AP R I L 2006 ■ VO LU M E 16, NUMBER 4

Also Inside:■ RSNA Workshop Addresses Need for Clinical Trials Training■ Adjuvant Radiation for Endometrial Cancer Increases Survival, Study Shows■ Long-Term Survival Possible After Radiosurgery for Brain Cancer■ Leaders Look to Establish Teleradiology Standards

Advance Registration for RSNA 2006

Begins April 24

MR Imaging Used to Track Accuracy and Effectiveness of

Stem Cell InjectionsIm

age

cour

tesy

of

Dara

L.

Krai

tchm

an,

V.M

.D.,

Ph.D

.

AP R I L 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.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.Mary 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 NewsApril 2006 • Volume 16, Number 4

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: rsnanews@rsna.orgFax: 1-630-571-7837RSNA News820 Jorie Blvd.Oak Brook, IL 60523

SubscriptionsPhone: 1-630-571-7873 E-mail: subscribe@rsna.org

Reprints and PermissionsPhone: 1-630-571-7829Fax: 1-630-590-7724E-mail: permissions@rsna.org

RSNA Membership: 1-877-RSNA-MEM

1 Announcements

3 People in the News

Feature Articles

4 MR Imaging Used to Track Accuracy andEffectiveness of Stem Cell Injections

6 RSNA Workshop Addresses Need for Clinical TrialsTraining

8 Adjuvant Radiation for Endometrial CancerIncreases Survival, Study Shows

10 Long-Term Survival Possible After Radiosurgery for Brain Cancer

11 Leaders Look to Establish Teleradiology Standards

Funding Radiology’s Future®

19 R&E Foundation Donors

13 Journal Highlights

14 Radiology in Public Focus

15 Program and Grant Announcements

17 RSNA: Working for You

18 Product News

20 Exhibitor News

21 Meeting Watch

25 RSNA.org

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

ANNOUNCEMENTS

Frequently Cited Radiology Articles

A1982 article offering a representa-tion and interpretation of the areaunder a receiver operating charac-

teristic (ROC) curve obtained by the“rating” method is the Radiology articlemost frequently cited by the journalshosted at HighWire Press since High-Wire started keeping statistics in 1995.A division of the Stanford UniversityLibraries, HighWire hosts more than900 journals, including Radiology and

RadioGraphics.“The Meaning and Use

of the Area Under aReceiver Operating Charac-teristic (ROC) Curve,” byJames A. Hanley, Ph.D., andBarbara J. McNeil, M.D.,Ph.D. (Radiology1982;143:29-36) had beencited 645 times as of February 2, 2006.

Another article on the same subject

by Drs. Hanley andMcNeil, “A Method ofComparing the Areasunder Receiver Operat-ing Characteristic CurvesDerived from the SameCases” (Radiology1983;148: 839-843) isthe second most cited

article, with 275 citations.Rounding out the top 10 are:

3 “Small Hepatocellular Carcinoma: Treatment with Radio-Frequency Ablation Tito Livraghi, M.D. 164Versus Ethanol Injection” (Radiology 1999;210:655-661)

4 “Hyperacute Stroke: Evaluation With Combined Multisection Diffusion-Weighted A. Gregory Sorensen, M.D. 157and Hemodynamically Weighted Echo-Planar MR Imaging” (Radiology 1996;199:391-401)

5 “Diffusion Tensor MR Imaging of the Human Brain” (Radiology 1996;201:637-648) Carlo Pierpaoli, M.D. 120

6 “Hepatocellular Carcinoma: Radio-Frequency Ablation of Medium and Large Lesions” Tito Livraghi, M.D. 116(Radiology 2000;214: 761-768)

7 “MR Imaging of Intravoxel Incoherent Motions: Application to Diffusion and Perfusion Denis Le Bihan, M.D. 114in Neurologic Disorders” (Radiology 1986;161:401-407)

7 “Peripheral Lung Cancer: Screening and Detection with Low-Dose Spiral CT Versus Masahiro Kaneko, M.D. 114Radiography” (Radiology 1996;201:798-802)

9 “Hepatic Metastases: Percutaneous Radio-Frequency Ablation with Cooled-Tip Electrodes” Luigi Solbiati, M.D. 111(Radiology 1997;205:367-373)

10 “Breath-Hold Gadolinium-Enhanced MR Angiography of the Abdominal Aorta and Its Martin R. Prince, M.D. 110Major Branches” (Radiology 1995;197:785-792)

NUMBER OF ARTICLE LEAD AUTHOR CITATIONS

THE RSNA Highlights: Clinical Issues for 2007 conference willbe held February 26–28, 2007, at the J.W. Marriott DesertRidge Resort & Spa in Phoenix, Ariz.

This new RSNA educational conference will include selectedrefresher courses and electronic education exhibits from RSNA2006, with special emphasis on: • Cardiac imaging• PET/CT• Breast imaging• Sports injuries

RSNA Highlights isintended for anyone who was unable to attend RSNA 2006 or whomissed educational sessions in which they were interested. Allcourses will be taught in an interactive format, using audienceresponse technology.

Registration begins September 5. Up-to-date information isavailable at RSNA.org/highlightsconference. For more information,contact RSNA Program Services at programs@rsna.org.

New RSNA Educational Conference in 2007

Important Dates for RSNA HighlightsSept. 5 Registration opens

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

2 R S N A N E W S A P R I L 2 0 0 6

ANNOUNCEMENTS

Medicare to Work with NOPR to Obtain PET Scan Data The Centers for Medicare & MedicaidServices (CMS) has announced it willwork with the National OncologicPET Registry (NOPR) to collect datanationwide to help manage patientswith various cancers.

“Working closely with NOPR isanother example ofCMS collaboratingwith the physiciancommunity to enhancethe availability ofinnovative treatments and improvepatient care,” said CMS AdministratorMark McClellan, M.D., Ph.D.

The announcement follows a deci-sion by CMS in January to expandcoverage of PET scans for brain, cer-

vical, ovarian, pancreatic, small celllung, testicular and other cancers notcovered in prior National CoverageDeterminations.

NOPR is a national, Internet-based,audited data repository designed togather PET data from beneficiaries

and providers andreport on the data.It is sponsored bythe Academy ofMolecular Imaging

(AMI) and managed by the AmericanCollege of Radiology (ACR) throughthe American College of RadiologyImaging Network (ACRIN).

VIEWING TECHNOLOGY

Question of the MonthQA radiology resident

asks, “Why can’t I usemy laptop to interpret

digital chest images?”[Answer on page 25.]

Travel Awards for Molecular Imaging Abstract PresentersRSNA will assist with travel expensesfor up to 15 young investigators whosemolecular imaging abstracts areaccepted for presentation at RSNA 2006.

To be eligible, an abstract presenteror poster exhibitor must be a predoc-toral student or have been awarded hisor her doctoral degree no more thanseven years prior to the time of abstractsubmission. Only young investigatorswith accepted abstracts in the area ofmolecular imaging will be considered.To claim the travel award, the recipient

must personally attend RSNA 2006 topresent his or her work.

The deadline to submit abstracts forRSNA 2006 is April 15. Notificationsof abstract acceptance and travelawards will be made simultaneously.

For more information about thetravel award program, go to RSNA.org/Research/upload/MITA_flyer.pdf. Formore information on submitting anabstract for RSNA 2006, go toabstract.rsna.org.

RadiologyInfo™ Receives Health Communication AwardRadiologyInfo.org, the pub-lic information Web sitedeveloped and funded byRSNA and the AmericanCollege of Radiology(ACR), received a 2005 Aes-culapius Certificate of Meritfrom the Health Improve-ment Institute.

Named for the ancientGreek god of healing, the AesculapiusAwards for Excellence in Health Com-munication recognize organizationsthat provide health information to thepublic through Web sites, television or

radio public serviceannouncements. Entriesare judged based on theirobjectives/planning, con-tent, credibility, interactiv-ity, user-friendliness,visual design/innovationand user evaluation.

RadiologyInfo™ pro-vides patients and refer-

ring physicians simple yet thoroughdescriptions of diagnostic imaging,interventional radiology and radiationtherapy procedures and treatments. Residents Helped with

“Review for Residents” in RadiologyResidents will find content speciallytailored to their needs in the “Reviewfor Residents” section of Radiology.Noting that trainees as well as seniorprofessionals are Radiology readers,Editor Anthony V. Proto, M.D., andDeputy Editor Douglas S. Katz, M.D.,launched the section in January 2005.“Review for Residents” featuresappeared in July 2005 and November2005, and another, “The Solitary Pul-monary Nodule,” is slated for thismonth. Dr. Proto encourages anyoneinterested in writing such a review tocontact him regarding the topic. Poten-tial authors should also include a briefoutline of the items to be included inthe manuscript. Correspondenceshould be sent to radiology@rsna.orgor the Radiology Editorial Office,1001 East Broad Street, Suite 310,Richmond, VA 23219.

MEDICAL IMAGING COMPANY NEWS:

CytoCorp Becomes CytoCore■ CytoCorp, Inc., of Chicago, has changedits name to CytoCore, Inc. The new namebetter represents the company’s expandedproducts and markets, CEO David Weiss-berg said. CytoCore develops biomolecularcancer screening systems, used in a labora-tory or at a point of care, to assist in theearly detection of cervical, uterine, gastroin-testinal and other cancers.

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

National Academy of EngineeringElects Glover

THE National Acad-emy of Engineeringhas elected RSNA

Outstanding ResearcherGary Glover, Ph.D., as amember. A professor ofradiology and director ofthe Radiological SciencesLaboratory at StanfordUniversity, Dr. Glover isinternationally recog-nized as a pioneer in developingsystems and establishing standardsfor MR and CT imaging.

“I am, of course, extremelypleased to have been selected forthis prestigious award,” Dr.Glover said. “However, I reallyrepresent only the visible piece ofthe iceberg, and the real credit

goes to the dozensof colleagues inindustry and acade-mia and my incredi-bly bright studentswith whom I’ve hadthe joy and privilegeof working withover the years.”

Dr. Glover wasnamed an RSNA

Outstanding Researcher in 2001.Membership in the National Acad-emy of Engineering honors out-standing contributions to engi-neering research, practice andeducation, including pioneering ofnew and developing fields of tech-nology.

PEOPLE IN THE NEWS

Send news about yourself, a colleague or your department to rsnanews@rsna.org, 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.

GE Diagnostic Imaging has New CEOMark Vachon has beenpromoted to presidentand CEO of GE Health-care’s Diagnostic Imag-ing business, based inWaukesha, Wisc. Vachonreplaces Reinaldo Gar-cia, who has been namedpresident and CEO of GEHealthcare-International.Vachon has worked inseveral GE divisions and recently received thecompany’s annual Chairman Leadership Award.

AIUM Names Basic Science PioneerDouglas L. Miller,Ph.D., a research profes-sor of radiology at theUniversity of MichiganMedical School in AnnArbor, is the recipient ofthe American Institute forUltrasound in Medicine(AIUM) Basic SciencePioneer award. Theaward will be presentedthis month at the AIUMannual meeting in Washington.

Singleton is “Legend in Medicine”Edward B. Singleton, M.D., professor of radi-ology at Baylor College of Medicine and theUniversity of Texas Health Science Center inHouston and an RSNA 1995 Gold Medalist,was named an inaugural Legend in Medicineby the University of Texas Medical Branch inGalveston (UTMB). UTMB created the honorto recognize alumni who have influencedhealthcare in Texas and across the nation.

