What do Vikings, skiing and multiple sclerosis have in common? They are all part of a recent initiative by UW scientists Dr. Ian Duncan of the School of Veterinary Medicine and Dr. Aaron Field of the Department of Radiology to support multiple sclerosis (MS) research and awareness by appearing as scientific experts in Norwegian film on the subject. The documentary, titled “Multiple Sclerosis, The Vikings and Nordic Skiing,” was created by Norwegian-born documentarian Steinar Hybertson to show how an active lifestyle, specifically cross country skiing, can benefit those living with MS. MS is a degenerative disease of the central nervous system which can lead to poor coordination, paralysis, and blindness. More than 2.3 million people worldwide live with MS, according to the National Multiple Sclerosis Society (NMSS), and the disease currently has no cure. No one knows what causes MS, but according to a 1995 study by neurologists at Harvard Medical School, a genetic susceptibility to the disease may have been spread by the Vikings during their conquests. MS is most frequently found in countries inhabited by the Vikings and their descendants, including Scandinavia, the British Isles, the U.S., Canada, and New Zealand. “The discovery of MS and its connection with the Vikings intrigued me,” Hybertson said. “one particular people — the Vikings — may have helped spread the disease through their genes and lust for travel.” Maintaining an active lifestyle can benefit those with MS, especially by reinforcing balance, muscular and bone strength, and a healthy immune system, according to Dr. Duncan. Exercise also helps improve fatigue, which is one of the biggest challenges those with MS face. Dr. Duncan has been an avid skier more than 30 years, and participated numerous times in a world famous marathon ski race, the American Birkebeiner. He began to think about the connection between MS and skiing when he was a participant in the American Birkebeiner raising funds for the NMSS in 2009. “I knew very well many people with MS who were skiers,” Duncan said. “I realized we had to have some sort of larger presentation, because there was a more important story that needed to be told.” The film follows six individuals ranging from 26 to 55 years old who have been diagnosed with MS—three in the US and three in Norway—as they share their stories of their diagnoses and train to participate in the Birkebeiner. “It’s important for patients with MS to know they shouldn’t give up anything they want to do, no matter the level of disability,” said Dr. Duncan. “You don’t have to be a super hero in a marathon ski race. Exercise of any kind is important.” UW Radiology’s Dr. Field became involved in the project because he wanted to make an impact for viewers by combining expert information on MS with inspiring stories from patients themselves, he said. “I find that patients and their families are hungry for information on their disease and on what’s being done to improve the way we diagnose, monitor, and treat it – especially when it comes to the strikingly detailed images of the brain provided by MRI,” Field said. “It seems that everywhere I go and talk about MS, someone tells me that they or someone they’re close to is affected by the disease; yet at the same time, so many people seem unaware of its impact.” “Our ultimate goal is to have this documentary shown internationally to increase awareness of MS in the general public and provide hope and inspiration to patients, their families and friends,” Duncan said in a statement. “This is an exciting project and one we think will resonate with families everywhere who enjoy an active, outdoor lifestyle.” The documentary, when finished, will be shown in the US on some public television channels, and in Norway on the NRK Network, according to Field. However, the team still lacks part of their budget, which will finance production costs. They have created a Kickstarter campaign to raise the remaining $20,000 for the film. In accordance with the guidelines of Kickstarter, however, if they fail to raise the full amount, they will not receive any of the donations pledged to them. With 8 days remaining to raise the funds, the group has raised approximately $7,926 of their total so far. For more information and to donate to the documentary project, visit: the group's Kickstarter profile The documentary will be broadcast on Wisconsin Public Television on December 19. -- Update: On November 6, the last day of their fundraising, the group exceeded their goal and raised a total of $25,185. Two-hundred thirty one individuals contributed financially to the project. Those who donated were eligible to participate in a Google Hangout with the production team.
