Page 1 ABDOMINAL IMAGING SECTION The Fellow Follow · PDF fileThe conference will then...

U N I V E R S I T Y O F W I S C O N S I N D E P A R T M E N T O F R A D I O L O G Y A B D O M I N A L I M A G I N G S E C T I O N

The Fellow Follow-up

December 2011

www.radiology.wisc.edu

How time flies. I hope you're doing well in your practice and that you had time to enjoy this summer and

fall. Another fellow class has come and gone. This year’s group is settling in nicely. They are getting into proce-

dures and ablations in earnest. Please see the class bios on page four. They have been busy searching for practice

positions next year, but several are still not committed for next year. Perhaps you have an opening and it may be of

interest to them.

We have a new section head. As of July 1, I've stepped down and Louis Hinshaw has taken over. Louis has

trained with us throughout his residency and fellowship. He spent a brief time at the University of Colorado in Den-

ver. He brings a refreshing youthful ambition to the position. It is time for this crusty curmudgeon to step aside.

Our section has recently experienced some growth. Well, relatively speaking. We've had some additions to

our families. Jessica Robbins and Joe Tavano welcomed Quintin Vincent on November 7th and Lily Elise arrived

on May 15th to parents Pam and Nick Adams. Also, three of last year's fellow class had new additions to their fam-

ilies.

We have something new to announce. Madison as you know is noted for its cycling terrain. Just about every

weekend you can find a charity ride or a race. We’ve come up with a new concept in radiology meetings. Next Au-

gust we will host a Radiology / Cycling meeting. This conference will run for 2 1/2 days. Each morning will feature

a 20 to 30 mile supported ride, followed by presentations on the latest and greatest advances in imaging by our UW

faculty. The conference will then dovetail with the Dairyland Dare (Gran Fondo Wisconsin), a major cycling event

with distances to please or challenge all levels of riding skill. If you are a weekend or an avid cyclist, please mark

your calendar. If not, please let those in your practice or your imaging friends who you know are cyclists know

about this meeting. Help us spread the word. Stay tuned for details.

Letter From the Editor

Myron Pozniak, MDMyron Pozniak, MD

Happy holidays and a prosperous new

year to all.

Sincerely,

Myron Pozniak, MD,FACR

In this issue:

Who’s New at UW 2

Fellowship Program Update

3

Current Fellows 4

Neuwave News 5-6

In the News 7

Accomplishments 8

Who’s New at UW

The Fellow Follow-up Page 1


Quintin Introducing Quintin Vincent Tavano

November 5, 2011 ~ 7 lbs, 8 oz, 20.5 in

Congratulations Jessica Robbins and Joe Tavano

Samuel Thomas

Paul & Brooke Stanton

Lily Elise,

Pam & Nick Adams

There are babies everywhere in the

Abdominal Imaging Division! Here are

all 7 of the babies new to the division in

the last year. Coffee anyone?

Bernard (Ben) Edward, Meg and

Sam Lubner

Pierce Lucas,

Shelby and

Bo Fishback

Madeline, Cody and Heidi Boyce

Ainsley Elizabeth, Dec 6,

Allison Grayev and EJ Borman


Not too long ago, I was writing a Fellow Follow-Up piece discussing the transition of the abdominal

imaging fellowship from Fred to me. Now that I have a year under my belt, I am glad to report that the sky did

not fall and in fact, I think we had a great year. To repeat myself from last year,

“There is only one constant and that is change.” This year that change is that I am

also taking on the responsibility of being the Chief of Abdominal Imaging here at

the UW. Once again, I am lucky enough to follow in the footsteps of people who

created something great, but unlucky enough to be in the position where it is hard

to make many improvements. This division has thrived and continuously

improved under the direction of Fred and Myron and I just hope that I can main-

tain the current trajectory.

This past year was a lot of fun and we had another talented and dedicated

group of fellows. Although most of our fellows stayed relatively close to home

this year and will presumably immediately improve the radiological care in the

state of Wisconsin (Paul Stanton, Lacrosse, WI; Nathan Zelinski, Marshfield, WI;

EJ Borman, Madison, WI), we did send one great addition to Kansas (Shelby

Fishback, KU) as well, so they owe us. They all performed in a superior manner

as fellows and I am sure that they will do so as radiologists as well. Congratulations.

