noplans to change jobs, the other half saidthey’d like to change jobs within the nextthree years. About 23 percent said they planto make a job change within the next sixmonths. Those considering a job search saidthey’re looking for a better community forthemselves and their families or a better workenvironment.

The survey results came as a shock to2001 RSNA President Jerry Petasnick, M.D.,who began working as a radiologist in 1967.“No one in radiology is lamenting a lack ofmoney,” said Dr. Petasnick, director of theradiology resident program at Rush Univer-

sity Medical Center in Chicago. “But the jobdissatisfaction expressed by those surveyed isnot the case with respect to friends of minein radiology.”

Dr. Petasnick noted that, unlike others involatile fields, most physicians are secure intheir work. “Unlike 50-year-olds in middlemanagement in U.S. corporations, myfriends are not finding themselves suddenlyunemployed at the age of 50,” Dr. Petasnicksaid. “Some of my colleagues have retired,but 65- and 70-year-old physicians, particu-larly radiologists, can still work today.”

Now is an exciting time for young radiolo-gists just entering the field, Dr. Petasnickadded. “There are multiple career choices fortoday’s new radiologists,” he said. “Most resi-dents finishing their programs have a lot ofjob opportunities. They usually can get theirfirst choice,” he said.

Newly practicing radiologist FilipBanovac, M.D., also was surprised by thesurvey results. Like Dr. Petasnick, he notedthat compensation is likely not the root of

dissatisfaction. He said he suspects unhappi-ness with career choice has to do withincreasing demand for imaging, combinedwith the recent radiologist shortage.

Dr. Banovac, an assistant professor in theDivision of Interventional Radiology atGeorgetown University Hospital, said his jobsatisfaction is enhanced by the mission inher-ent in an academic setting. He said he couldsee how young radiologists who haven’t madepartnership yet and are working long hoursmight express dissatisfaction with their work.Those working in small radiology groups andinterpreting an overwhelming and ever-increasing variety of imaging studies mightbe unhappy too, he added. ■■

■ To read portions of the LocumTenens.com“2005 Annual Physician Compensation andEmployment Survey” pertaining to radiolo-gists, go to www.locumtenens.com/radiol-ogy-careers/2005-radiology-salary-survey-report.pdf.

❚

Some Radiologists Wouldn’t Choose Medicine Again, Survey Shows

■ To view “2005 Enrollment Snapshot of Radiography, Radiation Therapy and Nuclear Medi-cine Programs,” go to www.asrt.org/media/pdf/research/enrollmentsurvey05.pdf. ■ A March 2006 update to the study can be accessed at www.asrt.org/media/pdf/research/EnrollmentGapUpdate.pdf.

Issues Limiting Enrollment in Radiography ProgramsFACTOR % OF RESPONDENTS MEAN RANK

WHO MENTIONED (1-5, 5 MOST IMPORTANT)

Funding 56% 3.17

Space 68% 2.59

Equipment 51% 3.68

Number of qualified applicants 41% 4.55

Availability of faculty 64% 2.74

Number, staffing of clinical sites 80% 1.71Source: American Society of Radiologic Technologists

14 R S N A N E W S M A Y 2 0 0 6

Thin-Section CT of the Secondary Pulmonary Lobule:Anatomy and the Image—The 2004 Fleischner Lecture

THE secondary pulmonary lobule is afundamental unit of lung structure

and reproduces the lung in miniature.Airways, pul-monary arteries,veins, lymphaticsand the lung interstitium are all repre-sented at the secondary lobule level.Several components of the secondarylobule are normally visible on thin-sec-tion CT lung scans.

In an article in the Reviews sectionof the May issue of Radiology(RSNA.org/radiologyjnl), W. RichardWebb, M.D., of the Department ofRadiology at the University of Califor-nia San Francisco, discusses how rec-ognizing lung abnormalities relative tosecondary lobule structures is funda-mental to interpreting thin-section CTscans. Pathologic alterations in second-ary lobular anatomy visible on thin-sec-tion CT scans include interlobular sep-tal thickening and diseases with periph-eral lobular distribution andcentrilobular and panlobular abnormali-ties. The differential diagnosis of lobu-lar abnormalities is based on compar-isons between lobular anatomy andlung pathology.

Dr. Webb emphasizes:• Pulmonary disease occurring predom-

inantly in relation to interlobular septaand the periphery of lobules is termed“perilobular;” this disease distributionmay reflect abnormalities of the inter-lobular septa or peripheral alveoli.

• Centrilobular abnormalities visible onthin-section CT scans may consist of

nodular opacities; the tree-in-budappearance, which usually indicates asmall-airways abnormality; increasedvisibility of centrilobular structuresdue to thickening or infiltration of thesurrounding interstitium; or abnormallow-attenuation areas related to bron-

chiolar dilatation or emphysema. “Thin-section CT can show many

features of the secondary pulmonarylobule in both normal and abnormallungs, and many lung diseases producecharacteristic abnormalities of lobularanatomy,” Dr. Webb states.

Journal HighlightsThe following are highlights from the current issues of RSNA’s twopeer-reviewed journals.

RSNA JOURNALS

Interlobular septalthickening in pulmonary edema. Transverse thin-section CTscan shows thickened septa(small arrows) in upper lobes.Smooth thickening of inter-lobular septa outline a num-ber of secondary pulmonarylobules. Pulmonary veins(large arrows) in septa are visible as small rounded dots or linear or branchingopacities. Septa are well developed in the apices, and septal thickening is oftenwell depicted in this region.

