ACR Bulletin January 2017

Final Read

Daniel Ortiz, MDfinal read

Q: When and why did you first join the ACR?

As a first year radiology resident, I was encouraged by my more senior co-residents to join several of the radiology organizations, including the ACR, as “the thing to do.” My first direct exposure came at the state level with the annual Virginia Chapter meeting.

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The Importance of Self-Motivation in a Non-Clinical Mini-Fellowshipself motivation

One morning during my fourth-year mini-fellowship in quality and patient safety, I walked into work and ran into one of the radiology fellows, who was surprised to find that I had arrived on time. “My mini-fellowship involved watching ESPN in my underwear,” he quipped.

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Meet the ACR Leadership: Alexander Norbash, MD, FACRacr leadership

This is an installment of a series titled “Meet the ACR Leadership.” Throughout the series, we interview the ACR Leadership to get insight into their background and involvement in the ACR. For this installment, we talk with Alexander M. Norbash, MD, FACR.

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JACR December 2016 Highlights


The December issue of the JACRⓇ covers, health care spending, nonclinical mini-fellowships, and self-aggrandization among other things. There was also a special issue dedicated to patient and family centered care. Here are a handful of articles of special interest to radiologists in training.

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A Primer on Machine Learningmachine learning

Machine Learning (ML) and other artificial intelligence (AI) tools have become a staple in the non-medical and medical news as these techniques are applied to increasingly complex challenges. Much like the term "big data," these terms get loosely applied to varied projects, but it is important to know the fundamentals and situations where ML can be effectively applied.

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When Students Become Teachers: The  Southern Sudan Medical Education Collaborative

Lessons from Abroad

In April 2011, I had the distinct pleasure of joining the Southern Sudan Medical Education Collaborative (SSMEC) on a trip to Juba, which is now the capital city of the Republic of South Sudan. This would come to be one of the most formative and memorable experiences of my life.

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Not Your Typical Day

A recent fellow provides a snapshot of a day in the life of a breast imager.breast imager day

“Part of my enjoyment in practicing breast imaging is that there is rarely a typical day,” says Ann L. Brown, MD, who completed her breast imaging fellowship at Beth Israel Deaconess Medical Center in Boston this summer.

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Radiologist, Inc.

How radiologists can craft their own personal brand.radiologist inc

It's no secret that many radiologists spend plenty of time in a dark reading room. Even though that's changign thanks to initiatives like Imaging 3.0®, imagers work hard to define their reputations in the workplace.

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Connecting the Dots

How incentives under a Medicare alternative payment model might affect radiology practices.Connecting the Dots

We're in uncharted territory. More than ever before, our health care system is so complex that it is increasingly difficult to foresee the consequences of proposed policies and organizational changes.

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Knowledge Sharing

The ACR Education Center takes its breast imaging workshop to Saudi Arabia as part of its efforts to improve global health.knowledge sharing

Breast cancer kills more than 500,000 women worldwide annually. In countries with few resources and limited screening programs, women with breast cancer are often diagnosed in advanced stages of the disease and have low chances of survival.

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Pick Your Pace Under MACRA

The ACR Commission on Economics stands ready to provide tools for radiologists to achieve Quality Payment Program Success.

MACRA pace silva

The Medicare & Chip Reauthorization Act (MACRA), now referred to as the Quality Payment Program (QPP), will impact radiology payments beginning in January 2019. But the performance period for 2019 started on January 1, 2017. Well, sort of.

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Standing Out from the Crowd

What does your brand say about you and your practice?

Branding Brink Radiology

This past September, I had the privilege of attending the fourth annual summit of the Radiology Leadership Institute® held at Babson College in Wellesley, Mass. Each year, I have found the programming to be absolutely terrific.

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January Case of the Month

Access case here.

Authors: Andrea L. Magee, MD, PGY2, radiology resident, and Steven M. Montner, MD, assistant professor of radiology, Thoracic Imaging, Department of Radiology, University of Chicago, Chicago, Ill.

Why did you select this case for submission?

Pulmonary capillary hemangiomatosis (PCH) is a rare cause of pulmonary arterial hypertension (PAH), and many radiologists often don’t encounter it. Dr. Montner and I chose to submit the PCH case to provide a refresher of the clinical and imaging findings associated with this diagnosis.

What should readers learn from this case?

Patients with PCH may present with nonspecific findings such as progressive dyspnea, fatigue, and chronic cough. Pulmonary function tests may be completely unremarkable. Critically, the management of PCH differs from the management of other causes of PAH, and the routine use of vasodilators can be fatal in patients with PCH. Radiologists are well-positioned to recognize the imaging findings and suggest PCH in the correct clinical setting.

What did you learn from working on the case?

Although imaging findings may suggest PCH, it is a microscopic diagnosis. Patients are often unable to tolerate lung biopsy, and so most cases are confirmed only at autopsy, if at all.

How did guidance from senior staff at your institution impact your learning and case development?

Working with Dr. Montner was essential in understanding the pathophysiology of PCH and how this manifests in the imaging findings. He walked me through the findings in other PCH cases and provided additional cases with common differential considerations for PCH.

Why did you choose Case in Point for submission of your case?

We chose to submit this case in order to provide a digestible, but still informative, summary of PCH for radiologists who might not have seen a case recently. CIP allowed us to share our case with a large number of radiologists in varying levels of training and practice.

Are you a regular reader of Case in Point? What are your favorite types of cases?

Yes, I receive the daily CIP emails and make it a point to complete each case. I especially appreciate cases showing unusual etiologies or abnormal presentations of common etiologies.

What else should we know about the case that you'd like to share?

We feel that we provided high-yield facts in our case and would like to emphasize to others the importance of considering PCH in patients with PAH and appropriate imaging findings. We're glad our case was well-received!