Paul M. Harari, M.D., professor and chairman of the Department of Human Oncology at the University of Wisconsin School of Medicine and Public Health, urged collaboration between oncologists and radiologists to fuel valuable research. Imaging has spurred remarkable advances in cancer treatment and will continue to play an integral role as treatment becomes more personalized and moves to the molecular level, according to Harari, who delivered the Annual Oration in Radiation Oncology Wednesday at the Arie Crown Theater. After recalling the days when external anatomy and plain X-rays served as the primary guide for radiation therapy and collateral normal tissue damage was a necessary accompaniment of treatment, Harari described the "dramatic, seismic changes" that have taken place in the field. "Radiation delivery has become increasingly precise, enabling us to reduce treatment margins on tumors," he said. "Now we can shape radiation dose to the exact three-dimensional shape of each tumor and gate dose delivery to account for motion from breathing." The revolution in imaging and treatment technology has fostered meaningful gains for patients, Dr. Harari said. While dose traditionally has been limited by normal organ tolerance, modern technology can now provide very sharp dose gradients between tumor and critical normal tissues. The complementary use of CT, MR and PET imaging routinely facilitates improvements in tumor staging, treatment recommendations and outcomes. "We rely more on imaging in the field of radiation oncology than ever before," Dr. Harari said during his presentation, "Beneficial Liaisons: Imaging and Therapy." Dr. Harari, a former RSNA Research & Education (R&E) Grant Scholar, highlighted technological advances like intensity modulated radiation therapy (IMRT) and image-guided radiation therapy (IGRT) that are now routinely available and contribute to high tumor control rates and improved quality of life for patients. He cited examples from his head and neck cancer specialty to demonstrate how precise treatment delivery has helped to preserve important structures that were commonly damaged or destroyed with older methods. "For example, now we are able to spare major salivary glands and diminish radiation dose to the spinal cord, jawbone and voice box," he said. The recent advances only scratch the surface of possibility, according to Dr. Harari, who pointed to molecular imaging and biology as exciting areas of active development. "The blossoming of molecular biology over the last several decades is now providing opportunities to tailor drug and radiation treatment approaches more specifically for individual patients," he said. "Through the blending of modern imaging with molecular drugs and precision radiation, we are poised to further improve cure rates and diminish side effects." Along with molecular biology, Dr. Harari expects dramatically improved visualization to have a beneficial impact on treatment by lowering the threshold of cancer detection and enabling the tracking of individual tumor cells. "Through the unprecedented increased visualization of tumors with modern imaging, we are unmasking tumor characteristics previously unknown to us, including micro-extensions of tumors and even small metastases in other parts of the body," he said. Dr. Harari also touted the promise of diapeutic (diagnostic + therapeutic) agents that simultaneously image and treat cancer, and tumor biology imaging, a new discipline that can characterize individual tumors in terms of proliferation, metabolism and other variables to help shape more personalized and effective future therapies. Annual Oration in Radiation Oncology: Beneficial Liaisons: Imaging and Therapy Together, all these advances are helping to move imaging beyond the "see the tumor, treat the tumor" model of the past, said Dr. Harari, increasing the value of cooperation among surgeons, radiation oncologists and interventional radiologists. "Strengthening the bond of interaction between diagnostic and therapeutic practitioners in oncology has never been more vital and gratifying," he said. This year's oration was dedicated to the late K. Kian Ang, M.D., Ph.D., a head and neck cancer specialist who pioneered the use of molecular targeted agents with radiation therapy to improve patient survival rates. Press release courtesy of the Radiological Society of North America
UPDATE: We have added a section of the site dedicated to UW Protocols. Learn more about recent developments. At the University of Wisconsin - Madison, the medical physics and radiology departments have been collaborating with the hospital staff to refine CT imaging protocols in an effort to reduce dose, enable the acquisition of more clinically useful images, and reduce the frequency of repeat scans. According to Myron A. Pozniak, M.D., Professor of Radiology at the University of Wisconsin, the UW protocols have been constantly evolving. "We have the privilege of working with one of the largest medical physics departments in the world," Dr. Pozniak says. "With their help, we have taken our protocols and modified them so we image gently, but also we image well." This project has been so successful that the UW is partnering with GE Healthcare to share their protocols with current and future GE CT users. This has the potential to save time and money for GE customers. A study at the William W. Backus hospital presented at the 2011 annual meeting of the RSNA, revealed that the annual cost of reviewing and optimizing 30 protocols can exceed $150,000.(1) This release of UW protocols will cover nearly all clinical indications for CT imaging including neuro, MSK, chest, body, vascular, and pediatric. By adjusting the type, amount, and timing of oral and intravenous contrast as well as modifying patient positioning, and scan and reconstruction parameters, each protocol is optimized to enhance potential for accurate diagnosis of a suspect clinical condition.