Dr. Singleton also is a recipient of goldmedals from the Society for Pediatric Radiol-ogy (SPR) and the American College of Radi-ology. He is a past-president of SPR and theSociety of Gastrointestinal Radiologists.

Talner Receives SUR Gold MedalLee B. Talner, M.D., aprofessor of radiology atthe University of Wash-ington Harborview Med-ical Center in Seattle,received a gold medalfrom the Society of Uro-radiology (SUR) at theSUR annual meeting inKauai, Hawaii.

Mark Vachon

Lee B. Talner, M.D.

Douglas L. Miller, Ph.D.

Edward B. Singleton,M.D.

Gary Glover, Ph.D.

4 R S N A N E W S A P R I L 2 0 0 6

RESEARCHERS at Johns HopkinsUniversity School of Medicineare perfecting a way to use MR

imaging to track stem cells as theyrepair damaged tissue in the body.

In a series of animal experiments,scientists incorporated miniscule ironoxide particles into mesenchymal stemcells deployed to repair damaged heartmuscle. The team then used MR imag-ing and a technique called InversionRecovery with ON-resonant water sup-pression, or IRON, to monitor the iron-labeled cells. The signal created by uti-lizing IRON MR imaging can be seenas a bright spot, making it easier forclinicians to see cells or metal devicesin the body. In a related experiment, theteam also used MR imaging and IRONto guide stent deployment.

These findings, presented lastNovember at the American Heart Asso-ciation meeting and published in a sup-plement to the journal Circulation, arebelieved to be the firstdemonstrations of howMR imaging and IRONMR imaging can be usedto assess the clinical bene-fit of cell-based therapies.

Techniques Provide Needed FeedbackMesenchymal stem cellsare found in bone marrowand have the potential todevelop into mature cells that producefat, cartilage, bone, tendons and mus-cle. Because they are in an early stageof development, they don’t trigger animmune response when placed insomeone else’s body, the researcherssaid.

Senior investiga-tor and veterinaryradiologist Dara L.Kraitchman, V.M.D.,Ph.D., an associateprofessor at JohnsHopkins, said shebelieves the tech-niques may providethe accuracy andimmediate feedbackclinicians need whenusing stem cells.“Previously, we weredelivering stem cells,even in pre-clinicalmodels, and we didn’t know if we gotour stem cells there,” she said. “If wedid get them there, what percentage didwe get there? Furthermore, do theyneed to stay in order to do any work?”

For two months after stem cellinjection into infarcted canine heart tis-sue, researchers used cardiac MR imag-

ing to monitor the dogs at weekly inter-vals. The damaged heart area decreasedsignificantly—by 120 percent—in ani-mals treated with stem cells as well asthose receiving no stem cell injections.However, the dogs receiving the stemcell injections maintained muscle

strength while the control heartsshowed steady signs of failure andreduced function.

Co-investigator Jeff Bulte, Ph.D., anassociate professor of radiology atJohns Hopkins, developed the magneticlabeling method. “Ideally, you want toinject the cells as close as you can to

the tissue they haveto repair,” he said.“With MRI you cando this in real time—the patient is thereand you can re-injectif necessary. The ver-ification of accurateinjection will be the#1 clinical applica-tion for this, I’msure.”

The research team made stem cellsvisibly distinct from all others by label-ing them with a metallic compoundmade up of iron oxide nanoparticlesless than one thousandth of a millime-ter in diameter. The microscopic parti-cles can be absorbed into the cells and

MR Imaging Used to TrackAccuracy and Effectiveness ofStem Cell Injections

FEATURE SCIENCE

Previously, we were delivering stem cells,

even in pre-clinical models, and we

didn’t know if we got our stem cells there.

If we did get them there, what percentage

did we get there? Furthermore, do they

need to stay in order to do any work?

Dara Kraitchman, V.M.D., Ph.D.

Jeff Bulte, Ph.D.

Dara Kraitchman,V.M.D., Ph.D.

5R S N A N E W SR S N A N E W S . O R G

are seen as bright spots rather than darksignal voids when using IRON MRimaging. “When you have somethingthat’s a loss of signal, you’re never sureif it is from your agent, if it is some-thing else in the image, or if it is some-thing you’re not expecting that is caus-ing the signal loss,” Dr. Kraitchmanexplained. “When you see somethingthat you’re expecting to become bright,you have a high level of confidencethat it is our original group of cells orthat it is the stent or other metal devicewe’re putting in the body.”

Dr. Kraitchman, with co-inventorsMatthias Stuber, Ph.D., and Wesley D.Gilson, Ph.D., visualized metal objectsby suppressing the vast majority of theconventional MR image produced fromwater molecules (the so-called on-reso-nant signal). By eliminating the signalsbased on water—the most commonsubstance in the body—the team sawonly signals produced from iron-labeled cells or metal objects (the so-called off-resonant signals). The brightsignals from the iron-labeled cellsallowed the team to differentiatebetween various concentrations of stemcells injected into infarcted canine hearttissue and the ischemic limb of rabbits.They also tracked the deployment ofconventional stainless steel stents intothe carotid and iliac arteries usingIRON imaging.

IRON Offers Benefits Over BiopsyMembers of the research team work-ing to develop magnetically labeledstem cells believe the method can bereplicated. “The technique can be eas-ily implemented and anybody shouldbe able to do it,” said Dr. Bulte.“These are clinical scans using clinicalinstruments.”

He also pointed out the advantageand real-time benefits of using MRimaging and IRON imaging, as opposedto biopsy, to track stem cells’ work.

“The IRON tracking technique orany MRI tracking technique is non-invasive,” Dr. Bulte said. “For biopsy, aneedle has to be inserted and tissue

needs to be removed, which is oftennot without risk. MRI can also be donerepeatedly to follow changes in abnor-mal or injured tissue.”

Although MR imaging can be usedin cellular labeling and tracking with-out IRON, Dr. Kraitchman said shebelieves clinicians are taking a seriouslook at the Hopkins results. “IRONimaging has the potential for imaginglabeled stem cells with a higher degreeof confidence or, perhaps, detectingsmaller numbers of cells due toenhanced contrast-to-noise ratios andthe ability to distinguish labeled cellsfrom other hypointense artifacts,” shesaid.

Kevin Johnson, M.D., assistant pro-fessor of diagnostic radiology at YaleUniversity School of Medicine andmedical director of Long Wharf Radi-ology, said he looks forward to hearing

more about the IRON method, particu-larly when results from human trialsare available. “If you could show thestem cells lighting up as bright areas inmyocardium, liver, kidney or otherplaces where you want to use stemcells, I think that would be very help-ful,” he said. “You prepare these stemcells and you put them in and you wantto know, did they go where they’re sup-posed to go? Are they staying wherethey’re supposed to be? It opens up allkinds of interesting possibilities.”

Studies are now under way at JohnsHopkins and elsewhere to test whetherMR imaging can assess stem cell loca-tions and effects in humans. ■■

■ To read the abstract for “Mesenchymal Stem Cells for Cardiac Regeneration,” from theAmerican Heart Association annual meeting go to www.abstractsonline.com/arch/RecordView.aspx?LookupKey=12345&recordID=20933.

Maximum intensity projection(MIP) from a 3D MR angiogram(MRA) of the distal aorta and iliacvessels. The colored region is thebright signal from IRON imagingof a stainless steel stent superim-posed on the MRA. Normally onMRA a metal object, such as astainless steel stent, will appear asa signal void. IRON imaging allowsreal-time placement of thesedevices, as well as imaging afterconventional x-ray deployment.Images courtesy of Dara L. Kraitchman, V.M.D., Ph.D.

Long axis cardiac MR image (left) shows hypointense spots from transmyocardialinjections of mesenchymal stem cells into the heart. The same imaging slice wascaptured at 1, 2 and 4 weeks after injection. In one area where cells were injectedin non-infarcted myocardium, the hypointense signal disappears, indicating thatthe stem cells had left the location.

6 R S N A N E W S A P R I L 2 0 0 6

ORGANIZERS of an RSNA-spon-sored workshop designed totrain more clinical investiga-

tors in the field of radiology havedeemed the inaugural outing a hugesuccess and are optimistic abouthow it can evolve over the nextseveral years.

“I’m bullish on this,” said Con-stantine A. Gatsonis, Ph.D., co-director of the Clinical TrialsMethodology Workshop, held Janu-ary 7–13 in Phoenix. “It has thepotential of becoming a distinctpart of what radiologists want to doas they develop careers in research.”

Co-director Daniel C. Sullivan,M.D., of Rockville, Md., agreed there isa need to train radiologists to conductclinical trials. Imaging is a critical partof many drug trials, he said, and nowthird-party payers and others also arebeginning to demand much more rigor-ous data to justify clinical decisions.

“If we just providea lot of tests and diag-nostic procedures topeople where we don’thave good data, we’rewasting money andresources we don’thave in our healthcaresystem,” said Dr. Sulli-van, chief of the CancerImaging Program (CIP)at the National CancerInstitute (NCI).

Twenty-five peopleattended this year’sworkshop. Another is planned for Janu-ary 6–12, 2007, in Phoenix. Partici-pants learn study design, statisticalmethods for imaging studies and regu-latory processes, as well as how todesign and execute multi-institutional

studies. The information was presentedvia lectures, small group discussionsand one-on-one mentoring, with manymore hours set aside for students tocreate their own study protocols.

Developing a Research CadreRSNA Board Liaison for Science GaryJ. Becker, M.D., of Tucson, Ariz., said

the RSNA ResearchDevelopment Commit-tee (RDC) began con-sidering the idea twoyears ago. In particularthe committee lookedto the success of a long-running annual clinicaltrials workshop hostedby the American Asso-ciation for CancerResearch (AACR) andAmerican Society ofClinical Oncology(ASCO).

“The product of the AACR-ASCOworkshop is an army of new clinicalresearchers,” Dr. Becker said, notingthat Dr. Sullivan had worked with theAACR-ASCO workshop and as a newmember of the RDC had encouraged

RSNA to consider a similar offering.“We thought it would be good if radiol-ogists could figure out a similar way totrain clinical investigators because wejust don’t have that many of them.”

Dr. Gatsonis, a professor of biosta-tistics and director of the Center forStatistical Sciences at Brown Univer-sity, has vast experience in imaging-based research and has served on thefaculty of the AACR-ASCO workshop.He said there’s a lot of room for growthin clinical trial research in radiology,both in scope and in overall quality.

“There’s not enough personnel inradiology who can really do this,” hesaid. “There’s a real need to develop aresearch cadre. This is the kind of thingradiology should be doing as a field toincrease the number of clinicalresearchers and also their level of abil-ity and skill.”

Workshop Goals MetDr. Becker said the team did its best toparallel the format and objectives of theAACR-ASCO meeting. Dr. Gatsonissaid most students, with the help ofabout 25 faculty, met the goal of pro-ducing a viable protocol by the end of

RSNA Workshop Addresses Needfor Clinical Trials Training

FEATURE CLINICAL TRIALS

Constantine A. Gatsonis,Ph.D.

Daniel C. Sullivan, M.D. Gary J. Becker, M.D.

There’s a real need to

develop a research cadre.

This is the kind of thing

radiology should be doing

as a field to increase the

number of clinical

researchers and also their

level of ability and skill.

