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Imaging Institute UpdatesImaging Institute Renovation/Expansion Continues

Imaging Institute renovation and expansion continues. Construction for Phase II (expansion of CT facilities to Gb3) continues, with all chillers installed and areaway wall construction continuing. Certificate of occupancy for CT is scheduled for mid-April. Three additional CT scanners have been delivered and installed in the new area. Relocation of existing CTs will commence in May.

Construction for the Mellen Center 7T MRI is substantially complete, with equipment delivery delayed due to helium shortage.

Construction planning for Phase III Angio expansion continues, with construction bids received and

scope reviews being completed. A21 updates are complete, including front desk renovation. The design for the A10 upgrade project is complete,

RadiologyAlumni ConnectionQ1/Q2 2013 Edition

with project cost being submitted to the Radiology Capital Review Committee for

approval. Construction of PET/MR (mMR) facility in Qb continues, with equipment delivery in March.

Agfa PACS Migration Being Implemented

The Agfa Impax upgrade is now complete. Migration of legacy images from Siemens PACS to Agfa continues.

The Enterprise Image Viewer was upgraded to version 2.0, having the ability to display more sharply key images, positional indicators, slice position and improved image scrolling (with speed control on cine). Syngo Workflow version 32 upgrade is complete. Commissure upgrade to Powerscribe 360 is targeted to begin in April. Hardware has been installed; configurations and testing continue.

Imaging Institute AnnouncementsCleveland Clinic Implements Molecular MRI Scanning

The Imaging Institute at Cleveland Clinic is one

CT work area

CT recovery and induction room with eight recovery bays

CT scanner

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mailto:radiologyalumni%40ccf.org?subject=

2Cleveland Clinic Radiology Alumni Connection



of only a few clinical sites globally to implement molecular MRI (mMR or PET/MR) scanning technology. The equipment of the mMR has been delivered, and installation is under way with clinical launch in early May. The Institute’s mMR resource will reside in the Qb MRI.

This advanced imaging technology will offer Cleveland Clinic patients requiring imaging for oncology, neurosciences, and cardiology applications significant benefits that include patient convenience, lower radiation, exquisite soft tissue contrast resolution and vastly improved diagnostic capability at detection, staging, restaging of pathology and therapy response monitoring. Collaborative efforts to date include identification and resolution of operational issues surrounding construction, billing, IT/data analytics, scheduling and workflow. In addition, clinical sub-teams have been formed comprised of representation from Neuro, Abdominal, Chest/Cardiac, Pediatrics and MSK sections, with an initial focus on engaging, educating and building relationships with respective clinical colleagues.

Over the next several months, subspecialty mMR champions within the Center for PET and Molecular Imaging will reach out to individual clinical services to highlight an efficient, effective and value-based use of imaging with the mMR. Please look for future Institute Communication Updates as this innovative technology is implemented. For questions please contact Shetal N. Shah, MD, mMR Clinical Director ([email protected], 216.445.8168).

Ajit Goenka, MD, Recognized for Research

The Society of Computed Body Tomography and Magnetic Resonance recognized Imaging Fellow Ajit Goenka, MD, with the Cum Laude Award for his research presentation “Multi-reader detectability of simulated low-contrast liver

lesions on MDCT” at its annual meeting in October 2012 in Boston. The co-authors of this presentation are Drs. Goenka, Herts, Dong, Primak, Obuchowski and Baker.

RSNA Selects Imaging Institute Education Exhibits

Two Imaging Institute education exhibits received awards at the 98th Scientific Assembly and Annual Meeting of the Radiological Society of North America in November in

Chicago. The selected exhibits are recommended for publication in RadioGraphics.