Interaction Between DepartmentsOver the years as CT scanner complexity increased, Frank Ranallo, Ph.D., Associate Professor of Medical Physics and Radiology at the University of Wisconsin, became closely involved in protocol development. "I realized there was a great opportunity for improving image quality and also lowering radiation dose." He has interacted extensively with the radiologists and evaluated numerous parameters for CT image acquisition and reconstruction. "In most protocols, there are over 30 different technical parameters that can be adjusted and we consider all of them to be fair game for modification," says Dr. Ranallo. What is truly unique about the UW protocol optimization project is that for each clinical protocol, there are multiple protocol sub-sets tuned-in to patient size: adult (3 sets) and pediatric (5 sets). "With larger patients, image quality can really suffer, and if you try to improve it you quickly get very high radiation doses," explains Dr. Ranallo. This was the key issue—how to generate diagnostic quality images at a reasonable dose for all size patients. At many institutions, there is a single set of technical scan parameters per clinical protocol. They then rely on automatic exposure control (AEC), to produce the needed dose modification as patient size varies. That's a good start. But AEC only varies the mA. We tweaked multiple settings: kV, mA, rotation time, pitch, slice thickness, viewing window width and level, iterative reconstruction methods, etc., so the end result was maximum dose reduction for specific scanners across the spectrum of body sizes.
Each Scanner is Different"Typically when an institution acquires a new CT scanner they simply take the set of protocols that they've been using on their old scanner, copy it over, and start scanning. Some modifications may happen but it really takes time and an understanding of the new scanner's capabilities to fine-tune those protocols so they can take full advantage of it," explains Dr. Pozniak. "We are trying to provide those protocols with that scanner. They are optimized, validated and take full advantage of the new scanner's capabilities."
Industry ValidationBefore the protocols could be turned over to GE, UW Radiology had to become ISO compliant (an industry standard for quality). "For an academic institution to go through this exercise is unusual and I won't deny; it was painful," says Dr. Pozniak. "We hired an ISO specialist to generate formal documentation of our protocol management and optimization framework that we developed organically since our early days of CT." "When the AAPM Medical Physics Practice Guidelines came out for CT protocol management this year (2), we were glad to see we were meeting or exceeding all of the AAPM recommendations" says Dr. Timothy Szczykutowicz, Ph.D., Clinical Medical Physicist. To ensure that patient exams are accepted internally at the UW Madison, a robust quality assurance procedure had to be set-up. Every exam read by UW radiologists from CT scanners participating in the GE protocol project is QA'd for image quality. The radiologists leave feedback in the form of "good" or "bad" responses and if bad provide details as to why the image was not adequate for their needs. To date, over 10,000 unique image quality reviews have been received. "We are able to analyze the performance of our protocols across each of our scanners, for each of our patient sizes", says Dr. Szczykutowicz who is spearheading the compilation and analysis of the QA data. This QA data lets us take an aggregate view of our protocol performance, and often spurs changes or consultations between the physicists and clinical staff. "That's something that would be hard to do without an automatic QA system as our protocol set contains hundreds of protocols, each tuned slightly differently depending on which CT scanner the protocol was written for" says Dr. Szczykutowicz.