Constantine A. Gatsonis, Ph.D.

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

the week and learned just how muchhard work and focus goes into design-ing a clinical study.

“It’s one thing to have a general ideaabout the protocol, but quite another tomake it into a real study,” he said.

Participant Fred M. Moselein,M.D., Ph.D., is in his final year of resi-dency in diagnostic radiology at theCleveland Clinic and will continue histraining as one of the clinic’s vascularand interventional radiology fellowsnext year. He said that before the work-shop, he found the process of protocoldevelopment very daunting.

“Now that I have completed thecourse, I feel that the task is realizable,although still daunting,” said Dr. Mose-lein, whose study involves novel adju-vant therapy coupled with chemoem-bolization to treat hepatocellular carci-noma. “More importantly, I feel that myresearch ideas are truly worth pursuing.”

“Total Immersion Experience”A majority of students are consideringstudies in oncology, though others arefocused on image-guided interventionand vascular and musculoskeletal radi-ology. Students were grouped by topic,giving them not only an opportunity toshare issues and challenges, but also todevelop a network on which to relywhen they return to their jobs.

During the workshop, students alsocapitalized on time devoted solely towriting their protocols, Dr. Becker said.Mapping out the background science,specific aims, hypotheses, informedconsent, methodological detail, statisti-cal design and myriad other elementsof a study can be next to impossible intoday’s work environment, he said.

The workshop was a “total immer-sion experience,” said participantJoseph Roebuck, Ph.D., M.D., of theDivision of Abdominal Imaging andIntervention in the Department of Radi-ology at Brigham and Women’s Hospi-tal in Boston.

“I left feeling energized and moreconfident that my clinical trial couldstand the ultimate test of peer review

and that it was worth the time andeffort it will require to complete,” saidDr. Roebuck, who plans to compare thepractical advantages of using MRimaging/MR spectroscopy-based meth-ods for detecting prostate cancer at 3 Tvs. 1.5 T.

Future Depends on FundingOrganizers said they want to ensurethat next year’s students come to theworkshop equipped with more informa-tion. Dr. Sullivan said an understandingof the fundamentals of clinical trialsand biostatistics, as well as knowledgeof their local institutional reviewboards and the kinds of studies towhich their colleagues would be will-ing to send patients, will help students

to be more productive.Dr. Sullivan added that interest in

future workshops will depend on howoptimistic would-be researchers areabout availability of funding. Organiz-ers too are considering financial issuesas they explore possibly covering thecosts of future workshops with industrypartnerships, sponsorships and grants.

Dr. Becker said RSNA will con-tinue to measure the success of theworkshop in terms of how many stud-ies are eventually implemented, addingthat he is excited about the possibilities.

“I’d like to see more clinical trial-ists in radiology and I’d like RSNA tobe right at the center of training them,”he said. ■■

■ The deadline to apply for the 2007 Clinical Trials Methodology Workshop is June 5, 2006.For more information, go to RSNA.org/Research/upload/Clinical_Trials_flyer2006.pdf or contact Fiona Miller at 1-630-590-7741 or fmiller@rsna.org.

Participants in the first RSNA Clinical Trials Methodology Workshop learned studydesign, statistical methods, regulatory processes and other information necessaryto develop a clinical protocol. The workshop was held in Phoenix.

8 R S N A N E W S A P R I L 2 0 0 6

RADIOTHERAPY after surgery forstage I endometrial cancer canincrease survival for high-risk

women, according to the largest retro-spective study performed to date.

Christopher M. Lee, M.D., and col-leagues retrospectively studied 21,249patients with American Joint Commit-tee on Cancer stage IA-C node-nega-tive endometrial adenocarcinoma usingdata from the Surveillance, Epidemiol-ogy, and End Result (SEER) programof the National Cancer Institute. Of themore than 21,000 women studied,4,080 (19.2 percent) received adjuvantradiation therapy. The study was pub-lished in the January 25 issue of TheJournal of the American Medical Asso-ciation (JAMA).

Although endometrial cancer is themost common gynecological malig-nancy in the United States, the optimaladjuvant therapy forstage I endometrialadenocarcinoma hasyet to be determined.Previously publishedrandomized trialsyielded mixed results.

“In the past, multi-ple randomized phasethree trials haverevealed that radiotherapy improveslocal control of disease in the pelvisafter surgery for endometrial cancer,but the effects on survival have beencontroversial,” commented Dr. Lee, ofHuntsman Cancer Hospital at the Uni-versity of Utah in Salt Lake City.“These data suggest that a survivalbenefit exists for select subsets of

patients with stage I disease who havehigh-risk features.”

The study showed that adjuvantradiation therapy significantlyimproved the overall and relative sur-vival for patients with stage IC/grade 1and stage IC/grades 3 and 4 endome-trial adenocarcinoma. A separate analy-sis of patients with surgical lymphnode examination produced similarresults.

According to studies published inObstetrics & Gynecology, The Lancet,Gynecologic Oncology, InternationalJournal of Radiation Oncology Biologyand Physics and Cancer, women withstage I disease who have undergonetotal hysterectomy and bilateral sal-pingo-oophorectomy and adjuvantradiation therapy have an overall five-year survival rate of 80 percent to 90percent. The subgroup of patients with

stage IC (more than 50percent myometrialinvasion) and high-grade disease haspoorer outcomes andhigher relapse rates,both local and distant.

“As the largestreported populationanalyses to date of

adjuvant radiation therapy in early stageendometrial adenocarcinoma, it is sig-nificant that our study reveals a benefitin overall and relative survival forpatients with high-risk stage I disease,”Dr. Lee explained. “This study confirmsbeneficial effects of adjuvant radiationon both local and distant tumor controlfor certain patient cohorts.”

Revolutionary Study“What Dr. Lee has done is entirelyrevolutionary,” said Beth A. Erickson,M.D., professor of radiation oncologyat the Medical College of Wisconsin/Froedtert Hospital in Milwaukee.“This is the first time anyone hasproven survival advantage with a largenumber of patients. As a radiationoncologist, I view it as a relative vic-tory for the specialty.”

Previous studies have frustratedradiation oncologists because theyevaluated a small number of patientswho were at low risk of cancer recur-rence, according to Dr. Erickson. Thedifference in survival is undetectable ina small, low-risk subset of patients, sheexplained.

The Lee study is the largest seriesof patients who have been retrospec-tively reviewed that has shown a dif-ference in survival with radiation. A

Adjuvant Radiation for Endometrial Cancer IncreasesSurvival, Study Shows

Christopher M. Lee, M.D.

FEATURE RADIATION ONCOLOGY

What Dr. Lee has done is

entirely revolutionary. …

As a radiation oncologist,

I view it as a relative

victory for the specialty.

Beth A. Erickson, M.D.

9R S N A N E W SR S N A N E W S . O R G

previous prospective study, by Aalderset. al., showed improvement in survivalfor women with high-risk features whoreceived pelvic radiation. However, therelatively small Gynecologic OncologyGroup (GOG 99) and the PostoperativeRadiation Therapy for EndometrialCarcinoma (PORTEC) trials did notfind a significant benefit from radiationin similar subsets of patients.

“The beauty of the Lee study isthat they evaluated the IC patients whohave a risk of recurrence,” Dr. Erick-son said. “They looked at thousands ofpatients and did find a survival differ-ence with the addition of radiation. Dr.Lee studied the right subgroups and anumber of large patients, thus avoidingthe flaws of the previous studies.”

Treatment RamificationsDr. Erickson said she frequently usesradiation for stage I endometrial can-cer. Radiation oncologists at the Med-ical College of Wisconsin use externalbeam to treat the lymph nodes and thevagina, and vaginal brachytherapy totreat the vagina only.

The Lee research will impact radia-tion oncology, she said. “If a womanhas had just a few lymph nodes sam-pled, I automatically now would say‘this patient with IC disease, with neg-ative nodes, needs radiation becausethere is a survival advantage,’ ” shesaid.

Dr. Lee added that the study hasproven helpful not only in clinicaldecision-making, but also in counsel-ing patients and families. “In treatmentdecisions and counseling sessions withpatients, we now utilize this informa-tion in addition to previously reportedstudies in the literature to aid in tailor-ing the post-operative treatment plan tothe individual patient,” he said.

The Lee article also could influ-ence the extent of surgeries performed,Dr. Erickson said. “If gynecologic

oncologists are more conservative interms of the number of lymph nodesthat they remove, then this may have abig impact on referred patients andradiation oncologist-recommendedtreatment,” she said. “The surgeons arethe gatekeepers. The aggressiveness ofthe resection determines which patientswe treat. Often, so many lymph nodeshave been removed that we don’t wantto add radiation because it couldincrease complications.”

“It should be emphasized that sta-tistical analysis cannot replace clinicaljudgment when considering the indi-vidual patient, tumor characteristics,and the potential risks and benefits ofadjuvant radiation therapy,” Dr. Leeconcluded. “We are hopeful that future

research will continue to delineate clin-ical and biological factors that canguide treatment decisions among var-ied patient subsets.” ■■

■ To view the abstract of Dr. Lee’s study, “Frequency and Effect of Adjuvant Radiation Therapy Among Women With Stage I Endometrial Adenocarcinoma,” go to jama.ama-assn.org/cgi/content/abstract/295/4/389.

Kaplan-Meier curves for overall survival of patients with stage IC/high-gradeendometrial adenocarcinoma with or without adjuvant radiotherapy. Figure courtesy of Christopher M. Lee, M.D.

10 R S N A N E W S A P R I L 2 0 0 6

SOME PEOPLE with brain metastasescan live much longer thanexpected if managed aggressively

with radiosurgery, according to newresearch.

“It is difficult to pick the best can-didates at the beginning,” said studyauthor Douglas Kondziolka, M.D.,M.Sc., of the Department of Neurologi-cal Surgery at the University of Pitts-burgh Medical Center. He and co-author L. Dade Lunsford, M.D., serveas consultants for Elekta Instruments,Inc., manufacturer of the GammaKnife. Their study appeared in theDecember 15, 2005, issue of the jour-nal Cancer.

Over the last decade, more andmore institutions have begun treatingbrain metastases with radiosurgery,powerful focused radiation adminis-tered in a single session to the tumor,with or without additional whole-brainradiation.

Dr. Kondziolka and colleagues con-ducted their study tofind out why some braintumor patients whounderwent radiosurgerywere doing much betterthan anyone would haveexpected.

“Through the 1990s,the general expectationfor patients with brain metastases whowere managed aggressively was anaverage survival of about a year,” saidDr. Kondziolka. “And yet, there werepeople who were clearly living manyyears longer than this. We wanted tounderstand why. Who were these peo-ple? Why were they beating the odds,so to speak?”

The researchers studied 677patients with brain metastases who

underwent radiosurgery proceduresbetween 1988 and 2000. They reportedthat 44 of the patients (6.5 percent)were still alive four or more years afterradiosurgery.

“I think the most surprising findingwas that for many of these people, onewould not have initially predicted thatthey would have been in this long-termsurvivor group,” said Dr. Kondziolka.“That’s because the extent of their can-cer was more than just to the brain.”

Survivors included patients withprimary cancers of the lung, breast,kidney, skin and other sites. Eighteenof the surviving patients had cancer intwo or more organs outside the brain.“People in that group, one would pre-dict, would do the worst,” Dr. Kondzi-olka said. “But almost half of the entirelong-term survivor group included peo-ple who had multiple organs involved.At the beginning one would have beenfairly nihilistic and not predicted thatthey would have done very well.”