Peripheral lobular fibrosis in idiopathic pulmonary fibrosis. (a) Transverse thin-section CT scan through right upper lobe in a patient with idio-pathic pulmonary fibrosis shows irregular reticular opacities (arrows). (b) Histologicspecimen from open lung biopsy in a different patient with idiopathic pulmonaryfibrosis shows irregular fibrosis (arrows) in periphery of secondary pulmonary lobules. (Radiology 2006;239:322–338) © RSNA, 2006. All rights reserved. Printed with permission.

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15R S N A N E W SR S N A N E W S . O R G

CT Enterography as a Diag-nostic Tool in EvaluatingSmall Bowel Disorders:Review of Clinical Experi-ence with Over 700 Cases

INCREASED SPEED and resolutionhave made multi-detector row CT

a first-line modality for examiningsmall bowel disease and an impor-tant alternative to traditional fluo-roscopy in assessing other smallbowel disorders such as celiac sprueand small bowel neoplasms.

In an article in the May-Juneissue of RadioGraphics(RSNA.org/radiographics), Scott R.Paulsen, B.S.. of the Mayo ClinicCollege of Medicine in Rochester,Minn., and colleagues:• Describe methods for performing CT enterography• Discuss various considerations in achieving small bowel distention• Discuss and illustrate CT enterographic findings in common diseases,

including Crohn disease, ulcerative colitis, small bowel tumors andceliac disease, and incidental findings

Paulsen and colleagues reviewed recordsfor 756 patients who underwent CT enterography at the Mayo Clinicfrom March 2001 and March 2004. The team notes that the number ofCT enterography examinations performed at the institution increasedfrom 99 in 2001 to more than 900 in 2004, as referring clinicians gainedconfidence in the examination.

The researchers note that CT enterography has several advantagesover traditional small bowel follow-through examination, including howit displays the entire thickness of the bowel wall. CT enterography alsoallows assessment of solid organs and provides a global overview of theabdomen, they said.

“CT enterography is a powerful tool in the evaluation of small boweldisease,” Paulsen and colleagues conclude. “Adequate luminal distentioncan usually be achieved with oral ingestion of a large volume of neutralenteric contrast material in the evaluation of diseases affecting themucosa and bowel wall, thereby obviating nasogastric intubation andmaking CT enterography a useful, well-tolerated study in this setting.”

Active Crohn disease in a 14-year-old patient. The patient had been treated medically since undergoingileal resection one year earlier. Follow-up CT enterogramshows engorged vasa recta producing the comb sign(arrows) involving two ileal loops with asymmetricenhancement and wall thickening.(RadioGraphics 2006;26:641-657) © RSNA, 2006. All rights reserved. Printed with permission.

Spectrum of segmental mural hyperenhancement indicating active inflammatory Crohn disease. (a) Active jejunal Crohn disease in a 19-year-old woman. CT enterogram shows mural hyperen-hancement (arrows). Compare the normal enhancement of the unaffected small bowel (arrowhead).(b) Active ileal Crohn disease in an asymptomatic 38-year-old man. CT enterogram depicts muralhyperenhancement (arrows) with mural stratification within the thickened bowel wall. (c) Duode-nal Crohn disease in a 42-year-old woman. CT enterogram demonstrates mucosal hyperenhance-ment (arrows) and stratification (arrowhead). The diagnosis was confirmed at endoscopy.

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16 R S N A N E W S M A Y 2 0 0 6

RSNA JOURNALS

A press release has been sent to the medical news media for the following articleappearing in the May issue of Radiology (RSNA.org/radiologyjnl):

in Public Focus

Terahertz Pulsed Imaging ofHuman Breast Tumors

USING A new region of the electro-magnetic spectrum, terahertzpulsed imaging could improve

overall sensitivity in identifying cancerin exposed breast tissue, according toresearchers in Cambridge, England.

Anthony J. Fitzgerald, Ph.D., andcolleagues report that terahertz pulsedimaging provides information comple-mentary to other imaging modalitiesand techniques—such as infrared andoptical imaging, thermography, electri-cal impedance and MR imaging—being investigated as adjuncts to mam-mography. Dr. Fitzgerald works forTeraView, a company that developscommercial uses for terahertz radiation.

The terahertz region of the electro-magnetic spectrum lies between themicrowave and infrared regions.Because terahertz wavelengths arelonger than infrared and optical radia-tion, scattering in biologic tissue iscomparatively small, according to theresearchers.

For their study, Dr. Fitzgerald andcolleagues imaged 22 human breast tis-sue specimens with carcinoma excisedfrom 22 women. Comparing the sizeand shape of tumor regions on terahertzimages with those identified athistopathologic examination, the teamfound significant correlation.

“Findings of this study demonstrate

the potential of terahertz pulsed imag-ing to depict both invasive breast carci-noma and ductal carcinoma in situunder controlled conditions and encour-age further studies to determine thesensitivity and specificity of the tech-nique,” Dr. Fitzgerald and colleagueswrote.

(a) Photomicrograph of specimen with invasive ductal carcinoma with lobular features. Dashed area indicates region of tissue that was imaged with terahertzimaging. (b) Terahertz image of Emin and (c) Emin/Emax. Two terahertz images of overlapping regions were imaged and have been tiled together. Bright regiondominating b was caused by an air gap.(Radiology 2006;239:533–540) © RSNA, 2006. All rights reserved. Printed with permission.

Media Coverage of RadiologyMarch Radiology press releasesreached almost 150 million peopleworldwide.