An Efficient WorkflowWith so many various protocols, one might think there would be a negative impact on workflow. "Not so," says the UW team. "Workflow actually improves!" "The first major advantage is that we tailor the protocol to the particular clinical indication. These are often straightforward (such as a known cancer follow-up) and we only employ a single scan sequence." This eliminates those multiple sequence studies that are not needed for diagnosis. The more sequences performed the more dose the patient gets, and the longer the study takes, Dr. Pozniak explains.(3) At many centers, the technologist is left to arbitrarily modify the protocol based on patient weight or BMI. The quality of the scan and dose are then highly dependent on their knowledge and expertise. "That's a big responsibility. We take the guess work out of it," states Dr. Pozniak. "The scanner user-interface presents the operator with the different clinical protocols. Once selected and the scout image obtained, the technologist selects the body size-specific protocol based on patient measurements and runs with it. No time wasted experimenting with the settings, and they are done right" Additionally, with timely advanced radiologist protocoling (motivated by insurance pre-approval process), the techs know exactly how long the patient preparation and the CT scan will take. This benefits patient scheduling and enables the scan to be completed more quickly. At the end of the day, it's all about making a confident diagnosis with an appropriately low dose. "Just a few years ago the primary focus in CT, was on increasing the number of slices and getting better resolution," says Dr. Pozniak. "Now we realize it's time to pull back from the over-pursuit of detail. We want make the diagnosis accurately, quickly and do it at an appropriate dose. Citations: (1) Siegelman, Jenifer RQW, and Dustin A. Gress. "Radiology Stewardship and Quality Improvement: The Process and Costs of Implementing a CT Radiation Dose Optimization Committee in a Medium-Sized Community Hospital System." J Am Coll Radiol. 2013 Jun;10(6): 416-22. (2) Cody, Dianna D., et al. "AAPM Medical Physics Practice Guideline 1.a: CT Protocol Management and Review Practice Guideline." J Appl Clin Med Phys. 2013 Sep 6;14(5):3-12 (3) Guite KM, Hinshaw JL, Ranallo FN, Lindstrom MJ, Lee FT Jr. "Ionizing Radiation in Abdominal CT: Unindicated Multiphase Scans are an Important Source of Medically Unnecessary Exposure," J Am Coll Radiol. 2011 Nov;8(11):756-61.
Jeffrey Kanne, M.D., Chief of Thoracic Imaging and Vice Chair for Quality and Safety, is a recipient of the 2013 Radiological Society of North America (RSNA) Honored Educator Award. According to the RSNA, the achievement recognizes, "dedication to furthering the profession of radiology by delivering high-quality educational content for the RSNA." The award recognizes members of the society who have contributed an array of educational resources in the past calendar year. These educational resources include: serving as faculty at one or more RSNA educational meetings, authoring an educational exhibit or online education materials, and donating a refresher course and writing CME questions for online learning. This is the 2nd year in a row Dr. Kanne has received the Honored Educator Award. The RSNA thanks Dr. Kanne for furthering the professional development of fellow radiologists and imaging scientists.
With help from the Department of Radiology's Research and Development fund, five medical students paired with research mentors to complete projects for the Shapiro Summer Research Program and presented their research on November 26. Students Joshua Bakke and Nicholas Stabo worked with Perry Pickhardt, M.D. Joshua Bakke's project was titled, "Colonic Fluid Volume Comparison of Cathartic Bowel Preparations for Computed Tomographic Colonography," and Nicholas Stabo's project was titled, "CT Volumetric Tumor Measurement for Assessing Treatment Response." view Joshua Bakke's presentation view Nicholas Stabo's poster Student Benjamin "Beau" Ebben worked with Kenneth S. Lee, M.D., on his project titled, "Noninvasive Quantification of Tissue Biomechanics: Shear Wave Imaging in a Porcine Tendinopathy Model." view Beau Ebben's poster Student John Renfrew worked with Jason W. Stephenson, M.D., on his project titled, "Algorithm-Based Quantification of Radiological Reporting Metrics." view John Renfrew's poster Student Sarah Sweetman worked with Scott Nagle, M.D., Ph.D., on a project titled, "Repeatability of Aortic Annulus Measurements on Pre-Procedure CT Scans For Transcatheter Aortic Valve Implantation (TAVI)." view Sarah Sweetman's poster According to Lynne Cleeland, Assistant Dean for Academic Affairs of University of Wisconsin School of Medicine and Public Health, 90% of students who participated in the program rated their satisfaction high on a survey. Cleeland also stated that the project is prompting many students to seriously consider academic medicine as a career path. Congratulations to UW Radiology's Shapiro students! … Updated 1/3/2014 to add links to posters.