David H.Hussey, M.D., 2005RSNA president anda clinical professorin the Department ofRadiation Oncologyat the University ofTexas Health Sci-ence Center at San

Antonio, said he was impressed that afair number of the survivors hadadvanced cancers. “Fifteen of thepatients that were long-term survivorshad lung cancers,” Dr. Hussey said.

Compared with patients who diedwithin the first three months afterradiosurgery, those who lived morethan four years showed no differencesin age, gender, percentage of lung car-cinoma, melanoma or renal cell carci-

noma, radiosurgery margin dose, use ofprior whole-brain radiation therapy,volume of the largest tumor or totaltumor volume.

The patients who beat the odds hadhigher pre-radiosurgery Karnofsky per-formance scores, fewer metastases andless extracranial disease burden thanthose who died in the early monthsafter radiosurgery.

“For the vast majority of people,we were able to get the brain tumorunder control, but most were dyingbecause of their systemic cancers,” Dr.Kondziolka said. “Obviously, for thepeople who lived, we learned that thereason they lived was because we wereable to bring the brain burden undercontrol and the body cancer was alsobrought under control.”

The median survival of the patientswas 68 months. Sixteen patientsremained alive at the time of last fol-low-up, with a maximum survival of156 months so far.

“I was impressed,” Dr. Hussey said.“I probably wouldn’t have wanted to

Long-Term Survival Possible AfterRadiosurgery for Brain Cancer

Douglas Kondziolka, M.D., M.Sc.

FEATURE MEDICINE IN PRACTICE

Effective and curative care

—not just palliative care—

can be provided for

brain tumors.

Douglas Kondziolka, M.D., M.Sc.

Continued on page 12

11R S N A N E W SR S N A N E W S . O R G

IF RADIOLOGISTS do not adopt a proac-tive approach to develop and imple-ment international teleradiology stan-

dards, they may be left out of the dis-cussion, according to a radiologist whomoderated an RSNA 2005 special focussession on international teleradiology.

“For professionalism and for thecare of our patients, we must take con-trol of the debate and the developmentof clinical teleradiology,” saidLawrence S. Lau, M.D., of MonashUniversity and director of the Depart-ment of Diagnostic Imaging at SouthernHealth in Melbourne, Victoria, Aus-tralia. “This is why professional organi-zations are trying to lead and facilitatesuch development.”

International teleradiology—hiringoverseas doctors to interpret films dur-ing their daylight hours—emerged as anappealing option as U.S. healthcareadministrators struggledto ease the radiologistshortage of a few yearsago. As teleradiologynow rapidly expands,those same leaders arelooking for acceptablequality standards.

While dramaticimprovements in computer technologyand image clarity, as well as the wide-spread adoption of Picture Archiving andCommunication Systems (PACS), helpedlessen the impact of the radiologist short-age, teleradiology has become the“norm” for hospital emergency depart-ments worldwide seeking image interpre-tation in the middle of the night. In addi-tion to the so-called “nighthawks,” thereare a growing number of companiesoffering “dayhawk” services as well.

Radiologists and radiology deci-sion-makers from the U.S., Great

Britain, France and Australia partici-pated in the RSNA 2005 session, “Inter-national Collaboration in Clinical Tel-eradiology.”

Clinical teleradiology has been usedin Australia, where Dr. Lau practices,for more than 10 years. It was first usedto offer primary interpretation or secondsubspecialty opinions to patients inremote areas, then to balance workloadsamong hospitals. In his study, “ClinicalTeleradiology in Australia: Practicesand Standards,” Dr. Lau reported thatthe reasons for the expansion of clinicalteleradiology in Australia mirror thosein the U.S.—increasing demand forradiology services, radiologist shortagesand technical advances in image pro-duction, image storage and transmissionacross secure virtual private networks.

While a radiologist in San Franciscomight not think much about a counter-

part reading images inMelbourne, Dr. Lausaid clinical teleradi-ology will affect thedaily work of all radi-ologists.

“Teleradiologywill affect the care ofpatients and alter

radiologists’ interactions with refer-rers,” said Dr. Lau, who is immediatepast-president of The Royal Australianand New Zealand College of Radiolo-gists (RANZCR), chair of the MedicalImaging Accreditation Advisory Com-mittee for RANZCR/NATA (NationalAssociation of Testing Authorities) andchair of the International RadiologyQuality Network (IRQN). “It mayaffect how they will be reimbursed fortheir services and how they may becovered for malpractice.”

Image Clarity No Longer Primary ConcernArl Van Moore Jr., M.D., a radiologistspecializing in interventional radiologyand body imaging with Charlotte Radi-ology, PA in Charlotte, N.C., said imageclarity is no longer the primary concernwhen it comes to teleradiology. “We areconcerned about unqualified radiolo-gists, other physicians and non-physi-cians providing reports,” he explained.

Dr. Van Moore is vice-chair of theBoard of Chancellors of the AmericanCollege of Radiology (ACR) and chairof the ACR’s Task Force on Interna-tional Teleradiology, which issued awhite paper last year on the major chal-lenges facing teleradiology.

The taskforce concluded that radiolo-gists interpreting images off-site must becredentialed, on the staff of a hospitaland licensed in the states they serve, aswell as carry liability insurance coverage.The taskforce also recommended that allradiologists providing image interpreta-tion—both in and out of the U.S.—docu-ment their participation in a qualityassurance program that is the same orbetter than the quality assurance pro-grams of their institutions.

In addition, the ACR report served

Leaders Look to EstablishTeleradiology Standards

FEATURE HOT TOPIC

Teleradiology will affect the

care of patients

and alter radiologists’

interactions with referrers.

Lawrence S. Lau, M.D.

Lawrence S. Lau, M.D.

Continued on next page

12 R S N A N E W S A P R I L 2 0 0 6

as a reminder to radiologists who hireoutside image interpreters that they, andthe interpreters, are subject to state andfederal privacy laws, including theHealth Insurance Portability andAccountability Act (HIPAA). ACR isnow working with several internationalradiology societies to develop teleradi-ology standards.

International StandardsDr. Lau said IRQN is working on anumber of steps to harmonize andimplement international teleradiologystandards, including:• Reviewing the existing range of stan-

dards, identifying similarities and dif-ferences and developing a set of basic

principles to underpin the develop-ment of international teleradiologystandards.

• Recognizing the need for close inter-national collaboration. “Globalizationis the key driver to harmonize theexisting international standards toavoid confusion. Our aim should be aset of consensus requirements recog-nized across jurisdictions and servingthe interest of all stakeholders,” Dr.Lau said.

• Understanding the difference betweenstandards and guidelines. Standardsare mandatory, while guidelines are

recommendations.• Making differing standards/guidelines

between jurisdictions more consistent.“Teleradiology is practiced interna-tionally as well as within a countryand among local hospital networks,”Dr. Lau said.

• Developing a system to implement thestandards and guidelines. Thisincludes establishing an accreditationsystem and determining who shouldenforce it. “This is a medium- andlong-term project requiring under-standing and close collaboration of allstakeholders,” Dr. Lau said. ■■

AS RADIOLOGISTS and other physicianswork to establish standards for health-

care outsourcing, particularly teleradiology,they should not lose sight of the opportuni-ties they have to preserve and enhance in-person practices, according to a perspectivein the February 16 issue of The New EnglandJournal of Medicine.

“The radiologist who not only reads his col-leagues’ radiographs but also discusses impor-tant findings with them may be less likely tobe replaced by a practitioner living a dozentime zones away,” wrote Robert Wachter,M.D., associate chairman of the Department

of Medicine at the University of CaliforniaSan Francisco, in “The ‘Dis-location’ of U.S.Medicine—The Implications of Medical Out-sourcing.”

“Competition may make us more respon-sive to the needs of our patients and col-leagues, even as it extracts waste from thesystem,” Dr. Wachter said.

While outsourcing can achieve cost andtime efficiency when done properly, Dr.Wachter said it also has the potential todiminish healthcare quality and hurt thelocal healthcare economy. He said physiciansexpecting modest growth in healthcare out-

sourcing need look no further than the tele-marketing industry to realize how quicklythe field may grow.

“The outsourcing of healthcare will growand it will challenge traditional arrangementsbetween patients and both physicians andinstitutions,” said Dr. Wachter. “It willrequire rapid and thoughtful development ofnew ethical, legal and quality standards andit will be controversial.”

The full text of Dr. Wachter’s perspectiveis available free at content.nejm.org/cgi/content/full/354/7/661.

❚

Teleradiology Featured in The New England Journal of Medicine

■ To view the abstract for the RSNA 2005 session, “International Collaboration in ClinicalTeleradiology,” go to the RSNA Meeting Program at rsna2005.rsna.org. The direct link isrsna2005.rsna.org/rsna2005/V2005/conference/event_display.cfm?em_id=4404462.

Continued from previous page

go to the expense and difficulty of hav-ing radiosurgery if I personally had ametastasis in my brain. After readingthis paper, maybe I would.”

The researchers concluded thatwhile the expected survival of patientswith brain metastases may be limited,select patients with effective intracra-nial and extracranial treatment formalignant disease can have prolonged,good-quality survival.

Dr. Kondziolka said radiosurgery isjust starting to move to spinal applica-

tions, with some additional reportsregarding the use of focused radiationin lung tumors.

“For other organs, such as the pan-creas and liver, there’s a potentialopportunity, but it’s just beginning,” Dr.Kondziolka added.

He said an American College ofSurgeons study is focusing not only onsurvival, but also on quality of life, inpatients who undergo radiosurgery orwhole-brain radiation.

“There have been significant gainsmade in the management of brain

metastases over the last decade,” hesaid. “Effective and often curativecare—not just palliative care—can beprovided for a brain tumor. Radio-surgery can be an effective approachfor such patients, together with theirsystemic cancer management.” ■■

■ To read the abstract for Dr. Kondziolka’sstudy, “Long-Term Survivors After GammaKnife Radiosurgery for Brain Metastases,”go to www3.interscience.wiley.com/cgi-bin/abstract/112142382/ABSTRACT.

Long-Term Survival Possible After Radiosurgery for Brain CancerContinued from page 10

13R S N A N E W SR S N A N E W S . O R G

Imaging of Fistula in Ano

PREOPERATIVE MR imaging findingshave been shown to influence subse-

quent surgery and markedly diminishthe chance of recurrent disease inpatients with fistula in ano (anal fistula).The common condition has a tendencyto recur despiteseemingly ade-quate surgery, and recurrence is usuallydue to infection that escaped surgicaldetection and thus has gone untreated.Preoperative imaging, notably MRimaging, can help identify infectedtracts and abscesses that would other-wise have been missed.