This year is starting with a bang. We are once again lucky enough to have two of our exceptional

residents joining us (Meghan Hanson and Heather Webb), but in addition, we have managed to steal one and a

half of Michigan’s best residents (Julie Ruma and Shane Wells (MRI fellowship primarily)) and have additions

from Maine (Scott King) and St. Joe’s (Lucas Ludeman) as well. The talent is impressive and I look forward

to seeing them develop and excel over the year.

We are looking forward to another great year and hope this finds everyone healthy and well. Please

drop us a line and let us know how you are doing and if you are in the area, drop in for a visit.

-J. Louis Hinshaw

P.S. We had another incredible “Fishing Meeting” last summer. For those of you who weren’t able to make it,

we had 70+ trophy fish caught, the best weather

you can possibly imagine in northern Canada,

lots of quality time together, and a great array

of lectures. Please try to join us in the summer

of 2013 for the next iteration…

Fellowship Program Update-2011 Page 3


J. Louis Hinshaw, MD

2013 Fellow Recruitment

2010-2011 Fellow Class

We currently have two remaining fellowship position for 2013. Please send any interested residents to our website.

Meghan Hanson was born and raised

in Sturgeon Bay, WI. She did her

undergrad and medical school at the

University of Wisconsin, followed by

internship and residency at UW Hos-

pital and Clinics. Her interests in-

clude female pelvic imaging, ultra-

sound, and ultrasound guided inter-

ventions. She has done a fair bit of

research on extracolonic findings at CT colonography.

She currently lives in Stoughton with her husband, Ben,

and their small menagerie of 3 dogs and a cat, but will be

moving closer to home next summer when she joins

Green Bay Radiology.

Scott King joined the UW Ab-

dominal Imaging team from Maine

Medical Center in Portland, Maine,

where he completed his residency

training. Prior to residency, he at-

tended Medical School at the Univer-

sity of Nevada. He is joined by his

wife, Sarah, and their two young

boys, Alex (3.5 yrs) and Ryan (11

months). He grew up in Kenai, Alaska, and is no stranger

to frigid winters, ice fishing, pond hockey and snow

blowers. In addition, Scott enjoys to fish, golf and is a

football fan. Scott is currently planning to work in pri-

vate practice either in the Upper Midwest or the West.

Ideally, his future practice would encompass diagnostic

CT, US, Body MRI, Virtual Colonoscopy and image-

guided procedures.

Lucas Ludeman originates from a

small town in southwestern Minnesota

(Tracy, MN). After completing his

undergraduate work at the University

of Minnesota, he attended medical

school in Milwaukee, WI at the Medi-

cal College of Wisconsin. He then

completed residency at St. Joseph's

Hospital in Milwaukee, WI. He is pursuing a fellowship

in body imaging at UW Hospital to fulfill his interests in

body MRI and image guided interventions. His wife's

name is Laura and has two boys ages 5 and 2. After the

fellowship year, he will be practicing with St. Paul Radi-

ology, St. Paul, MN.

Meghan Hanson, MD

Meet the 2011-2012 Fellows

The Fellow Follow-up

Julie Ruma, MD

Heather Webb, MD

Julie Ruma is originally from Omaha, Ne-

braska. She made her first move to Wiscon-

sin for her undergraduate studies at the Uni-

versity of Wisconsin-Milwaukee, where she

also played soccer. She headed back home

for medical school at the University of Ne-

braska and then completed her residency at

the University of Michigan. She is excited

to be back in WI and reconnecting with

many old soccer friends. After fellowship, Julie will be moving

back to Michigan to join her fiance, Brian, who practices Emer-

gency Medicine in the greater Detroit area. She is open-minded

to both academics and private practice with an emphasis on ad-

vanced abdominal CT and MRI imaging and cross-sectional

interventional procedures

Heather Webb is originally from Bremer-

ton, WA, a small town outside Seattle.

Following her undergraduate studies at

BYU, she attended Washington University

Medical School in St Louis. She completed

her radiology residency at the University

of Wisconsin in 2011. After this fellowship

year, she hopes to enter private practice,

preferably “somewhere out west.” She

enjoys hiking, biking, reading, and traveling, and has been

known to drag family members and friends to various exciting

and obscure locations around the world, often on short notice.