Using a novel stroke rehabilitation device that converts an individual's thoughts to electrical impulses to move upper extremities, stroke patients reported improvements in their motor function and ability to perform activities of daily living. Results of the study were presented today at the annual meeting of the Radiological Society of North America (RSNA). "Each year, nearly 800,000 people suffer a new or recurrent stroke in the United States, and 50 percent of those have some degree of upper extremity disability," said Vivek Prabhakaran, M.D., Ph.D., director of functional neuroimaging in radiology at the University of Wisconsin-Madison. "Rehabilitation sessions with our device allow patients to achieve an additional level of recovery and a higher quality of life." Dr. Prabhakaran, along with co-principal investigator Justin Williams, Ph.D., and a multidisciplinary team, built the new rehabilitation device by pairing a functional electrical stimulation (FES) system, which is currently used to help stroke patients recover limb function, and a brain control interface (BCI), which provides a direct communication pathway between the brain and this peripheral stimulation device. In an FES system, electrical currents are used to activate nerves in paralyzed extremities. Using a computer and an electrode cap placed on the head, the new BCI-FES device (called the Closed-Loop Neural Activity-Triggered Stroke Rehabilitation Device) interprets electrical impulses from the brain and transmits the information to the FES. "FES is a passive technique in that the electrical impulses move the patients' extremities for them," Dr. Prabhakaran said. "When a patient using our device is asked to imagine or attempt to move his or her hand, the BCI translates that brain activity to a signal that triggers the FES. Our system adds an active component to the rehabilitation by linking brain activity to the peripheral stimulation device, which gives the patients direct control over their movement." The Wisconsin team conducted a small clinical trial of their rehabilitation device, enlisting eight patients with one hand affected by stroke. The patients were also able to serve as a control group by using their normal, unaffected hand. Patients in the study represented a wide range of stroke severity and amount of time elapsed since the stroke occurred. Despite having received standard rehabilitative care, the patients had varying degrees of residual motor deficits in their upper extremities. Each underwent nine to 15 rehabilitation sessions of two to three hours with the new device over a period of three to six weeks. The patients also underwent functional magnetic resonance imaging (fMRI) and diffusion tensor imaging (DTI) before, at the mid-point of, at the end of, and one month following the rehabilitation period. fMRI is able to show which areas of the brain are activated while the patient performs a task, and DTI reveals the integrity of fibers within the white matter that connects the brain's functional areas. Patients who suffered a stroke of moderate severity realized the greatest improvements to motor function following the rehabilitation sessions. Patients diagnosed with mild and severe strokes reported improved ability to complete activities of daily living following rehabilitation. Dr. Prabhakaran said the results captured throughout the rehabilitation process—specifically the ratio of hemispheric involvement of motor areas—related well to the behavioral changes observed in patients. A comparison of pre-rehabilitation and post-rehabilitation fMRI results revealed reorganization in the regions of the brain responsible for motor function. DTI results over the course of the rehabilitation period revealed a gradual strengthening of the integrity of the fiber tracts. "Our hope is that this device not only shortens rehabilitation time for stroke patients, but also that it brings a higher level of recovery than is achievable with the current standard of care," Dr. Prabhakaran said. "We believe brain imaging will be helpful in both planning and tracking a stroke patient's therapy, as well as learning more about neuroplastic changes during recovery." Other co-authors are Dorothy Farrar-Edwards, Ph.D., Justin Sattin, M.D., Mitch Tyler, Ph.D., Veena A. Nair, Ph.D., Svyatoslav Vergun, B.S., Leo Walton, B.S., Jie Song, M.S., and Brittany Young, B.A., B.S. See local video coverage of the story from WKOW 27 This story submitted by RSNA Media Relations © RSNA 2013
Here's a preview of UW Radiology's presence at RSNA 2013: Jitesh Ahuja, M.D., MBBS
- Histiocytic Disorders of the Lungs: CT Findings
- Case-based Review of Musculoskeletal Radiology: Hip
- Musculoskeletal Radiology Series: Pelvis and Hip Imaging
- Developmental Hip Dysplasia in the Child and Adult
- MR of the Hip Labrum
- Interventional Oncology Series: Progress, Challenges and Opportunities, Ablation Devices
- Decision Support in Clinical Practice
- Decision Support in Predicting Diagnosis and Outcomes
- Radiation Safety in the Interventional Radiology Suite
- Quantifying Tendon Damage with Ultrasound (US) Shear Wave Elastography Using a Porcine Flexor Tendon Tear Model
- MRI Contrast Use: Have Quality and Safety Collided?
- MR Quantification of Liver Iron
- Waiting to Exhale: What's the Latest with Inhalation Lung Diseases?
- It's Not All in the CAD or BI-RADS: Optimizing Your Interpretation of Breast MRI by Avoiding Perils of CAD and Including Diagnostic Imaging Data Not Yet Included in BI-RADS
- Gastrointestinal: CT Colonography Update, Summary of Results
- CT Diagnosis of Gastroduodenal Ulcers: Imaging Findings with Endoscopic Correlation
- Coagulation Profiles: Can We Safely Relax the INR and Platelet Parameters for Image-Guided Percutaneous Liver Biopsy?