•Cum Laude: Benign and Malignant Tumors of the Rectum and Perirectal Region A.S. Purysko, MD; C.R. Thupili, MD; H.M. Leao Filho, MD; C.P. Coppa, MD; E.M. Remer, MD

•Certificate of Merit: Bladder Cancer Imaging: What the Radiologist Needs to Know A.S. Purysko, MD; E.M. Remer, MD; H.M. Leao Filho, MD; J.S. Jones; B.R. Herts, MD

Neil Vachhani, MD, Named Pediatric Imaging Section Head

The Imaging Institute Administration and Pediatric Imaging Search Committee are pleased to announce the appointment of Neil Vachhani, MD, as the new Head of the Section of Pediatric Imaging. A member of the Cleveland Clinic professional staff since 2009, Dr. Vachhani is very enthusiastic about growing pediatric imaging enterprise-wide and continuing to provide high-quality pediatric imaging and excellent patient care.

A.S. Purysko, MD






Michael Paradise, MD, and Lindy Paradise, MD, Join Regional Radiology

Michael Paradise, MD, joined the Department of Regional Radiology in

November 2011; his wife, Lindy Paradise, MD, joined the Department of Regional Radiology at Fairview Hospital in July 2012. Both Lindy and Mike are Ohio natives. They completed their Diagnostic Radiology residencies at The University of Texas, Southwestern in Dallas. Mike is fellowship-trained in MRI; Lindy is most recently fellowship-trained in Breast Imaging. In their free time, their lives revolve around family and their yellow labs, Lily and Captain.

Charles Martin III, MD, Joins Vascular and Interventional Radiology

Charles Martin III, MD, joined the Section of Vascular and Interventional Radiology in February. Prior to joining Cleveland Clinic, Dr. Martin

was in private practice with Diagnostic Imaging Incorporated in Philadelphia, PA.

Radiology Alumni Education Award to Recognize Outstanding Resident’s Performance

Daniel Lockwood, MD (DR’08, NR’09), Diagnostic Radiology

Program Director, and Pauline Kwok, MD (TRS’95, DR’00, ABI’01), Radiology Alumni Specialty Director, are pleased to announce the new Radiology Alumni Education Award for Excellence.

“This award will recognize the academic and clinical performance of an outstanding third-year resident — the cream of the crop of the Cleveland Clinic Radiology Residency Program,” Dr. Lockwood said.

To first be presented at the 2014 Senior Residents’ Graduation Dinner, the award will enable the recipient to go to an attendance-only national radiology meeting/conference of his or her choice.

Any Imaging Institute staff member can nominate a prospective award recipient, submitting the nomination to the Radiology Alumni Education Committee, who will review the nominations and make the final selections.

We are launching an annual fundraising campaign to support the cost of one resident (or more, if funding allows) to attend a national meeting, now about $3,000 a person. Would you consider a gift to the Radiology Alumni Education Award Fund to enrich the training of the residents who are following in your footsteps?

Imaging Institute staff and alumni who would like to contribute to the Radiology Alumni Education Award Fund (Fund # 30-055460) can make a donation at

http://giving.ccf.org/radiologyalumnieducationaward

We welcome your support at any level:

____Friend $100 ____ Cornerstone $1,000

____Partner $250 ____ Ambassador $1,500

____Patron $500 ____ Other Amount $ ____

Donors will be recognized in Radiology Alumni Connection and on the Imaging Institute Alumni webpage.

For more information on this award and our annual fundraising campaign, please contact Dr. Lockwood ([email protected], 216.444.2136) or Dr. Kwok ([email protected], 216.476.7964).



http://giving.ccf.org/radiologyalumnieducationaward




Christine Quinn, MD, Reflects on Her Career in Breast Imaging

Breast imaging staff radiologist Christine Quinn, MD (DR’75), who retired at year-end 2011, began her career at Cleveland Clinic in 1975.

After completing her residency in diagnostic radiology at Cleveland Clinic, she worked as a Cleveland Clinic staff radiologist for six years before joining her husband and associates in private practice. She returned to Cleveland Clinic in 1993, subspecializing in breast imaging.

“The changes in the practice of radiology are incredible,” she said, recalling that there was no CAT scanning when she started her training.

“The way we obtain mammographic images is also very different today. Initially we obtained images using a Xerox technique. Then imaging went to film. Today it’s digital, all on a monitor.”

