Associate Professor Tim Szczykutowicz, PhD, DABR has been appointed to two prestigious positions. He will be serving as a Consultant Editor in Physics for the Journal of Thoracic Imaging. Additionally, he was named the Radiologic Physicist Member on the State of Wisconsin Department of Safety and Professional Services (DSPS) Radiography Examining Board.
The Journal of Thoracic Imaging (JTI) is a premier journal that provides information on the use of imaging techniques in the diagnosis of cardiac and pulmonary diseases. Dr. Szczykutowicz has done multiple reviews for the journal over the last year, and he enjoys taking time to think about the paper and how it can contribute to the field of radiology. JTI – where Department of Radiology Professor and Vice Chair of Quality Jeff Kanne, MD serves as a Deputy Editor – recognized Dr. Szczykutowicz’s contributions by giving him this consulting role. As Consultant Editor in Physics, Dr. Szczykutowicz will help find the correct physics expert reviewers to judge manuscripts and review physics-related content. He will also help assess the physics merit and novelty of articles. “I am happy to use my physics knowledge to help JTI as best I can,” says Dr. Szczykutowicz.
Members of the Radiography Examining Board are appointed by the Governor and then confirmed by the state Legislature to serve four-year terms. As the Radiologic Physicist member of the Wisconsin Radiography Examination Board, Dr. Szczykutowicz will lend his imaging expertise to consider changes to state of Wisconsin licensing requirements for radiology imaging technologists. He is also responsible for helping decide what to do in cases of disciplinary action for technologists that are at risk of losing their license or who are practicing under a limited license.
Dr. Szczykutowicz was proud to have been selected to the Wisconsin Radiography Examination Board. “I have a deep respect for the day-to-day decisions our CT technologists make in everything they do, from billing to scanning our patients. I work very closely with them, and when I was invited to participate on the board, I felt it was a responsibility I looked forward to. I am happy and honored to be an advocate for my technologist colleagues in Wisconsin and ensure the regulations from the State are as burdenless as possible, while also ensuring our technologists are competent and able to serve our patients,” he says.
It was not just the faculty that were recognized for their excellence. Resident Ece Meram, MD, received the Philips/RSNA Research Resident Grant for her work, A Quantitative Angiographic Technique for Characterizing Flow Through Normal and Stenotic Iliofemoral Arteries. Neuroradiology Fellow Thomas Reher, MD, received the Ralph Schlaeger Charitable Foundation Research Fellow Grant for his research, Multi-compartment Diffusion Weighted Imaging Across the Lifespan in Healthy Aging and Alzheimer's Disease. Edward Lawrence, MD, PhD, a 2020 graduate from the UW Diagnostic Radiology Residency program, received the Roentgen Resident/Fellow Research Award, which recognizes residents and fellows for their contributions to the success of a radiologic research program within their department. Department of Radiology resident Kyle Lacy, MD, acted as an RSNA Resident Representative at this year's meeting. These residents help raise awareness of RSNA resources, increase resident engagement with RSNA, and encourage continued RSNA involvement beyond training.In addition to the numerous honors bestowed upon Department of Radiology members, faculty from 10 different sections of the Department spoke at the meeting. Highlighting the lectures given by UW faculty was the plenary session featuring Professor and Radiology Department Chair Thomas M Grist, MD, FACR, and Professor Charles Mistretta, PhD. Their lecture, “Together We Can Make a Difference: Radiology/Physics Collaboration in the Development of New Imaging Techniques” focused on X-ray, MRI and CT techniques for diagnostic and interventional angiographic applications, as well as the history that led to these developments. You can read more about their presentation here. These faculty presentations covered a wide array of topics, ranging from clinical applications of research, to becoming a better educator and leader within the profession, to the relevance of AI in radiology education. A list of these faculty speakers, and the topics of their presentations, can be seen below. Thank you to all the faculty that participated in RSNA 2020 and represented UW so well! Awards