A study on the dangers of benignbreast lesions (Radiology 2006;238:801-808) was picked up by the LosAngeles Times and Chicago Tribune, aswell as wire services Reuters Health,United Press International (UPI) andHealthDay News. The study alsoappeared online in such outlets asYahoo! News, CNN.com, Forbes.com

and DrKoop.com.Another study on

using MR imaging torule out appendicitisduring pregnancy (Radi-ology 2006;238:891-899) was circulated bythe Reuters and UPIwire services. The studyalso was featured on online medicaloutlets including Medical News Todayand Medscape, as well as on Red-

Orbit.com, an Internet forumfor space, science, health andtechnology enthusiasts.

Two additional articlesfrom the March issue, one onscreening mammography(Radiology 2006;238:793-800)and a second on bone marrowedema (Radiology 2006

238:943-949), were featured byReuters, Medscape and RedOrbit.com.

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17R S N A N E W SR S N A N E W S . O R G

THE Research Department implements a diverse range ofprograms and activities. Under the leadership of TracySchmidt, M.S., the department is responsible for organ-

izing courses and programs to support radiologists and radi-ologic scientists in many aspects of research development,such as grant writing and protocol develop-ment. The department also oversees RSNA’sinvolvement in the fields of molecular imag-ing, biomedical engineering and, mostrecently, continuous quality improvement.

RSNA’s international radiology educationprograms also fall under the purview of the ResearchDepartment. These programs provide research training andeducation for young international radiologists and radiolo-gists in developing countries.

The Research Department reports to Assistant Executive Director for Research andEducation Linda B. Bresolin, Ph.D., M.B.A., C.A.E.

Working For You

RSNA MEMBER BENEFITS

My CME Action Plan Join the more than 200 RSNA members who havedownloaded My CME Action Plan, RSNA’s newWeb-based document that helps you identify yourpersonal CME needs. To access My CME ActionPlan, go to RSNA.org/education/moc and click onMy CME Action Plan. The plan will guide you inlisting your CME requirements, prioritizing youreducational needs, planning future CME activitiesand keeping a record of what you’ve done.

If you have a colleague who would like to become an RSNA member, you can download an application at RSNA.org/mbrapp or contact the RSNA Membershipand Subscriptions Department at 1-877-RSNA-MEM [776-2636] (U.S. and Canada), 1-630-571-7873 or membership@rsna.org.

RSNA Research Department

Workingfor you

DEPARTMENTPROFILE

(from left) Fiona MillerDianna BeresoffTracy Schmidt, M.S.

Managing Director

18 R S N A N E W S M A Y 2 0 0 6

EDUCATION RESEARCH

Program and Grant Announcements

Molecular Imaging in MedicineRSNA/SNM/SMI • August 29–30, Hilton Waikoloa Village,Hawaii

HELD BEFORE the annual meeting of the Societyof Molecular Imaging (SMI), this symposium

will provide an overview of molecular imagingfor radiologists, nuclear medicine physicians,neuroradiologists and other physicians. Topicsinclude advances in PET imaging technology andnew PET imaging agents, as well as the molecu-lar basis of cancer, cardiovascular disease andneurological disorders.

The symposium is sponsored by RSNA, Soci-ety of Nuclear Medicine and SMI. More informa-tion is available at www.molecularimaging.org/preconferencesymp06.php.

NIH Roadmap Inventory and Evaluation of IECRNNational Leadership Forum May 31 and June 1, Rockville, Maryland

The National Leadership Forum will present findings from the NIH-spon-sored Inventory and Evaluation of Clinical Research Networks (IECRN).The forum also will support cross-network exchange and facilitate ongo-ing dissemination of information and practice models. There is no regis-tration fee and a free Web cast is available. For more information, go towww.clinicalresearchnetworks.org/forum.asp.

World Conference on Interventional OncologySM (WCIO) June 12–16, Cernobbio, Italy

Sponsored in part by RSNA, the World Conference on InterventionalOncologySM will focus on image-guided interventional oncologic thera-pies and their relationship to other existing and emerging treatments. The meeting will include presentations of basic, translational and clinicalresearch as well as discussions on available and emerging therapies. Formore information, go to www.wcio2006.com.

RSNA Outstanding Researcher, Educator AwardsNomination deadline–June 15

The 2006 RSNA Outstanding Researcher and Outstanding Educatorawards will recognize and honor senior physicians or scientists whohave made a career of significant contributions to the field of radiologyor radiologic sciences through research and/or education. Awardees willbe announced during the RSNA 2006 opening session. More informa-tion is available at RSNA.org/Foundation/programs.cfm.

RSNA Derek Harwood-Nash International FellowshipApplication deadline–July 1

International radiologists 3-10 years beyondtraining are invited to apply for a 3-month fel-lowship at a North American institution. Candi-dates must demonstrate how the fellowshipmeets their specific educational goals and howthe knowledge and experience gained will bene-fit and improve radiology practice in their homeinstitutions and the radiology community. Eng-lish proficiency required.

RSNA will provide up to $10,000 to covertravel, 6-12 weeks of modest living expensesand education materials. In addition, each fellowwill receive a one-year complimentary subscrip-tions to Radiology and RadioGraphics. One ortwo fellows will be selected.

Details are available at RSNA.org/Interna-tional/CIRE/dhnash.cfm or by calling 1-630-590-7741.