Commenting on the role of radiologists in healthcare today, she said, “When I started training, radiologists were in the background reading images. Now radiologists are more involved in patient interaction. We always talk with patients in breast imaging — before, during procedures and after.”

Speaking about the growth of Cleveland Clinic, she said, “It’s huge now! In 1972 Main Campus was a much smaller place. Residents could sit at any table in the doctors’ dining room, across from the department chair of orthopaedic surgery, a pediatrician or a fellow radiologist. It was very collegial.”

A graduate of St. Joseph’s Academy in Cleveland, she went to medical school at what is now Drexel

University in Philadelphia, graduating in 1971. “I loved my classmates. We were a really diverse group.”

She married Paul Janicki, MD (DR’75), between her junior and senior years of medical school. After taking an elective in radiology, she decided that would be her specialty. “It’s a wonderful specialty.”

On the challenges of juggling a family and a career, she said: “I was blessed that I could work part-time. When I decided that I wanted to cut my hours back, my department chair, Thomas Meany, MD, said ‘That would be great.’ No other Cleveland Clinic radiologist had asked to work part-time before. Dr. Meany made everything possible.”

The Janickis live in Shaker Heights and have two daughters. Sarah Janicki, MD, MPH, is an assistant professor of psychiatry and neurology at Columbia University Medical Center, specializing in the treatment of Alzheimer’s disease and memory disorders. Their younger daughter, Megan Janicki, JD, is an assistant attorney general for the state of Illinois. The Janickis are excited about the birth of their first grandchild — Gabriel Paul — in April.

Dr. Quinn is enjoying taking classes at Cuyahoga Community College. She is studying literature, the U.S. Civil War and Qigong, a Chinese practice of aligning breath, movement and awareness for exercise. “I’m having fun!”






Residents’ CornerNew Curriculum for Radiology Residents

by Sylvia Zavatchen Diagnostic Radiology Residency Program Coordinator

The Radiology Residency Review Committee (RRC) of the Accreditation Council for Graduate Medical Education (ACGME) has suggested some interesting curriculum changes to coincide with the change in the Board exams. The change will affect the current R3 class. Instead of taking the physics exam during R2, written during R3, and oral during R4, residents will take a core exam after 36 months of training and a final certifying exam 15 months after the completion of residency. All exams will be computer-based interactive exams administered at selected test centers throughout the U.S.

The Diagnostic Radiology Residency Program, in response to the ACGME’s request to provide R4 residents with experience in rotations that “reflect their desired areas of concentration as they enter practice,” will offer two three-month AOCs (Areas of Concentration), each in a different subspecialty. The R3 class has already selected which rotations they prefer for their AOCs. The various sections are working to ensure that enough work station space and other resources are available. Each resident, with faculty oversight, will design a specific curriculum for his/her AOC.

The 2013 – 2014 academic year will be unlike any that radiology alumni have experienced. The Class of 2014, though, is meeting the challenge head-on. In June, they will be in Chicago taking the pilot core exam. Then in October the real deal. The only constant is change.

Radiology Residents Achieve 100-percent Pass Rate

Congratulations to our fourth-year residents for achieving a 100-percent pass rate on the Radiology Oral Board exams. This is the second year in a row that we’ve had a 100-percent pass rate!

Here is where our seniors are going for their fellowships:

Mike Graybill – Cleveland Clinic, Interventional Radiology

Bindu Mikkilineni – Cleveland Clinic, Musculoskeletal Imaging

Dipika Patel – Cleveland Clinic, Abdominal Imaging

Scott Tyson – Cleveland Clinic, Musculoskeletal Imaging

Ravi Guttikonda – Northwestern University – Chicago IL, Body Imaging

Joe Meranda – Northwestern University – Chicago IL, Body Imaging

James Massey – Indiana University – Indianapolis IN, Pediatric Imaging

Tracey Mehlman – Cincinnati Children’s – Cincinnati OH, Pediatric Radiology

Back row, left to right: Michael Graybill, MD; James Massey, MD; Scott Tyson, MD; Joseph Meranda, MD; Ravi Guttikonda, MD. Front row: Bindu Mikkilineni, MD; Dipika Patel, MD; Tracey Mehlman, MD