- Honored Educator Award
- Scott B Reeder, MD, PhD
- Magna Cum Laude Award
- Meghan G Lubner, MD and Perry J Pickhardt, MD – Mucin-Producing Cystic Hepatobiliary Neoplasms
- Cum Laude Award for NM105-ED-X Education Exhibit:
- Joanna Kusmirek, MD; Steve Y Cho, MD; Nevein Ibrahim, MD; Alan McMillan, PhD; and Elizabeth Sadowski, MD – Pearls and Pitfalls in Assessment of Gynecological Malignancies on 18F-FDG PET/MRI;
- Cum Laude Award
- Mark A Kliewer, MD, MHSc, How to Read Abdominal CT
- Meghan G Lubner, MD, Gastrointestinal Manifestations of Immunodeficiency
- Meghan G Lubner, MD and Lori Mankowski Gettle, MD, MBA, Evaluation of Pancreas Transplants
- Certificate of Merit
- Michael C Brunner, MD, FACR, FSIR
- Kirkland W Davis, MD, FACR
- Jeffrey P Kanne, MD
- David Kim, MD
- Kenneth S Lee, MD
- Meghan G Lubner, MD
- Lori Mankowski Gettle, MD, MBA
- Scott Sheehan, MD
- Lindsay Stratchko, DO
- Resident/Fellow Research Grants and Awards
- Ece Meram, MD: Philips/RSNA Research Resident Grant for A Quantitative Angiographic Technique for Characterizing Flow Through Normal and Stenotic Iliofemoral Arteries
- Thomas Reher, MD: Ralph Schlaeger Charitable Foundation Research Fellow Grant for Multi-compartment Diffusion Weighted Imaging Across the Lifespan in Healthy Aging and Alzheimer's Disease
- Edward Lawrence, MD, PhD: Roentgen Resident/Fellow Research Award
- RSNA Resident Representative
- Kyle Lacy, MD
- Gregory D Avey, MD – Optimizing Head and Neck PET/MRI
- Donna G Blankenbaker, MD, FACR – Best in Show: Adult Musculoskeletal CT, A Case-Cased Imaging Review
- David A Bluemke, MD, PhD, MsB – Photon Counting CT: Principles and Neuroradiology Applications; New Research that Should Impact Your Practice: From the Editors of RADIOLOGY
- Guang-Hong Chen, PhD – Applications of Deep Learning in CT Image Formation
- Laura Eisenmenger, MD
- Thomas M Grist, MD, FACR and Charles Mistretta, PhD – Together We Can Make a Difference: Radiology/Physics Collaboration in the Development of New Imaging Techniques (Plenary Session)
- Tabby Kennedy, MD – Vision: Disease of the Orbit and Visual Pathway – Vision Loss; Turning ZZZ’s to Buzz: Improving the Medical Student Radiology Rotation
- Anthony Kuner, MD – A Symptom Based Approach to Head and Neck Pathology
- Joanna Kusmirek, MD – Pearls and Pitfalls in Assessment of Gynecological Management on 18-FFDG PET/MRI
- Kenneth S Lee, MD – Does Platelet-rich Plasma Really Work for Treating Tendon Injuries; Hip Ultrasound Demonstration
- Lori Mankowski Gettle, MD, MBA – Sensitivity for Pre-treatment In-vivo Extra-prostatic Lesion Detection Using 18F-DCFPyL PSMA PET/CT and PET/MR: Multi-reader Performance of Modality/acquisition Comparison
- Maria Daniela Martin, MD – Adult Small Airway CT
- Cristopher Meyer, MD, FACR “Meta”
- Perry J Pickhardt, MD – Best in Show: Adult Hepatobiliary Tract CT
- Scott B Reeder, MD, PhD – Introduction to Academic Radiology: Practical Tips for Building a Research Career; Optimized Abdominal MRI Protocols; Pulmonary MRA; 4D Flow MRI
- Jessica Robbins, MD – Dealing with Uncomfortable Bias in Your Career, Introduction to Academic Radiology; Mentoring and Coaching in Radiology: Coaching Junior Faculty: Refresher Course
- Andrew Ross, MD, MPH – Ultrasound-Guided Musculoskeletal Intervention of the Upper Extremity: “Arming” You with the Knowledge to Help Your Patients; Ultrasound-Guided Musculoskeletal Interventions of the Body Wall and Core: Treating Pain with “Abs”-olute Confidence; A Multi-disciplinary Referral Pathway to Improving Secondary Fracture Prevention Post-vertebroplasty: Implementation of a Fracture Liaison Service
- Andrew Ross, MD, MPH and Lori Mankowski Gettle, MD, MBA – Contrast Enhanced Ultrasound-Guided Musculoskeletal Biopsies: Our Experience and Technique
- Howard A Rowley, MD – Hot Topic Session: Stroke Imaging – How Recent Trials are Changing Radiologists’ Practices; Current Stroke Imaging Paradigms
- Elizabeth Sadowski, MD – O-RADZ Case Review
- Jonathan Swanson, MD – The Duality of Artificial Intelligence in Radiology Education
- Jason W Stephenson, MD – Give Me Your Best Shot: Helping Residents and Faculty Receive Feedback; Coaching Under-represented Minorities in Radiology
- Tim Szczykutowicz, PhD, DABR – ASRT@RSNA 2020: How CT Protocols Affect Technologist Repeat Rates, Throughput, and Image Quality; CT Protocol Management Across a Healthcare System