Introduction to Research ProgramRSNA/AUR/ARRS • Application deadline–July 15

RSNA, the Association of University Radiologists (AUR) and the Amer-ican Roentgen Ray Society (ARRS) offer an Introduction to Researchprogram for second-year residents. Events will beheld during RSNA 2006, November 26–December 1at McCormick Place in Chicago, and during the 2007ARRS meeting, May 6–11 at the Grande Lakes Resortin Orlando, Fla.

The program encourages young radiologists topursue research careers by demonstrating the impor-tance of research to the practice and future of radiol-ogy and introducing residents to successful radiologyresearchers, future colleagues and potential mentors.

More information is available at RSNA.org/i2rappor by calling 1-630-590-7741.

19R S N A N E W SR S N A N E W S . O R G

W ITH AN innovative approach todeveloping novel molecularimaging agents, RSNA

Research Fellow Martin Pomper, M.D.,Ph.D., is a “radiologist-scientist of thefuture,” according to a colleague.

“Through his team-orientedresearch style, emphasis on collabora-tion and creativity, and his enthusiasm,Marty is making great strides in movingthe whole field forward,” said JonathanLewin, M.D., Martin W. Donner profes-sor and chair of the Department ofRadiology and Radiological Science atJohns Hopkins School of Medicine andradiologist-in-chief at Johns HopkinsHospital.

Dr. Pomper, a research fellow from1996–1998, is now an associate profes-sor of radiology, pharmacology andoncology and an associate director ofthe Molecular Imaging Center at theJohns Hopkins Medical Institutions.

“As we begin to understand diseasemore in a molecular sense and begin touncover the cellularnetworks in diseasedcells and tissues, weare going to needmore specific ways tolook at these networksas they operate invivo under physio-logic conditions, saidDr. Pomper. “I thinkthe only way to dothat is through in vivomolecular imaging.”

Dr. Pomper’s RSNA-funded project,“The Role of Nitric Oxide in Cere-brovascular Regulation: In Vivo Assess-ment with Positron Emission Tomogra-phy,” sought to identify the location ofthe neuronal isoform of the enzymenitric oxide synthase (nNOS) within the

brain. He then hoped to correlate thelocation of nNOS with changes inregional cerebral blood flow upon brainactivation to show whether nNOS couldunderlie those blood flow changes.

While he was able to identify andsynthesize a positron-emitting nNOS-

selective inhibitor,Dr. Pomper said itturned out not to besufficiently specificin vivo to quantifyenzyme activity.“We published thework in the Journalof Nuclear Medicinebecause it was novelto have developed anisoform-selectiveNOS inhibitor for

imaging,” he said. “But in vivo studiesonly hinted at selectivity, so an alterna-tive class of probes had to be developedto provide truly useful imaging agentsfor nNOS.”

Studying SchizophreniaDr. Pomper took what he had learnedfrom his RSNA-sponsored project andcombined it with some preliminary dataindicating there might be a difference innNOS between healthy controls andpatients with schizophrenia. Thisresulted in a grant from the NationalAlliance for Research of Schizophreniaand Depression (NARSAD). Persistingin the development of new imagingagents for schizophrenia, Dr. Pomperhas gone on to develop other radiophar-maceuticals that he hopes will eventu-ally be used to study the illness in vivo.He continues to focus on developingnew imaging agents, primarily radio-pharmaceuticals, for cancer and applica-tions within the central nervous system.

Using molecular imaging tech-niques to explore pathways by whichdrugs are supposed to work is an exam-ple of how molecular imaging is thefuture of radiology, Dr. Pomper said.

“We need to follow new therapiesvery specifically in the body to see how

RSNA Grant Leads to Novel Molecular Imaging Agents

As we begin to uncover the

cellular networks in diseased

cells and tissues, we are going

to need more specific ways to

look at these networks as they

operate in vivo under

physiologic conditions.

Martin Pomper, M.D., Ph.D.

Martin Pomper, M.D., Ph.D.

RESEARCH & EDUCATION OUR FUTURE

Continued on next page

20 R S N A N E W S M A Y 2 0 0 6

RESEARCH & EDUCATION OUR FUTURE

Research & Education Foundation DonorsTHE BOARD OF TRUSTEES of the RSNA Research & Education Foundation and its

recipients of research and education grant support gratefully acknowledge the con-tributions made to the Foundation between February 18 – March 16, 2006.

For more information on Foundation activities, go to RSNA.org/foundation.

PRESIDENT’S CIRCLE

Patricia G. Becker, M.D. & Gary J. Becker, M.D. Sallie & Michael H. Bleshman, M.D. Rainer G. Bluemm, M.D. Victoria & Michael N. Brant-Zawadzki, M.D. Linda Bresolin, Ph.D., M.B.A., C.A.E. &Michael Bresolin, Ph.D.

Ritsuko U. Komaki, M.D. & James D. Cox, M.D.

Robert J. Douglas, M.D. Leon E. Kinasiewicz, M.D. Herbert Y. Kressel, M.D. Louise & Richard G. Lester, M.D. Carol E. & David C. Levin, M.D. Hedvig Hricak, M.D., Ph.D. & AlexanderR. Margulis, M.D.

Anne & Walter L. Robb, Ph.D. Eric J. Russell, M.D. William P. Shuman, M.D. In memory of Larry Mack, M.D.

Jacob Valk, M.D., Ph.D.

$1,500 per year

PLATINUM ($1,000 – $1,499)Gabrielle K. & William C. Black, M.D. Karen & Michael A. Sullivan, M.D.

GOLD ($500 – $999)Linda M. Gruener, D.O.In honor of Lorette P. & Michael D. Lavine,M.D.

