ACR Bulletin October 2016

Final Read

Pooja R. Voria, MD, MBA

final read

Q: What would you say to a young physician considering radiology?

To be honest, I went into medical school thinking that I would be a cardiothoracic surgeon. I wasn't even considering radiology.

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3 Things to Read Today

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This week we’re looking at the use of MRI over ultrasound to find deadly cancer in cirrhosis patients, why some men are at greater risk than others when receiving prostate cancer therapy, and more.

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Becoming a Change Leader

This year’s RLI Summit discussed machine learning and how to place patients in the center of care.GettyImages 504365817

September 8-11 2016, marked another successful collaboration between the Radiology Leadership Institute(RLI)® through the American College of Radiology and one of the nation's top business schools, Babson College.

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A Life’s Passion

Michael N. Linver, MD, found his calling in breast imaging.lifes passion

Michael N. Linver, MD, FACR, director of mammography at X-Ray Associates of New Mexico, is a distinguished breast imaging radiologist who has helped proliferate modern mammography techniques in the United States.

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JACRⓇ September 2016 HighlightsJACRBlog

The September Issue of the JACRⓇ covers sharing cases on social media, bundled payments, state legislative fellowships, and the “unknown” in radiology education, among other things. Here are a handful of articles of special interest to radiologists in training.

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Out of the Dark

The Johns Hopkins Radiology Resident Consult ServiceJohn Hopkins

Advancements in imaging technology in the last several decades have ushered in a new golden age of radiology. The development of PACS, new imaging modalities, and new protocols and techniques has greatly improved our ability to serve our patients and our referring providers.

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ACR RLI Leadership Summit 2016 HighlightsRLI Summit

Do you think those in business have little to teach physicians about how to work effectively in a hospital? Think again.

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3 Things to Read Today: October 5, 2016


This week we’re looking at the use of MRIs in stem cell therapies, how more hands-on internships may draw medical students into radiology electives, and how an experienced radiologist’s diagnosis of thyroid cancer bested the algorithms he helped develop.

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Meet the ACR Leadership: Howard Fleishon, MD, FACR, MMM


For this installment, I will be interviewing Howard Fleishon, MD, who is the current Secretary/Treasurer of the ACR. He also serves as the Vice Chair of the Commission on Government Relations.

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Porting for Patients


In the spring of 2016, I traveled to Nepal with the help of a grant from the American College of Radiology. My goal was to help the department of radiology at the NAMS/Bir hospital in Kathmandu recover after a series of devastating earthquakes.

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A Look Inside

Boosting value in your practice can be as simple as examining what you're already doing.A Look Inside

Value-based change is coming. It's a phrase you've heard for a while now, along with a host of acronyms and advice on how to make changes to your practice.

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Great Expectations

Unprecedented practice transformation is underway, and radiologists need to get involved.great expectations

Now more than ever, patients expect the right care, at the right time, and at a reasonable cost. To reach that goal, health providers must achieve practice transformation on an unprecedented scale.

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Transforming Practices

More than 140,000 clinicians will be transforming their practices over the next four years. The ACR Commission on Economics wants radiology engaged.transforming practice

"Better care, smarting spending, and healthier people." CMS has committed $685 million to support these important goals through the Transforming Clinical Practice Initiative (TCPi). It is imperative that we are engaged in this effort. In this column, I describe ways in which radiology can participate.

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Cutting Down on Missed Opportunities

Skipped appointments tell us more about our patients' access to care than you might think.missed opportunities

As a professional organization, the ACR has been a tremendous advocate for women's access to screening mammography annually starting at age 40, which gives the maximum life-saving benefit.

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Moving the Message

What are the most effective ways to educate both patients and clinicians about the benefits of screening?


The black-and-white video features women who were diagnosed with breast cancer in their 40s and 50s. They talk about their families and discovering their cancer. They all say that starting annual mammograms at age 40 likely saved their lives.

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Stage 1

When Barbara received her breast cancer diagnosis, she joined two of her aunts in fighting the disease.


My family has a history of breast cancer. Two aunts on my mother's side battled the disease.

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Reducing Anxiety, One Patient at A Time


Can radiologists help their patients feel more comfortable with screening procedures? According to a recent study published in the JACR, the answer is yes.

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Leading the Way in Patient Interaction

What can breast imagers share with the specialty when it comes to patient communication?LeadingthewWay

Communication is a fundamental part of the human experience. Any average day is filled with countless moments of personal interaction, from exchanging a simple "good morning" with a colleague to dictating a case to starting a dialogue to resolve a problem. Yet finding a moment to speak directly with a patient can be challenge for many radiologists.

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Seeking Widespread Coverage

Get the latest on legislative and regulatory efforts to reimburse digital breast tomosynthesis.breast tomosynthesis

Breast cancer mortality rates have declined more than one-third since 1990, according to the American Cancer Society1 — in part, as digital screening has helped enable earlier detection.

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October Case of the Month

Access case here.

Authors: Katie Davis, DO, Resident Physician, Diagnostic Radiology,Department of Radiology,MetroHealth Medical Center, Cleveland, Oh.; Vikas Jain, MD, Assistant Professor, Assistant Program Director, Diagnostic Radiology, Neurology, Department of Radiology, MetroHealth Medical Center, Cleveland, Oh.

Why did you select this case for submission?

I selected this case for submission because it emphasizes the difference between impending rupture, contained rupture, and rupture of abdominal aneurysms. Distinguishing between these entities is important for clinical care.

What should readers learn from this case?

Although there is some overlap regarding the radiographic signs of contained rupture and rupture of abdominal aortic aneurysms, prompt recognition of contained abdominal rupture is critical to decreasing the overall patient morbidity and mortality, as there is a benefit from preoperative assessment and urgent surgery rather than emergent surgery.

What did you learn from working on the case?

I learned about the “draping aorta” sign, which is an indicator of aortic wall insufficiency. It is defined as an irregular contour of the posterolateral wall of the aorta, which is not identifiable as distinct from adjacent structures. The posterolateral wall of the aorta will closely follow the contour of the adjacent vertebral bodies.

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

The guidance from senior staff supplemented and enriched my understanding of the pathologies affecting abdominal aortic aneurysms.

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

I submitted a case to Case In Point once before, so I felt very comfortable with the submission requirements and the format.

What is the appeal of online learning, like Case in Point, as opposed to other learning venues, such as print?

Gone are the days of card catalogs and heading to the library in the hopes that a radiology text will be available! Online learning is an easily accessible, time-efficient, and more cost-effective option for residents.

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

 I am a regular reader of Case in Point. My favorite types of cases are those relating to women's health issues. 

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

This case came across our board as an outpatient study. We were able to quickly diagnose the entity and coordinate vascular surgery referral with the primary provider. The patient underwent surgery and did well!