Residency Update

by Lulu He, MD First-year Resident

It has been a great year for the diagnostic radiology residents at the Cleveland Clinic! Most of us (if not all) are involved in research; some have already been accepted at conferences and publications. Many of us plan to attend RSNA 2013. Quality improvement is also a top priority, and the R1 class proudly boasts 100-percent pass and completion of the Institute for Healthcare Improvement courses. We are also involved in a quality improvement project with the abdominal section.

Aside from studying and expanding our knowledge of radiology, we have discovered the vibrant city of Cleveland through happy hours and restaurants. Some of our favorite activities include Melancholy Monday’s at Melt, happy hours in Ohio City, movie nights, dancing on West 6th Street, and game night on Fridays at Sarah Stock’s house. Anyone who walks past the residents’ lounge at noon will hear the chatter and laughter of happy residents.

We are also very excited about the match and the group of bright young doctors who will carry on the tradition of excellence in our program. We look forward to meeting our incoming R1 colleagues

in July, and will welcome them with an informal BBQ after work on July 3.

In the MediaPediatric Radiologist Marilyn Goske, MD, Recognized as 2012 RSNA Outstanding Educator1

Former Cleveland Clinic staff radiologist Marilyn J. Goske, MD, was recognized as the 2012 RSNA Outstanding Educator for her achievements in radiology education. She helped create the Cleveland Clinic Web Curriculum, a free

website used by more than 200 radiology residency programs nationally and internationally, and the pediatric research component of the American College of Radiology’s Dose Index Registry. She is perhaps best known for her work with Image Gently™, a campaign that she founded to promote “child-sized” imaging.

Dr. Goske is now the Corning Benton Endowed Chair for Radiology Education and professor of radiology at the University of Cincinnati School of Medicine and staff radiologist at Cincinnati Children’s Hospital Medical Center.

She joined the Cleveland Clinic in 1990 as the first full-time section head of pediatric radiology. While building the new section, she collaborated with Janet Reid, MD, to create the Cleveland Clinic Web Based Curriculum. A 2004 – 2005 medical education fellowship within the Cleveland Clinic Lerner College of Medicine focusing on professionalism helped Dr. Goske further refine her teaching approach, focusing on innovation and capitalizing on technology.

It was during her tenure as chair of the Society for Pediatric Radiology that she helped create the Alliance for Radiation Safety in Pediatric Imaging and launch the Image Gently™ campaign. She became increasingly concerned about the apparent lack of change in practice by a majority of pediatric radiologists, despite growing reports






of adverse side effects from radiation dose. Her answer was a public awareness campaign aimed at inspiring physicians to decrease radiation exposure to children when possible. Both the Alliance and Image Gently™ initially focused on CT and subsequently have expanded to other modalities.

The Alliance’s “child-sizing” message is credited with prompting a groundswell of awareness, change in practice and research. More than 70 organizations, including 24 international societies, with more than 800,000 members have joined the Alliance, which also has spawned the adult-focused Image Wisely™ campaign.

An Ohio native, Dr. Goske graduated from the University of Connecticut School of Medicine in Farmington in 1977. She completed a residency in diagnostic radiology, served as chief resident, and completed her fellowship in pediatric radiology at Strong Memorial Hospital in Rochester, NY, an affiliate of The University of Rochester School of Medicine. 1Abstracted from “Congratulations to the 2012 RSNA Outstanding Educator: Marilyn J. Goske, MD,” by Richard L. Baron, MD, RadioGraphics, Nov. – Dec. 2012, 32:7, pp. 1871-1872.

Imaging Institute Events2012 Pumpkin Hunt and Fall Party

On a beautiful, sunny Saturday in October, more than 600 Neurological and Imaging Institute alumni, staff, employees, spouses and children gathered at the farm of Michael Modic, MD, to gather pumpkins from the fields, listen to lively country music and enjoy each other’s company.

