Undersea Mission Emphasizes Radiology’s Telemedicine Role · 2012-03-05 · 6 Undersea Mission...

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A UGUST 2006 V OLUME 16, N UMBER 8 Also Inside: PET and Enhanced MR Imaging Predict Response to Cancer Treatment Invention Aims to Eliminate Physician Radiation Exposure During Angiography Drug-Ultrasound Stroke Treatment Appears Promising RSNA 2006 Moves Informatics into the Mainstream Chicago Events and Attractions Offer Timeout at RSNA 2006 Register Online for RSNA 2006 Courses rsna2006.rsna.org Undersea Mission Emphasizes Radiology’s Telemedicine Role Image courtesy of NASA

Transcript of Undersea Mission Emphasizes Radiology’s Telemedicine Role · 2012-03-05 · 6 Undersea Mission...

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AU GUST 2006 ■ VO LU M E 16, NUMBER 8

Also Inside:■ PET and Enhanced MR Imaging Predict Response to Cancer Treatment ■ Invention Aims to Eliminate Physician Radiation Exposure During Angiography■ Drug-Ultrasound Stroke Treatment Appears Promising■ RSNA 2006 Moves Informatics into the Mainstream■ Chicago Events and Attractions Offer Timeout at RSNA 2006

Register Online for RSNA 2006 Courses

rsna2006.rsna.org

Undersea Mission EmphasizesRadiology’s Telemedicine Role

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AU GUST 2006

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

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

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

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

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

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

Assistant Executive DirectorPublications and Communications

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

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

Board Liaison

C O N T R I B U T I N G W R I T E R SJoan DrummondAmy Jenkins, M.S.C.Caroline McNeilMary E. NovakMarilyn Idelman Soglin

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

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

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

ChairGary J. Becker, M.D.,

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

Liaison for Publications andCommunications

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

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

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

Robert R. Hattery, M.D., President

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

RSNA NewsAugust 2006 • Volume 16, Number 8

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

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

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

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

Letters to the EditorE-mail: [email protected]: 1-630-571-7837RSNA News820 Jorie Blvd.Oak Brook, IL 60523

SubscriptionsPhone: 1-630-571-7873 E-mail: [email protected]

Reprints and PermissionsPhone: 1-630-571-7829Fax: 1-630-590-7724E-mail: [email protected]

RSNA Membership: 1-877-RSNA-MEM

1 Announcements2 People in the News3 My Turn4 Board of Directors Report

Feature Articles 6 Undersea Mission Emphasizes Radiology’s

Telemedicine Role8 PET and Enhanced MR Imaging Predict Response to

Cancer Treatment 10 Invention Aims to Eliminate Physician Radiation

Exposure During Angiography12 Drug-Ultrasound Stroke Treatment Appears

Promising14 RSNA 2006 Moves Informatics into the Mainstream17 Chicago Events and Attractions Offer Timeout at

RSNA 2006

Funding Radiology’s Future®

21 R&E Foundation Donors

23 Journal Highlights24 Radiology in Public Focus26 RSNA: Working for You27 Program and Grant Announcements28 Meeting Watch30 Exhibitor News31 Product News33 RSNA.org

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

ANNOUNCEMENTS

FDA Warns About Gadolinium and Patients with Kidney FailureThe Food and Drug Administration (FDA) is investigating a possible linkbetween gadolinium-containing contrast agents and a disease known asnephrogenic systemic fibrosis or nephrogenic fibrosing dermopathy(NSF/NFD) that occurs in patients with kidney failure. The FDA has learnedof 25 cases of NSF/NFD in patients who received the agent Omniscan™ formagnetic resonance angiography (MRA). To read the FDA’s recommenda-tions for healthcare providers and patients and to report adverse event infor-mation, go to www.fda.gov/cder/drug/advisory/gadolinium_agents.htm.

GE Healthcare, maker of Omniscan, said it is cooperating with thereporting hospitals and authorities to investigate the cases. Providers andpatients with inquiries for GE Healthcare may call 1-800-654-0118.

NCI Adopts No-Smoking Rule for Meeting VenuesThe National Cancer Insti-tute (NCI) has implementeda new policy requiring thatall meetings and confer-ences organized or prima-rily sponsored by NCI beheld in a state, county, city or townthat has adopted a comprehensive

smoke-free policy. Onlyspecific circumstanceswill justify an exemp-tion. NCI based the newpolicy on scientific datasummarized recently in

the U.S. Surgeon General report “TheHealth Consequences of Involuntary

Exposure to Tobacco Smoke,” whichindicated that secondhand smoke (alsoknown as environmental tobaccosmoke) causes premature death anddisease in children and in adults whodo not smoke.

Thomson Acquires MercuryMD■ Thomson Corporation, of Stamford, Conn., hasacquired MercuryMD, a mobile information systemscompany based in Research Triangle Park, N.C.

MercuryMD gives physicians instant access topatient information via personal digital assistants(PDAs), smartphones and other Web-enableddevices. It will become part of Micromedex, aThomson scientific and healthcare business.Thomson offers software tools and applications tousers in the fields of healthcare and scientificresearch, as well as law, tax, accounting, financialservices, higher education and corporate e-learningand assessment.

SPECT/CT Image Named SNM Image of the Year

THE Society of Nuclear Medicine (SNM) Image of theYear for 2006 demonstrates the complementary nature oftwo imaging modalities to show coronary anatomy and

blood flow to the heart. The image fuses CT with single pho-ton emission computed tomography (SPECT), which usesnoninvasive imaging systems and pharmaceutical tracers toshow the function and metabolism of cells in the body.

Image courtesy of Oliver Gaemperli, M.D., and Philipp A. Kauf-mann, M.D., University Hospital Zurich, Switzerland.

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Niederhuber is Acting NCI DirectorJohn E. Niederhuber, M.D., has beennamed acting director of the NationalCancer Institute (NCI). He replacesAndrew von Eschenbach, M.D., whowas named last year as FDA actingcommissioner.

Since September 2005, Dr. Nieder-huber has been the NCI’s DeputyDirector for Translational and ClinicalSciences. He also has served the NCI as an external advisor,grant reviewer and chair of the National Cancer AdvisoryBoard. Dr. Niederhuber is scheduled to deliver a lecture at theRSNA 2006 NCI Showcase (see page 15 for more details).

During his four-decade career as a cancer surgeon, Dr.Niederhuber has held positions at the University of Michigan,Johns Hopkins University and Stanford University. Mostrecently he was director of the University of Wisconsin Com-prehensive Cancer Center.

THE Society of NuclearMedicine (SNM) hasnamed Martin P. San-

dler, M.D., of Nashville,Tenn., as its 2006-2007president. Dr. Sandler ischair of the Department ofRadiology and RadiologicalSciences at Vanderbilt Uni-versity School of Medicineand holds the post of CarolD. and Henry P. PendergrassProfessor of Radiology and Radiologi-cal Sciences at Vanderbilt.

SNM also named these officers:Alexander J.B. (Sandy) McEwan,M.D., of Edmonton, Alberta, Canada,president-electRobert W. Atcher, Ph.D., of WhiteRock, N.M., vice-president-elect

SNM also awarded Sanjiv SamGambhir, M.D., Ph.D., its 2006 PaulC. Aebersold Award for Outstanding

Achievement in BasicNuclear Medicine Science.Dr. Gambhir is a professorof radiology and bioengi-neering, director of the Mol-ecular Imaging Program andhead of the Nuclear Medi-cine Division at StanfordUniversity.

Walter Wolf, Ph.D., dis-tinguished professor of phar-maceutical sciences and chair

of the Biomedical Imaging Science Ini-tiative at the University of SouthernCalifornia, was awarded SNM’s 2006Georg Charles de Hevesy Nuclear Pio-neer Award for his contributions to thenuclear medicine profession.

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

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

SNM Names Officers, Honorees

AFIP Distinguished Scientist NamedDeborah J. Rubens, M.D., willserve as the distinguished scientistin the Department of RadiologicPathology at the Armed ForcesInstitute of Pathology (AFIP) forthe 2006–2007 academic year. Dr.Rubens is a professor of radiologyand surgery at the University ofRochester School of Medicine inRochester, N.Y.

The distinguished scientist program allows aca-demic radiologists to study radiologic-pathologic corre-lation and integrate the understanding of the pathologicbasis of disease with their teaching and research inter-ests. The position is supported by contributions fromRSNA, American College of Radiology, AmericanRoentgen Ray Society and American Osteopathic Col-lege of Radiology.

Deborah J. Rubens,M.D.

Martin P. Sandler,M.D.

John E. Niederhuber,M.D.

PEOPLE IN THE NEWS

RADIATION SAFETY

Questionof theMonthQ A radiologist asks,

“I performed chest radiography on a

patient and now I am toldthat she is pregnant. Whatare the risks to the fetus?”[Answer on page 22.]

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

MY TURN

In Phase – Out of Phase

IRECENTLY attended the AmericanBoard of Radiology (ABR) exams inLouisville, Kentucky, as an examiner

in GU. My questions to candidates fre-quently were about patient safetyrelated to the use of iodinated contrastmedia (CM), either CM-induced nephrotoxicity ortreatment of reactions.

Let me tell you, our futurecolleagues, associates andpartners know a lot more about MRIsequences and phases than conven-tional uroradiology. So be it. That maybe our current real world of practice.

There are still some knowledgegaps related to the aforementioned CMquestions, but patient safety and qualityimprovement (QI) now include a wholenew lexicon regarding oversight, docu-mentation, evidence-based practiceguidelines, pay-for-performance meas-ures and, of course, maintenance ofcertification (MOC).

A recent report from Dr. DonaldBerwick of Harvard School of PublicHealth concerning an initiative for

reduction of serious patient care errorsillustrates the commitment of all physi-cians to re-examine their practice envi-ronment to reduce human error. Whileit may seem that we live and work in a“Big Brother,” Orwellian world of

scrutiny and verification,MOC being just one facet,there should be little doubtthat accountability, withinformation on individual

performance and patient safety, will benecessary not only to get paid but alsoto practice radiology in hospitals andclinics.

MOC will hopefully be more thanjust the renewal of certificates that ouryoung colleagues work so hard to earnin Louisville. It should also stand forMaintenance of Competence to practicesafe diagnostic radiology, interventionand radiation therapy. In MOC, the Cshould also stand for a caring culturecentered on our patients.

My faith is restored each year whenI have the privilege to participate in theLouisville ABR experience. I am reas-

sured that we not only know how tomake a diagnosis, but that we alsoknow how to safely make that diagno-sis part of the care and consultation weprovide our patients and referringphysicians.

Bruce L. McClennan, M.D., is aprofessor of diagnostic radiology atYale University School of Medicine andan attending at Yale New Haven Hospi-tal. He is also editor of RSNA News.

My TurnONE RADIOLOGIST’S VIEW

PEOPLE IN THE NEWS

Roach Earns Prestigious LocalAwardMack Roach III, M.D., a professor of radiationoncology and urology and interim chair of theDepartment of Radiation Oncology at the Uni-versity of California San Francisco (UCSF), hasbeen named one of the 10 Most InfluentialAfrican Americans in the Bay Area for 2005 bythe Bay Area-based CityFlight Media Network.Dr. Roach recently worked on a clinical trial thatdemonstrated the value of pelvic nodal radiother-apy for patients with high-risk prostate cancer.

SPR Installs Goskeas PresidentMarilyn Goske, M.D.,is the new president ofthe Society for PediatricRadiology. Dr. Goskejoined the Department ofRadiology at Akron Chil-dren’s Hospital earlierthis year after serving asthe head of pediatricradiology at the Cleveland Clinic for 15 years.

Mack Roach III, M.D.Marilyn Goske, M.D.

Bruce L. McClennan, M.D.

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THE RSNA 2006-2007 budget waspresented and approved at the Junemeeting of the RSNA Board of

Directors. The operating plan includesseveral new projects and enhancementsto existing programs.

New/Expanded ProjectsSome of the new projects approved aredesigned to help radiologists enrichtheir interaction with patients and tohelp improve the public’s perception ofradiologists and understanding of radi-ology. Beginning this fall, RSNA willbegin distributing a “60-SecondCheckup” audio program to radio sta-tions in the United States. Each pro-gram will feature a single topic, suchas virtual colonoscopy or imagingheart disease, with a short introductionby a reporter and a short interviewwith an expert on that topic.

RSNA will also begin distributingtwo video news releases (VNRs) peryear to television stations in the UnitedStates. Each VNR will correspond to ahighlighted article in Radiology. A VNRis a prerecorded report that includes thevoice of a reporter, a videotaped inter-view with an expert on a particulartopic and video footage of a particularprocedure, selected patients and/ormedical images.

The Board approved the formationof a Taskforce on Oncologic Imagingand Therapies. The taskforce, com-prising diagnostic radiologists, inter-ventional radiologists, radiation oncol-ogists, physicists and cancer biolo-gists, will develop annual meetingprograms with blended content oninnovations in the use of imaging todiagnose, treat and monitor diseaseprogression and treatment response incancer patients.

The newly revised radiation biol-ogy syllabus, Radiation Biology forDiagnostic and Interventional Radiolo-gists—5th Edition, will be made avail-able on RSNA.org as a downloadableportable document format (PDF) file.

RSNA will sponsor two workshopsas part of the Medical EducationResearch Certificate program at theAssociation of Program Directors inRadiology (APDR) annual meeting inApril 2007 in Denver.

The 2007–2008 cycle of the Revi-talizing the Radiology ResearchEnterprise (RRRE) program willinclude an educational workshop, sitevisits of programs competitivelyselected and a revamped Introductionto Grant Writing course.

In spring 2007, RSNA will host asmall consensus workshop on method-ologies for validating the use of imag-ing as a biomarker. This workshop fol-lows a September 2006 conference inMaryland that RSNA is cosponsoringwith the National Institutes of Health,National Cancer Institute, NationalInstitute of Standards Technology andthe Food and Drug Administration.