Shane Wells is originally from Huntington,

WV, the proud home of the Thundering

Herd of Marshall University. Prior to attend-

ing medical school at Marshall University,

Shane completed undergraduate degrees in

both Nursing (’97) and Biology (’02) also at

Marshall. He practiced nursing, as a RN, for

7 years, primarily in the ICU. After medical

school, Shane completed residency training at the University of

Michigan where he served as chief resident from 2010-2011. He

and his family transitioned to Madison, WI for fellowship train-

ing in MRI and abdominal imaging in 2011. Shane has practice

interests in advanced CT (CT colonography, CT enterography,

CT urography), MRI (hepatobiliary, pelvic) and cardiac

(Coronary CT, cardiac MRI) applications, in addition to a partic-

ular interest in cross-sectional interventions. Outside of work,

Shane enjoys spending time with his wife, Lisa, and children,

Rian (7) and Luke (4) and playing sports, golf in particular.

Shane Wells, MD

Scott King, MD

Luke Ludeman, MD


Page 4

Technological Advances—NeuWave Medical, Inc

.

NeuWave Medical, Inc. - A spin-off company from The

University of Wisconsin Abdominal Radiology written by Fred Lee In the mid-1990’s I became increasingly disillusioned with the radiofrequency ablation devices that were clini-

cally available. The ablation zones were too small, too unpredictable, and took too long to create. What really both-

ered me however, was the hype that the companies put out on the street, and how poorly their marketing materials cor-

related with the results. In 1997 I decided to do something about it, and along with an engineering PhD student (Dieter

Haemmerich, now at the Medical University of South Carolina), invented a multiple probe RF unit. The idea was that

the use of multiple RF probes would help create larger and more predictable ablation zones. Over the course of the

next several years, we (Chris Brace, Paul Laeseke, Lisa Sampson, and Dieter) refined the device, tested it, and eventu-

ally it was licensed by a large medical device manufacturer, Covidien (Previously Tyco Healthcare, Boulder, CO). In

2004 the device was released as the Covidien Switching Controller™ (Catchy name, huh?) and has been in widespread

clinical use ever since. Despite the name, it is now the most widely used ablation device in the United States.

Unfortunately, my wife’s attempts at naming the machine (The Therminator, the DieLeeTer) were summarily rejected

by Covidien for some strange reason. Another trivia fact: Louis Hinshaw was the first person in the world to do a

clinical case with the unit when he was a fellow.

I wish that the moral of the story was that everyone lived happily ever after, but if any of you have had any

dealings with a large company, you know that this is rarely the case. Even though the device has been a huge commer-

cial hit, Covidien has not been an easy partner to deal with, and the University and the company are still at odds over

the business arrangements. Based on this, I decided that if I was ever involved with another significant invention, I

would start my own company to avoid being at the mercy of corporate America.

In 2001 I was at Dieter’s PhD thesis defense where he presented our multiple probe RF work. One of the oth-

er committee members (an engineering professor, Dan van der Weide) started questioning Dieter about the use of RF

energy for this purpose: wouldn’t microwave work better? We were intrigued by this possibility, and after some dis-

cussion of what it would take, Dan actually built a functioning MW ablation unit out of a microwave oven, WWII

spare parts, and a spinal needle. Lisa and I were recently recalling the first ablation that we actually made with this

unit: While she and I were cowering behind a wall, after some puzzled consultation Dan made the first ablation zone

by pushing the “popcorn” setting on the MW oven. Everything was going fine until the unit started to smoke and

eventually blew up in the middle of our lab. This incendiary start motivated us to write some grants to build a more

“stable” power supply and get some graduate student help (eventually Chris Brace and Paul Laeseke). Chris defended

his thesis in 2005, and is now an assistant professor

here in our department (as well as Medical Physics

and Engineering), and after Paul received his MD-

PhD he went on to a radiology residency at Stanford

University.

Within the next year, it became clear that

we had a best-in-class device on our hands, despite

the prototype nature of our system. Paul and Chris

had done a ton of development, inventing, and ani-

mal studies to show the potential of the device, and

Dan and I realized that we were at an important

cross-roads: do we follow the earlier path of giving

the invention to the university to license to a com-

mercial partner like Covidien, or do we gut it out

and do it ourselves? After much soul searching, we

decided to form our own company, which Dan

named Micrablate, LLC.