Philip C. Pieters, M.D. In honor of Howard Faunce, M.D.

Josephine & John W. Vosskuhler, M.D.

SILVER ($200 – $499)Tena Marie & John J. Alcini Jr., M.D. Bibb Allen Jr., M.D. Saba & Muhammed S. Anwer, M.D. Ada & Michael V.U. Azodo, M.D. Nancy L. Brown, M.D. & William M. BrownDenise D. Collins, M.D. Lisa A. Corrente, M.D. Carol A. Dolinskas, M.D. Kathleen G. Draths-Hanson, M.D. & LarryHanson

Ximena L. Wortsman, M.D. & RodrigoFerreira

Mary E. Fisher, M.D. & Don FisherLeanne L. Seeger, M.D. & Rudi FoormanMandip Gakhal, M.D. Scott R. Gerst, M.D. Richard A. Haas, M.D. Sally Harms, M.D. & Steven E. Harms, M.D.

Linda A. Heier, M.D. Ashok B. Jain, M.D. Susan D. John, M.D. & Darrell JohnSandra & Howard H. Johnson, M.D. J. Daniel Jones, M.D. Judy & Richard Kaprowy, M.D. Judy & Mark J. Kransdorf, M.D. Ronald D. Kunst, M.D. Mary L. & Paul W. Lewis, M.D. Anthony Lomonaco, M.D. Tor A. Mattsson, M.D., Ph.D. Jonathan A. Morgan, M.D. Sylvia & Philame S. Oronan, M.D. Hernando G. Ortiz, M.D.Rajaram E. Reddy, M.D. John W. Renner, M.D. U. Yun Ryo, M.D., Ph.D. Prateek Sahgal, M.D. Jessie M. Kane & Dieter Schellinger, M.D. Margaret Lee & Jeffrey L. Schmitter, M.D. Steven M. Schonfeld, M.D. Polly L. & Joachim F. Seeger, M.D. Gordon V. Smith, M.D. Cande L. Sridhar, M.D. In memory of C. Lakshminarasimhan

Edward Steiner, M.D. Bill Thompson, M.D. Thomas A. Tomsick, M.D. Richard M. Welcome, M.D. Paul W. Wong, M.D. Cathleen A. Woomert, M.D.

BRONZE ($1 – $199)Katherine P. Andriole, Ph.D. Lynn K. Arcara, M.D. & Alan ArcaraNami R. Azar, M.D. Locke W. Barber, D.O.Marla & David H. Berns, M.D. Andrew S. Blum, M.D. Daniel L. Brasfield, M.D. Robyn & Patrick L. Brien, M.D. Erin Yourtz & Lawrence D. Bub, M.D. Kenneth G. Carter, M.D. In memory of James M. Packer, M.D.

Alan D.S. Chan, M.D. F. Spencer Chivers, M.D. David J. Dowsett, M.Sc., Ph.D. Elaine & Paul L. Dratch, M.D. Carmen Limon & Rolando Enriquez, M.D. Kathleen C. Finzel, M.D. Anna K. Rusztyn-Fitz & Charles R. Fitz, M.D. Valerie & John J. Frederick, D.O.Mary Rose & John Ghazi, M.D. Alice & Pierre V. Haig, M.D. Melissa & David L. Handley, M.D. Stephanie & Olin L. Harbury, M.D. Jacquelyn & Roger K. Harned, M.D. Gwen & J. Bruce Hauser, M.D. Gary W. Heath, M.D. Brian J. Holloway, M.B.B.Ch.Adrienne & Alan D. Kaye, M.D. Michael Kessler, M.D.

Nuha A. Khoumais, M.B.B.S. & HassanDarami

Ruben Kier, M.D. Mark E. Klein, M.D. Wolfgang Lederer, M.D. Luc M. Linster, M.D. Fanny E. Moron, M.D. & Carlos MartinezNancy & Alan H. Matson, M.D. James E. McGill, M.D. Joel R. Meyer, M.D. Theodore J. Molnar, M.D. Jean N. Nauwelaers, M.D. Richard H. Patt, M.D. Rebecca G. Pennell, M.D. Maria Mendes & Antonio P. Peres, M.D. Dieu H. Pham, M.D. Duc V. Pham, M.D. Suelio M. Queiroz, M.D. Marta & Carlos S. Restrepo, M.D. Pablo R. Ros, M.D., M.P.H.Klaus Ruedisser, M.D. Jerome M. Sampson, M.D. Michael F.H. Schocke, M.D. Louis N. Scotti, M.D. Aram Semerdjian, M.D. Debby & Randy R. Sibbitt, M.D. Phillip J. Silberberg, M.D. Susan G. & Richard J. Sukov, M.D. Tjong P. Tan, M.D. Main Yee, M.D.

VANGUARD GROUP

Hitachi Medical Corporation

$20,000A Vanguard company since 2004

they work,” he said. “It’s more thanjust looking for anatomic changes likewatching a tumor shrink because somedrugs don’t shrink tumors, they justkeep them in check. So how then doyou know if your therapy is working ifyou just take an x-ray? You don’t.”

Dr. Pomper now spends one day aweek in the neuroradiology clinic andfour days running his research group.He said he knew from the moment hestarted medical school that he wantedto pursue translational research, whichhas allowed him to bring important dis-coveries into the clinic.