International OutreachEach year RSNA leadership and staffvisit more than a half-dozen medicalmeetings throughout the world. Thepurposes of the visits include informingpotential members about what the Soci-ety has to offer, updating attendeesabout the upcoming RSNA annualmeeting and RSNA Highlights confer-ence, and assisting current memberswith questions about their benefits,such as online journal subscriptions.

The Board has approved creating acustomized RSNA booth for some ofthese meetings. Using eye-catching

graphics and a short PowerPoint pres-entation on a 42-inch plasma screen,the booth will visually reinforce theSociety’s commitment to patient carethrough research and education.

A list of meetings at which theRSNA booth will be present will bepublished in future editions of RSNANews so members can stop by to sayhello or bring a colleague to learn moreabout RSNA membership.

The Board has also approved rec-ommendations from the RSNA Com-mittee on International Relations andEducation for participants in the 2006Introduction to Research for Interna-tional Young Academics (IRIYA) Pro-gram and the 2007 International Visit-ing Professor (IVP) Program. The focusof the IRIYA Program is to encourageyoung radiologists from countries out-side of the United States and Canada topursue careers in academic radiology.The focus of the IVP Program is to sendsmall teams of imaging professionals tolecture at the national radiology meet-ings of emerging nations, as well as

RSNA Board of Directors Report

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

RSNA NEWS

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5

local hospitals and teaching institutionsin the host institutions.

The names of the program partici-pants will be released in future editionsof RSNA News. The host countries forthe 2007 IVP Program are Algeria,Honduras and Uganda. A similar IVPteam travels each year to Mexico.

An International Advisory Com-mittee is being formed to provideadvice to the Board regarding RSNAactivities and programs, particularly asthey impact international members andannual meeting attendees. The commit-tee will include at least on representa-tive from Africa, Asia, Oceania, Europeand South America. A survey of inter-national members is also under way tolearn more about the professional needsof international members.

RSNA 2006Beginning this year, all RSNA serviceswill be combined in one central loca-tion at the annual meeting. Rather thanfinding registration on one floor andsubscription services and the EducationCenter Store onanother floor, theRSNA Services pavil-ion will be located inthe Lakeside CenterBallroom at theMcCormick Placeconvention center. Asmaller RSNA Ser-vices booth will be onthe technical exhibitsfloor in the SouthBuilding.

New this year, RSNA 2006 profes-sional attendees will have the opportu-nity to receive a durable meeting bagin addition to a limited supply of dis-posable bags that will be available instorage racks at McCormick Place. Pro-fessional attendees will receive a stubwith their registration materials thatwill enable them to pick up a sturdycanvas bag with multiple pockets,including a drink holder.

The RSNA Continuous QualityImprovement Initiative (CQI2) is

sponsoring the opening session and afocus session on quality at RSNA 2006and expanded programs, includingrefresher courses on quality, at RSNA2007. The Board received an update onthe initiative at the June Board meetingand will get further updates at the Sep-tember Board meeting.

The Board also received an updateon the new Molecular Imaging Zone.The Zone was created to providemolecular imaging information to prac-ticing radiologists and to introduce resi-dents to the training and researchopportunities in molecular imaging.The Zone will incorporate scientificposters and education exhibits and willshowcase booths, posters and informa-tion from various training and researchprograms, molecular imaging societiesand funding agencies.

All molecular imaging activities atRSNA 2006 will be included in a sub-specialty content brochure that will beavailable on the annual meeting Website (rsna2006.rsna.org) in portabledocument file (PDF) format. About 20

other subspecialty con-tent brochures will alsobe available.

A hard copy of themolecular imagingbrochure will be avail-able at McCormickPlace during the meet-ing and will be distrib-uted at the Society forMolecular Imagingmeeting in Hawaii

August 30–September 2. RSNA is co-sponsoring a pre-conference sympo-sium on molecular imaging prior to themeeting. For more information, go towww.molecularimaging.org/2006meeting/preconferencesymp06.php.

Many activities related to medicalinformatics are planned for RSNA2006 (see feature article on page 14).Demonstrations will be held on twonew Integrating the Healthcare Enter-prise (IHE®) profiles—IHE Cross-enterprise Document Sharing for Imag-ing (XDS-I) and Teaching File and

Clinical Trial Export (TCE). These newprofiles will make it easier to deployimage-enabled electronic health records(EHRs).

The demonstrations will be held inthe new Lakeside Learning Center (seethe June issue of RSNA News atrsnanews.org). Information will also beavailable on RSNA’s radiology lexiconproject, RadLex®, and the RSNA Med-ical Imaging Resource Center (MIRC).

Other educational activities onmedical informatics include hands-onworkshops, education exhibits, scien-tific posters and two refresher coursetracks—basic informatics (track 26)and advanced informatics (track 30).For more information on the specificcourses in these or other refreshercourse tracks, go to rsna2006.rsna.organd click on Registration, Housing &Courses.

In addition, the Board has approveda name change for the Electronic Com-munications Committee. The commit-tee will now be known as the Radiol-ogy Informatics Committee. Moreinformation about RSNA’s technologyefforts can be found at www.rsna.org/Technology/index.cfm.

ABR ExamsThe American Board of Radiology(ABR) will conduct computerized sub-specialty certification exams duringthe RSNA annual meeting. A pilot washeld last year. ABR wants to make iteasier for diagnostic radiologists toschedule their primary certification andrecertification exams.

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

DIRECTORS

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

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

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

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AS GROUNDBREAKING research con-tinues to expand the frontiers oftelemedicine and telementoring,

radiology remains right at the center ofthe action.

Radiologists and surgeons fromHamilton, Ontario, recently helped anundersea crew in the waters near KeyLargo, Fla., diagnose and simulatetreatment of a knee injury.

“It was a wonderful experience forus,” said Julian Dobranowski, M.D.,chief of diagnostic imaging at St.Joseph’s Healthcare in Hamilton.“We’re educating people that theresources are available right now to beable to provide really good health-care—no matter where in the worldpeople are.”

Dr. Dobranowski teamed up withthe National Aeronautics and SpaceAdministration (NASA), CanadianSpace Agency (CSA) and Centre forMinimal Access Surgery(CMAS) at McMasterUniversity in Hamiltonfor NASA Extreme Envi-ronment Mission Opera-tions 9 (NEEMO 9).NEEMO 9 demonstratedand evaluated a varietyof diagnostic and thera-peutic technologies, withthe goal of enhancingdelivery of state-of-the-art medical care inremote and harsh environments.

The project added to the evidencethat even a 1- or 2-second time delay intelemedicine doesn’t have to negativelyaffect outcomes when critical care isprovided in extreme environments, oreven in more typical settings wherethere’s simply not enough radiologystaff to provide state-of-the-art imag-

ing, Dr. Dobranowski said.“The technologies are available

right now for not only transferring radi-ologic information, but also interactingwith individuals so we can be instru-mental in how the examinations arebeing performed before the informationis transferred,” he said.

Second Collaboration with NASADr. Dobranowski worked on NEEMO 9and the earlier NEEMO 7, profiled inthe December 2004 issue of RSNANews. In NEEMO 7, his team guidedmedical and non-medical personnelaboard the underwater habitat Aquariusthrough an abdomen and neck evalua-tion using the portable Titan ultrasoundunit produced by SonoSite. The Aquar-ius habitat was also the site of NEEMO9, which used a SonoSite portableultrasound unit called MicroMaxx.

“We took a little different slant thistime,” Dr. Dobranowskisaid. “We focused moreon musculoskeletalimaging and diagnosisof orthopedic typeinjuries. And we didsimulation of x-rays,which hadn’t been donebefore in our experi-ments. Everything wetested turned out verywell. We were veryhappy with the results.”

Aquanauts Dave Williams, NicoleStott, Ron Garan and Tim Broderick,M.D., made up the undersea team forNEEMO 9. Jim Buckley and RossHein, research divers from the Univer-sity of North Carolina at Wilmington,provided undersea engineering support.The mission ran from April 3 to 20.

“In this scenario, the aquanauts are

65 feet under water, and they can’tcome to the surface automatically,” Dr.Dobranowski said. “They have to beprotected, and getting to the surfacewould take a decompression procedure,which is quite lengthy. So this is theclosest that we have to a really extremeenvironment on Earth.”

Radiologists and other physicianscommunicated directly with the astro-nauts and telementored them throughthe program. “We’ve also developedquite elaborate manuals, so that in casethe telecommunication links are bro-ken, they would be able to go in a step-by-step manner through the processesand achieve the same outcomes,” Dr.Dobranowski said.

MicroMaxx is an ultrasoundmachine the size of a laptop computerand turns on instantly, a plus in extremesituations. “You’re scanning in lessthan 15 seconds from a cold start,” saidDrew D’Aguilar, general manager ofSonoSite Canada Inc., based inMarkham, Ontario. He added thatbecause the system optimizes itself,

Undersea Mission EmphasizesRadiology’s Telemedicine Role

We’re educating people

that the resources are

available right now to

be able to provide really

good healthcare—no

matter where in the

world people are.

Julian Dobranowski, M.D.

FEATURE TECHNOLOGY

Julian Dobranowski, M.D., St. Joseph’s Healthcare, Hamilton Ontario

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

very few manipulations are required bythe user.

The ultrasound images generated atthe undersea habitat were beamed bysatellite to the hospital in Ontario.

“We were linked with the orthope-dic surgeons,” Dr. Dobranowski said.“We guided the aquanauts in pickingup the probes and doing an ultrasoundof the knee. After that, they did a simu-lation of an arthroscopic examination

Teleradiology at RSNA 2006

A“Survival Guide for Teleradiology” is among the topics addressed in one of the manyinformatics classes at RSNA 2006. To register for this or any other courses, go to

rsna2006.rsna.org and click on Registration, Housing & Courses.

■ COURSE 085Practical Informatics for the Practicing Radiologist—Part 2(In conjunction with the Society for Imaging Informatics in Medicine)• New Radiology Reporting Strategies • Developing Enterprisewide PACS Sharing • Survival Guide for Teleradiology• Information Sharing in Community Networks

Continued on page 16

(Clockwise, from upper left)Crew members for the ninthNASA Extreme EnvironmentMission Operations (NEEMO 9)mission arrive at their under-water home. NEEMO 9 was con-ducted April 3-20 inside theNational Oceanic and Atmos-pheric Administration's(NOAA) Aquarius UnderwaterLaboratory, located off thecoast of Key Largo, Fla.

NEEMO 9 Aquanaut Nicole P.Stott poses beside a habitatwindow in the Aquarius Under-water Laboratory. Ross Hein, aprofessional aquanaut from theUniversity of North Carolina atWilmington, is seen outsidethe window.

NEEMO 9 Aquanaut Ronald J.Garan Jr. helps with a Centerfor Minimal Access Surgery(CMAS) experiment in theAquarius Underwater Labora-tory. The experiment evaluatedthe use of telementoring foremergency treatment of med-ical conditions that could ariseduring a space mission.

Stott and Hein help NEEMO 9Aquanaut and University ofCincinnati Physician Tim Brod-erick, M.D., apply a net withelectrodes for an electroen-cephalogram (EEG) study. Dr.Broderick was studying brainactivity while performing simu-lated surgical procedures. Images courtesy of NASA

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POSITRON emission tomography(PET) and MR imaging accu-rately predicted response to can-

cer therapy in two recently publishedstudies, raising the possibility that thesemodalities may eventually help oncolo-gists and their patients determine treat-ment strategies for certain tumors inspecific circumstances.

Fluorodeoxyglucose (FDG) PETpredicted response to preoperativechemotherapy and radiation in patientswith locally advanced esophageal can-cer. Fast dynamic contrast-enhancedMR imaging predicted which patientswould respond to chemotherapy formetastatic bladder cancer after just twocycles of treatment.

Both trials are part of a growingnumber of studies on using advancedimaging techniques to plan cancertreatment regimens by estimatingresponse. “This is an important area forfuture study—it’s a hottopic,” said Edward A.Levine, M.D., chief ofsurgical oncology andprofessor of surgery atWake Forest Compre-hensive Cancer Centerin Winston-Salem, N.C.Among other studyauthors were Michael R. Farmer, M.D.,and A. William Blackstock, M.D., ofthe Department of Radiation Oncologyand Paige B. Clark, M.D., of theDepartment of Nuclear Medicine.

PET in Esophageal CancerDr. Levine and his colleagues at WakeForest looked at whether FDG PETcould predict response to preoperative

chemoradiation in patients with locallyadvanced esophageal cancer—tumorsthat have spread only within the esoph-agus. Determining response is espe-cially important for these patients, sincethose who have complete responses topreoperative therapy—common for thisstage of esophageal cancer—couldavoid surgery. Esophagectomy has ahigh rate of morbidity and some associ-ated mortality.

Currently, about 25 percent ofpatients with locally advancedesophageal tumors have completeresponses to chemoradiation, based onhisotologic specimens obtained duringsurgery. The goal of a number of imag-ing studies is to determine prospec-tively who those patients are. Severalpreliminary studies have shown thatFDG PET measurements of responseto chemoradiation are strongly associ-ated with histological response and

improved overall sur-vival in esophagealcancer.

“The hope is thatwe can find a subsetof patients who have ahigh likelihood ofavoiding surgery,” Dr.Levine said.

In the Wake Forest study, publishedin the April 2006 issue of the Annals ofSurgery, the researchers studied 64 con-secutive patients who were eitherentered in a prospective phase II trial orformally monitored off-study betweenJanuary 2000 and August 2004. Allpatients received chemoradiation fol-lowed by surgery. The median radiationdose was 50.5 Gy, given concurrently

with chemotherapy that consisted ofcisplatin or carboplatin and 5-fluo-rouracil in most cases.

A total of 57 patients were stagedwith FDG PET before chemoradiationand 50 patients after chemoradiation.Forty-six patients had both pre- andpost-chemoradiation scans.