In an article in the State of the Artsection of the April issue of Radiology(RSNA.org/radiologyjnl), Steve Halli-gan M.D., F.R.C.P., F.R.C.R., of the

Department of Specialist Radiology atUniversity College Hospital in London,and Jaap Stoker, M.D., Ph.D., of theDepartment of Radiology at the Acade-mic Medical Center in Amsterdam, theNetherlands:

• Detail the pathogenesis of fistula inano

• Explain how pathogenesis causes thedifferent types of fistula encountered

• Describe how these types can be

Gastrointestinal StromalTumor: Role of CT in Diagnosis and in ResponseEvaluation and Surveillanceafter Treatment with Imatinib

CT IS THE imaging modality ofchoice for diagnosing gastroin-

testinal stromal tumors (GISTs), as wellas monitoring the effects of treatmentand detecting tumor progression. GISTsare the most common nonepithelialtumors of the gastrointestinal tract, withan estimated 4,500 to 6,000 new casesreportedeach year inthe U.S. Imatinib, a new molecularlytargeted tyrosine kinase receptorblocker, results in a dramatic responseand markedly improved long-term sur-vival in patients with GISTs.

In an article in the March-April

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

Development of an intratumoral hemorrhage as an adverse effect of ima-tinib in a 60-year-old woman with recurrent small bowel GIST in the liver. (a) Pretreatment contrast-enhanced CT scan shows multiple heterogeneous hepatic metas-tases with moderately enhancing solid nodules at the peripheries (arrows). Prominent tumorvessels (arrowheads) are noted within the masses. (b) Contrast-enhanced CT scan obtained 2months after imatinib treatment shows that the tumors (arrows) have become homogeneousand the enhancing tumor nodules have markedly resolved, indicating a good response to thetreatment. (c) Unenhanced CT scan from the same data acquisition shows a fluid-fluid levelwithin the smaller tumor (black arrow); the fluid-fluid level was caused by an intratumoralhemorrhage. The attenuation of the smaller tumor increased from 73 HU to 115 HU. Whitearrow = larger tumor.(RadioGraphics 2006;26:481-495) © RSNA, 2006. All rights reserved. Printed with permission.

RSNA JOURNALS

Fistulography in a male patient. Coronal image shows several obvious highextensions (arrows) surrounding theanorectal junction; however, the exactanatomic location of these is unclearbecause the pelvic floor (i.e., levator aniin this case) cannot be directly visual-ized. Definition of extension location(supra- or infralevator) is central to sur-gical management.(Radiology 2006;239:18-33) © RSNA, 2006. All rights reserved.Printed with permission.

Continued on page 15

Continued on page 15

ba c

RSNA JOURNALS

A press release has been sent to the medical news media for the following articleappearing in the April issue of Radiology (RSNA.org/radiologyjnl):

in Public Focus

Imaging of Breast Cancer Diagnosedand Treated withChemotherapy during Pregnancy

MAMMOGRAPHY andsonography have acomplementary role

in imaging the pregnantpatient, while sonographyshould be used as the initialimaging modality in symp-tomatic pregnant women,researchers at the Univer-sity of Texas M.D. Ander-son Cancer Center haveconcluded.

Wei Tse Yang, M.D.,and colleagues retrospec-tively assessed mammogra-phy, high-frequency-trans-ducer ultrasonography andcolor Doppler ultrasonogra-phy for initial and subse-quent evaluation of breastcancer diagnosed andtreated with chemotherapyduring pregnancy. The teamstudied 23 women in whom24 cancers were imaged between Janu-ary 1989 and December 2003. Threecancers were imaged withmammography alone, fourwith sonography alone and 17with both mammography andsonography.

“Breast cancer diagnosedduring pregnancy is mammo-graphically evident despitedense parenchymal back-ground,” the team wrote.“Ultrasonography, when performed,demonstrates all masses and provides

information regarding response toneoadjuvant chemotherapy.”

Mammographyremains useful in diag-nosing breast cancer dur-ing pregnancy, the teamconcluded, as it maydemonstrate malignantcalcifications not imagedat ultrasonography. “Webelieve mammographyshould be performed on

pregnant women with a diagnosis ofinvasive or in situ malignancy,” the

team wrote. “Both breasts of the preg-nant woman with a diagnosis of breastcancer should be imaged to rule outbilateral malignant disease.”

14 R S N A N E W S A P R I L 2 0 0 6

Palpable mass at 20 weeks gestation in a 33-year-old woman. (a) Bilateral craniocaudal mammograms show no abnormality despite palpable mass (skinmarker) in right breast. (b) Sonogram with extended-field-of-view imaging shows index pal-pable lesion as irregular mass with indistinct margins (short arrow) and as associated withmass in separate quadrant (long arrow), which confirms multicentric disease. (c) TransverseUS scan shows three separate nonpalpable solid nodules with indistinct margins (arrows),consistent with multifocal disease. (d) Transverse power Doppler US in infraclavicular regionshows oval, homogeneously hypoechoic node (arrows) deep to pectoralis major (��) and pectoralis minor (+) muscles. Adjacent vessel is yellow-orange.(Radiology 2006;239:52-60) © RSNA, 2006. All rights reserved. Printed with permission.

ba

c d

15R S N A N E W SR S N A N E W S . O R G

Media Coverage of RadiologyStories generated from twoarticles in the February issueof Radiology reached anestimated 98 million peopleworldwide.

Stories regarding the useof functional MRI (fMRI)for lie detection (Radiology2006;238:679-688) were

featured on CNN’s AndersonCooper 360°, the DiscoveryHealth channel, WGN-TVand Fox News, as well as inthe Boston Herald, Philadel-phia Inquirer, WashingtonTimes and Reuters Health-care. Stories also appearedon the Internet news outlets

Yahoo! News, Forbes.comand Excite.com and in one ofItaly’s national daily news-papers, La Repubblica.

A study on using SPECTto guide lower back paintreatment (Radiology2006;238:693-698) was thesubject of stories featured by

the Los Angeles Times andIvanhoe Broadcast News, aswell as Internet news outletsDoctor’s Guide, MedPageToday and Medical NewsToday. The Society ofNuclear Medicine alsoshared this story with itsmembers.

imaged, with the emphasis on MR• Describe how the radiologist is well

placed to answer the surgical ques-tions that must be solved for treat-ment to be effective

“In those patients with fistula inano who have a high likelihood ofcomplex disease, the evidence that pre-operative MR imaging influences thesurgical approach and the extent ofexploration and improves the ultimateoutcome is now overwhelming,” Drs.Halligan and Stoker concluded.

issue of RadioGraphics (RSNA.org/radiographics), Xie Hong, M.D.,Ph.D., and colleagues from the Univer-sity of Texas M.D. Anderson CancerCenter in Houston:• List the clinical features and imaging

findings of GISTs• Describe how GISTs

can be diagnosed on the basis of theimaging findings

• Discuss the use of imaging in evaluat-ing the response to imatinib treatmentand in detecting tumor progression

The authors noted that contrast-enhanced CT is as reliable as fluo-rodeoxyglucose (FDG) PET in evaluat-ing treatment responses, assuming thatchanges in enhancement patterns aretaken into account along with the tradi-tional measure of tumor size. FDG PET

is indicated whenever CTfindings are inconsistent

with the clinical presentation or areinconclusive, the authors stated, addingthat a short-term follow-up CT studycan be a good alternative when FDGPET is not available.

This article meets the criteriafor 1.0 CME credit.

Imaging of Fistula in AnoContinued from page 13

Gastrointestinal Stromal Tumor: Role of CT in Diagnosis andin Response Evaluation and Surveillance after Treatmentwith ImatinibContinued from page 13

EDUCATION RESEARCH

Program and Grant Announcements

NEW!

NIH Pathway to Independence Award Program

THE NEW National Institutes ofHealth (NIH) Pathway to Inde-pendence Award program

allows postdoctoral scientiststo receive both mentored andindependent research supportfrom the same award.

NIH expects to issuebetween 150 and 200 awards for thisprogram each of the next five years,with the first awards issued this fall.

NIH will spend almost $400 millionon the program, which is part of a

larger NIH effort to supportnew scientists as they tran-sition to research inde-pendence.

For more informationon the NIH Pathway to Inde-

pendence Award program, go tohttp://grants.nih.gov/grants/guide/pa-files/PA-06-133.html. Continued on next page

16 R S N A N E W S A P R I L 2 0 0 6

EDUCATION RESEARCH

Program and Grant Announcements

Introduction to Research ProgramRSNA/AUR/ARRS • Application deadline – July 15

RSNA, the Association of Uni-versity Radiologists (AUR) andthe American Roentgen RaySociety (ARRS) offer this Intro-duction to Research program forsecond-year residents. The pro-grams will be held during RSNA2006, November 26–December 1at McCormick Place in Chicago,and during the 2007 ARRS meet-ing, May 6–11 at the GrandeLakes Resort in Orlando, Fla.

The program aims to encour-age young radiologists to pursueresearch careers by:• Introducing residents to

research early in their training• Demonstrating the importance

of research to the practice andfuture of radiology

• Sharing the excitement and sat-

isfaction of research careers inradiology

• Introducing residents to suc-cessful radiology researchers,future colleagues and potentialmentors

The program will cover suchtopics as designing a researchquestion, finding a mentor, criti-cally reviewing scientific litera-ture and publishing a manuscriptin Radiology.

Nominations must be madeby the candidate’s departmentchair or training director and arelimited to one nomination perdepartment. Eighty residents willbe selected to attend the annualmeeting of either RSNA orARRS. Applications are availableat RSNA.org/i2rapp.

More than 90 people attended the fourth Biomedical Imaging and Research Opportunities Workshop (BIROW 4) in NorthBethesda, Md., February 24–25. The goal of BIROW is to identify and explore new opportunities for basic science researchand engineering development in biomedical imaging, as well as related diagnosis and therapy. BIROW is sponsored by RSNA,Academy of Radiology Research, American Association of Physicists in Medicine, American Institute for Medical and Biologi-cal Engineering and Biomedical Engineering Society.

Molecular Imaging in MedicineRSNA/SNM/SMI • August 29-30, Hilton Waikoloa Village,Hawaii

HELD BEFORE the annual meeting of the Societyof Molecular Imaging (SMI), this symposium

will provide an introduction and overview ofmolecular imaging to radiologists, nuclear medi-cine physicians, neuroradiologists and other physi-cians. Topics will include:• Molecular biology for imaging scientists • Advances in PET imaging technology and new

PET imaging agents • Advances in MR imaging technology and new

MR imaging agents • Advances in optical technology and new optical

imaging agents • Molecular basis of cancer, cardiovascular

disease and neurological disorders • Clinical applications of new technology and tracers

The symposium is sponsored by RSNA, Soci-ety of Nuclear Medicine and SMI. More informa-tion is available at www.molecularimaging.org/2006meeting/preconferencesymp06.php.

BIROW 4

Continued from previous page

17R S N A N E W SR S N A N E W S . O R G

ACTIVITIES of the RSNABoard of Directors are sup-ported by the Executive

Department. Under the directionof Barbara Jarr, director of boardaffairs, the department helpsdevelop Board agendas, coordi-nate meetings, implement Boardactions and keeprecords. The departmentalso oversees the annualcommittee appointmentprocess, maintaining adatabase of RSNAmembers who have volunteered to serve onRSNA’s approximately 90 committees, sub-committees and editorial boards.

The department also supports RSNA’s

strategic planning process and the interactionof RSNA Officers and Board members withthe leadership of other national and interna-tional radiology organizations.

The Executive Department reports to DaveFellers, C.A.E., executive director of RSNA.

Working For You

RSNA MEMBER BENEFITS

Online CME Credits via RadioGraphics Increase in 2005RSNA awarded more than 63,000CME credits to users accessing Radio-Graphics online and mailing in Radio-Graphics postcards in 2005. This is a 6 percent increase over 2004. OnlineCME via RadioGraphics can beaccessed through the RSNA EducationPortal at RSNA.org/education. Click onInteractED® and then RadioGraphicsCME Tests/Education Exhibits.