RSNA Fellowship an Important First StepThe RSNA Research Fellowship pro-gram is an important first step in a jun-ior person’s career, he added. “Themost important way aspiring physicianresearchers can actually get into radiol-ogy research in a meaningful way is byhaving protected and uninterruptedtime away from the clinic to focus andpursue their work,” he said.

Dr. Lewin agreed. “The entrée intoindependent research enabled by theRSNA grant clearly helped Marty gainmomentum, and we now see the resultsas he has matured into a tremendouslysuccessful senior scientist,” he said. “It

is evident we need to bring more youngradiologists into cutting-edge researchlike Marty’s, and the RSNA grants areimportant and effective ways to achievethis goal.”

Dr. Pomper received his bachelor’sdegree with a double major in chem-istry and biochemistry from the Univer-sity of Illinois, where he also receivedhis M.D. and a Ph.D. in organic chem-istry. He completed his internship, resi-dency and fellowships in nuclear medi-cine and neuroradiology at Johns Hop-kins University before joining the staffin 1996. ■■

Continued from previous page

21R S N A N E W SR S N A N E W S . O R G

Important Dates for RSNA 2006May 22 Non-member registra-

tion and housingopens

June 19 Course enrollmentopens

Nov. 10 Advance registrationdeadline

Nov. 26– RSNA 92nd Scientific Dec. 1 Assembly and Annual

Meeting

MEETING WATCH RSNA 2006

News about RSNA 2006

International DelegatesInvitation Letters Personalized invitation letters are availableat www2.rsna.org/visa_form/invitation_letter.cfm.

Apply Early for Your Visa! Visa applicants are advised to apply assoon as they decide to travel to the UnitedStates and at least three to four months in

advance of their travel date. That meansinternational attendees should start the visaprocess by July or August.

The following Web sites have addi-tional information on applying for a visa:• www.unitedstatesvisas.gov• travel.state.gov/visa• nationalacademies.org/visas

How to RegisterThere are four ways to register for RSNA 2006:

➊ InternetGo to RSNA.org/registerUse your memberID# from theRSNA News label or meetingflyer sent to you. If you havequestions, send an e-mail torsna@itsmeetings.com.

➋ Fax (24 hours)1-800-521-60171-847-940-2386

➌ Telephone (Monday–Friday, 8:00 a.m.–5:00 p.m. CT)1-800-650-70181-847-940-2155

➍ MailITS/RSNA 2006108 Wilmot Rd., Suite 400Deerfield, IL 60015-0825USA

Advance Registration for RSNA 2006RSNA and AAPM members can register now for RSNA 2006. General registration andhousing opens May 22.

Registration FeesBY 11/10 ONSITE

$0 $100 RSNA Member, AAPM Member

$0 $0 Member Presenter

$0 $0 RSNA Member-in-Training, RSNA Student Member and Technical Student

$0 $0 Non-Member Presenter

$120 $220 Non-Member Resident/Trainee

$120 $220 Radiology Support Personnel

$570 $670 Non-Member Radiologist, Physicist or Physician

$570 $670 Hospital Executive, Research and Development Personnel, Healthcare Consultant, Industry Personnel

$300 $300 One-day registration to view only the Technical Exhibits area

■ For more information about registeringfor RSNA 2006, visit rsna2006.rsna.org,e-mail reginfo@rsna.org or call 1-800-381-6660 x7862.

Fastest wayto register!

CME Update: Earn up to 85 AMA PRACategory 1 CME Credits™ at RSNA 2006

92nd Scientific Assembly and Annual MeetingNovember 26–December 1, 2006McCormick Place, Chicago

Refresher Course EnrollmentBegins June 19Course enrollment information will bemailed in mid-June and will also beavailable online at RSNA.org/register.

22 R S N A N E W S M A Y 2 0 0 6

THOSE unable to attend RSNA2006 or who want to attend addi-tional education sessions are

encouraged to check out RSNA’s neweducational conference, RSNA High-lights: Clinical Issues for 2007. Theconference will beheld February26–28, 2007, at theJ.W. Marriott DesertRidge Resort & Spain Phoenix, Ariz.

The conference will includeselected refresher courses and elec-

tronic education exhibits from RSNA2006, with special emphasis on car-diac imaging, PET/CT, breast imagingand sports injuries. All courses will betaught in an interactive format, usingaudience response technology.

Registrationbegins September5. Up-to-dateinformation isavailable at

RSNA.org/highlightsconference. Formore information, contact RSNA Pro-gram Services at programs@rsna.org.

RSNA Highlights: Clinical Issues for 2007

Important Dates for RSNA HighlightsSept. 5 Registration opens

Feb. 26–28 RSNA Highlights: ClinicalIssues for 2007

MEETING WATCH RSNA HIGHLIGHTS

EXHIBITOR NEWS RSNA 2006

RSNA 2006 Exhibitor News

Exhibitor Housing RSNA will send exhibitors a letter this month explaining block andindividual housing. The housing formula (three rooms per 100square feet of purchased exhibit space) determines which one to use.

Exhibitors requiring 25 rooms or more must submit a blockhousing form. Block housing assignments are based on the same priority point system used for exhibit space assignments. Maximumpoints will be awarded to block housing forms submitted on orbefore June 5.

Exhibitors requiring fewer than 25 rooms may access the hous-ing bureau’s Web site to reserve hotel rooms beginning June 5.Please note individual housing is reserved on a first-come, first-served basis.

June Exhibitor Planning MeetingBooth assignments will be released on June 27 at theExhibitor Planning Meeting and Luncheon. All exhibitorsfor RSNA 2006 are invited to attend the meeting at Rose-wood Restaurant and Banquets near Chicago O’HareInternational Airport. RSNA will send an e-mail invitationto all confirmed 2006 exhibitors this month.