Among those who had a PET scanbefore chemoradiation, the standarduptake value (SUV), or amount ofradioactivity in the region, was closelyassociated with treatment response.Nine patients had an SUV of 15 ormore, and seven of those, or 77.8 per-cent, had a complete pathologicresponse or a complete response withmicroscopic residual disease at the timeof surgery. In contrast, of 34 patientswhose pre-chemoradiation SUV wasless than 15, only nine, or 26.4 percent,had comparable responses.

The researchers also examined theassociation between treatment response

PET and Enhanced MRImaging Predict Responseto Cancer Treatment

FEATURE ONCOLOGY

Edward A. Levine, M.D.Wake Forest University

The hope is that we can

find a subset of patients

who have a high likelihood

of avoiding surgery.

Edward A. Levine, M.D.

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and an SUV decrease post-treatmentwhen compared to pre-treatment. A sig-nificant response was observed in fiveof seven patients, or 71.4 percent,whose SUV decrease was 10 or more,compared to seven of 21 patients (33.3percent) whose decrease was less than10. The post-chemoradiation FDG PETwas able to show metastatic diseasewith 83.3 percent sensitivity and 88.2percent specificity.

Dr. Levine and his colleagues con-cluded that while prospective, multiin-stitutional studies are needed, the dataso far suggest that FDG PET is a usefultool for identifying patients likely toexperience a significant response topreoperative chemoradiation. “For nowI’d certainly recommend a PET scanbefore chemoradiation, and we and oth-ers will continue to evaluate its valueafterwards,” said Dr. Levine.

MR imaging in Bladder CancerMR imaging studies have the potentialof imaging to guide therapeutic deci-sions. In a study led by B. Ph. Schrier,M.D., of the Radboud UniversityNijmegen Medical Centre in TheNetherlands, researchers compared con-ventional MR imaging with fastdynamic contrast-enhanced MR imagingin 36 patients with regionally metastaticor inoperable transitional cell carcinomaof the bladder. Patients underwent MRimaging before and after two, four andsix cycles of chemotherapy and theresults were compared with pathologyfindings at surgery.

The findings, which appeared in theApril 2006 issue of European Urology,showed that after two cycles ofchemotherapy, the fast dynamic contrast-enhanced technique distinguishedbetween responders and non-responderswith 91 percent sensitivity and 93 percentspecificity. Conventional MR imaging, onthe other hand, had just 81 percent sensi-tivity and 50 percent specificity. Themedian survival was 42 months for thosewho responded according to the contrast-enhanced MR imaging, versus 12 monthsfor non-responders.

The small number of patients isobviously a limitation in this study, theauthors said, and a larger prospectivestudy would help to validate the results.Nevertheless, the findings suggest thatit is possible to predict which patientswill respond to chemotherapy after justtwo cycles, they said.

“The practical consequences ofthese findings are obvious,” the authorswrote. “Patients who respond toenhanced MR imaging after two cycles[of chemotherapy] can be encouraged

to complete the whole course of sixcycles. Patients who do not respondmay want to discontinue therapy so asto avoid the adverse effects and have abetter quality of life in the monthsahead.”

Not all experts agree, however. Aneditorial comment following theresearch report, by Stephané Culine,M.D., Ph.D., of the Centre Régional deLutte Contre le Cancer, Centre ValD’Aurelle-Paul Lamarque, Montpelier,

Continued on page 16

Assessing Therapeutic Response at RSNA 2006

AREFRESHER course at RSNA 2006 will review the use of novel analy-sis methods and modalities such as PET for therapy response assess-

ment. To register for this or any other courses, go to rsna2006.rsna.organd click on Registration, Housing & Courses.

■ RC118Therapeutic Response Assessment in Oncology• Conventional and Novel Techniques for Therapeutic Response Assessment• MR Imaging Techniques in Tumor Response Assessment• PET in Tumor Response Assessment

Demonstration of response and re-staging by 18F-FDG PET.(left) Pre-chemoradiation imaging is displayed revealing an abnormality consis-tent with malignancy within the esophagus (SUV 24), retroperitoneum and celiacnodal station. (right) Post-chemoradiation imaging is displayed revealing resolu-tion of the abnormality within the esophagus, retroperitoneum and celiac nodalstation. Interval development of a left supraclavicular lymph node is noted.Image courtesy of Edward A. Levine, M.D. Annals of Surgery 2006;243(4):472-478. © 2006 Annals of Surgery.

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PLATO’S adage about necessitybeing the mother of invention hasproven true again. A Maryland

radiologist’s dissatisfaction with tradi-tional radiation safety precautions dur-ing coronary angiography led him tocreate a new device that he said nearlyeliminates radiation exposure to thephysician.

Martin Magram, M.D., an assistantprofessor in the Department of Diag-nostic Radiology at the University ofMaryland Medical Center in Baltimore,said the longer curved handle he devel-oped to attach to the patient table giveshim flexibility in performing coronaryangiograms while significantly cuttinghis own radiation exposure. The han-dle, he said, allows the physician toremain safely behind the lead plasticshield while retaining table control forpanning.

“It has alwaysbothered me that thehead, arms and legs areexposed. We wear alead apron and some ofus wear lead glassesand a thyroid shield,but that’s not enough,”said Dr. Magram. “Itoccurred to me itmight be possible toaugment the protection so you couldwork behind the screen and yet still beas functional right near the table.”

A study Dr. Magram conducted totest his invention attracted attention viathe annual meeting of the AmericanRoentgen Ray Society (ARRS) in Van-couver, British Columbia, earlier thisyear. Using his technique and recording

radiation exposure to various parts ofthe physician’s body during coronaryangiography on 25 patients, Dr.Magram compared the results to physi-cian’s radiation exposure during 25procedures using conventional radiationprotection. The new table controldevice, he concluded, reduced radiationexposure to the physician’s head, arms,and legs by 90 percent.

Dr. Magram’s curved extension barreplaces the traditional short handle.“The extension bar is rather like abroomstick, which is a yard long andcurves behind the leaded glass panel,”he said. He added that his goal was toput the physician as far out of dangeras possible, while still being able to dohis or her job effectively.

“You don’t have to be standingright next to the table if you need to

pan while you’re doingthe angiogram that ismoving the table withthe patient on it,” Dr.Magram said. “Bystanding behind theshield and moving thetable with the bar con-nected to the table, yourentire body is protectedfrom radiation, so youget only about one

tenth of the radiation that you wouldhave gotten without the shield and bar.”

Ergonomics Still an IssueWhether the technique can be modifiedto suit the needs of other radiologistsremains to be seen. It has been testedonly during coronary angiography.Donald L. Miller, M.D., professor of

radiology at the Uniformed ServicesUniversity in Bethesda, Md., acknowl-edged the widespread physician interestin radiation protection. Since the princi-ple of “as low as reasonably achiev-able” (ALARA) still guides institu-tions—which check exposure regularlyvia badges and review the practices ofstaff members who receive 10 percentand 25 percent of the permitted annualdose—safety research collaborationsbetween angiographers and interven-tional radiologists also continue toinvestigate ways to improve protection.

Dr. Miller said that while Dr.Magram’s device does reduce radiationdose to the body, it doesn’t address anissue just as troublesome to physi-cians—the ergonomic problems associ-ated with the lead aprons routinelyworn to shield the body. Weighingbetween 9½ and 13½ lbs., the apronsstress the neck and spine and maycause significant injuries.

Invention Aims to EliminatePhysician Radiation ExposureDuring Angiography

It occurred to me it might

be possible to augment the

protection so you could

work behind the screen

and yet still be as func-

tional right near the table.

Martin Magram, M.D.

Martin Magram, M.D.University of Maryland

FEATURE SAFETY

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Because Dr. Magram’s reported reduc-tion in radiation exposure occurred while hewas wearing a lead apron, said Dr. Miller,his technique does little to address thosestress issues. “Most of us who do this workthink there is a clear relationship betweenspine problems suffered by some physiciansand the kinds of positions we are in and theweight of the lead protection,” said Dr.Miller.

Working Toward Eliminating Lead GownsDr. Miller added that interventional radiolo-gists’ need to stand in various places aroundtheir patients might prevent them from uti-lizing the technology. “The area of interestof the patient’s anatomy can be anywherefrom the head to the foot and the operatorcould be standing anywhere. In coronaryangiography, the operator is standing at thepatient’s hip and that’s a relative constantfor most cardiology procedures,” said Dr.Miller.

However, Dr. Magram said that becausehe was able to clearly demonstrate a signifi-cant exposure reduction, this encouragesfurther exploration of his technique and oth-

ers like it. “Previously people did things acertain way and that’s how we were taught.Now we are rethinking all this,” he said.

The new technique may eventually freephysicians from the need to wear lead gowns,Dr. Magram explained. “As the sophisticationof radiologic diagnostics has increased, it istragic when a physician can no longer per-form procedures because the lead gownscause onset of neck or back degeneration andthe physician becomes unable to tolerate theweight of a lead gown,” he said. “This mayextend by years their ability to apply theskills they have developed over long careersof serving patients.”

Dr. Miller said that even as new tech-niques are developed and evolve, the basicprinciples of radiation safety will alwaysapply.

“Keeping the image receptor as close tothe patient as possible, collimating tightlyaround the area of interest, using reduced-dose pulsed fluoroscopy and limiting fluo-roscopy time and the number of angio-graphic images, will reduce dose to both thepatient and operator,” he said. ■■

■ To read the abstract for “Reduced Physician Radiation Exposure during Coronary Angiography withNew Radiation Protection Technique,” presented at the 2006 annual meeting of American RoentgenRay Society, go the RSNA News Extras page at RSNA.org/Publications/rsnanews/extras.cfm.

Radiation Dose Optimization and Safety at RSNA 2006

SPECIAL CONSIDERATIONS for angiography will be among the topics examined during theRSNA 2006 Categorical Course in Diagnostic Radiology Physics. In addition

to angiography, the course will also touch on fluoroscopy, CT and mammogra-phy. Attendees may register for individual sessions of the course. To register for these sessions or any other courses, go to rsna2006.rsna.org and click on Registration, Housing & Courses.

Categorical Course in Diagnostic Radiology Physics: From Invisible to the Visible—The Science and Practice of X-Ray Imaging and Radiation Dose Optimization

■ RC125Introduction, Radiographic Image Forma-tion and Characteristics, Measures of ImageQuality■ RC225Medical Radiation Dosimetry, RadiationRisks in Diagnostic Radiology, BalancingRisks and Benefits in Medical Radiography■ RC325Computed Radiography/Digital Radiogra-phy: Adult, Pediatric and Radiologist, Per-spective of Controlling Dose and StudyQuality

■ RC425Fluoroscopy (Gastrointestinal): Dose, Clinical Practice—Controlling Dose and Study Quality

■ RC525CT: Dose and Image Quality■ RC625Clinical Practice: Controlling Adult and PediatricRadiation Dose and Study Quality■ RC725Special Procedures (Angiography): Dose, ImageQuality and Clinical Practice■ RC825Mammography: Dosimetry, Screen-Film and Digital

Thyroid Disease Prevalent in AtomicBombing SurvivorsIn one recently published study on the effectsof radiation exposure, researchers report thatthe prevalence of thyroid diseases—includingsolid nodules, malignant tumors, benign nod-ules and cysts—among survivors of theatomic bombings in Hiroshima and Nagasaki,Japan, is significantly associated with radia-tion dose to the thyroid gland.

In addition, dose effects were significantlyhigher in those exposed when young, MisaImaizumi, M.D., of the Radiation EffectsResearch Foundation, Nagasaki andHiroshima, and colleagues reported in theMarch 1 issue of The Journal of the AmericanMedical Association (JAMA).

Between 2000 and 2003, Dr. Imaizumiand colleagues looked at 4,091 survivors.The mean age of the participants was 70 andtwo thirds were women.

Excluding approximately 900 peopleexposed in utero, not in the cities at the timeof the atomic bombings or with unknownradiation dose, researchers identified thyroiddiseases in 44.8 percent of the participants.The researchers estimated that 28 percent ofall solid nodules, 37 percent of malignanttumors, 31 percent of benign nodules and 25percent of cysts were associated with radia-tion exposure.

The researchers found no significantdose-response relationship for positiveantithyroid antibodies, antithyroid antibody–positive hypothyroidism, or Graves disease,an inflammatory disorder of the thyroid gland.

“The present study revealed that, 55 to 58years after radiation exposure, a significantlinear dose-response relationship existed tothe prevalence of not only malignant thyroidtumors but also benign thyroid nodules, andthat the relationship was significantly higherin those exposed at younger ages,” theresearchers wrote. “Careful examination ofthe thyroid is still important long after radia-tion exposure, especially for people exposedat younger ages.”

■ To read the abstract for “Radiation Dose-Response Relationships for Thyroid Nodulesand Autoimmune Thyroid Diseases inHiroshima and Nagasaki Atomic Bomb Sur-vivors 55-58 Years After Radiation Exposure,”go to jama.ama-assn.org/cgi/content/abstract/295/9/101.

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ADECADE after the Food and DrugAdministration approved the useof a clot-busting medication to

treat strokes within three hours of onset,radiologists continue to find ways tocombine the drug with other technologyto improve functional outcomes.

Specifically, a drug-ultrasoundcombination can increase the chancesfor reopening blocked arteries after astroke, according to a new study. Thestudy was co-sponsored by the NationalInstitute of Neurological Disorders(NINDS) and EKOS Corporation, man-ufacturer of a catheter used in thestudy.

Co-principal investigators ThomasTomsick, M.D., director of neuroradiol-ogy at the University of Cincinnati andCincinnati’s University Hospital, andJoseph Broderick, M.D., chair of theDepartment of Neurology at the Uni-versity of Cincinnati, presented theirfindings at the 2006 InternationalStroke Conference.

Their pilot showed the standardclot-busting medication, tissue plas-minogen activator (tPA),when used in combina-tion with low-energyultrasound, appears toreopen clogged arteriesbetter than medicationalone. “The studylooked at the effect ofultrasound microcatheterthrombolysis following a reduced doseof IV-tPA,” Dr. Tomsick said.