- Emerging Technology: Silent MR
- Resident Interviewing: Resident, Fellow, and Radiologist as Interviewees
- Interview Role-Playing
- Controversy Session: The Evolving Role of Image-guided Pulmonary, Hepatic, and Renal Mass Biopsy: Current Indications and Controversies: Liver Biopsy
- When Should I Be Using that Specialized Device: MW Systems
- Hands-on Review: Nerve Ultrasound Based on a Regional Approach: Shoulder and Neck
- Infectious Complications of Solid Organ Transplant: A Pictoral Review
- Dose Metrics and Radiation Risks: A Primer for Radiologists
- Making the Undoable Case Doable: Advanced Adjunctive Techniques in Percutaneous Ablation
- Nuts and Bolts of Microwave Ablation
- Prospective Evaluation of Prior Image Constrained Compressed Sensing (PICCS) Algorithm in Abdominal CT: Preliminary Results Comparing Reduced Dose with Standard Dose Imaging
- Artifacts Associated with MR Angiography (MRA) for Pulmonary Embolism (PE)
- Changes in Resting-State Functional Connectivity Following BCI-EEG Based Intervention in Sub-Acute and Chronic Stroke Patients
- MR Imaging of Endometrial Cancer and Its Role in Directing Surgical Management
- Oral Contrast Issues
- Initial Endoscopy Following Screening CT Colonography: Confirmed vs. Discordant Polyps
- Gastrointestinal Pathology Identified on Standard Chest Radiography: Living on the Edge
- Comparison of Fixed to Weight-Based Contrast Dose for CTA of the Chest, Abdomen, and Pelvis
- Dual Energy CT Improves Visibility of Early Bowel Ischemia Compared to Conventional CT in a Swine Model
- Case-based Review: Transplant Ultrasound of the Liver, Pancreas, and Kidney
- MDCT Protocol Optimization Using an Automated IT Solution Providing Size-Specific Patient Doses, Automatic Tube Current Modulation Information, and Radiologist Feedback.
- The Influence of kV and Patient Positioning on CT Image Quality and Dose: Why Low kV CT Scans Have a Higher Sensitivity to Patient Positioning.
- Novel Rehabilitation Device Improves Motor Skills after Stroke
- Usage of fMRI for Pre-Surgical Planning in Tumor and Vascular Lesion Patients: Task and Statistical Threshold Effects on Language Lateralization
- Pediatric CNS Cases
- Non-Contrast MRA of the Abdomen
- Hot Topic Session: MR Quantification of Liver Fat
- Vascular Imaging Series: Phase-contrast MRA
- Assessment of Tissue Oxygenation in Cervical Cancer Using Blood Oxygenation Level-Dependent (BOLD) MRI
- Emergency Symposium on CNS Emergencies: CNS Trauma, Interactive Case Discussion
- MR imaging of Endometrial Cancer and Its Role in Directing Surgical Management
- Leveraging Imaging Informatics to Improve Radiology Education: Beyond the Teaching File, Taking Audience Response to the Next Level
- Pulmonary MRA: How I Do It
- ASRT@RSNA 2013: Elbow and Forearm Trauma: Mechanisms of Injury and Patterns of Fractures
- Comparison of Quantitative Magnetization Transfer of Patellar Cartilage in Asymptomatic Volunteers and Patients with Early Osteoarthritis
- Brain Aneurysms: The Neurointerventional Suite of the Future
- Sub-mSv Cerebral CT Perfusion Using PICCS
- Pre-Wallerian Degeneration in Neonates Presenting with Acute Infarct: The 3 Tesla Magnetic Resonance Imaging (3TMRI) Experience.