Advertising at RSNA 2006RSNA offers many opportunities for companies to promote theirRSNA 2006 exhibits. For more information, go to RSNA.org/Advertising/upload/meeting-3.pdf or contact:

• Jim DrewDirector of Advertising1-630-571-7819jdrew@rsna.org

• Judy KapicakSenior Advertising Manager1-630-571-7818jkapicak@rsna.org

Important Exhibitor Dates for RSNA 2006May 30 Block housing forms available onlineJune 5 Exhibitor block housing point system initiated

Individual exhibitor housing system opensJune 27 Exhibitor Planning/Booth Assignment MeetingJuly 5 Technical Exhibitor Service Kit available online

Block housing deadline July 28 Deadline for reduction/cancellation (for full refund)August 11 Deadline for final payment

Deadline for reduction/cancellation (for partialrefund)

Nov. 10 Exhibitor advance badge request deadlineNov. 26– RSNA 92nd Scientific Assembly and Annual Dec. 1 Meeting

■ For up-to-date information about technical exhibits, go to rsna2006.rsna.org. For more information, contact RSNA Technical Exhibits at 1-800-381-6660 x7851 or exhibits@rsna.org.

23R S N A N E W SR S N A N E W S . O R G

Product News

Information for Product News came from the manufacturers. Inclusion in this publication should not be construed as a productendorsement by RSNA. To submit product news, send your information and a non-returnable color photo to RSNA News, 820 Jorie

Blvd., Oak Brook, IL 60523 or by e-mail to rsnanews@rsna.org. Information may be edited for purposes of clarity and space.

NEW PRODUCT

Philips Introduces New PET/CT SystemRoyal Philips Electronics (www.philips.com) has introduced theGEMINI TF PET/CT system, which uses atomic particle time-measurements to deliver increased image quality and consistency.

Billing the GEMINI TF as a “time-of-flight PET/CT system,”Philips stated that the system measures the difference in time ittakes each pair of gamma rays to reach the PET scanner, enablingthe point of origination to be more accurately predicted. The GEM-INI TF raises effective image sensitivity by more than two timesover conventional PET and shortens image acquisition time to lessthan 10 minutes for a whole-body PET or PET/CT scan, accordingto the company.

RADIOLOGY PRODUCTS

PRODUCT RECOGNITION

HIMSS Book of the Year

A BOOK sponsored by Thom-son Micromedex(www.micromedex.com),

“Improving Outcomes with Clini-cal Decision Support: An Imple-menter’s Guide,” was named aBook of the Year by the Health-care Information and ManagementSystems Society (HIMSS).

The guide helps healthcareorganizations use clinical decisionsupport programs to improve the quality, safety and cost-effec-tiveness of patient care. The HIMSS award honors a book thatoffers outstanding practical guidance and/or strategic insight forhealthcare information and management systems professionals.

NEW PATENT

Patent to Biophan for MR ImagingCatheter SystemA U.S. patent has been issued to Biophan Tech-nologies, Inc. (www.biophan.com), of WestHenrietta, N.Y., for its Optical MRI CatheterSystem. The system uses photonic technologyin combination with miniature MR imagingreceiver coils incorporated into diagnosticcatheters. The intraluminal coils are smallenough to be part of a catheter running throughany blood vessel, providing high-quality imagesin a localized area, Biophan said in a release.The use of photonics eliminates any heatingrisk, the company said. The invention could becritically important in diagnosing vascularplaque and other conditions.

NEW PRODUCT

Terumo Introduces New Microcatheter SystemTerumo InterventionalSystems (www.terumomedical.com) has com-bined its Progreat™ Microcatheterwith its Glidewire® GT to create theProgreat Coaxial Microcatheter Sys-tem. The microcatheter withstandshigh-pressure injections of embolics andother agents and has a polytetrafluoroeth-ylene (PTFE) inner layer to ensure smoothdelivery. The Glidewire GT has an elas-tic nitinol alloy core designed to resistkinking and ease navigation of diffi-cult anatomy. The wire’s hydrophiliccoating also reduces friction toenhance vessel navigation and its 45-degreeangled tip is reshapeable for unique cases. Combin-ing the two products, the company said, eliminatesprocedural steps, which increases physician conven-ience and improves procedure efficiency.

25R S N A N E W SR S N A N E W S . O R G

RSNA ON THE WEB

RSNA.orgYour Member ProfileUPDATING your RSNA member profile is

easy and ensures you receive importantRSNA information without delay.

To view or change your member profile:Go to RSNA.org and click on Mem-

ber’s LOGIN at the top of the page ➊. Inthe boxes on the login page, type your username and password, then click Log in ➋.

If you have forgotten your user nameor password, you may click the linkbeneath the login boxes for assistance.

On the My Profile page, use the linksto the right of Update Information to view,add or change your:• Address/Phone/Fax/E-mail • Specialties ➌• Spouse • Password • User ID • Login Reminder

RSNA encourages you to provide infor-mation regarding your specialty area. Hav-ing this information allows RSNA to bettertarget educational materials and resourcesto your specific needs. These targetedmaterials make it easier for you to identifyprograms relevant to your practice andyour continuing professional development.If you are participating in the maintenanceof certification (MOC) process, these mate-rials also help you organize your lifelonglearning and self-assessment activities.

• NIH Bulletin: getinvolved.nih.gov/newsbulletins.asp.