Ultrasound Vibrated and Dissolved ClotsThe Interventional Management ofStroke Study (IMS-II) involved 73patients seeking treatment for a severeischemic stroke at one of 13 medicalcenters. Ischemic strokes make up

about 88 percent of all strokes. Partici-pants, between the ages of 18 and 80,were given lower doses of tPA over ahalf-hour period within three hours ofthe onset of stroke.

Patients then underwent angiogra-phy. Twenty-two patients did notreceive intra-arterial tPA (IA rtPA); 13

did not have a visibleand treatable clot andconsequently were notgiven any additionaltreatment. The remain-ing 51 subjects weregiven up to 22 mil-ligrams of additionaltPA, delivered directly

to the blockage via a catheter, extend-ing the treatment time to seven hours.

In addition, 30 subjects were thenadministered a low-energy ultrasoundtreatment at the site of the clot, in thehope that sound waves would vibrateand help dissolve the clot. Theresearchers used the EKOS Micro-Infu-sion Catheter MicroLysUS infusion

system, except in 21 participants wherea standard catheter was used instead.

Positive Results Prompted Further StudyOf the 26 patients receiving treatmentwith the final ultrasound-designcatheter, 69 percent were shown tohave complete reopening of theblocked artery. Dr. Tomsick said this isnotable because in IMS-I—a trialwhere a standard microcatheter wasused to bring tPA to the location of thestroke-causing clot—only 50.5 percentof patients achieved complete reopen-ing of the blockage.

The mortality rate of IMS-II was 16percent, identical to the mortality rateof IMS-I and lower than the 21-percentmortality rate for the NIH-NINDS tPAStroke Trial. However, in IMS-II, therate of bleeding in the brain leading toa worsening of the patients’ conditionwas 11 percent, compared to 6.3 per-cent in IMS-I. Dr. Tomsick said furtherstudy comparing patient outcomes andsafety is in the works.

Drug-Ultrasound Stroke Treatment Appears Promising

Thomas Tomsick, M.D.University of Cincinnati

Howard A. Rowley, M.D.University of Wisconsin

The most important thing

we can do is open the

blood vessels quickly.

Every minute is crucial.

Howard A. Rowley, M.D.

FEATURE CLINICAL TRIALS

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Overall, the findings of IMS-I andIMS-II were so encouraging that amuch broader phase III trial is about tobegin. Some 45 to 50 medical centerswill participate in a study involving 940U.S. and Canadian stroke patients overthe course of four to five years. Dr.Tomsick said this $21-million trial willcompare full-dose tPA with reduced-dose tPA and three different interven-tional techniques. The study is spon-sored by NINDS, the EKOS Corpora-tion, Concentric Corporation, CordisNeurovascular and Genentech, Inc.

“If we prove there is a benefit tointraarterial intervention beyond thestandard early intravenous therapy, peo-ple will jump on the interventionalbandwagon,” said Dr. Tomsick, whohas no financial interest in the compa-nies involved.

Radiologists Can Maximize Stroke Treatment Role

Dr. Tomsick said with ultra-earlytreatments, a 50 percent improvementin functional outcomes in certain selectstroke patients could be achieved. “Ourgoal is improved functional outcomes,”he said.

Howard A. Rowley, M.D., chief ofneuroradiology and Joseph Sackett Pro-fessor of Radiology at the University ofWisconsin in Madison, agreed. “Themost important thing we can do is openthe blood vessels quickly,” he said, not-ing that radiologists play a large role instroke triage by imaging and treating

patients. “Every minute is crucial,” headded.

Dr. Tomsick said radiologists canmaximize their role in triage by facili-tating CT scans of the brain as quicklyand accurately as possible and rapidlytransmitting that information to theemergency department and referringphysicians. “Radiologists can also con-tribute to care by developing interven-tional skill sets and aggressively treat-ing appropriate stroke patients,” he said.

Noting that better patient selectioncan also improve results, Dr. Rowleysaid such studies provide evidence thatradiologists can use imaging to target

patients for the exact care they need andsuccessfully use thrombolytic agentseven beyond the currently approved 3-hour window. Ultrasound is anotherweapon in the arsenal, he said, butadded, “Even in the best of hands, itcan be hard to get blood vessels open.”

An August 2005 article by Dr.Rowley, published in the journalNeuroimaging Clinics of North Amer-ica as “Extending the Time Windowfor Thrombolysis: Evidence fromAcute Stroke Trials,” shows that whilethe current standard is giving tPAwithin 3 hours of the onset of a stroke,

The fabric of a blood clot, called fibrin, is naturally tightly bound (left). Ultrasound helps temporarily loosen and separate the fibrin (center) for more blood clot permeability. Loosened fibrin increases the availability of plasminogen activation receptor sites(right), leading to quicker clot dissolution.Images courtesy of EKOS Corporation.

Stroke Treatment at RSNA 2006

ACOUPLE OF RSNA 2006 refresher courses will examine CT and MRimaging evaluation, as well as endovascular treatment, of acute

stroke. To register for these or any other courses, go to rsna2006.rsna.organd click on Registration, Housing & Courses.

■ RC350Intraarterial Acute Ischemic Stroke Therapy (How-to Workshop)

■ RC505*Comprehensive Imaging for Acute Stroke Treatment (An Interactive Session)* A self-assessment module (SAM) can be completed in this course and applied toward maintenance of certification (MOC)requirements.

■ To view the abstract for “Interventional Management of Stroke Study Part II (IMS II),” pre-sented at the 2006 International Stroke Conference, go to www.abstractsonline.com/arch/RecordView.aspx?LookupKey=12345&recordID=16949■ To view the abstract for “Extending the Time Window for Thrombolysis: Evidence fromAcute Stroke Trials,” go to www.neuroimaging.theclinics.com/article/PIIS1052514905000523/abstract■ The National Institute of Neurological Disorders and Stroke (NINDS) now offers a Web-basedtutorial in acute stroke imaging. See “Other Web News” on page 33 for more information.

Continued on page 16

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JUST AS informatics has changed theway radiologists do their jobs,RSNA is changing how it presents

this ever-changing science at the annualmeeting.

After almost 20 years of beinggrouped in a special infoRAD® area,this year’s exciting informatics demon-strations have been integrated with therest of the electronic and hard-copyeducation exhibits and posters in thenewly redesigned and renamed Lake-side Learning Center (formerly Hall D).

“Practicing radiologists will benefitfrom making good informatics choicesand implementing integrated solutionsthrough knowledge enhanced by partic-ipating in the activities in the new andfriendly Lakeside Learning Center,”said David Avrin, M.D., Ph.D., a pro-fessor of radiology, adjunct professor ofbiomedical informatics and chief ofbody imaging in the Department ofRadiology at the University of Utah.Dr. Avrin is chair of the RSNA Radiol-ogy Informatics Com-mittee (formerly theElectronic Communica-tions Committee).

“Informatics is thekey to workflow, andgood workflow is thekey to running an effi-cient imaging practice,”said Dr. Avrin. “AtRSNA 2006 you’ll also get to experi-ence cutting-edge technology of thenot-too-distant future.”

Clinical Informatics Moved to Organ AreasDavid S. Mendelson, M.D., a memberof the Radiology Informatics Commit-tee, said attendees will find that clinicalinformatics exhibits, when relativelymature and specific to an organ system,

have been integrated into the exhibitsof that organ area.

“RSNA is trying to integrate infor-matics as much as possible by featuringdemonstrations with specific clinicalapplications within the relevant organareas at the meeting,” said Dr. Mendel-

son. “We are trying topresent these technolo-gies as part of the main-stream.”

As for informaticsexhibits not tied to aspecific clinical area orin a more embryonicform—including trendsin image processing and

analysis, as well as decision supportand workflow topics and new tech-nologies in development—they will besubspecialty “spokes” in the new“wheel” layout of Lakeside LearningCenter. Integrating the HealthcareEnterprise (IHE®) and a new NationalCancer Institute (NCI) showcase willoccupy space on the perimeter of thecenter, along with classrooms for how-

to workshops (see sidebar).

IHE Exhibits Will Enhance Physician KnowledgeIHE will demonstrate its Cross-enter-prise Document Sharing for Imaging(XDS-I) and Teaching File and ClinicalTrial Export (TCE) integration profiles.These profiles offer standards-basedsolutions for sharing medical images andreports across care sites defined by IHE.

Developed nine years ago byRSNA and the Healthcare Informationand Management Systems Society(HIMSS), IHE strives to improvepatient care by standardizing the wayhealth systems exchange information.Fields such as cardiology, eye care,laboratories, patient care coordinationand patient care devices have joinedIHE. The IHE demonstration at RSNA2006 is one of more than a dozenplanned presentations, some of whichwill be held at meetings of the Ameri-can Academy of Ophthalmology andSociety for Cardiovascular Angiogra-phy and Interventions.

RSNA 2006 Moves Informaticsinto the Mainstream

David S. Mendelson, M.D., and John Halamka, M.D., M.S., address attendees of anIHE workshop in Oak Brook, Ill., in June.

Informatics is the key to

workflow, and good

workflow is the key to

running an efficient

imaging practice.

David Avrin, M.D., Ph.D.

FEATURE TECHNOLOGY

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In January 2007, IHE will combinean educational conference with itsannual Connectathon for the first time.See page 27 for more details.

The need for clinicians to under-stand and embrace the capabilities ofIHE is critical, said Dan Russler, M.D.,vice-president for clinical technologyat McKesson and co-chair of IHE’sPatient Care Coordination TechnicalCommittee. For example, he said,think of a patient who has completedthe uncomfortable but necessary prepa-rations for a colonoscopy, only toarrive at the appointment and find thatthe specialist has not received theneeded pre-procedure information fromthe primary care physician and conse-quently the procedure cannot be per-formed.

IHE also will play a significantrole in the work of the new HealthcareInformation Technology StandardsPanel (HITSP) established by theDepartment of Health and Human Ser-vices (HHS), said John Halamka,M.D., M.S., chair of HITSP and chief

information officer at Harvard MedicalSchool.

“IHE is more essential than everbecause of the experiences you’vehad,” Dr. Halamka told attendees of anIHE workshop in Oak Brook, Ill., inJune.

NCI Director to Lecture in New CancerShowcaseThe new NCI Showcase at RSNA 2006will include a number of informaticsdemonstrations as part of its focus onrecruiting more physicians into clinicaltrials work. A theater area will feature

lecturers throughout the week, includ-ing NCI Acting Director John E.Niederhuber, M.D., and Ken Buetow,director of the NCI Center for Bioinfor-matics.

“These demonstrations havetremendous implications for cancerclinical care and research,” said EliotSiegel, M.D., professor and vice-chairof the Diagnostic Radiology Depart-ment at the University of Maryland’sSchool of Medicine, chief of imagingat the Baltimore Veterans Affairs Med-ical Center and member of the Radiol-ogy Informatics Committee. Dr. Siegelis also part of the NCI cancer Biomed-ical Informatics Grid (caBIG) initiative.

Also part of the informatics demon-strations this year will be RadLex®, anRSNA initiative aimed at developing acomprehensive radiology lexicon, andRSNA’s Medical Image Resource Cen-ter (MIRC). The goal of MIRC is toenable the wealth of information gener-ated by radiologists to be used for edu-cation and research. ■■

Informatics at RSNA 2006

HERE IS A sampling of the informatics courses, classes and workshops offered at RSNA 2006. For a full listingand to register for these or other courses, go to rsna2006.rsna.org and click on Registration, Housing &

Courses. Courses with multiple numbers repeat throughout the week.

■ COURSES 073, 074, 075, 076Overview of RSNA’s Teach-ing File and Clinical TrialSoftware (MIRC)

■ COURSES 031, 032, 033, 034,035Using the RSNA TeachingFile: Hands-on Workshop

■ COURSE 070Electronic Measurements,Electronic Reports: IHE,DICOM, and HL7 CDA

■ COURSES 060, 061, 062, 063,064, 065Purchasing and IntegratingRadiology Systems withIHE: A Tutorial and a Real-world Case

■ COURSE 067IHE Radiology: What’sNew in 2006?

■ COURSES 077, 078Workshop: Installing aTeaching File System onYour Laptop (MIRC)

■ COURSES 084 AND 085Practical Informatics for thePracticing Radiologist—Parts 1 & 2 (In conjunctionwith the Society for Imag-ing Informatics in Medi-cine)

■ COURSE 081RadLex for Radiologists: AClinical Introduction to aNew Lexicon for Radiology

■ COURSE 066The IHE Initiative World-wide: An Update fromEurope, Asia, and NorthAmerica

■ COURSE 068IHE Mammography:What’s New in 2006?

■ COURSE 072IHE: Building the Elec-tronic Health Record

■ COURSE 079Using MIRC for ClinicalTrials

■ COURSE 069IHE Nuclear Medicine:What’s New in 2006?

■ COURSE 071IHE for Administrators:Overcoming Implementa-tion Obstacles

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France, suggested that, even if con-firmed, these results are not likely tomodify clinical practices. “As there isunfortunately no current effective sal-vage treatment to offer for thesepatients who fail primary chemother-apy, I would continue to recommendstandard CT scans only for daily prac-tice,” she wrote.

However, in patients with operabledisease, enhanced MR imaging couldbe an important tool in assessingneoadjuvant therapy, Dr. Culine said.“In a prospective clinical trial, I wouldsuggest an MR imaging assessmentalong with pathological evaluation after

two cycles of neoadjuvant chemother-apy, followed by bladder preservationin responder patients or cystectomy innon-responder patients.”

Using advanced imaging techniquesto identify a subset of patients who canavoid resection would be similar tostudies at Wake Forest, where Dr.Levine and his colleagues look forward

to continued favorable research withesophageal cancer. They believe it willimpact the standard of care. “Whileadditional studies are needed, the evi-dence does suggest the potential forPET to change clinical practice,” Dr.Levine said. ■■

■ To view the abstract for “Predictive Value of 18-Fluoro-Deoxy-Glucose-Positron EmissionTomography (18F-FDG-PET) in the Identification of Responders to Chemoradiation Therapyfor the Treatment of Locally Advanced Esophageal Cancer,” go to www.annalsofsurgery.com/pt/re/annos/abstract.00000658-200604000-00007.htm.