- Michael J Tuite, MD, FACR – Shoulder Imaging in Athletes
- Mai Elezaby, MD; Amy Fowler, MD, PhD; Pamela A Propeck, MD, FACR; Lonie Salkowski, MD, PhD, FACR; Roberta Strigel, MD, MS; Ryan Woods, MD, MPH – Breast Imaging Case of the Day
In April, Neuroradiology Section Chief and Associate Professor Tabby Kennedy was selected as a faculty inductee into the UWSMPH Alpha Omega Alpha (AOA) Medical Honor Society. AOA recognizes individuals for their excellence in scholarship, professionalism, leadership, and teaching. Each year, faculty are asked to nominate another faculty member that is deserving of induction into the honor society. The criteria for induction include recognizing high educational achievement, honoring gifted teaching, encouraging the development of leaders in academia and the community, supporting the ideals of humanism, and promoting service to others.
Director of Medical Student Education and Associate Professor Jason Stephenson nominated Dr. Kennedy for induction. “The criteria for AOA are literally a point-for-point recap of the highest-ranking items on a much longer list of Dr. Kennedy’s noteworthy attributes. I have had the good fortune to work with her for several years and witness first-hand the remarkable quality of work that she does and the steadiness and visionary nature of her leadership. I decided to nominate her because I could think of no other single human being that is a more worthy and appropriate match for this organization,” says Dr. Stephenson.
In addition to her induction into the AOA, Dr. Kennedy was also awarded the Women in Neuroradiology Leadership Award. This is a joint award from the Foundation of the American Society of Neuroradiology (ASNR), the American College of Radiology (ACR), and the American Association for Women Radiologists (AAWR) that recognizes women that have demonstrated leadership in neuroradiology. Dr. Kennedy believes she made her greatest impact through the websites she created. These websites allow her to reach a broader audience and break down complex topics to help others gain a better understanding of the material. One website is focused on neuroradiology, while the other is focused on radiology of the head and neck.
Dr. Kennedy notes that being recognized by her peers makes these awards meaningful. "I was really honored to have received this recognition. In my mind, these awards are recognizing my sustained commitment to the education of medical trainees and advancement of the field of neuroradiology."
Musculoskeletal Fellowship Program Director and Kenneth S Lee, MD, was awarded the 2020 International Skeletal Society (ISS) President’s Medal. ISS is an interdisciplinary society focused on the practice, science, and teaching of musculoskeletal medicine. The President’s Medal is awarded to an ISS member, who is younger than 46-years-old by October 2020, for outstanding scientific achievements at an international level.
Dr. Lee’s research is focused on sports medicine. His multidisciplinary musculoskeletal ultrasound research team is studying tendon elasticity and how it can predict injury and monitor healing. He also acts as the Principal Investigator on numerous randomized control trials studying treatment outcomes of platelet-rich plasma therapy in patients with plantar fasciitis and Achilles tendinitis. Dr. Lee has presented his research globally, including recently receiving an invitation to lecture at the US Olympic Training Center.
Dr. Lee was proud to receive this prestigious award. "I felt immensely honored and humbled when I learned that I was awarded the 2020 ISS President’s Medal. This award wouldn’t have been possible without the support of my mentors, the MSK Section and the Department of Radiology. I feel fortunate that I get to explore research ideas in a team-oriented environment that ultimately helps advance the diagnosis and treatment of sports injuries."
Physician burnout is a real problem. According to the Agency for Healthcare Research and Quality (AHRQ), burnout can cause physicians to leave the field and has the potential to negatively impact quality of patient care when physicians suffer from impaired attention, memory, or executive function (AHRQ). Burnout is caused by a multitude of problems, including time pressures, chaotic environments, low control of work pace, electronic health records, and family responsibilities (AHRQ).