Approximately 43,000 CME creditswere awarded by InteractED, whichoffers more than 300 peer-reviewedprograms as an RSNA member benefit.

RadioGraphics Editor and RSNAEducation Editor William W. Olmsted,

M.D., said he is enthusiastic about theincrease in CME use.

“RSNA is the major contributor tothe continuing educa-tion of radiologists aswe move into the era ofmaintenance of certifi-cation,” Dr. Olmstedsaid. “Journal-basedCME, self-assessmentmodules, and interac-tive online learningmaterials are going to be extremelyimportant to practitioners as weadvance in these areas in education.”

Virtual Monographs, collections of

important topics and materials fromRadioGraphics and InteractED, alsocan be accessed from the RSNA Educa-

tion Portal by clickingContinuing ProfessionalDevelopment and thenRSNA Education Col-lections. The AFIPArchives, topics withradiologic-pathologiccorrelation from theArmed Forces Institute

of Pathology receive the most hits eachmonth of any of the Virtual Mono-graphs.

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 membership@rsna.org.

(from left) Natalie Enriquez, Barbara Jarr, Director,Judy Marton, Gina Tepavchevich,Debra Brody

RSNA ExecutiveDepartment

Workingfor you

DEPARTMENTPROFILE

18 R S N A N E W S A P R I L 2 0 0 6

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 rsnanews@rsna.org. Information may be edited for purposes of clarity and space.

NEW PRODUCTS

New Treatments for Radiation Dermatitis, XerostomiaAlign Pharmaceuticals (www.alignpharma.com) has introduced new products for thetreatment of radiation dermatitis and xerostomia.

Xclair™ Cream is water-based and intendedto hydrate skin and provide protective barriersto maintain skin integrity during the course ofradiation therapy. The cream contains nosteroids or alcohol and is fragrance-free.

Numoisyn™ Lozenges and Numoisyn™ Liq-uid are designed for people who experiencexerostomia while undergoing radiation treat-ment for head and neck cancers. The lozengesare saliva stimulants for people with some sali-vary function, while the liquid is a salivareplacement for people with little or no salivaryfunction.

RADIOLOGY PRODUCTS

NEW PRODUCT

New Ergonomic Reading Station

BROADWEST CORPORATION

(www.broadwest.com) nowoffers the E-Carrell™

ergonomic reading station.Designed for softcopy reading, theE-Carrell maintains ambient andbackground luminance in an opti-mal ratio for viewing productivity.

The height, monitor stands anddesktop surface angle are adjustableand the station also has a privacyand sound barrier. The lighting sys-tem includes a downward task light,a background light behind the mon-itors and an upward ambient light.

NEW PRODUCT

Lighter Lead-FreeRadiation Protec-tion ApronsAliMed Inc. (www.alimed.com)has introduced its new line oflightweight StarLiteLead-Free Radia-tion Protec-tion Aprons.The apronsweigh up to20 percent lessthan standardlightweight,lead-freeaprons andoffer protec-tion equal to0.5-mm Pb at100kVp. Theaprons are availablein several styles includingQuick Drop and Wraparound.

PRODUCT VIDEO

Fluke Biomedical Offers Instructional VideoFluke Biomedical RadiationManagement Services(www.flukebiomedical.com/rms) has launched aninstructional video on itsWeb site featuring the Hal-cyon Cantilever Board™

designed for intensity-mod-

ulated radiation therapy(IMRT) of head and neckcancer.

Fluke Biomedicaldesigned the Halcyon Can-tilever Board to allow for afull 360° treatment withminimal attenuation. The

board also was designed toincrease setup reproducibil-ity and reduce patientmotion without requiring alarge sheet of thermoplasticto the shoulders.

19R 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 & Education Foundation and its

recipients of research and education grant support gratefully acknowledge the con-tributions made to the Foundation between January 21 – February 17, 2006.

For more information on Foundation activities, go to RSNA.org/foundation.

PRESIDENT’S CIRCLE

William M. Angus, M.D., Ph.D. Claudia I. Henschke, Ph.D., M.D.John W. Thomas, M.D. Scott S. White, M.D.

$1,500 per year

SILVER ($200 – $499)Jung & Sungkee S. Ahn, M.D. Teresa A. Buendia-Alejo, M.D. & LolitoD.C. Alejo

Yoshimi Anzai, M.D. Theresa Aquino, M.D. Jeanne W. Baer, M.D. Brent W. Beahm, M.D. Dianne H. & Daniel D. Beineke, M.D. Ladikpo D.C. Bellow, M.D. Rebecca L. Belsaas, M.D. & RichardBelsaas

Sonia Bermudez, M.D. Paul A. Bilow, M.D. Maud & Erik Boijsen, M.D. Kim D. Burroughs, M.D. Bernice M. Capusten, M.D. John B. Carico, M.D. Kyu-Ho Choi, M.D. William Chuang, M.D., Ph.D. Winston Franklin B. Clarke, M.D. Ronald J. Cocchiarella, M.D. Edgar Colon, M.D. Mary Louise & Basil Considine Jr., M.D. Michael A. Crew, M.D. Philip M. Ditmanson, M.D. Suzanne & Richard L. Dobben, M.D. Paul E. Dybbro, M.D. Barbara R. & Frederick A. Eames, M.D. Svein-Dag Eggesbo, M.D. Erwin H. Engert Jr., M.D. Victoria & Eugenio Erquiaga, M.D. William A. Finger, M.D. Marcos Flajszer, M.D. Jessica & W. Dennis Foley, M.D. Tse C. Fong, M.D. James M. Forde, M.D. Wolfram R. Forster, M.D. Juan D. Gaia, M.D. Martin Garcia, M.D. Alfonso Gay Jr., M.D. Joyce & Herbert Gerstein, M.D. Robert Gould, M.D. William R. Green, M.D. In honor of Carolyn Ann Green

Charles K. Grimes, M.D. Dale W. Gunn, M.D. Joseph H. Harpole Jr., M.D. Richard S. Hartman, M.D. Anita E. Hawkins, M.D.

Michael W. Hill, M.D. Ann Yoshida & Milton W. Hummel, M.D. M. Denisse Hurvitz, M.D. Uchenna J. Ikokwu, M.B.B.Ch. &Chibeze Ikokwu

Kerrie & William T. Jacoby, M.D. John T. James, D.O. Eric D. Johnson, M.D. Lyne Noel de Tilly, M.D. & Edward E.Kassel, M.D. In memory of Derek Harwood-Nash,M.D., D.Sc.

Paul T. Khoury, M.D. Tae Woo Kim, M.D. Anthony L. Kudirka, M.D. Yen-Zen Kuo, M.D. Patricia Silva, M.D. & Richard E.Latchaw, M.D.

Craig A. Lehman, M.D. Henri E.A.S.J. Lemmers, M.D. Errol Lewis, M.D. Zhongxing Liao, M.D. Angelica Torres Aguirre & Jesus A.Loza, M.D.

Paul A. Lyle, M.D., Ph.D. Paulette & David E. Magarik, M.D. Janine R. Martyn, M.D. Manuel Filipe D.E.C. Matias, M.D. John G. McAfee, M.D. Michelle D. McDonough, M.D. Robert M. McFarland II, M.D. James A. McGee, M.D. Barry D. McGinnis, M.D. Philippe J. Mercier, M.D. Stephanie A. Miske, M.D. Kieran J. Murphy, M.D. Elise & David B. Neeland, M.D. John D. Newell Jr., M.D. Kazuyuki Ohgi, M.D. James I. Okoh, M.D. Adriana Cabrera & Juan P. OrnelasBanuelos, M.D.

Thomas W. Peltola, M.D. Steven Peyser, M.D. James B. Philipps, M.D. Rita Squaranti, M.D. & GianfrancoPissolesi

Linda & Alan Pollack, M.D., Ph.D. Michael F. Quinn, M.D. Christine A. Quinn, M.D. Vathsala T. Raghavan, M.D.

Connie S. Crawford-Rahn & Norman H.Rahn III, M.D.

Robert D. Reinhart, M.D. Elke Reiser, M.D. & Maximilian F.Reiser, M.D.

Karen A. & Melvin E. Ritch, M.B.B.S. Grigory N. Rozenblit, M.D. Richard W. Satre, M.D. Robert W. Seaman, M.D. Michael T. Semotuk, M.D. Andrew H. Shaer, M.D. Ira Silberman, M.D.In honor of Myron Blumberg, M.D. andMorrie Kricun, M.D.

Sudha P. Singh, M.D. & Pradumna P.Singh

C. Randall Smith, M.D. Robert K. Sparrow, M.D. Eric M. Spickler, M.D. Lloyd E. Stambaugh III, M.D. Jason M. Stoane, M.D. Thomas J. Sullivan, M.D. Jalal Tabatabaie, M.D. Kaori Togashi, M.D. Sabah S. Tumeh, M.D. Vlastimil Valek, M.D. Saravanan Valliappan, M.D. Francois R.J. Van Mieghem, M.D. Ruth & William D. Varnell Jr., M.D. Rommel G. Villacorta, M.D. Elizabeth Vokurka, Ph.D. Mark R. Walters, M.D. Sony Chong & Kao-Lun Wang, M.D. Jerold B. Weinberg, M.D. Edward Hunter Welles III, M.D. D. John Wester Jr., M.D. John S. Wills, M.D. Janet & H. Rodney Withers, M.D., D.Sc.Robin & Clifford R. Wolf, M.D. Lisa M. & Rick G. Wright, D.O.Wakako Yamamoto, M.D. Alain Zilkha, M.D. Dieter Zur Nedden, M.D.

BRONZE ($1 – $199)Hussein M. Abdel-Dayem, M.D. Annie & Mitchell D. Achee, M.D. Denise R. Aberle, M.D. & John S.Adams

Ildefonso G.D. Almonte, M.D. Teresa & Thomas M. Anderson, M.D.

Bruce S. Baker, M. D. Carlos Bekerman, M.D. Richard M. Benator, M.D. Barbara P. BennettIn memory of Robert Parker, M.D.

Robin S. & William G. Bennett, M.D. Stanley Benzel, M.D. Robert C. Berlin, M.D. Melanie I. & John L. Bircher, M.D. Gerald A. Black, M.D. Gordon L. Black, M.D. Mitra B. Boodram, M.D. Brianna G. Boun-Taing, M.D. Fred R. Brandon, D.O.Karen T. Brown, M.D. Michael A. Bruno, M.D. In memory of Malcolm D. Jones, M.D.

Jeffrey C. Buchsbaum, M.D., Ph.D. Kenneth Burton, M.D. Sergio C. Cariola Sanz, M.D. Monica & Nils-Olov Carlsson, M.D. Anne & Thomas M. Carr III, M.D. Sandra & Philip N. Cascade, M.D. Adeen & James H. Chafey, M.D. Ophelia B. Chang, M.D. Gina A. Ciavarra, M.D. Crandon F. Clark Jr., M.D. Joyce F. & Allyn M. Cohen, M.D. Estelle Cooke-Sampson, M.D. Samuel F. Cort Jr., M.D. Tommy E. Cupples, M.D. Raymond L. Del Fava, M.D.In honor of Mary K. Del Fava

VANGUARD GROUP

Berlex, Inc.