■ To view the abstract for “Evaluation of Chemotherapy with Magnetic Resonance Imaging inPatients with Regionally Metastatic or Unresectable Bladder Cancer,” go to linkinghub.elsevier.com/retrieve/pii/S0302283806000418.

PET and Enhanced MR Imaging Predict Response to Cancer Treatment Continued from page 9

only 20 percent of stroke patients pres-ent to a hospital in that time frame.Only about 2 to 4 percent of patientsactually receive tPA today, leavinghundreds of thousands untreated. Dr.Rowley said these current limitations

underscore the need for radiologists tohelp rapidly triage stroke patients andguide acute interventions beyond thetraditional 3-hour window.

In the future, Dr. Tomsick saidthere could be potential benefit ofadministering IV-tPA with other med-

ications. “Researchers are investigatingother drug agents to break up clotswhen used in a timely fashion or evenneuroprotective agents that could helpdiminish the effects of strokes,” Dr.Tomsick said. ■■

Drug-Ultrasound Stroke Treatment Appears PromisingContinued from page 13

and a meniscectomy, which was alsotelementored by one of the orthopedicsurgeons from our site. That went verywell, also.”

The project also included a simu-lated x-ray procedure using a portablex-ray device—deactivated to avoidradiation exposure—manufactured byMinXray, Inc., of Northbrook, Ill.

Time Delay Not a ProblemDr. Dobranowski said no one involvedin the project had trouble adjusting tothe signal time-delay that occurs insatellite transmissions.

“If a space mission was set up onthe moon, it would take about a secondto communicate information from theEarth to the moon, and then anothersecond to get information back from the

moon to the Earth,” he said. “We didn’tknow how people would react to havingthat delay. But we found that both theperson who was teaching and the recipi-ent of the information adapted very rap-idly. That time-delay environment,which we created artificially for thisproject, became the new norm for thecommunication. People adapted veryquickly to that new norm and were ableto do all the tasks quite successfully.”

CMAS founder and directorMehran Anvari, M.D., was the lead sur-geon on the scientific mission andremotely manipulated the arms of asurgical robot for a simulated treatmentof the knee injury. Stott, one of theaquanauts, called it amazing.

“This was a medical first becausenot only did he perform the procedurefrom a remote location, [but] he also

successfully performed the procedurewith a 2-second delay in the communi-cation/video signal he was receiving ashis only reference,” Stott wrote in theonline expedition journal published byNASA.

“It was a very impressive demon-stration of skill and new technologythat will change the face of surgicalcare,” Williams, another aquanaut,added in the journal.

Dr. Dobranowski said he and hiscolleagues always believed that a 400-to 500-millisecond delay was the maxi-mum possible. “But even with the one-second delay, he was still able to dofine surgical procedures,” he said. ■■

■ To learn more about the NEEMO 9 mis-sion, visit www.nasa.gov/mission_pages/NEEMO/NEEMO9.

Undersea Mission Emphasizes Radiology’s Telemedicine RoleContinued from page 7

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The Field Museum

KING TUT’S treasures along with riches from neighboring tombsin the Valley of the Kings are available for viewing in the

exhibit Tutankhamun and the Golden Age of the Pharaohs.Approximately 30 objects are displayed including the “boy king’s”crown and organ jars and containers. The artifacts are estimated tobe between 3,300 and 3,500 years old. Tickets may be arranged inadvance for this popular exhibit.

While visiting The Field Museum, say hello toSue, the largest, most complete and best preservedTyrannosaurus rex fossil ever discovered. Sue is only one of themany noteworthy specimens in the Field’s permanent collection. Inthe Evolving Planet exhibit, which explores 4 billion years of evo-lution, visitors can touch a real dinosaur bone and the teeth of amastodon and a wooly mammoth. The Field Museum anchors theMuseum Campus, which also includes the Shedd Aquarium andAdler Planetarium, on South Lake Shore Drive at Soldier Field.■ 1400 S. Lake Shore Dr.

1-312-922-9410 www.fmnh.org

Art Institute of Chicago

THE Art Institute’s world-renowned permanent collection includes a note-worthy exhibition of surrealistic paintings and Impressionist art.

This winter, a special exhibit will feature the work of CharlesSheeler, an important 20th-century American photographer andpainter. A second exhibit, So the Story Goes: Photographs by Tina Barney,Philip-Lorca diCorcia, Nan Goldin, Sally Mann, and Larry Sultan, offers anintimate view of these photographers’ private lives.■ 111 S. Michigan Ave.

Tickets: 1-312-930-4040Membership: 1-312-575-8000

www.artic.eduwww.ticketmaster.com

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Chicago Events and AttractionsOffer Timeout at RSNA 2006REGARDLESS of age or interest, Chicago offers something for everyone

during RSNA 2006. Chicago’s diverse selection of activities and eventsincludes art, music, theater and a number of other pursuits.RSNA Tours & Events RSNA is sponsoring a series of tours and eventsduring RSNA 2006. The RSNA Tours & Eventsbrochure is available at rsna2006.rsna.org. ClickTours and City Events in the left-hand column.

RSNA members who participated in tours atRSNA 2004 and RSNA 2005 will automaticallyreceive a brochure in the mail.

Please look for the “RSNA Tour” icon next toevent listings in this article, signifyingthat a pre-arranged RSNA package isavailable. Enroll for tours and eventsonline when registering for the annual meeting orwhile adding courses.

FEATURE CHICAGO 2006

Tours

Tour 11

Tours13 & 31 (above) Sue, the largest, most completeand best preserved Tyrannosaurus rexfossil ever discovered, welcomes visitorsto The Field Museum.(left) This nearly life-size paintedwooden model of the head and torso ofthe boy king Tutankhamun was foundpartially hidden behind one of his chari-ots in the Antechamber of his tomb.Tutankhamun and the Golden Age of thePharaohs continues through January 1,2007 at The Field Museum.

Two bronze lionsthat flank the

Michigan Avenueentrance to theArt Institute of

Chicago weremade for the ArtInstitute's open-ing at its currentlocation in 1893.

Shown here is the“north lion,” whois “on the prowl.”

© A

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Peggy Notebaert NatureMuseum

PERCHED on the edge of a Lincoln Parklagoon, Chicago’s newest museum welcomes

children of all ages. Visitors should be sure toenjoy the beauty of the Butterfly Haven. Otherpermanent exhibits include the Look-in AnimalLab, Extreme Green House, Mysteries of the Marsh, River-Works, Water Lab, Wilderness Walk and Hands on Habitat forvisitors age seven and younger.

Smith Museum of Stained GlassWindowsLocated on the east end of NavyPier, this free museum houses thenation’s largest permanent collec-tion of Tiffany stained glass win-dows. This tranquil exhibit offers awonderful repose from the recre-ational chaos of Navy Pier. Themuseum has more than 150 stainedglass works—some dating back tothe 1890s—by artists includingJohn LaFarge, Louis Sullivan, FrankLloyd Wright, Franz Mayer and F.X.Zettler. Free guided tours are alsoavailable by appointment. ■ 600 E. Grand Ave.

1-312-595-5024

Museum of Contemporary ArtOn display are two related exhibits,Sustainable Architecture in Chicago:Works in Progress, which focuseson sustainable building practices,and Massive Change: The Future ofGlobal Design, which considers eth-ical and environmentally responsibleenergy, land and materials use.Another special exhibit surveys thework of American artist Richard Tut-tle, including his drawings, installa-tion art, furniture, paintings, print-making and sculpture.

The MCA’s permanent collectionrepresents trends in art after 1945,with a special emphasis in Surreal-ism (1940s and 1950s), Minimalism(1960s), conceptual art and photog-raphy (1960s to the present), instal-lation art and art by local artists. Thecollection includes paintings, sculp-ture, photography, video, film andinstallations.■ 220 E. Chicago Ave.

1-312-280-2660www.mcachicago.org

Shedd Aquarium

LIZARDS and the Komodo King is aspecial exhibit featuring lizards

of all shapes and sizes from aroundthe world. Komodos, which cangrow up to 8-feet long and weighas much as 300 lbs., can eat a pigin 20 minutes.

The aquarium is home toaquatic life from around the world.The Wild Reef exhibit offers one ofthe most diverse displays of sharks in North America.Visitors can also enjoy seahorses, otters, seals, dol-phins, penguins and whales. The Shedd, a principalpart of the Museum Campus, is a tasteful blend of con-temporary and 1930s architecture situated on the shoreof Lake Michigan. ■ 1200 S. Lake Shore Dr.

1-312-939-2438www.sheddnet.org

Adler Planetarium

PLANETARIUM visitors can see thenewly restored Gemini 12 space-

craft in the new Shoot for the Moonexhibit, where cutting-edge technol-ogy helps tell the story of America’spart in the space race.

Planetarium shows play continu-ously throughout the day. Scheduledin the virtual reality StarRider Theater

are Stars of the Pharaoh, SonicVision and TimeSpace, where time travelers quickly flipthrough the highlights of 14 billion years of our universe’s history. The Sky Theaterdepicts stars and other nighttime wonders projected on Adler’s distinctive dome. SkyTheater presentations include Egyptian Nights: Secrets of the Sky Gods and Space…InYour Face. The Adler Planetarium is located on a scenic section of the Museum Campusjutting into Lake Michigan.■ 1300 S. Lake Shore Dr.

1-312-922-7827www.adlerplanetarium.org

FEATURE CHICAGO 2006M

US

EU

MS

■ 2430 N. Cannon Dr.1-773-755-5100www.chias.org

© De

nver

Zoo

Faust, an 8-foot, 120-poundKomodo dragon, is the high-light of Lizards and theKomodo King, a Shedd Aquar-ium exhibit featuring morethan 25 species of lizards.

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Lincoln Park ConservatoryA tropical oasis features greeneryfrom around the world. Seasonalfeatures include a chrysanthe-mum show in November and aChristmas show in December. ■ 2391 N. Stockton Dr.

1-312-742-7736

Garfield Park ConservatoryView the holiday flower show atthe Garfield Park Conservatory,which was built in 1907. Theconservatory was designed byarchitect Jens Jensen and is onethe world’s largest gardensunder glass.■ 300 N. Central Park Ave.

1-312-746-5100www.garfield-conservatory.org

Chicago Historical SocietyThis urban museum presents thefascinating multicultural heritageof the region in creative, up-to-date exhibits. Check the Web sitefor neighborhood tours, lectures,performances and events.■ 1601 N. Clark St.

1-312-642-4600www.chicagohs.org

Museum of Science and Industry

THE Museum of Science andIndustry is one of the most

popular tourist destinations inthe City of Chicago and amongseven of the most visited muse-ums in the United States.Opened in 1933, it was the firstmuseum in North America todevelop hands-on, interactiveexhibits.

Permanent exhibits includethe U-505 World War II subma-rine, Colleen Moore’s FairyCastle, the Apollo 8 CommandModule and IMAGING: Toolsof Science, an exhibit fea-turing the use of computer-based imaging technologyin the fields of medicine, sci-ence, law enforcement andentertainment.

Annual exhibits include theChristmas Around the Worldand Holidays of Light. Also ondisplay in a special exhibit are

more than 200 robots andspace toys from the RobertLesser collection. RobotsLike Us explores how thesedelightful toys once illus-trated a generation’s fan-tasies and fears of thefuture.

Additional specialexhibits include, Frogs! AChorus of Colors, whichunites 150 fantastic frogs inall shapes, patterns and col-ors imaginable from aroundthe world, and a visiting

exhibit from the DrugEnforcement Adminis-tration’s museum. Tar-

get America: Opening Eyesto the Damage Drugs Causeconsiders the societal cost ofdrugs and the forensic scienceand technology used to stem theillegal drug trade.

The Omnimax theater at the

Museum of Science and Indus-try features Volcanoes of theDeep Sea and Wired to Win:Surviving the Tour de France.■ 57th St. and Lake Shore Dr.

1-773-684-1414www.msichicago.org

FEATURE CHICAGO 2006

T H E A T E RM

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ryU-505 World War II submarine

Frogs! A Chorus of Colors

Hotel CassiopeiaAnne Bogart directsthe SITI Company ina performance explor-ing the life of a Man-hattan artist.■ Court Theatre

5535 S. Ellis Ave.1-773-753-4472www.courttheatre.org

Late Nite CatechismThis witty perform-ance is a favoriteamong those whowere taught by nunsin the parochialschool system.■ Royal George Theatre

1641 N. Halsted St1-312-902-1400www.ticketmaster.com

The Pirate QueenThe story of Ireland’s16th centurypirate chief-tain GraceO’Malley.■ Cadillac Palace Theater

151 W. Randolph St.1-312-902-1400www.ticketmaster.com

The Second City Chicago’s favorite comedyvenue, the venerable Sec-ond City, has spawned starssuch as John Belushi, BillMurray and Mike Myers.The ETC stage features up-and-coming Chicagocomics.■ Mainstage and ETC stage

1616 N. Wells St.1-312-337-3992www.secondcity.com

A Christmas CarolThis production of thefamous Dickens’ tale makeseven Scrooge seem magical.■ Goodman Theatre

170 N. Dearborn St.1-312-443-3800www.goodman-theatre.org

A Christmas SchoonerA holiday tradition, this per-formance takes a wonderfullook at families and customs. ■ Bailiwick Repertory Theater

1229 W. Belmont Ave. 1-773-883-1090www.bailiwick.org

A Nutcracker ChristmasA children’s musical basedon the famous Nutcrackerstory. ■ Apollo Theater

2540 N. Lincoln 1-312-902-1400www.ticketmaster.com

Rewiredby Blue Man GroupPerformance art and comedy meet music. ■ Briar Street Theatre

3133 N. Halsted 1-773-348-4000www.blueman.comwww.ticketmaster.com

Tour 4

Tour 17Continued on next page

F A M I L Y P E R F O R M A N C E S

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Lyric Operaof Chicago

THE world-renowned Lyric

Opera of Chicagoperforms in one ofNorth America’smost beautiful operahouses, the CivicOpera House, thatopened in 1929.■ 20 N. Wacker Dr.