- Essentials of Musculoskeletal Imaging: Elbow MRI
- Image Interpretation Session
- Non-Traumatic Neuro Emergencies: Non-Traumatic CNS Hemorrhage
- PACS and Radiologist Workflow in a Multi-Enterprise Environment
- Advanced Image Analysis, Including Applications Such as Automated Stent Planning and Multimodality Image Fusion and Treatment Planning
- Cloud Computing for Radiologists: A Primer
- Virtualization and Remote Rendering: Enterprise Imaging in the Cloud
- Percutaneous Microwave Ablation of Hepatocellular Carcinoma: Early Clinical Results with 106 Tumors
- Gastrointestinal: Ablation and Abdominal Interventions
Dr. Perry Pickhardt has appeared across many areas of media lately to discuss virtual (CT) colonography, from scientific publications to podcasts and more. His most recent project is to make sure Wisconsin legislators know the importance of this growing modality. In October, a representative for Rep. Mark Pocan, D-Wis., visited Dr. Pickhardt’s lab to learn more about the innovative research going into virtual colonography. “The goal is to make our Wisconsin representatives and senators aware of our unique screening program and how our success could to greatly expanded to benefit all Medicare beneficiaries if Senate Bill S.2265 and Bill H.R. 4165 can be passed by Congress,” Dr. Pickhardt said. He also noted that Sen. Tammy Baldwin, D-Wis., visited the lab last year. S.2265 and H.R. 4165 provide that a colonography screening through CT would be covered under Medicare in the same way that non-virtual screening would, beginning in the 2014 fiscal year. “Virtual colonography is a better, faster, safer, and cheaper relative to the current standard of invasive colonoscopy,” Dr. Pickhardt said, which is why he hopes to reach politicians about why the bills should be implemented.
On October 20, Dr. Jarrett Kuo, an Abdominal Imaging Fellow, completed the Detroit Free Press International Marathon. Dr. Kuo finished the marathon with a time of 3:50:56, averaging 8.48 minutes to run a mile. Dr. Kuo reportedly selects his marathons based on the “coolness factor,” or uniqueness of the medal he will get upon finishing. The medal for the Detroit Free Press Marathon features a Detroit cityscape with skyscrapers, a vintage Ford automobile, and a vinyl record and microphone. According to Abdominal Fellowship Coordinator Kristin Hubers, Dr. Kuo says in the future, he plans to complete the Surf City USA Marathon on Super Bowl Sunday in Huntington Beach, California, because the finisher’s medal is shaped like a surfboard. Professionally, Dr. Kuo says he is enjoying Madison, is looking forward to perfecting his MRI reading skills, and is very excited about the procedures being done at UW. Photo courtesy of Detroit Free Press and FinisherPix
Paul Rowley, the son of UW Radiology’s Dr. Howard Rowley, is a typical undergraduate junior. He is majoring in neurobiology, and loves traveling and playing the guitar and piano. He has also received a nomination by the European Congress of Radiology to present his paper, titled “Unexpected brain MRI findings in research volunteers” at the 2014 annual meeting in March in Vienna, Austria. Co-authors include the Department of Radiology’s Aaron Field, M.D., Ph.D., Alejandro Munoz del Rio, Ph.D., Elizabeth Simcock, and Paul's father. It started in the summer of 2012, when Paul was hired by the department to check through a database the of brain research scans of volunteers participating in a wide range of studies. During a transition from paper forms to an online platform, some of the data may have been entered incorrectly or mistyped, and it was Paul’s job to track down the correct information and rectify the entries. While amassing information on close to 7000 individual entries, Paul began to reflect on his interest in incidental findings in neuroimaging research. The co-authors realized they had valuable raw data about the neurologic status of a large general population with no prior neurologic complaints, and sought IRB approval to fully study the data and look for abnormalities. The authors then pored over the scans, categorized abnormal scans, and Munoz del Rio performed statistical analysis of the data. “Where this study diverges from prior studies is in the sheer size of the subject population, so the conclusions carry greater statistical power,” Paul said. Around 80 percent of the scans they looked at were normal. However, despite the fact that almost 4 percent needed further follow up for their abnormalities, less than 1 percent had been flagged during the initial scan. “When volunteers were contacted regarding abnormal findings, they were almost universally grateful for the information, and opted for additional clinical evaluation,” the group’s abstract states. “This project paves the way for further investigation into… procedures for handling the discovery and disclosure of adventitious findings, as well as numerous other ethical considerations,” Paul said. Beyond graduation, Paul hopes to attend medical school and become a physician. He also says he’d like to remain active in neuroscience research. The Department of Radiology is pleased to be able to facilitate emerging research and foster learning in such novel ways.