Taking the hay wagon

Returning from the pumpkin hunt

Jim Bartyzel and son Benjamin

Joe Parker






2012 RSNA Cleveland Clinic Radiology Alumni Reception

The CCF Radiology Alumni Reception at the Radiological Society of North America annual meeting in November in Chicago attracted more than 45 alumni, staff, residents, fellows, spouses and friends. Below are photographs from the event:

Radiology Alumni Reception attendees

Pauline Kwok, Michael Modic, Thomas Masaryk, Paul Ruggieri

Ali Esmaili, Bethanie Hammond, Paulette Lebda Amy Deipolyi, Gordon McLennan, Bethanie Hammond

Ronald Lorig, Ellen Abeln George Kafiti, Bradford Richmond Paul Johnson, his wife Tammy and daughter Brittany

Jacobo Kirsch, Joe Stengel, Joshua Polster Justin LeBlanc, Ravi Guttikonda, Dana Ataya, Esther Udoji Kevin Wiesmann and his wife Jennifer






2012 Holiday Party

More than 500 Imaging Institute employees and guests attended the 2012 Holiday Party at the Cleveland Browns Stadium on Sat., Dec. 15.

Dr. and Mrs. Borkowski Dr. and Mrs. Cerqueira

Dr. Kwok, Dr. and Mrs. Borkowski, Joe Parker

Drs. Kansi and Feldman Drs. Gandhi, Gandhi and Herts

Dancing with Cleveland in background

Joe Parker and Sue Weber pulling raffle tickets

Mark and Laura Puletti






Upcoming Alumni Events/Mark Your Calendar2013 Senior Residents/Fellows Graduation Dinner −Mon.,June17;detailstofollow

2013 Golf Outing

The Imaging Institute’s 2013 Golf Outing will be held on Sat., Aug. 31, at Bunker Hill Golf Course, 3060 Pearl Rd., Medina. The start time is 11:00 a.m. The cost to participate in the 4-person scramble is $75 per golfer. Please contact Mark Moore, A21, Main Campus, 216.444.6484 for more information.

2013 RSNA Cleveland Clinic Radiology Alumni Reception – tentatively scheduled for Sun., Dec. 1, 6 to 8 p.m., at Renaissance Chicago Hotel, 1 W Wacker Drive, Chicago

Around CHHSCEO/President Toby Cosgrove, MD, Delivers Annual State of the Clinic Address

American healthcare is in a state of unprecedented change that will require hospitals to deliver better patient outcomes and faster care, all at a lower cost. Cleveland Clinic is poised for that challenge, and ready to lead the

charge, said Cleveland Clinic CEO and President Toby Cosgrove, MD, in his annual State of the Clinic address on February 27.

“Only a few organizations earn the opportunity to lead,” Dr. Cosgrove said. “We have that opportunity, that ability and that duty to lead. . . . This is our time.”

Going forward, Cleveland Clinic’s mission – striving to be the world’s leader in patient experience, clinical outcomes, research and education – will not change. What will change is how the health system achieves those goals. A Value-Based Care Team – made up of physicians, nurses and other experts – will work to translate “better, lower cost, faster” into everyday practice.

Cleveland Clinic is already making strides in these areas. The health system reached the Top 20 of the University Health System Consortium’s quality index, earning UHC’s Rising Star award by improving in all six measurements, including patient centeredness, mortality, equity, efficiency, effectiveness and safety.

The hospital has been able to lower costs in various ways, such as avoiding 12,082 lab tests for a $1.2-million savings and lowering the cost of lung-transplant surgery by 11 percent. We are also getting patients into treatment faster, with the total number of same-day visits increasing by 14 percent and the average emergency room door-to-doctor time reduced to 17 minutes.