1-312-332-2244 x5600www.lyricopera.org

Chicago SymphonyOrchestraNovember 24, 25, 28Conductor: Pierre BoulezProgram: Mahler’s Seventh Symphony

November 30 and December 1, 2 and 5Conductor: Pierre BoulezPiano: Pierre-Laurent AimardProgram: Ravel: Valses nobles et senti-mentalesLigeti: Piano concertoBartók: The Miraculous Mandarin

■ Chicago Symphony Orchestra220 S. Michigan Ave.1-888-294-3550www.chicagosymphony.org

Chicago Children’s MuseumChicago Children’s Museum is committed tocreating a community where play and learningconnect. More than 12 interactive exhibits andnew programs offer hours of creative play.Hands-on exhibits are creatively focused onscience, literacy, humanities and the arts. Theannual Gingerbread Fantasy Factory exhibitwill open for holiday visitors so children ofall ages can pretend to make, bake and deco-rate gingerbread goodies and participate increating gingerbread-scented sculptures in theKraft Artabounds Studio. Children can readand sing-a-long with the Gingerbread Man.■ 700 E. Grand Ave. (on Navy Pier)

1-312-527-1000www.chichildrensmuseum.org

American Girl Place

SHOPPERS at American Girl Placemay choose among the beautiful

dolls and catch American GirlReview in the theater. Lunch, tea anddinner are served at The Café. Reser-vations are recommended.■ 111 E. Chicago Ave.

1-877-247-5223www.americangirl.com

Navy Pier IMAX TheatreVisit the Navy Pier IMAX theatre tosee The Polar Express: An IMAX 3DExperience and Wild Safari as well astwo child-oriented animated 3-D films,Open Season and Happy Feet.■ 700 E. Grand Ave.

1-312-595-5629www.imax.com/chicago

Lincoln Park ZooThe Lincoln Park Zoo is the oldestzoological garden in the country, aswell as one of the most modern. Cast-ing a festive glow on the zoo grounds,the ZooLights Festival is a nightlyevent during the holiday season.■ 2200 N. Cannon Dr.

1-312-742-2000www.lpzoo.comF

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FEATURE CHICAGO 2006

Sonia FlewAs an immigrant familyprepares to celebrate Christ-mas and Hanukkah, memo-ries of escaping the CubanRevolution emerge. Pre-views begin Dec. 1. Ticketsgo on sale in August.■ Steppenwolf Theater

1650 N. Halsted St.1-312-335-1650www.steppenwolf.org

Tommy Gun’s GarageSet in a Prohibition-eraspeakeasy, this 1920s musi-cal comedy revue includesdinner. ■ Tommy Gun’s Garage

1239 S. State St.1-773-728-2828www.tommygunsgarage.com

Wicked: The Untold Storyof the Witches of Oz Wicked examines the

friendship betweenGilda the GoodWitch and the

Wicked Witch of the West.■ Ford Center for the Performing Arts

Oriental Theatre24 W. Randolph St.1-312-902-1400www.ticketmaster.com

Continued from previous page

Tours3,28,45

il TrovatoreNovember 26 and 29A love triangle ends with aflair to which only classicItalian opera can aspire.by Giuseppe VerdiConductor: Bruno Bartolettiwith Dolora Zajick and Nicola Rossi Giordano

Romeo et Juliette November 27 and 30A story of love, loyalty andyouth. Tickets go on sale inAugust.by Charles GounodConductor: John Mauceri with Dina Kuznetsova andMatthew Polenzani

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

RESEARCH & EDUCATION OUR FUTURE

Research & Education Foundation DonorsTHE Board of Trustees of the RSNA Research

and Education Foundation and its recipients ofresearch and education grant support gratefullyacknowledge the contributions made to the Foun-dation May 20 – June 23, 2006.

The Foundation is now recognizing donorsfor their cumulative giving. These donors will

be recognized for achieving giving milestonesthrough the Foundation’s Visionary Donor Pro-gram. At the end of the year, a complete rosterof Visionary Donors will be listed in the 2006RSNA Annual Report.

For more information on Foundation activi-ties, go to RSNA.org/foundation.

PRESIDENT’S CIRCLE ($1,500 PER YEAR)Atis K. Freimanis, M.D. Lise & D. Ian Hammond, M.D. Elizabeth & Douglas W. MacEwan, M.D. Mary E. Nelson, M.D. & Marvin D.Nelson Jr., M.D.

Jean M. & James H. Thrall, M.D. Robert D. Zimmerman, M.D.

$1,000 – $4,999Jerome J. Gehl, M.D. Donna & Lee F. Rogers, M.D.In memory of Milton Elkin, M.D.

$500 – $999William J. Glucksman, M.D.

$200 – $499Francisco J. Arraiza, M.D. Mary & Peter R. Hulick, M.D., M.S.In memory of Peter V. Hulick, M.D.

Reena C. Jha, M.D. Alvian Lesnik, M.D. Melissa S. Liebling, M.D. Mary Beth Moore, M.D. & Steve MooreIn honor of Ernest J. Ferris, M.D.

Ewa Kuligowska, M.D. & John NobleGregory W. Petermann, M.D. Sabiha Raoof, M.D. & Suhail RaoofKofoworola O. Soyebi, M.B.Ch.B. &Gabriel A. Soyebi

Thomas E. St Amour, M.D. Emma B. & Leonard Stanton, M.S. Karen & Michael A. Sullivan, M.D. Jerri L. & William C. Wells, M.D.

$1 – $199Arash Afari, M.D. Nick H.K. Baelde, M.D. Ronald J. Dolin, M.D. In memory of Oksana H. Baltarowich,M.D., Levon N. Nazarian, M.D. andLisa M. Tartaglino, M.D.

VANGUARD PROGRAM

Tyco Healthcare/Mallinckrodt

$25,000A Vanguard company since 1989

Varsaben H. & Hasmukh J. Prajapati,M.B.B.S.

Nakiisa M. Rogers, M.D. & Derrick RogersMark J. Sands, M.D. Akash Sharma, M.D. Karen Gomes Ordovas & Antonio Carlos A.Westphalen, M.D.

Edward J. Farmlett, M.D. In memory of George Farmlett, M.D.

Jason E. Grennan, M.D. Clare M. Hartigan, M.B.B.Ch.Jean Jeudy Jr., M.D. Susan & Oscar J. Longoria, M.D. Marc D. Molho, M.D. William M. Molpus, M.D. Guillermina Zavaleta & JaimeMorales-Arce, M.D.

William O. Petrella

Philips Medical SystemsHealthcare Informatics

$30,000A Vanguard company since 2004

EXHIBITOR’S CIRCLE PROGRAM

Vital Images, Inc.

$5,000Gold Level

ContextVision AB

$1,000Bronze Level

InfiMed, Inc.

$1,000Bronze Level

Hitachi Medical Corporation

$15,000A Vanguard company since 1999

Canon U.S.A., Inc.

$10,000A Vanguard company since 1999

Varian Medical Systems, Inc.

$25,000A Vanguard company since 2001

BRONZE VISIONARY DONORS ($5,000 CUMULATIVE)Lise & D. Ian Hammond, M.D. Jean M. & James H. Thrall, M.D. Robert D. Zimmerman, M.D.

Jabil Circuit

Neurostar Solutions, Inc.

$1,000Bronze Level

$1,000Bronze Level

NightHawk RadiologyServices

$1,000Bronze Level

RADInfo SYSTEMS, Inc.

Springer

$1,000Bronze Level

$1,000Bronze Level

Surpassing TechnologiesInc.

$1,000Bronze Level

XIMIS, Inc.

$1,000Bronze Level

VISIONARIES IN PRACTICE PROGRAM

Austin Radiological AssociationAustin, TX

$75,000Platinum Level

Newport Harbor Radiology AssociatesMedical Group, Inc.Newport Beach, CA

$5,000

Continued on next page

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22 R S N A N E W S A U G U S T 2 0 0 6

RESEARCH & EDUCATION OUR FUTURE

R&E FOUNDATION GIVING PROGRAMS

RSNA President’s Circle Program

AN ANNUAL contribution of at least$1,500 to the R&E Foundationqualifies a donor for the RSNA

President’s Circle Program. Establishedin 2001, the President’s Circle Pro-gram encourages RSNA mem-bers to support the future ofradiology by giving backto their profession.

Each year, President’sCircle Program memberscan monitor the impact oftheir gifts as they are used tofund the annual President’s Cir-cle/RSNA Research Grant. Thesegrants give young investigators furtherinsight into scientific investigationwhile developing their competence inresearch techniques and methods.

Benefits of joining the RSNA Presi-dent’s Circle Program include:

• Early registration and hotel selectionnotice for RSNA annual meeting

• Special Recognition in RSNA News,the R&E Pavilion at annual meeting,the RSNA Annual Report and on the

R&E Foundation Web site• Access to premier services

in the Donor Lounge atRSNA annual meeting• Priority taxi/shuttle bus

lines at RSNA annualmeeting

• Exclusive annual thank yougift

For more information about theRSNA President’s Circle Program orother R&E Foundation giving pro-grams, visit RSNA.org/Foundation orcontact the Foundation at R&[email protected] or 1-800-381-6660x7885.

25 Questions Submissions End August 31RSNA members areinvited to help the R&EFoundation chart thecourse for future radio-logic discovery by identi-fying the most compellingquestions still to beanswered.

Questions may beentered at RSNA.org/25questions. Scientificreviewers will choose thetop 25, which will beannounced along with thenames of the submitters during RSNA2006 and in RSNA publications.

“People’s Choice” voting startsSeptember 1 and continues throughSeptember 30. Log on toRSNA.org/25questions to read the

questions that have been submittedand vote for your favorite 10. People’sChoice voting results also will beannounced.

RADIATION SAFETY

Answer[Question on page 2.]

AThe fetus receives onlya small amount of scat-tered radiation from

radiography if the uterus isnot in any beam. The dose ishigher for abdominal or pelvicradiographic procedures. Evenso, fetal dose usually is lessthan 2.0 mSv (less than oneyear’s background radiation).Q&A courtesy of AAPM.

New R&EBrochuresThe RSNA R&EFoundation haspublished a seriesof brochuresexplaining theguidelines andbenefits of itsvarious givingprograms. Thebrochures will beavailable at RSNA2006 and RSNAHighlights: Clini-cal Issues for2007.

Continued from previous page

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

1H MR Spectroscopy of theBrain: Absolute Quantificationof Metabolites

METABOLITE concentrations in thebrain, obtained with noninvasive

hydrogen 1 (1H) MR spectroscopy, aremost often presented as ratios ratherthan as absoluteconcentrations.

In a review article in the Reviewsand Commentary section of the Augustissue of Radiology (RSNA.org/radiolo-gyjnl), Jacobus F.A. Jansen, M.S., of theDepartment of Radiology at MaastrichtUniversity Hospital in The Netherlands,and colleagues note that ratios can be

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

RSNA JOURNALS

Continued on page 25

Continued on page 25

US Diagnosis of UCL Tears ofthe Thumb and Stener Lesions:Technique, Pattern-basedApproach, and DifferentialDiagnosis

ULTRASONOGRAPHY (US) has evolvedas a reliable adjunct to clinical exam-

ination in evaluation of the ulnar collat-eral ligament (UCL) of the thumb, offer-ing a safe,simple, andeffective method of assessing the liga-ment and its supporting structures at thebedside.

In an article in the July-August issueof RadioGraphics (RSNA.org/radio-graphics), Farhad S. Ebrahim, M.D., ofthe University of Michigan Health Sys-tem and colleagues outline how to per-form US of the thumb, focusing particu-larly on:• Basic techniques used to perform US

of the UCL of the thumb

Stener lesion. (a) Coronal US thumb scan shows aproximal lobulated nodule (S, arrows), representing theretracted displaced proximal seg-ment of the ulnar collateral liga-ment (UCL). The smooth contour ofthe aponeurosis is distorted by thesuperficially lying ligament, result-ing in aponeurosis surface bulging.MCP = metacarpal, PP = proximalphalanx. (b) Axial US thumb scanshows a thickened lobulated UCL(cursors). There is loss of thesmooth contour of the aponeurosiswith bulging (arrow). ET = extensortendon, MCP = metacarpal head, TH = thenar eminence. (c) Axial USthumb scan shows a normal UCL.The adductor aponeurosis (blackarrowheads) covers the muscle andUCL (white arrowhead). There is nonodule, lobulation, or bulging. ET = extensor tendon, MCP =metacarpal head, TH = thenar emi-nence.(RadioGraphics 2006;26:1007–1020) © RSNA, 2006. Allrights reserved. Printed with permission.

Schematic illustratesexperimental setup ofcalibration strategiesused to quantify cere-bral metabolite concen-trations. Left: Setup for brain exami-nation. Right: Calibrationmeasurement. A, Internalendogenous marker, watersignal reference method andprinciple of reciprocity. B,External reference method.C, Replace-and-matchmethod.(Radiology 2006;240:318–332) © RSNA, 2006.All rights reserved. Printed with permission.

b

a

c

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RSNA JOURNALS

Press releases have been sent to the medical news media for the following articlesappearing in the August issue of Radiology (RSNA.org/radiologyjnl):

in Public Focus

Is There Improvement of“Vascular Depression” afterCarotid Artery Stenting?

PATIENTS with high-grade carotidstenosis are likely to suffer depres-

sion symptoms that carotid artery stent-ing (CAS) appears to improve,researchers in Austria have found.

Wolfgang Mlekusch, M.D., andcolleagues from Vienna General Hospi-tal Medical School compared thedepressive symptoms of 143 patientsundergoing CAS to symptoms in a con-trol group of 102 patients undergoinglower limb angioplasty for advancedperipheral artery disease (PAD) withoutcarotid stenosis.