While burnout may seem inevitable, healthcare organizations can implement solutions and wellness initiatives to help combat it. Associate Professor and Vice Chair of Faculty Development and Enrichment Jessica Robbins, MD talked about some steps that the Department of Radiology has taken to reduce burnout. One thing the Department does is provide opportunities for physicians to learn new skills beyond radiology. The Department offers presentations, Grand Rounds Speakers, and small group workshops centered around a new theme each academic year. This year’s theme is identifying and mitigating the effects of implicit bias.
The pandemic is exacerbating burnout as physicians become overwhelmed caring for COVID-19 patients. Longer shifts, inadequate access to PPE, and the fear of bringing COVID-19 back to friends and family are just a few ways that the pandemic has accelerated physician burnout. These challenges make it difficult to implement new wellness initiatives. “There are so many extraordinary demands on employees that are amplified and augmented by the pandemic,” says Dr. Robbins.
Despite the difficulty, the Department of Radiology, and UW as a whole, have implemented resources to help employees cope with mental well-being. In the spring, the Department of Psychiatry held group counseling sessions for employees that needed extra support dealing with the new demands. UW also instituted a peer support program within each department.
Another wellness initiative comes in the form of Grand Rounds Speaker and UW-Madison Clinical Professor Christine Whelan, PhD. Dr. Whelan’s talk, “Do the Next Right Thing: Purpose in Times of Uncertainty”, will be held at noon on December 17th via WebEx. Her presentation will focus on embracing a purpose mindset in times of uncertainty and will include research on preventive health and well-being. She will also offer tips for re-energizing purpose in people’s everyday lives. “My hope is that folks will leave my presentation energized and willing to try a few of these deceptively simple, yet research-backed and psychologically powerful, exercises themselves in the coming months,” says Dr. Whelan.
While wellness initiatives can provide some relief, the pandemic has exacerbated the existing problem of burnout. It is important to remain empathetic, as everyone is faced with different obstacles. “There are unique demands for everyone, and everyone is stressed in different ways,” says Dr. Robbins. “There is no one-size-fits-all approach to well-being".
There are many exciting developments transpiring in the Nuclear Medicine and Molecular Imaging Section. The Section’s is working with an investigational new drug (IND) tracer to identify abnormal parathyroid tissue. The tracer, fluorocholine, is only being used in a few places across the country. The UW Radiopharmaceutical Production Facility recently had success purifying a form of this drug for use. Abnormal parathyroid tissue is difficult to image, but the fluorocholine tracer will help improve PET/CT and MR imaging. Section Chief and Professor Scott B Perlman, MD, MS is leading the charge with the help of other section personnel. There is a lot of paperwork and approval processes to go through, but Dr. Perlman hopes that clinical work with the tracer can begin in late spring of 2021.
Clinical Director of PET/MR and Assistant Professor Ali Pirasteh, MD is leading the expansion of the PET/MRI program. The program is a clinical and research collaboration between the Nuclear Medicine and other Department of Radiology sections. The simultaneous PET and MR imaging delivers the optimal diagnostic information, empowering physicians to make the best treatment decisions for patients. “The program is evolving to improve patient satisfaction by reducing scan times as it has the advantage of acquiring two image sets simultaneously. Furthermore, novel PET and MR imaging techniques are constantly in development, which will make a tangible impact on the future of hybrid molecular and morphologic imaging,” says Dr. Pirasteh.
Professors within the Nuclear Medicine and Molecular Imaging Section have collaborated with AIQ Solutions, a Madison-based start-up, to develop a software to help with tumor response assessment. The aim is to develop a software that can assess tumors on an individual level to determine whether each tumor is responding to treatment. This software would help physicians read scans and determine the best course of treatment. While current prototypes are in the early stages of development, the preliminary software is very impressive, notes Dr. Perlman.
Assistant Professor Joanna Kusmirek, MD is collaborating on numerous research studies, mostly focused on cardiology. She collaborates with Professor Elizabeth Sadowski, MD, on PET and MR projects focused on pulmonary nodules and gynecologic malignancies. Clinical Assistant Professor Nevein Ibrahim, MD assists with the pulmonary nodule research, and Assistant Professor Steve Y Cho, MD works with the gynecologic malignancy research. Dr. Kusmirek helps evaluate pulmonary hypertension patients with V/Q scans for research in the Pulmonary Hypertension Clinic. She also recently started working with Assistant Professor Sofia Masri, MD on cardiac sarcoidosis evaluation by helping with PET, CT, and cardiac MRI.