It is essential that the Cleveland Clinic Health System continue to grow. In Northeast Ohio, growth will come through expanded service areas, regional planning to reduce duplication of services within the system, and improved patient services. National growth will come through partnerships that export Cleveland Clinic’s clinical expertise to hospitals throughout the country. International growth will focus on facilities in Abu Dhabi and Canada, with referral offices in Riyadh, Turkey, China and London.

2012 Golf Outing – Informatics Foursome: Scott Knoch, Mike Brugnoni, Mike Hajek & guest






Other achievements highlighted in the 2012 State of the Clinic address included:

• The 2012 Sones Innovation Award was given to vascular surgeon Roy Greenberg, MD, for his work in developing endovascular devices and techniques to repair complex aortic and peripheral arterial problems.

• Applications to the Cleveland Clinic Lerner CollegeofMedicinecontinuedtorise−1,921applications for 32 positions for the incoming 2013 class. The Medical College Admission Test scores of accepted medical students remain in the top 5 in the U.S., according to U.S. News & World Report.

• Cleveland Clinic continues to focus on employee engagement and patient satisfaction. In 2012, patient satisfaction ranked in the 66th percentile, though the goal is to reach the 90th percentile

Cleveland Clinic Places in National Top Workplaces

Announced in February, Cleveland Clinic Health System was ranked 48 out of 150 top workplaces nationwide by WorkplaceDynamics. The research firm conducts top workplace surveys with 30 leading regional newspapers, including The Plain Dealer, Chicago Tribune, Atlanta Journal-Constitution and Boston Globe. The National Top Workplaces 2013 list was determined solely by feedback gathered from surveys of more than 1 million employees among 872 organizations with more than 1,000 employees last year. The survey data showed that employees most want to work at companies that set a clear direction for the future, execute well and bring real meaning to work. For more information go to

http://www.topworkplaces.com/frontend.php/national/standard

Cleveland Clinic Adding Urology Services in Las Vegas

Cleveland Clinic, the nation’s No.1-ranked urology program, will start offering services in Las Vegas in April through acquisition of the private practice of respected local urologists Scott Slavis, MD (U’89), and Laurie Larsen, MD. The physicians will become employees of Cleveland Clinic, along with nine other employees in their office.

Dr. Slavis did his fellowship training in urology/renal transplant at Cleveland Clinic after finishing his urological residency at University of California at Irvine. Dr. Larsen also trained at University of California at Irvine.

The Glickman Urological & Kidney Institute at Cleveland Clinic is recognized worldwide as a leading treatment center. The Institute’s two departments, Urology and Nephrology, are both ranked No. 1 in U.S. News & World Report. GUKI has more than 300 employees, including more than 100 physicians/scientists who see patients at 15 locations in Northeast Ohio, and also manages a kidney transplant program in Charleston, WV, and a kidney/pancreas transplant program in Indianapolis, IN.

Cleveland Clinic’s 2013 Medical Innovation Summit to Be Held at Cleveland Medical Mart

Cleveland Clinic’s 11th Annual Medical Innovation Summit, one of the premier healthcare gatherings in the United States, will be held at the Cleveland Medical Mart & Convention Center, Oct. 14 – 16, marking the grand opening of downtown Cleveland’s newest medical showplace.

Cleveland Clinic’s annual summit has steadily grown over the last decade and this past year brought together more than 1,100 clinicians, entrepreneurs, executives and investors to share insights on the industry’s most challenging issues. Having outgrown its former location, the summit will move to the Cleveland Medical Mart and






provide an exciting event with which to open the facility.

The 2013 Medical Innovation Summit – Finding Balance through Innovation: Obesity, Diabetes & the Metabolic Crisis – will take an in-depth look at one of the nation’s most troubling healthcare issues. The summit will conclude with a look at the Top 10 Medical Innovations for 2013, which were required to:

• Have significant potential for short-term clinical impact (either a major improvement in patient benefit or an improved function that enhances healthcare delivery)

• Have a high probability of success

• Be on the market or close to being introduced

• Have sufficient data available to support its nomination.

1. Bariatric Surgery for Control of Diabetes Exercise and diet alone are not effective for treating severe obesity or Type 2 diabetes. Once a person reaches 100 pounds or more above his/her ideal weight, losing the weight and keeping it off almost never happens.