Depressive disorders causativelyassociated with degenerative processesbased on cerebrovascular disease areknown as “vascular depression.”

“We found a significantly higher

prevalence of depressive symptoms inpatients with carotid stenosis comparedto PAD patients at baseline,” theresearchers write. Following up at fourweeks, they report “a substantial reduc-

tion of depressive symptoms was foundin CAS patients, while the frequency ofdepressive disorders remained unaf-fected in controls.”

Effect of Obesity on Image Quality: Fifteen-year Longitudinal Study for Evaluation ofDictated Radiology Reports

ASTUDY of more than 5 million radi-ology reports from a Massachusetts

hospital from 1989-2003 has shown asmall but progressive increase in thenumber of habitus-limited reports—those limited by the patient’s size.

Raul N. Uppot, M.D., of theDepartment of Radiology, Division ofAbdominal Imaging and InterventionalRadiology at Massachusetts GeneralHospital and Harvard Medical School,and colleagues also found that themodality most commonly associatedwith habitus-limited reports wasabdominal ultrasonography.

Seeking to retrospectively assessthe effect of obesity on image quality,

Dr. Uppot and colleagues identified apositive correlation between theincreased number of habitus-limitedreports and the increased prevalence ofobese individuals in Massachusettsbetween 1991 and 2001.

Difficulties radiologists must facein examining obese patients, theresearchers note, include transportingthem, accommodating them on imagingequipment and obtaining diagnostic-quality images. After abdominal ultra-sonography, the modalities most fre-quently classified as habitus-limitedwere chest radiography, abdominalradiography, abdominal CT, chest CTand MR imaging.

“Radiologists should be aware ofthe limitations of current imagingequipment and be knowledgeable in theoptimization of imaging protocols andequipment settings when examininglarge patients,” the researchers write.“Future prospective studies performedto establish a correlation between bodymass index and image quality for eachmodality could help manufacturers andradiologists achieve their goal ofimproving image quality in an increas-ing population of obese Americans.”(Radiology 2006;240:435-439)

Graph of percentage and num-ber of patients with clinicallysubstantial depressive symp-toms before and 4 weeks aftercarotid artery stenting (CAS),compared with those of controlsubjects with peripheral arterydisease (PAD) before and 4weeks after percutaneous trans-luminal angioplasty (PTA). Sig-nificant decrease in frequencyof depressive symptoms wasfound in 143 patients after suc-cessful CAS. No significantchange in frequency of depres-sive symptoms was observed in100 control subjects after PTA.Bars represent percentages and95 percent confidence intervals.(Radiology 2006;240:508-514) © RSNA, 2006. Allrights reserved. Printed with permission.

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

Media Coverage of Radiology

IN JUNE, RSNA media coveragereached more than half a billion peo-ple worldwide.

RSNA issued two press releasesrelated to studies appearing in the Juneissue of Radiology. Lia Bartella, M.D.,and colleagues detailed how the appli-cation of MR spectroscopy reduces theneed for breast biopsy (Radiology 2006;239:686-692). This story reached anestimated audience of 378 million viaappearances in the Chicago Tribune,The Australian and The IndianapolisStar, as well as on MSN.com, Yahoo!

News, Forbes.com, iVillage.com andthe online Discovery Hospital.

Sean Fain, Ph.D., and colleaguesoutlined the use of hyperpolarized-helium MR imaging to detect earlyemphysema in asymptomatic smokers(Radiology 2006; 239:875-883). Cover-age appeared on ABC and NBC broad-cast stations across the country, as wellas in the Chicago Tribune, Newsday,The Indianapolis Star, The CincinnatiPost and The Australian. Stories alsoappeared on Yahoo! News, Forbes.com,Red Orbit, HealthCentral and MedPage

Today, bringing the estimated totalaudience for the story to almost 76 million.

Additional June coverage appearedon CNN Money and in Popular Sci-ence, Harper’s Bazaar, The VancouverSun, St. Paul Pioneer Press and theDaily Herald of Suburban Chicago.

useful for clinical diagnosis to charac-terize pathologic tissue. However, theyadd, relative quantification can alsointroduce substantial errors and maylead to misinterpretation of spectraldata and to erroneous metabolite values.

Dr. Jansen and colleagues reviewhow to obtain absolute concentrationswith a clinical MR system by using sin-gle-voxel spectroscopy or chemicalshift imaging. Discussing the advan-tages and disadvantages of absoluteconcentrations and methods of dataanalysis, the researchers also specifi-cally address these aspects of absolutequantification strategy:• Radiofrequency coil properties

• Calibration procedures• Spectral fitting methods• Cerebrospinal fluid content correction• Macromolecule sup-

pression• Spectral editing

The researchersnote that to obtain reli-able absolute concentra-tions, potential compli-cating factors must beconsidered. However,they state, most of theseproblems have beencritically addressed.

“Absolute quantifi-cation is available andcan improve the diagnostic utility of 1HMR spectroscopy procedures,” the

researchers write. “Therefore, furtherprogress in the development of auto-mated spectral analysis methods and

databases of normalregional and age-dependent metaboliteconcentrations has tobe encouraged to makethe absolute quantifica-tion procedures moreeasily applicable inclinical routine.”

Continued from page 23

1H MR Spectroscopy of the Brain: Absolute Quantification of Metabolites

• US features of UCL injury of thethumb with emphasis on the Stenerlesion

• US features of other common acuteconditions affecting the base of thethumb

While both MR imaging and USare currently used to directly evaluatethe UCL of the thumb and are both safe

and accurate, US is more dynamic andless time-consuming and may be easierto perform, Dr. Ebrahim and colleagueswrite. For their study, they looked atsonograms of 32 patients with a clini-cally suspected UCL injury and corre-lated the imaging findings with onefresh and two embalmed cadavericspecimens.

“Furthermore, other disorders such

as tenosynovitis, tendon tears and artic-ular pathologic conditions can involvethe thumb and thenar region and mayalso be diagnosed with US,” they add.“In this context, US is an underusedtool because it is potentially an adjunctto the clinical examination in theappropriate setting.”

US Diagnosis of UCL Tears of the Thumb and Stener Lesions: Technique, Pattern-based Approach,and Differential DiagnosisContinued from page 23

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THE RadioGraphics EditorialOffice staff in Bethesda,Md., works with Editor

William W. Olmsted, M.D., toobtain material to publish inRSNA’s bimonthlyeducation journal. Staffmembers facilitate thereview of educationexhibits by 17 subspe-cialty panels at the annual meet-ing and then oversee progress ofmanuscripts from solicitationthrough submission, peer review,revision and final acceptance.The staff also manages submis-sions for regular features includ-ing the Armed Forces Institute ofPathology (AFIP) Archives,

Inner Visions and AmericanAssociation of Physicists inMedicine (AAPM)/RSNAPhysics Tutorials for Residents.To better serve authors and

reviewers, the office isdeveloping a newonline submissionapplication, RGX-Press, with projected

completion in fall 2006. Sup-porting the RadioGraphics editorand RSNA in offering the verybest educational material andCME opportunities, the stafftakes pride in their work and inthe popularity RadioGraphicshas gained since Dr. Olmsted’stenure began in 1990.

Working For You

RSNA MEMBER BENEFITS

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

Workingfor you

DEPARTMENTPROFILE

RSNA 2005 Cases of the Day Now Online

GET READY for the RSNA 2006 Casesof the Day by taking another look at

those from RSNA 2005. Cases of theDay are offered as part of InteractED®,an online CME resource available freeto RSNA members as a membershipbenefit. RSNA 2005 Cases of the Dayare available in:

■ Breast ■ Cardiac■ Chest ■ Gastrointestinal ■ Genitourinary ■ Musculoskeletal

■ Neuroradiology ■ Nuclear Medicine ■ Obstetrical Imaging ■ Pediatric■ Ultrasound ■ Vascular/Interven-

tional

InteractED is located in the Educationportal of RSNA.org, which includes othervaluable resources such as links to RSNA’sonline self-assessment modules (SAMs) andRSNA CME Repository, as well as informa-tion for residents and medical students.Access InteractED and other Education linksat RSNA.org/education.

Brochures Detail MOC ProcessRSNA has released the first two titles in its series ofbrochures regarding the American Board of Radiology(ABR) maintenance of certification (MOC) process.“MOC: What Is It and What Does It Mean for You?”gives the basics of the process, while“CME: What’s New?” covers theCME requirements under MOC.Future brochures in the series willaddress topics such as creating an edu-cation plan, making time for self-assessment modules (SAMs) and par-ticipating in communities of learners.

Radiologists certified in 2002 andafter and those who received time-lim-ited certification are now required tocomplete the MOC process in 10-yearcycles. RSNA is committed to helpingmake the process easier by offering avariety of tools such as the brochuresand other educational materials.Brochures will be mailed to peopleparticipating in the MOC registry, anonline feature designed to assist mem-bers in participating in the MOCprocess and who have completed apractice profile.

To participate in the MOC registry or access thebrochures online, go to RSNA.org/Education/moc.cfm. For a tutorial on using MOC resources onRSNA.org, including the registry, go to page 33.Brochures also will be available at RSNA 2006 andthe new RSNA Highlights conference to be held Feb-ruary 26–28, 2007, in Phoenix.

(from left) Wendy Morris, Cindy Rogers,Teresa Smith

RadioGraphics Editorial Office

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EDUCATION RESEARCH

Program and Grant Announcements

NIH Grantsmanship WorkshopNovember 25, McCormick Place, Chicago

Held the day before the RSNA annual meet-ing begins, this 4-hour workshop coversgrant writing techniques from concept devel-opment to submission and the NIH reviewprocess. Attendees will also experience amock study section. Lee Rosen, Ph.D., fromthe NIH Center for Scientific Review, willfacilitate and speakers will address basicapplications, K grants and the NIH grantapplication experience. Registration is avail-able by visiting rsna2006.rsna.org andclicking on Registration, Housing &Courses.

IHE® Connectathon and Conference 2007January 15–19, 2007, Hyatt Regency Chicago—Wacker Drive

THE TWO missions of the Integrating the Healthcare Enterprise®

(IHE) initiative—systems testing and education—will convergeat the first-ever IHE Connectathon and Conference. As with past

Connectathons, participating companies will have an opportunity totest their systems with corresponding systems from industry peers.

For the new educational conference portion in 2007, the key play-ers who are implementing regional and national health informationnetworks will provide insight into the connected health system andhow IHE is helping make it happen.

Registration opens in October. Check www.ihe.net/events/connectathon07 for further information.

Imaging as a Biomarker: Standards for Change Measurements in TherapySeptember 14–15, Gaithersburg, Md.

Recent work has shown that biomedical imaging can provide an early indica-tion of drug response by use of x-ray, CT or PET-CT. This workshop willbring together industry, academic and government representatives to developa strategy for standardizing imaging methods of data collection and dataanalysis in the context of drug or radiation therapy trials. Developing stan-dards could significantly reduce the size of clinical trials for drug response.

RSNA is co-sponsoring this conference along with the National Instituteof Standards & Technology, National Cancer Institute, National Institute ofBiomedical Imaging and Bioengineering and the Food & Drug Administra-tion. For more information, go to www.nist.gov/public_affairs/conf-page/060914.htm.

Personal Financial Seminars at RSNA 2006

TWO comprehensive financial seminars are available again this year onSaturday, November 25, at McCormick Place in Chicago just prior to the

RSNA annual meeting.“Protecting Assets from Creditor Claims, Including Malpractice

Claims” will be held from 10:00 a.m. to 12:00 p.m. and costs $129. “Effec-tive Investment Strategies” will be held from 1:30 p.m. to 5:00 p.m. andcosts $159. Save almost $20 by registering for both courses for $269. Text-books written specifically for each course are included.

Register for the courses by going to rsna2006.rsna.org and clicking onRegistration, Housing & Courses. Please note that these seminars do not qual-ify for AMA PRA Category 1 Credits™. For more information, please contactthe RSNA Education Center at 1-800-381-6660 x3747 or [email protected].

At the IHEConnectathon,companiestest their sys-tems with thecorrespondingsystems oftheir peers.

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MEETING WATCH RSNA 2006

News about RSNA 2006

Receive Materials Prior to MeetingRSNA will mail registration materials in advance of the annual meeting toall North American attendees who register for RSNA 2006 by November10. RSNA will mail materials in advance to international attendees whoseregistration forms are received by October 27.

Registration materials enclosedin the badge wallet include:• Name badge and holder• Course and tour tickets (as

requested)• Attendance vouchers• Free pass for the Chicago Metra train system• Airport shuttle and limousine discount coupon• Coupon book

Registration materials also include an ExpoCard™ and Pocket Guide.

ExpoCard™

ExpoCard is an electronically-personalized busi-ness card attendees can use at the technical exhibi-tion to request exhibitor information. The card isencoded with the holder’s name, institution,address, e-mail, address, phone/fax numbers and radiologic specialty. Anyattendee who prefers that exhibitors contact him or her at a differentaddress than the one used during advance registration should provide alter-nate information directly to the exhibitor at the point of contact. Attendeesmay also visit either Help Center at McCormick Place to change registra-tion and ExpoCard detail.

Pocket GuideThe RSNA 2006 Pocket Guide is an easy-to-use reference guide with twomain sections:Overview of the RSNA Scientific Assembly and Annual Meeting• Complete A-Z listing of everything available to

attendees• Room assignments for scientific sessions, refresher

courses and plenary sessions• Floor plans of each building and each floor of

McCormick PlaceTraveling to and from McCormick Place• Shuttle bus schedules, routes and boarding locations• Taxi fees and loading and unloading areas• Airport transportation service times, costs and boarding information• Complete Metra train system schedule outlining station locations, times

and drop-off destinations• Parking lot locations, hours and fees

Transportation information is also available by visitingrsna2006.rsna.org and clicking on Transportation.

■ For more information about registration at RSNA 2006, visit RSNA.org/register, e-mail [email protected], or call 1-800-381-6660 x7862.