Company Co-Founders Dan van der Weide and Fred T Lee, Jr. posing

with the Certus 140.

The first couple of years of Micrablate were very humble, indeed. We started in a space owned

by another of Dan’s companies, and eventually moved into his basement lab. Our first employee was a

dynamite biomedical engineer from Minneapolis (Matt Thiel, brother of our ex-resident Jennifer Bergin).

Matt did everything from cleaning the toilets to tuning antennas, and somehow kept us moving forward

We eventually secured more federal grant funding, followed by venture capital funding from a local

company (Venture Investors), and attracted a world class CEO (Laura King) who used to run OEC for GE Medi-

cal. An interesting fact about Laura is that in the 1990’s when she was in charge of GE mammography, she was the sin-

gle person responsible for moving mammography from analog to digital, a decision for which she took tremendous heat

from GE leaders. Guess who was right about that one? After the hiring of Laura, the company really started to take

off. We renamed the company NeuWave Medical, moved into a wonderful facility on the east side near the airport (now

15,000 sf), hired a great chief engineer (Rick Schefelker, also from GE Medical), a leading sales/commercial expert

(Ginger Sands from Ohmeda), and an operations leader who was responsible for building the E9 ultrasound unit while at

GE Medical (Eric Clyse). This team rapidly turned the early prototypes into the best ablation unit in the world (in my

humble but biased opinion). Prior to clinical release, Meg Lubner, Louis, Paul, Chris, Erica Knavel (Med student, soon

to be one of our radiology residents), Anita Andreano (a visiting resident from Italy) and Lisa did the original animal

testing of the unit, and presented the first results at various meetings in 2010.

The Certus MW ablation device was FDA approved in October 2010, and ready for clinical and commercial

launch in December 2010. Once again, Louis Hinshaw was the first person to perform a clinical case with the device,

and it went spectacularly. This September, Louis and Tim Ziemlewicz performed the first lung ablation case at UW

without a pneumothorax or other complication. Since that time, the leading ablation centers in the country have bought

the device, and it is now in use at UW, Sloane Kettering, the entire Mayo system

(Rochester, Jacksonville, Scottsdale), Duke, UTMB, University of Florida (Shands

Hospital), UCLA, Brown University, and Wayne State University (Karmanos Cancer

Center) among others. We have a number of enhancements and new devices (mostly

invented by Chris Brace) in the pipeline for introduction over the next several

years. The fellows that graduated in July 2011 all had the opportunity to use the de-

vice, and they had the full effect of the before/after with the older RF devices. Our

ablation times now rarely exceed 5 minutes, and the number of probes that we use is

way down due to the high power available with the Certus.

Well, that’s the short history of NeuWave Medical. One thing that I am very

proud of is the large number of local jobs that NeuWave has brought to the Madison

area, how almost all the parts are built locally (everything is made in the USA) and

how we have pumped large amounts of money into the local economy. One failure: I

tried like crazy to get the Michigan fight song as the notification tone, but was shot

down by all of the highly biased Wisconsin types. What use is it in founding your

own company if you can’t even pick out the notification tone??

If any of you are interested in starting your own company, feel free to contact

me. It has been a tremendously rewarding experience, but it has taken years of sweat

equity, a lot of money, and more than a little good luck. If I’ve learned anything from

this experience, it’s been that getting the right people into the right spots is the most

important factor governing success. I’ve actually contributed little to what I hope

will eventually be a big success story, and if it hadn’t been for Dieter, Chris, Paul,

Lisa, Dan, Matt, Laura, Rick, Ginger, Louis, Meg, Tim, Marci, Jan, Erica, Anita, and

Eric we’d still be looking at a promising concept built from a microwave oven and

WWII surplus parts.


NeuWave Medical, Inc continued

The Certus 140 was approved by the

FDA in October 2010.


Abdominal Imagers in the News by Katie Teresi Page 7


The Renal Transplant Research Group has been awarded their third NIH grant for $1,250,000. This

RO1 is titled "Role of Nox2 in CNI-induced renal fibrosis" and will investigate the roles of oxida-

tive stress, renal perfusion and oxygenation on the development of chronic renal disease in patients

with transplanted organs. Drs. Elizabeth Sadowski (Radiology), Sean Fain (Medical Physics) and

Aji Djamali (Nephrology) have collaborated on multiple projects over the past 10 years, receiving

nearly $5,000,000 in grant funding for their work.