• NIH News in Health(monthly newsletteroffering practicalhealth news and tipsbased on recentresearch): newsinhealth.nih.gov.

• NIH Roadmap:nihroadmap.nih.gov.

• NIH Director EliasA. Zerhouni, M.D.:www.nih.gov/about/director/index.htm.

• Neuroscience Blue-print: neuroscience-blueprint.nih.gov.

• Medlineplus: medlineplus.gov.

• Clinical trialsinformation: clinicaltrials.gov.

EconnectionsYouronlinelinks toRSNA

Radiology OnlineRSNA.org/radiologyjnlRadiology Manuscript CentralRSNA.org/radiologyjnl/submitRadioGraphics OnlineRSNA.org/radiographicsRSNA News rsnanews.orgEducation PortalRSNA.org/educationCME Credit RepositoryRSNA.org/cmeCME GatewayCMEgateway.orgRSNA Medical ImagingResource CenterRSNA.org/mircRSNA Career ConnectionsRSNA.org/careersRadiologyInfo™

RSNA-ACR patient informa-tion Web siteradiologyinfo.orgRSNA Press ReleasesRSNA.org/mediaMy RSNA Profile & BenefitsRSNA.org/memberservicesRSNA Research & Education FoundationMake a DonationRSNA.org/donateR&E 25 Questions ForumRSNA.org/25questionsCommunity of ScienceRSNA.org/cosMembership ApplicationsRSNA.org/mbrappRSNA Membership DirectoryRSNA.org/directoryRSNA 2006rsna2006.rsna.orgRSNA Highlights: Clinical Issues for 2007RSNA.org/highlightsconference

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Find Your WayAround the NIH Zero in on the informa-tion you need from NIHwith this list of popularNIH Web pages:

Medical Meetings June – September 2006

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CALENDAR

MAY 28–JUNE 1 World Federation for Ultrasound in Medicine and Biology(WFUMB), 11th Congress, COEX Convention & Exhibition Center,Seoul, Korea • www.wfumb2006.comJUNE 3–7Society of Nuclear Medicine (SNM), 53rd Annual Meeting, San Diego Convention Center • www.snm.orgJUNE 4–7Radiology Business Management Association (RBMA) 2006 Radiology Summit, Loews Miami Beach Hotel South Beach • www.rbma.orgJUNE 8–11Caribbean Society of Radiologists, 13th Congress, Hilton MiamiAirport Hotel • www.csor.org JUNE 9–13International Society for Radiographers and Radiological Technolo-gists (ISRRT), 14th World Congress, hosted in conjunction withAmerican Society of Radiologic Technologists (ASRT) and theAssociation of Educators in Radiological Sciences (AERS), AdamsMark Hotel, Denver • www.asrt.orgJUNE 12–16World Conference on Interventional Oncology (WCIO), Centro Congressi Villa Erba, Cernobbio, Italy • www.wcio2006.comJUNE 19–23European Society of Gastrointestinal and Abdominal Radiology(ESGAR), 17th Annual Meeting, Society of Gastrointestinal Radiol-ogists (SGR), 35th Annual Meeting, Crete, Greece • www.esgar.orgJUNE 22–25American Radiological Nurses Association (ARNA), Annual Convention and 25th Anniversary, Stardust Resort and Casino, Las Vegas • www.arna.netJUNE 22–25Radiation Therapy Oncology Group (RTOG), Meeting, FairmontRoyal York, Toronto • www.rtog.orgJUNE 28–JULY 1Computer Assisted Radiology and Surgery (CARS), 20th Interna-tional Congress and Exhibition, Osaka International ConventionCenter, Osaka, Japan • www.cars-int-org

JULY 30–AUGUST 3American Healthcare Radiology Administrators (AHRA), 34th Annual Meeting & Exposition, MGM Hotel & Casino, Las Vegas • www.ahraonline.orgJULY 30–AUGUST 3American Association of Physicists in Medicine (AAPM), 48th Annual Meeting, Orange County Convention Center,Orlando, Fla. • www.aapm.orgAUGUST 6–911th Asian Oceanian Congress of Radiology (AOCR), Hong Kong Convention & Exhibition Centre, Hong Kong • www.aocr2006.orgAUGUST 6–10Society of Computed Body Tomography and Magnetic Reso-nance (SCBTMR), Summer Practicum, Quebec City, Canada • www.scbtmr.orgAUGUST 27–SEPTEMBER 1World Congress on Medical Physics and Biomedical Engineering 2006, COEX Convention Center, Seoul, Korea • www.wc2006-seoul.orgAUGUST 29–30RSNA/SNM/Society of Molecular Imaging (SMI), MolecularImaging in Medicine symposium, Hilton Waikoloa Village,Hawaii • www.molecularimaging.orgAUGUST 30–SEPTEMBER 2SMI, 5th Annual Meeting, Hilton Waikoloa Village • www.molecularimaging.orgSEPTEMBER 12–16International Society of Radiology (ISR), 24th InternationalCongress of Radiology, Cape Town International ConventionCenter, South Africa • www.isr2006.co.za

NOVEMBER 26–DECEMBER 1RSNA 2006, 92nd Scientific Assembly and Annual Meeting,McCormick Place, Chicago • rsna2006.rsna.org

FEBRUARY 26–28, 2007RSNA Highlights: Clinical Issues for 2007, J.W. MarriottDesert Ridge Resort & Spa, Phoenix, Ariz. • RSNA.org/highlightsconference