Many doctors performing bariatric surgery found that the surgical procedure would rid patients of Type 2 diabetes, often before the patient left the hospital. Many diabetes experts believe that weight-loss surgery should be offered earlier for patients with poorly controlled diabetes, not as a last resort.

2. Neuromodulation Device for Cluster and Migraine Headaches Researchers have invented an on-demand patient-controlled stimulator for the sphenopalatine ganglion nerve bundle. The size of an almond, this miniaturized implantable neurostimulator is placed through a minimally invasive surgical incision in the upper gum above the second molar. The lead tip of the implant is placed at the SPG nerve bundle

on the side of the face where headache pain is typically experienced by the patient. Whenever a patient feels a headache coming on, a remote control device is placed on the cheek to deliver as-needed stimulation to the SPG, blocking the headache pain within minutes. Already approved in Europe for the treatment of cluster headaches, the FDA has granted investigational use of the neurostimulation system for cluster headaches in the U.S.

3. Mass Spectrometry for Bacterial Identification New mass spectrometry technology provides rapid organism identification that is more accurate and less expensive than current biochemical methods. Using one of the two MALDI-TOF mass spectrometry systems now available in the U.S. provides more accurate identification of bacteria in minutes rather than days.

Rapid organism identification allows clinicians to prescribe appropriate treatment sooner and de-escalate therapy from broad-spectrum agents that drive antimicrobial resistance. Quick, accurate detection of these microorganisms helps guide patient treatment and improves outcomes.

4. Drugs for Advanced Prostate Cancer In the past two years, five new drugs have been approved for advanced prostate cancer: sipuleucel-T, denosumab, abiraterone, cabazitaxel and enzalutamide. Many in the prostate cancer research community believe that these drugs and others coming from the prostate cancer therapeutic pipeline will help make advanced prostate cancer a chronic disease that’s successfully managed with daily medication, lifestyle modification and regular checkups.

5. Hand-held Optical Scan for Melanoma A new FDA-approved handheld office device helps dermatologists identify skin lesions with characteristics of melanoma. Without cutting the skin, the device is placed on the skin over the






mole. Special lights of 10 specific wavelengths are shined on the skin, and the computerized system rapidly visualizes the micro-vessel structure of the lesion below the skin’s surface.

Using sophisticated algorithms, the device objectively analyzes the lesion and compares the image findings to a database of 10,000 archived images of melanoma and other skin diseases. An assessment of the skin lesion is given in less than a minute. In a clinical trial of 1,300 patients, the device detected 98 percent of the melanomas.

6. Femtosecond Laser Cataract Surgery Unlike a surgical blade that cuts, a femtosecond laser separates tissue by ablating and cleaving it. The novel FDA-approved bladeless cataract procedure is revolutionizing surgery by making it more predictable and accurate, allowing surgeons to make smaller incisions. It also requires less time inside the eye, causes less inflammation and offers more stability when implanting a new lens.

A femtosecond — one quadrillionth of a second — is the amount of time that numerous laser pulses of near-infrared light are used by a surgeon in this new cataract procedure. The femtosecond laser helps make a perfect circular hole in the lens capsule, splits the lens into sections and then softens and breaks up the cataract. The damaged lens is removed using ultrasound and an intraocular lens is then implanted. The device has been used successfully in ophthalmology, particularly for LASIK (Laser In-Situ Keratomileusis) refractive surgery.

7. Ex Vivo Lung Perfusion With ex vivo — outside the body — lung perfusion, damaged lungs are removed from a donor, placed in a bubble-like transparent chamber and connected to a cardiopulmonary pump and a ventilator. This novel “lung washing” procedure can reverse lung injury in many donor organs deemed unsuitable and allow for transplantation. Over a four- to six-hour period, the lungs are then

repaired and assessed as special proprietary fluids are forced through blood vessels and nutrients are used to re-nourish the lungs as oxygen is pumped through. Targeted medications can be introduced to clear infections. Once determined as being viable, the lungs are ready for immediate transplantation. Approved in Europe and Canada and now undergoing a major multicenter clinical trial in the U.S., ex vivo lung perfusion could significantly increase the number of available lungs.