$105,000A Vanguard company since 2004

Philips Medical Systems

$115,000A Vanguard company since 2001

Toshiba America Medical Systems

$25,000A Vanguard company since 2001

VISIONARIES IN PRACTICE

Southeast MedicalImaging at Brinton LakeGlen Mills, Pa.

Radiological Associates of SacramentoMedical Group, Inc. Sacramento, Calif.

$25,000Silver level

$10,000Bronze level

Continued on next page

20 R S N A N E W S A P R I L 2 0 0 6

Charles J. DeMarco, M.D. Claude Diday, M.D. Diane Hanley & Michael F. Dowe Jr.,M.D.

Kathryn A. Draves, M.D. James P. DrollMargaret & Jimmie L. Eller, M.D. Bassam Ershaid, M.D. David Evans, M.B.B.S. David L. Factor, M.D. Ana C. & Renato Campos Soares deFaria, M.D.

Richard M. Finer, M.D. James R. Fink, M.D. John J. Fitzpatrick, M.D. Katherine Wun Fong, M.D. Robert B. Forward, M.D. Parham R. Fox, M.D. Arlene & David B. Freiman, M.D. W. Jay Friesen, M.D. Akira Fujikawa, M.D. Josef K. Gmeinwieser, M.D. Laura & Alberto L. Gomez Del Campo, M.D.

Christopher J. Govea, M.D. Amorita A. Guno, M.D. In honor of St. Jude

Maurice J. Hale, M.D. Richard L. Hallett II, M.D. Gail C. Hansen, M.D. In honor of Juris Gaidulis

Gerald Hassan, M.D. Hiroto Hatabu, M.D., Ph.D. Francine J. & Jay P. Heiken, M.D.Sergio L. Heredia, M.D. In honor of Perla L. Heredia

Jose D.J. Herrera, M.D. Jaleh & Saied M.K. Hojat, M.D. N. Carol Dornbluth, M.D. & Don D.Howe, M.D.

Ming-Fang & Guo-Long Hung, M.D. Jen I. Hwang, M.D. Carl E. Johnson, M.D. Surekha D. Khedekar, M.D. Howard L. Kirzner, M.D. Susan & Kelly K. Koeller, M.D. Cynthia Reese & Keith Y. Kohatsu, M.D. Ronald B. Kolber, M.D. Helen & Kenneth S. Lee, M.D. Lo-Yeh Lee, M.D. Robert M. Levin, M.D. Jeannette & E. Mark Levinsohn, M.D. Michael Licata, M.D. Tae-Hwan Lim, M.D.Jay J. Listinsky, M.D., Ph.D.

Manuel A. Madayag, M.D. David C. Madoff, M.D. Satkurunathan Maheshwaran, M.D. Sandra & Hector Mendoza, M.D. George A. Miller Jr., M.D. Katherine L. Griem & Anthony Montag, M.D.

Christopher C. Moore, M.D., Ph.D. Elizabeth A. Moorehead, M.D. Dean A. Nakamoto, M.D. Noboru Niki, Ph.D. Satoshi Noma, M.D., Ph.D. Linda K. Olson, M.D. Mitchell Parver, M.D. Christopher S. Peeters, M.D. Helmut Peinsith, M.D. James C. Phillips, M.D. Beverly E. Hashimoto, M.D. & VincentPicozzi, M.D.

Eva-Marlis Lang-Poelkow, M.D. & StefanPoelkow

Kristin H. & Kent W. Powley, M.D. Glenn E. Rabin, M.D. Milly & Paul A. Riemenschneider, M.D. In memory of Milton Elkin, M.D.

Gisela B. Riesenberg, M.D. Catherine C. Roberts, M.D. Robert C. Roberts, M.D.

Gonzalez J.E. Rodriguez, M.D. Vivian L. & Laercio A. Rosemberg, M.D. Anthony F. Salvo, M.D. Gursel Savci, M.D. Shelley Adamo & Matthias H. Schmidt,M.Sc., M.D.

Stefan H. Schneider, M.D. Gustav Seliger, M.D. Diana & Alfred Shaplin, M.D. Shelly I. Shiran, M.D. Lyda Grimaldo & Josue S. Ugalde, M.D.Oliver J. Sommer, M.D. Eric M. Spitzer, M.D. Donna & Randall H. Stickney, M.D. Catherine & Bernard L. Tassin, M.D. Gill M. Taylor-Tyree Sr., M.D. Nina L.J. Terry, M.D., J.D. Giuseppe Vadala, M.D. Kimberly & Theodore L. Vander Velde II, M.D.

Francisco C. Vargas, M.D. Stephanie R. Wilson, M.D. & Ken WilsonRobert E. Woods, M.D. Clifford K. Yang, M.D. Peter T. Zimmerman, M.D.

Online donations can be madeat RSNA.org/donate.

EXHIBITOR NEWS RSNA 2006

RSNA 2006 Exhibitor News

Exhibitor ProspectusThe RSNA 2006 Exhibitor Prospectus was mailed inlate March. RSNA awards space assignment prioritypoints to its exhibitors. It is beneficial to submit theexhibit space application quickly to earn the mostpriority points possible and to ensure the best possi-ble exhibit booth position.

To achieve the maximum available space and assignment points, yourcompleted application must have been received by RSNA by April 10,2006. The first-round space assignment deadline is May 8.

June Exhibitor Planning MeetingBooth assignments will be released on June 27at the Exhibitor Planning Meeting and Lun-cheon. All RSNA 2006 exhibitors are invited toattend at Rosewood Restaurant and Banquetsnear Chicago’s O’Hare International Airport.

Advertising at RSNA 2006 Many opportunities exist for companies to promote their exhibit atRSNA 2006, the world’s largest annual medical meeting. For more infor-mation, go to RSNA.org/Advertising/upload/meeting-3.pdf or contact:

• Jim DrewDirector of Advertising1-630-571-7819jdrew@rsna.org

• Judy KapicakSenior Advertising Manager1-630-571-7818jkapicak@rsna.org Important Exhibitor Dates

for RSNA 2006

April 10 Exhibit Space Assignment Point System initiated

May 8 First-round space assignment deadline

June 27 Exhibitor Planning/ Booth AssignmentMeeting

July 5 Technical Exhibitor Service Kit available online

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

RESEARCH & EDUCATION OUR FUTURE

■ For more information, contact RSNA Technical Exhibits at 1-800-381-6660 x7851 or exhibits@rsna.org.

Continued from previous page

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

Important Dates for RSNA 2006April 15 Deadline for abstract

submission

April 24 Registration and hous-ing opens for RSNAand AAPM members

May 22 General registrationand housing opens

June 19 Course enrollmentopens

Nov. 10 Final advance registra-tion deadline

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

Meeting

MEETING WATCH RSNA 2006

News about RSNA 2006

International DelegatesInvitation Letters Personalized invitation letters are availableat www2.rsna.org/visa_form/invitation_letter.cfm.Apply Early for Your Visa! Visa applicants are advised to apply assoon as they decide to travel to the UnitedStates and at least three to four months inadvance of their travel date. That means

international attendees should start the visaprocess by July or August.

The following Web sites have addi-tional information on applying for a visa:• unitedstatesvisas.gov• travel.state.gov/visa• www.nationalacademies.org/visas

Accessing a Brochure

The Advance Registration and Housing brochure will be availablein electronic format only.

Go to RSNA.org/register andclick on the PDF file.

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

➊ InternetGo to RSNA.org/registerUse your memberID# from theRSNA News label or meetingflyer sent to you. If you havequestions, send an e-mail torsna@itsmeetings.com.

➋ Fax (24 hours)1-800-521-60171-847-940-2386

➌ Telephone (Monday–Friday, 8:00 a.m.–5:00 p.m. CT)1-800-650-70181-847-940-2155

➍ MailITS/RSNA 2006108 Wilmot Rd., Suite 400Deerfield, IL 60015-0825USA

Advance Registration and Housing Opens April 24RSNA 2006 advance registration and housing opens April 24 for RSNA and AAPM mem-bers. Non-member registration and housing opens May 22.

Registration FeesBY 11/10 ONSITE

$0 $100 RSNA Member, AAPM Member

$0 $0 Member Presenter

$0 $0 RSNA Member-in-Training, RSNA Student 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, Physicist or Physician

$570 $670 Hospital Executive, Research and Development Personnel, Healthcare Consultant, Industry Personnel

$300 $300 One-day registration to view only the Technical Exhibits area

For more information about registration for RSNA 2006, visit RSNA.org, e-mail reginfo@rsna.org,or call 1-800-381-6660 x7862.

Fastest wayto register!

CME Update: Earn up to 85 AMA PRA Category 1 CME Credits™ at RSNA 2006

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

22 R S N A N E W S A P R I L 2 0 0 6

Sat11/25

Sun11/26

Mon11/27

Tue11/28

Wed11/29

Thu11/30

Fri12/1

AAPM/ RSNA Physics Tutorial for Residents 12:00– 2:00 PS10

Opening Session 8:30–10:15 PS30

Scientific Sessions10:45–12:15 SSA

Lunch, Visit Posters & Exhibits 12:15–2:00

Radiology Assistants Program 8:30–10:00 RA

Radiology Assistants Program 10:15–11:45 RA

Technical Exhibits 10:00–5:00

Technical Exhibits 10:00–5:00

Technical Exhibits 10:00–5:00

Technical Exhibits 10:00–2:00

Technical Exhibits 10:00–5:00

Rad. Assist. Prog. 12:45–2:15 RA

Lunch, Visit Posters & Exhibits 11:45–12:45

Refresher Courses 8:30–10:00 RC200

Scientific Sessions 10:30–12:00 SSC

Pediatrics Session 8:30–12:00 VP

Associated Sciences Symposium 8:30–11:30 PS45

Case-based Review: NR 10:30–12:00 CN

Case-based Review: RO 10:30–12:00 CR

Case-based Review: NR 8:30–10:00 CN

Case-based Review: RO 8:30–10:00 CR

Lunch, Visit Posters & Exhibits 12:00–1:30

Refresher Courses 8:30–10:00 RC300

Pediatrics Session8:30–10:00 VP

Associated Sciences RC 8:30–10:00 AS

Associated Sciences RC 10:30–12:00 AS

Associated Sciences RC 8:30–10:00 AS

Case-based Review: IV 10:30–12:00 CI

Case-based Review: IV 8:30–10:00 CI

Case-based Review: PED 8:30–10:00 CP

Essentials Course8:30–10:00 ES

Essentials Course8:30–10:00 ES

Lunch, Visit Posters & Exhibits 12:00–1:30

Pediatrics Session10:30–12:00 VP

Essentials Course10:30–12:00 ES

Refresher Courses 8:30–10:00 RC500

Case-based Review: MR8:30–10:00 CM

Refresher Courses8:30–10:00 RC600

Refresher Courses 8:30–10:00 RC800

Case-based Review: MR10:30–12:00 CM

Scientific Sessions10:30–12:00 SSQ

Scientific Sessions 10:30–12:00 SST

Associated Sciences RC 10:30–12:00 AS

Case-based Review: PED 10:30–12:00 CP

Essentials Course10:30–12:00 ES

Image Symp. 12:45–3:15

Scientific Sessions 10:30–12:00 SSK

Scientific Sessions 10:30–12:00 SSG

Emergency Radiology Session 8:30–12:00 VE

**Protecting Assets Against Creditor Claims, Including Malpractice 10:00–12:00 PS01

Lunch12:00–1:00

Lunch, Visit Posters & Exhibits 12:00–1:00

Lunch, Visit Posters & Exhibits 12:00– 1:30

Lunch, Visit Posters & Exhibits 12:00– 1:30

Lunch 12:00–1:00

Lunch, Visit Posters & Exhibits 12:00–12:45

9:00 A.M.8:00 A.M. 10:00 A.M. 11:00 A.M. 12:00 P.M. 1:00 P.M.