The Therapy Service is continuing to expand to provide care for patients with neuroendocrine tumors. In January 2018 a new drug, Lutathera, was approved for use with neuroendocrine tumors. UW was the first hospital in Wisconsin to start administering the drug to patients. Since the hospital was approved to provide the treatment, Drs. Perlman and Cho have continued to treat patients. Dr. Perlman commented on the collaborative, interprofessional nature of this treatment, as he works with personnel in oncology, radiation safety, nuclear medicine, radiopharmacy, and more, to safely administer the treatment to patients.
This service is just one of the ways that the Nuclear Medicine Section is endeavoring to use more theranostics treatments. Theranostics, a combination of therapeutics and diagnostics, is a treatment where one radioactive isotope is used to identify the tumor and a second radioactive isotope is used to deliver therapy to the tumors. In theranostic cancer treatment, imaging-based dosimetry guides therapy dosing. Physicians can quantify tumor uptake for each patient and use that to deliver an individualized radiation dose of the therapeutic agent. “Our goal is to develop and expand theranostics because that is the future for cancer treatment,” says Dr. Perlman.
Related to theranostic treatments is the new SPECT/CT scanner that was installed in the UW Small Animal Imaging and Radiotherapy Facility (SAIRF) this summer, the first and only preclinical SPECT/CT in the state. This scanner has the potential to be a key player in theranostic cancer treatment, particularly during the preclinical research stages that test the effectiveness of different isotopes.
Professor Jamey Weichert discusses how theranostics is proving to be effective in mice. “We are now using our targeted radionuclide therapy agent, NM600, to enhance systemic immune detection and response to a variety of solid metastatic cancers in mice...when combined with immunotherapy, the results are striking with typically over 70% of mice experiencing complete tumor responses while developing T-cell immune memory which kills tumor cells injected months later,” says Dr. Weichert.
This and other studies on theranostics lend hope for the future. “This scanner is key for the development of a clinical theranostic center of excellence which will hopefully establish UW as a leading destination theranostic cancer treatment facility capable of conducting paradigm-changing clinical cancer treatment trials,” says Dr. Weichert. “One goal is to develop and expand theranostics because that is the future for cancer treatment,” says Dr. Perlman.
As part of RSNA 2020, Professor and Radiology Department Chair Thomas Grist, MD, FACR, and Professor Charles Mistretta, PhD, gave a collaborative lecture. The lecture, titled “Together We Can Make a Difference: Radiology/Physics Collaboration in the Development of New Imaging Techniques” focused on X-ray, MRI and CT techniques for diagnostic and interventional angiographic applications, as well as the history that led to these developments. Angiography is a medical imaging technique used to visualize the lumen of blood vessels, particularly arteries, veins, and heart chambers.
RSNA 2020 is a virtual event this year, being held from Sunday, November 29 through Saturday, December 5. This year’s focus is human insight and visionary medicine. The meeting provides an opportunity for radiology professionals to enhance their skills; connect with peers; and see the latest research, education, and technology.
Dr. Grist’s research focuses on developing and applying advanced, noninvasive MRI techniques to diagnose and provide therapy for cardiovascular disorders. Dr. Grist is the John H. Juhl Professor of Radiology, Medical Physics, and Biomedical Engineering. His physics background, and his interprofessional collaborative research team, help him bridge the gap from lab work to clinical practice. Dr. Grist also helped establish the Imaging Sciences Center in the Wisconsin Institutes for Medical Research (WIMR), which focuses on developing imaging technologies and then translating these technologies for clinical use.
Dr. Mistretta is a Professor Emeritus in Medical Physics, Radiology, and Biomedical Engineering. His research focuses on safe diagnostic angiographic interventions and time-resolved angiography, and has resulted in accelerated imaging techniques such as TRICKS, VIPR, and HYPR. He was also part of the research group that developed digital subtraction angiography (DSA). His current research interests include non-invasive techniques for MRI’s of the cardiovascular system, quantitation of flow, coronary artery imaging and flow measurement, and MR myocardial perfusion.