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

➊ InternetGo to RSNA.org/register. Use yourmember ID# from the RSNA News label ormeeting flyer sent to you. If you have questions,send an e-mail to [email protected].

➋ Fax (24 hours)1-800-521-60171-847-940-2386➌ Telephone(Mon.–Fri., 8:00a.m.–5:00 p.m. CT)1-800-650-70181-847-940-2155

➍ MailITS/RSNA 2006108 Wilmot Rd., Suite 400Deerfield, IL 60015-5124 USA

Fastest wayto register!

Enroll forCourses, Toursand EventsSpace remains inmany of thecourses, tours andevents at RSNA2006. Online regis-tration occursinstantly, whilefaxed or mailedregistration forms are processed in the order ofreceipt. The Advance Registration, Housing andCourse Enrollment and Tours and Eventsbrochures, as well as online registration, areavailable at RSNA.org/register. Registration forRSNA 2006 is required in order to enroll forcourses, tours and events.

Important Dates for RSNA 2006Oct. 27 International deadline to have full-confer-

ence badge and tickets mailed in advance

Nov. 6 Final housing reservation deadline

Nov. 10 Advance registration deadline

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

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News about RSNA 2006

MEETING WATCH RSNA 2006

REGISTRATION opens September 5for RSNA’s new educational con-ference, RSNA Highlights: Clini-

cal Issues for 2007. The conference willbe held February 26–28, 2007, at theJ.W. Marriott Desert Ridge Resort &Spa in Phoenix. For more informationabout course content or to reserve aroom or request a brochure, visitRSNA.org/highlightsconference.

RSNA Highlights: Clinical Issues for 2007

Important Dates forRSNA HighlightsSept. 5 Registration opens

Feb. 26–28RSNA Highlights: Clinical Issues for 2007

Obtain a Visa (International Visitors)Personalized invitation letters areavailable at www2.rsna.org/visa_form/invitation_letter.cfm. The InternationalVisitors section of rsna2006.rsna.orgalso includes important informationabout visa applications. Visa appli-cants are advised to apply as soon asthey decide to travel to the UnitedStates or at least three to four monthsin advance of their travel date. It isrecommended that international visi-tors start the visa process now.

For more information go to:• www.unitedstatesvisas.gov• travel.state.gov/visa• nationalacademies.org/visas

Arrange ChildcareChildren under the age of 16 may ride RSNAshuttle buses but will not be allowed to attendthe meeting. Onsite childcare will be availablefor children six months to 12 years throughACCENT on Children’s Arrangements, Inc.Online registration and application forms areavailable by going to rsna2006.rsna.org andclicking on Childcare, under Registration.

Registration FeesBY 11/10 ONSITE

$0 $100 RSNA Member, AAPM Member

$0 $0 Member Presenter

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

$0 $0 Non-Member Presenter

$120 $220 Non-Member Resident/Trainee

$120 $220 Radiology Support Personnel

$570 $670 Non-Member Radiologist, Physicistor Physician

$570 $670 Hospital Executive, Research andDevelopment Personnel, HealthcareConsultant, Industry Personnel

$300 $300 One-day registration to view onlythe Technical Exhibits area

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

MEETING WATCH RSNA HIGHLIGHTS

Each physician canearn up to 19 AMA PRA Category 1 Credits™

at RSNA Highlights

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EXHIBITOR NEWS RSNA 2006

Exhibitor News

Publishers Row a Must Seeat RSNA 2006

ONE OF the most popular desti-nations inside the RSNA 2006Technical Exhibit halls will be

Publishers Row, located in Hall A ofthe South Building. More than 20leading publishers of medical booksand products, including the RSNAEducation Store, will be on hand.

When browsing these aislesdon’t forget the RSNA PublisherPartners program. These publishersoffer discounts of at least 10 percentto RSNA members on the purchaseof popular medical books and prod-ucts. Details about specific discountsand how to obtain them are availableby going to RSNA.org and clickingon Membership and then PublisherPartners.

Searchable Exhibitor Database Available OnlineTo plan ahead for the RSNA 2006experience, search the database ofRSNA 2006 technical exhibitors, onlineat RSNA.org/showcase. The database,updated weekly, includes a list of thetechnical exhibitors, booth numbers andcompany contact information, as wellas an interactive floor plan.

More Hands-on Computer Workshop Classes AnnouncedAfter the printing of the RSNA2006 Advance Registration, Hous-ing and Course Enrollmentbrochure, Siemens Medical Solu-tions and Eastman Kodakannounced schedules for hand-onclasses they’ll conduct on their pro-prietary computer systems in the

Lakeside Learning Center. A com-plete listing of these and otherhands-on classes is available byvisiting rsna2006.rsna.org andclicking on Registration, Housing& Course, then Course EnrollmentDetails and Hands-on ComputerWorkshops.

Technical ExhibitFact■ With more than30,000 square feet ofspace apiece, the GEHealthcare, SiemensMedical Solutionsand Philips exhibitbooths at RSNA2006 will measurenearly 2/3 of a foot-ball field in size.

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Product News

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

Blvd., Oak Brook, IL 60523 or by e-mail to [email protected]. Information may be edited for purposes of clarity and space.

RADIOLOGY PRODUCTS

NEW PRODUCT

Biliary Stent Treats Blockages

CORDIS ENDOVASCULAR (www.cordis.com) has launchedthe Palmaz® Blue™ .014 transhepatic biliary stent, bal-loon-expandable stent delivery technology to treat

biliary blockages. The Palmaz Blue features a cobaltchromium alloy enhanced with tungsten to make itstronger than stainless steel stents and use less metal. Thestent was designed to offer physicians increased strengthand radiopacity while lessening overall procedure time.

NEW PRODUCT

Long-Length OrthopedicCassetteKonica Minolta Medical Imaging(medical.konicaminolta.us) hasintroduced a 14" x51" long-lengthcassette assemblyfor use with itsXpress and IQuecomputed radiog-raphy (CR) sys-tems. The assem-bly is designed fordigital capture offull-length leg andfull-length spineof patients tallerthan 6’6” withone single exposure.

The long-length cassettehouses three slightly overlappedCR plates to capture the entirespine or leg on multiple CR platessimultaneously. Plates are insertedonto cassettes of the same size forscanning by the CR reader andstitching software on the XpressCR and IQue CR automaticallyjoins the individual images as onecomposite image.

NEW PRODUCT

Advanced Printers IntroducedSony Electronics (www.sony.com) hasadded a selection of advanced printers toits lineup of hard copy solutions.

Included is the UP-D77MD, a nuclearmedicine printer capable of recreatinglarge image files exactly as displayed onscreen. Also recently unveiled are the UP-990AD and UP-970AD hybrid printers,which support full-page monochrome

printing for such appli-cations as mobile C-arm, ultrasound and car-diac catheterization.

Also in the newlineup is the FilmSta-tion, a compact dry filmimager designed with flexibility to fit anyoffice space regardless of size or layout.

FDA CLEARANCE

Cardiac SPECT DeviceCardiArc Ltd. (www.cardiarc.com) hasFDA clearance to market its new car-diac SPECT imaging device,which the company saidoffers sharper images ofblood flow and heart functionin half the time previouslyrequired.

The device was specificallydesigned for use in outpatientsettings and emergencyrooms. Patients sit upright,without rotating or holdingarms over their heads.Scan times are very fast,ranging from 2 to 6 min-utes at physician discretion.

Sony UP-990AD hybrid printer

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33R S N A N E W SR S N A N E W S . O R G

RSNA ON THE WEB

RSNA.org

EconnectionsYouronlinelinks toRSNA

Radiology OnlineRSNA.org/radiologyjnlRadiology Manuscript CentralRSNA.org/radiologyjnl/submitRadioGraphics OnlineRSNA.org/radiographicsRSNA News rsnanews.orgEducation PortalRSNA.org/educationRSNA CME Credit RepositoryRSNA.org/cmeCME GatewayCMEgateway.orgRSNA Medical ImagingResource CenterRSNA.org/mircRSNA Career ConnectionRSNA.org/careerRadiologyInfo™

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

RSNA.org

OTHER WEB NEWS

Tutorial Focuses on MR Imaging for Acute Stroke

ACCESS a free Web-based training module on MagneticResonance Gradient Echo (GRE) Imaging in Acute

Stroke at the National Institute of Neurological Disordersand Stroke (NINDS) GRE MRI tutorial. The module isworth 1 AMA PRA Category 1 Credit™ and is provided bythe NINDS Stroke Diagnostics and Therapeutics Branch.Designed for use by physicians involved in the full spec-trum of the treatment and evaluation of acute strokepatients, the site provides instruction on general principlesand interpretation of GRE MR imaging.

The NINDS GRE MRI Tutorial can be viewed at gre.ninds.nih.gov.

Maintenance of CertificationResourcesRSNA is committed to helping members meetmaintenance of certification (MOC) requirementsby offering educational resources and online toolsat RSNA.org.

To access online MOC resources, go toRSNA.org/Education and select the MOC button ➊.To access Self-assessment Modules (SAMs) quali-fied by the American Board of Radiology to meetMOC criteria, select self-assessment modules ➋.

The MOC Registry includes several resourcesthat complement RSNA online CME programs andSAMs. Completing and updating My Practice Pro-file ➌ puts you in the registry and helps you defineyour practice and target your lifelong learningactivities. E-mail notifications about RSNA MOCresources are an automatic benefit of the MOCRegistry.

To access accredited RSNA online continuingmedical education (CME) programs, such asselected refresher courses and RadioGraphicsCME tests, select Continuing Medical EducationPrograms ➍.

Accessing My CME Action Plan ➎ allows youto print a template of a personal learning plan,based on your completed practice profile. Youhave the option of saving this template to yourhard drive as a Microsoft Word document.

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Medical Meetings September – October 2006

NONPROFIT ORG.U.S. POSTAGE

PAIDPERMIT #186

EASTON, PA 18042

RSNA News820 Jorie Blvd.Oak Brook, IL 605231-630-571-26701-630-571-7837 [email protected]

CALENDAR

AUGUST 30–SEPTEMBER 2Society for Molecular Imaging, 5th Annual Meeting, HiltonWaikoloa Village • www.molecularimaging.orgSEPTEMBER 7–10American Society of Nuclear Cardiology (ASNC), 2006 Sympo-sium and Scientific Session, Palais des Congrès de Montréal • www.asnc.org/symposium06SEPTEMBER 8–9American Society for Therapeutic Radiology and Oncology(ASTRO), Translational Research in Radiation Oncology, Physicsand Biology, Radisson Boston Hotel • www.astro.orgSEPTEMBER 9–13Cardiovascular and Interventional Radiological Society of Europe(CIRSE), Annual Meeting and Postgraduate Course, Palazzo deiCongressi, Rome • www.cirse.orgSEPTEMBER 12–16International Society of Radiology (ISR)/Radiological Society ofSouth Africa (RSSA)/International Society for Magnetic Resonancein Medicine (ISMRM), 24th International Congress of Radiology,Cape Town International Convention Center, South Africa • www.isr2006.co.zaSEPTEMBER 13–1633rd Annual International Skeletal Society, Radiology RefresherCourse, Fairmont Hotel Vancouver, British Columbia • www.internationalskeletalsociety.comSEPTEMBER 14–15Imaging as a Biomarker: Standards for Change Measurements inTherapy, National Institute of Standards and Technology, Gaithers-burg, Md. • www.nist.gov/public_affairs/confpage/060914SEPTEMBER 14–16European Society of Gastrointestinal and Abdominal Radiology(ESGAR), 5th Hands-On Workshop on CT-Colonography, GreenPark Resort Hotel, Pisa, Italy • www.esgar.orgSEPTEMBER 15–16ASTRO, Health Services Outcomes Research in Radiation Oncol-ogy, The Westin Horton Plaza, San Diego • www.astro.orgSEPTEMBER 15–17Australasian Society for Ultrasound in Medicine (ASUM), AnnualScientific Meeting, Melbourne Convention Centre, Victoria, Australia• www.asum.com.au/asum2006.htm

SEPTEMBER 16–17Society of Computed Body Tomography and Magnetic Resonance (SCBT/MR), MDCT: A Practical Approach 2006,Westin Boston Waterfront Hotel • www.scbtmr.org/courses/MDCT/mdct_course.htmlSEPTEMBER 21–22National Institutes of Health (NIH) Diagnostic RadiologyDepartment Clinical Center, High Field Cardiovascular MagneticResonance Workshop, Washington Hilton • www.capconcorp.com/highfield/SEPTEMBER 27–29Argentine Society of Radiology, 52nd Argentine Congress ofDiagnostic Imaging and Radiation Therapy, Sheraton Hotel andConvention Center, Buenos Aires, Argentina • www.sar.org.arSEPTEMBER 27–30American Society of Emergency Radiology (ASER), 2006Annual Scientific Meeting and Post Graduate Course, The OmniShoreham, Washington • www.erad.orgSEPTEMBER 27–OCTOBER 1American Society of Head and Neck Radiology (ASHNR), 40th Annual Meeting, Sheraton Wild Horse Pass Resort and Spa,Chandler, Ariz. •www.ashnr.orgSEPTEMBER 30–OCTOBER 4European Association of Nuclear Medicine (EANM), 2006Annual Congress, Megaron International Conference Center,Athens, Greece • www.eanm.orgOCTOBER 8–12European Society for Therapeutic Radiology and Oncology(ESTRO), ESTRO25, Congress Center Leipzig, Germany • www.estro.orgOCTOBER 10–13World of Health IT 2006 Conference and Exhibition, GenevaPalexpo • www.worldofhealthit.org

NOVEMBER 26–DECEMBER 1RSNA 2006, 92nd Scientific Assembly and Annual Meeting,McCormick Place, Chicago • rsna2006.rsna.orgFEBRUARY 26–28, 2007RSNA Highlights: Clinical Issues for 2007, J.W. MarriottDesert Ridge Resort & Spa, Phoenix, Ariz. • RSNA.org/highlightsconference