8. Modular Devices for Treating Complex Aneurysms A new innovative fenestrated stent graft system enables surgeons to treat patients with complex aneurysms without having to take detailed measurements and then wait for weeks, sometimes months, for the customized endografts to be delivered. The FDA recently approved a multi-center trial of the modular stent device for aneurysms that come close to the renal artery. The device incorporates individual branches to both renal arteries and the superior mesenteric artery. The new stent graft system offers a significant reduction in morbidity and ICU stay and allows an application of life-saving technology to high-risk patients who previously could not have been treated for their aneurysms.

9. Digital Breast Tomosynthesis (DBT) Tomosynthesis, or 3D mammography, is a diagnostic technology approved by the FDA in 2011. Breast tomosynthesis is performed along with a conventional mammogram to provide a more accurate view of the breast. During the tomosynthesis portion of the exam, the x-ray arm of the machine makes a quick arc over the breast, taking dozens of images at a number of angles. Later combined to make a three-dimensional rendering of the breast, the images can be viewed by a radiologist at a computer workstation to check areas of concern.

What 3D technology offers is a much greater opportunity to discover small cancer cells obscured






by surrounding tissue that may not be visible on standard mammograms, particularly the case in women with dense breasts in which tumors often escape detection. Preliminary study results of 25,000 women reported a 47 percent increase in cancer detection when tomosynthesis was used.

In the past one in 10 women typically has been asked to return for additional testing following a routine mammogram screening that has raised concern. However, in a recent study of 7,500 women, the recall rate of women screened with breast tomosynthesis and traditional mammography combined was 6.6 percent compared to 11.1 percent for traditional mammography alone.

10. Health Insurance / Medicare Program / Rewards for Better Health The bipartisan Medicare Better Health Rewards Program Act of 2012 was presented to Congress as a way to improve healthcare and control costs for Medicare participants. The program encourages people to take an active role in their well being by maintaining healthy habits. The three-year program uses the annual wellness visits that Medicare already subsidizes to determine and measure improvements in six key areas of health: body mass index, diabetes indicators, blood pressure, cholesterol, vaccination status and use of tobacco.

In the first year, people are assessed in each of these areas and then work with their doctor to develop a plan to bring their indicators into a healthier range. Progress will be measured during subsequent wellness visits in years two and three of the program. By saving the Medicare program money, participants in the Better Health Rewards Program will be given up to $400 after checkups in the program’s second and third years. These

monetary incentives will come entirely from savings generated by seniors becoming healthy and utilizing fewer healthcare services.

Alumni UpdatesTodd Stultz, MD, DDS (DR’01, NR’02), and Allison Vidimos, MD (DM’89, DS’91), continue to enjoy family time with daughters Katherine, a sophomore at University of Notre Dame, and Kristen, a senior at Magnificat High School. Drs. Vidimos and Stultz both practice primarily at CCF Main Campus — Allison as Dermatology Chair in the Dermatology and Plastic Surgery Institute and Todd in the Neuroradiology section of the Imaging Institute.

Off duty, fun generally revolves around activities on or near Lake Erie or Lake Michigan — with sunscreen, of course!

Feedback on our newsletter is always welcome, as are your suggestions for future content. We would enjoy hearing about marriages, births, promotions, retirements and interesting hobbies or vacations that you would like to share, and photos are especially welcome!

The information will appear in the Alumni Updates column in the biannual Radiology Alumni Connection electronic publication. Please send your announcements or photos to [email protected]

Medical Editor - Pauline Kwok, MD (TRS’95, DR’00, ABI’01)

Cleveland Clinic Alumni Specialty Director, Radiology

Kristen Stultz with dad Todd



http://my.clevelandclinic.org/staff_directory/staff_display.aspx?doctorid=3591

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