Dr. Meghan Lubner has been selected as a recipient of the highly prestigious Association of Univer-

sity Radiologists GE Radiology Research Academic Fellowship Award (GERRAF).

Each year, up to four GERRAF Fellows are selected based on their commitment to research careers,

the creativity and quality of their proposed research projects, and the support provided by their insti-

tutions. The GERRAF Board of Review felt that Dr. Lubner's work, "Volumetric Tumor Measure-

ment for Assessing Treatment Response: Too Good to RECIST?" showed outstanding credentials in

all these areas. She was assisted by several talented mentors: Dr. Perry Pickhadt from Abdominal

Imaging, Dr. Beth Burnside of Breast Imaging, Dr. Daniel Sullivan of Duke University, and Vikas

Singh of the UW Biostatistics and Computer Sciences departments.

This highly sought-after award grants each recipient a two-year, $140,000 fellowship, paid directly to

the recipient's institution for salary, education, and research support. In the past, this money has

helped sponsor original clinical and health services research on decision analysis, health and

economic outcome methods, and technology assessment.

We are excited to announce that a National Institutes of Health R01 grant proposal

prepared by UWSMPH Radiology's Drs. Perry Pickhardt and David Kim has been

awarded $965,137 over the next five years. The awarded project, titled "Comparative

Effectiveness of Virtual and Optical Colonoscopy for CRC Surveillance," impressive-

ly scored within the 1st percentile. The grant is part of a multi-center trial which in-

cludes the UWSMPH, Mayo Clinic Rochester, and Fox Chase Cancer Center.

Dr. Pickhardt is serving as the UWSMPH principal investigator for the project while

the co-investigators include Dr. Kim and Dr. Sam Lubner from clinical oncology.

Article recognized by both the HealthImaging.com and the Journal of the American College

of Radiology (JACR)!

UW’s Kristie Guite, M.D., J. Louis Hinshaw, M.D., Fred T. Lee, Jr, M.D., Frank Ranallo, Ph.D., and Mary

Lindstrom, Ph.D., authored the article, titled "Ionizing Radiation in Abdominal CT: Unindicated Multiphase

Scans Are an Important Source of Medically Unnecessary Exposure." The work discusses the commonality

of medically unnecessary multiphase CT exams and the potential of these exams to deliver excess radiation

exposure. This overexposure led the authors to call for an end to routine use of "one-size-fits-all" multiphase

protocols for abdominal and pelvis exams.

JACR originally published "Ionizing Radiation in the Abdominal CT" in its November issue, and named it

the best article published in the journal’s Clinical Practice category in the past year. HealthImaging.com

also featured the piece as one of its top stories. Kristie Guite, MD

Grants

http://www.radiology.wisc.edu/people/facultyContent.php?vaultID=460

http://www.aur.org/GE/index.cfm





For additional infor-

mation and brochures

please visit our website

or contact Ann Schen-

sky at:

[email protected]

36th Annual Ski the

Sky January 22-25, 2012

Big Sky, Montana

WOW-Cardiothoracic

Imaging

April 14, 2012

Madison, WI

2012 Conference Schedule

David Kim, MD qualified to compete in the

Boston Marathon in April 2013 by a solid finish in

the Milwaukee Lakefront Marathon.

With a time of 3:09:51, a 7:15 mile pace, Dr. Kim

placed 106th overall and 22nd in his division.

Jessica Robbins, MD On Monday, April 19th

just over twenty three thousand runners raced in the

114th Boston Marathon. Assistant Professor Jessica

Robbins, MD finished the race in only 3 hours and

27 minutes, beating her personal best by 10

minutes!

We are pleased to announce the promotion of

Elizabeth Sadowski to Associate Professor. In

addition to her ground-

breaking research in

NSF and pelvic and re-

nal MRI, Dr. Sadowski

is highly involved in

resident education,

specifically in the area

of profession develop-

ment and mentorship.

She is the 2009 recipient

of the AAWR Profes-

sional Leadership

Award and has been instrumental in receiving

substantial NIH funding for the renal research

transplant group at UW. Congratulations Liz!

Accomplishments

Do you have an accomplishment or news

item you would like to share with us and

other alums? Please email Myron Pozniak at

[email protected].

Dr. Sadowski Promotion



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