* Awards/Ceremonies to open Plenary Session (1:30 –1:45) ** An additional fee is charged for this course

Pediatrics Session 10:30–12:00 VP

MEETING WATCH RSNA 2006 ■ PRELIMINARY PROGRAM GRID

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

Sat11/25

Sun11/26

Mon11/27

Tue11/28

Wed11/29

Thu11/30

Fri12/1

AAPM/ RSNA Physics Tutorial for Residents 12:00–2:00 PS10

Refresher Courses 2:00–3:30 RC100

Refresher Courses 4:30–6:00 RC400

Image Interpretation Session 4:00–5:45 PS40

Pediatrics Session 2:00–3:30 VP

Lunch, Visit Posters & Exhibits 12:15–2:00

Technical Exhibits 10:00–5:00

Technical Exhibits 10:00–5:00

Technical Exhibits 10:00–5:00

Technical Exhibits 10:00–2:00

Technical Exhibits 10:00–5:00

Radiology Assistants Program 12:45–2:15 RA

Radiology Assistants Program 2:30–4:00 RA

Scientific Sessions 3:00–4:00 SSE

Special Focus Sessions 4:30–6:00 SFF

Special Focus Sessions and Oncodiagnosis Panel 4:30–6:00 SFN

* New Horizon’s Lecture 1:30–2:45 PS50

Basic Physics Lecture for the RT 1:30–2:45 PS51

Associated Sciences RC 1:30–3:00 AS

Associated Sciences RC 3:30–5:00 AS

Case-based Review: NR 1:30–3:00 CN

Case-based Review: NR 3:30–5:45 CN

Case-based Review: RO 1:30–3:00 CR

Case-based Review: RO 3:30–5:00 CR

Physics Symposium 1:30–3:30 PS52

Physics Symposium 3:45–5:45 PS52

Lunch, Visit Posters & Exhibits 12:00–1:30

Essentials Course3:00–4:30 ES

* Annual Oration in Diagnostic Radiology 1:30–2:45 PS60

Lunch, Visit Posters & Exhibits 12:00–1:30

Associated Sciences RC 1:30–3:00 AS

Associated Sciences RC 3:30–5:30 AS

Case-based Review: IV 1:30–3:00 CI

Case-based Review: IV 3:30–6:00 CI

Essentials Course1:00–2:30 ES

Scientific Sessions 3:00–4:00 SSJ

Scientific Sessions 3:00–4:00 SSM

Pediatrics Session 3:00–4:00 VP

Pediatrics Session 4:30–6:00 VP

Case-based Review: MR 1:30–2:30 CM

* RSNA/AAPM Symposium 1:30–2:45 PS80

Case-based Review: MR 2:45–4:15 CM

Special Focus Sessions 3:00–4:00 SFS

Case-based Review: MR4:30–6:00 CM

Refresher Courses4:30–6:00 RC700

Case-based Review: PED 1:30–3:00 CP

Case-based Review: PED 3:30–5:00 CP

Essentials Course 1:00–2:30 ES

Friday Imaging Symposium 12:45–3:15 PS90

Essentials Course 3:00–4:30 ES

* Annual Oration in Radiology Oncology 1:30–2:45 PS70

AAPM/RSNA Physics Tutorial on Equipment Selection 2:15–4:15 PS20

** Effective Investment Strategies 1:30–5:00 PS11

Lunch, Visit Posters & Exhibits 12:00–1:30

Lunch, Visit Posters & Exhibits 12:00–1:30

** NIH Grantsmanship Workshop 1:00–5:00 PS12

2:00 P.M.1:00 P.M. 3:00 P.M. 4:00 P.M. 5:00 P.M. 6:00 P.M.

* Awards/Ceremonies to open Plenary Session (1:30 –1:45) ** An additional fee is charged for this course

CMEGatewayAd

CMEgateway.org

It’s Easy and Free!Log on to CME Gateway to:

• View or print reports of your CME credits from multiple

societies from a single access point.

• Print an aggregated report or certificate from each

participating organization.

• Link to SAMs and other tools to help with maintenance

of certification.

Sign Up Today!go to www.CMEgateway.org

CMEgateway.org

Manage Your CME Credits Online!

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

RSNA ON THE WEB

OTHER WEB NEWS:

Online Library of Breast Cancer Proteins Now AvailableHarvard Medical School investigators have created the first publiclyavailable library of reliably expressible proteins for breast cancer. TheBreast Cancer 1000, or BC1000, is available at the Harvard Institute ofProteomics Web site (www.hip.harvard.edu).

RSNA.org

VIEWING TECHNOLOGY

Answer [Question on page 2.]

AThe spatial resolution and number of availablegrayscale steps may not be sufficient for you tosee fine details such as a pneumothorax or subtle

consolidation. Caution is indicated when renderingclinical opinions on such displays.

Q&A

cou

rtes

y of

AA

PM

RSNA CME CreditRepository

USE THE RSNA CME CreditRepository at RSNA.org/education/repository.cfm to

check RSNA-awarded credits. Please note that the RSNA

CME Credit Repository isupdated in real-time for onlineprograms. As soon as you havecompleted the CME test for anyof these programs, you mustclick on the Click Here toClaim Credits link to registeryour credit.

Credits from RadioGraphics mail-in tests are posted about once amonth. Credits earned at the RSNAannual meeting or at an RSNA short-course will be posted no later than sixweeks after the meeting is completed.

Access the RSNA CME CreditRepository by going to RSNA.org/edu-cation/repository.cfm ➊ and clickingon For Members To View CumulativeCME Credit Earned Through ALLRSNA-Sponsored CME Activities ➋.

Click on To Search Your RSNA-Awarded Credits ➌. Complete the datespan, activity and subspecialty searchfields ➍ and click Search ➎. Leave allfields set to default to see a grand total ofall CME earned.

Credits added to the RSNA CMECredit Repository also will automati-cally appear in the CME Gateway(www.CMEgateway.org), a single onlineaccess point allowing users to viewcredits from multiple organizations.

➊

➌

➍

➎

➋

Radiology OnlineRSNA.org/radiologyjnl

Radiology Manuscript CentralRSNA.org/radiologyjnl/submit

RadioGraphics OnlineRSNA.org/radiographics

RSNA News rsnanews.org

Education PortalRSNA.org/education

RSNA CME CreditRepositoryRSNA.org/cme

CME GatewayCMEgateway.org

RSNA Medical ImagingResource CenterRSNA.org/mirc

RSNA Career ConnectionsRSNA.org/careers

RadiologyInfo™

RSNA-ACR patient information Web siteradiologyinfo.org

RSNA Press ReleasesRSNA.org/media

RSNA Online Products and ServicesRSNA.org/member services

RSNA Research & Education FoundationMake a DonationRSNA.org/donate

R&E 25 QuestionsForumRSNA.org/25questions

Community of ScienceRSNA.org/cos

Membership Applica-tionsRSNA.org/mbrapp

RSNA Membership DirectoryRSNA.org/directory

RSNA 2006rsna2006.rsna.org

RSNA Highlights: Critical Issues for 2007RSNA.org/highlightsconference

Econnections

Your online linksto RSNA

RSNA.org

Medical Meetings May – June 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 Faxrsnanews@rsna.org

CALENDAR

APRIL 29–MAY 5American Society of Neuroradiology (ASNR), 44th Annual Meeting,San Diego Convention Center • www.asnr.orgAPRIL 30–MAY 5American Roentgen Ray Society (ARRS), 106th Annual Meeting,Vancouver Convention and Exhibition Centre, British Columbia • www.arrs.orgMAY 5–6American Society of Interventional and Therapeutic Neuroradiology(ASITN), 4th Annual Practicum, Omni San Diego Hotel • www.asitn.orgMAY 6–12International Society for Magnetic Resonance in Medicine(ISMRM), 14th Scientific Meeting & Exhibition, Washington StateConvention & Trade Center, Seattle • www.ismrm.orgMAY 6–9Magnetic Resonance Managers Society (MRMS), 15th Annual Educational Conference, South Seas Island Resort, Captiva, Fla. • www.mrms.orgMAY 10–12American Brachytherapy Society, 27th Annual Meeting, Philadel-phia Marriott • www.americanbrachytherapy.orgMAY 15–17UK Radiological Congress (UKRC), UKRC 2006, National IndoorArena, International Conference Centre and Austin Court, Birming-ham, United Kingdom • www.ukrc.org.ukMAY 16–20International Pediatric Radiology 5th Conjoint Meeting, Society forPediatric Radiology (SPR) and European Society of Paedatric Radiology (ESPR), Fairmont Queen Elizabeth Hotel, Montreal • www.pedrad.orgMAY 20–25American College of Radiology (ACR), Annual Meeting and Chapter Leader Conference, Hilton Washington • www.acr.orgMAY 24–27German Radiology Society, 87th German Radiology Congress,Messe Berlin, Berlin • www.roentgenkongress.de

MAY 26–29InterAmerican Congress of Radiology (CIR), 23rd CIR Congress,Spanish Society of Radiology (SERAM), 28th National SERAMCongress, Zaragoza Convention Center, Zaragoza, Spain • www.radcentroamerica.orgMAY 28–JUNE 1 World Federation for Ultrasound in Medicine and Biology(WFUMB), 11th Congress, COEX Convention & ExhibitionCenter, Seoul, Korea • www.wfumb2006.comJUNE 3–7Society of Nuclear Medicine (SNM), 53rd Annual Meeting, San Diego Convention Center • www.snm.orgJUNE 4-7Radiology Business Management Association (RBMA) 2006Radiology Summit, Loews Miami Beach Hotel South Beach • www.rbma.orgJUNE 8–11Caribbean Society of Radiologists, 13th Congress, Hilton MiamiAirport Hotel • www.csor.org JUNE 9–13International Society for Radiographers and Radiological Tech-nologists (ISRRT), 14th World Congress, hosted in conjunctionwith American Society of Radiologic Technologists (ASRT) andthe Association of Educators in Radiological Sciences (AERS),Adams Mark Hotel, Denver • www.asrt.orgJUNE 12–16World Conference on Interventional Oncology (WCIO), CentroCongressi Villa Erba, Cernobbio, Italy • www.wcio2006.comJUNE 19–23European Society of Gastrointestinal and Abdominal Radiology(ESGAR), 17th Annual Meeting, Society of GastrointestinalRadiologists (SGR), 35th Annual Meeting, Crete, Greece • www.esgar.org

NOVEMBER 26–DECEMBER 1RSNA 2006, 92nd Scientific Assembly and Annual Meeting,McCormick Place, Chicago • rsna2006.rsna.org

FEBRUARY 26–28, 2007RSNA Highlights: Clinical Issues for 2007, J.W. MarriottDesert Ridge Resort & Spa, Phoenix, Ariz. • RSNA.org/highlightsconference