sign in sign up
<<
Home , Urogynecology

LETTER A Radiologist’s Approach to Imaging Vistas Stony Brook University Spring 2007

Outpatient Imaging Center Opens at Stony Brook

The new Outpatient Imaging Center at Stony Brook facility. Patients receive the added benefits of having HIGHLIGHTS University Medical Center provides service to outpatients their studies interpreted by subspecialized . Managed Care in a state-of-the-art 65,000 square ft facility. The grand Update 2 opening of the Imaging Center was celebrated on The Center is equipped with an advanced communica- February 15, 2007. The Center provides convenience tion system and image capabilities; all cases are sent to New Faculty 3 and comfort for its outpatients with bright treatment the Radiology PACS (Picture Archive Communication System). This allows the radiologist, not only at the Co-registration in areas in an easy and spacious atmosphere. The setting Molecular Imaging 4 is ideal for patients, families, and Stony Brook health Imaging Center but radiologists at the University Medical care professionals to partner in the management and Center, to interpret all the studies produced at the Dynamic MR treatment of a variety of medical conditions. Center. This is made possible by the high speed data Imaging of Pelvic connections between the Imaging Center and the Organ Prolapse 5 Stony Brook Imaging Center is a comprehensive imaging University. In addition to this, the News in the images and reports are available to Department 6 referring physicians electronically. Lectures 7 The imaging equipment includes Cardiovascular 2 GE 1.5 Tesla MR units, 64-slice Section Team 7 CT scan, and the first 40-slice PET/CT. The Center is also equipped with a digital diagnostic imaging room, and modern Bone Density room (DEXA).

The new center and patient waiting area Continued on page 5

Digital Breast Tomosynthesis by Paul R. Fisher, M.D., Director of Breast Imaging tomosynthesis screening in collaboration with Duke Digital Breast Tomosynthesis is an exciting new tech- University and The University nological achievement used to find and diagnose early of Malmö, Sweden. breast cancers. Mammography detects up to 85% of early diagnosis of breast cancer, and is the best modality Digital Breast Tomosynthesis to date for this important health screening. The remain- works by taking a series of ing 15% of women who develop breast cancer are projections through the breast initially missed on mammography. These cases are often using a modified x-ray tube undetected because the breast tissue is dense which and detector. Computer algo- blocks the x-rays and produces poor image quality. rithms then reconstruct images for review by a radiologist, Recently, Stony Brook University Medical Center and the similar to the reconstruction Carol Baldwin Breast Care Center (now located at the performed for CT and MRI new Pavilion) have entered into an images. A series of 60 or more exciting collaboration with Siemens Corporation, testing images are produced for each Small cancer seen only and developing clinical applications for digital breast patient and reviewed on a high resolution mammograph- on Tomosynthesis tomosynthesis. A state-of-the-art Siemens Digital Breast ic display station. By constructing “slices” through the Tomosynthesis unit, one of only three in the world, was breast tissue, the images show lesions much more installed at the new Ambulatory Cancer Center. Patients clearly, since they reduce the amount of overlapping will soon be enrolled in a number of clinical trials there. breast tissue shown on a given slice. Ordinarily, dense These screenings are part of a multi-center trial for breast tissue can obscure lesions, and early studies Continued on page 7 Chairman’s Corner Managed Care Update by Donald P. Harrington, M.D., M.A., F.A.C.R. Aetna/US Healthcare PPO/EPO HMO and Open Access Standard The Department is pleased to Non-HMO Standard Plus Managed Choice announce the opening of the new Independent Health Outpatient Imaging Center located Affinity Island Group adjacent to the Ambulatory American Medical Life JJ Newman Center on the Medical Center’s APA Partners Local 1199 campus. Many of you are familiar Atlantis (POS Plan Only) National Benefits Fund with Elaine Gould, M.D. who has BCE Emergis (UP & UP) Member’s Choice accepted the position of Medical BSC-Maxon Magna Care – Local 947, Local 3, Local 707 Director, Maryanna Mason, M.D. as Assistant Director (Student Insurance) Maxon (Student Insurance) and Charles Mazzarrese, M.P.S., R.T. as the Technical Beechstreet MDNY Director of the Imaging Center. The Carol M. Baldwin Empire BC/BS Managed Care Network Direct HMO/POS Breast Center has also moved from Tech Park to this HMO-Healthy NY/Blue Choice Classic HMO/POS location. The Centers will provide easy access to PPO Focus/Flex patients and their referring physicians. Federal Employee PPO Senior Plan (HMO) Medicaid Managed Care The Department of Radiology is blessed with many Indemnity Affinity outstanding faculty members. We are pleased to com- Child Health Plus Fidelis Care of New York plement the group with the successful recruitment of Dr. Out of State Care Plus Cliff Bernstein in the Division of Breast Imaging and Dr. Direct POS and EPO Medichoice HMO Direct Andrei Kranz in the Division of . CDHP MET Empire Multiplan On a sad note, we all mourn the passing of Dr. Jack Empire PPO C93 AKA Suffolk County Vytra W/Suff Prefix Best Western Deitch who was a devoted colleague and friend. Cambridge Oxford Jack was a Professor on the Emeritus Staff and an Freedom Plan / Freedom Plan Preferred active member of the Department for over twenty years. CIGNA HMO/POS Liberty Plan/ Liberty Plan Preferred He was also a faculty member when the campus was Open Access (PPO) Oxford HMO/Freedom Network being built and prior to the opening of University Government Plan (PPO) Oxford HMO/Liberty Network Hospital. We are also saddened by the passing of Freedom Plan Select/Freedom Plan PPO First Health Dr. Paul Lauterbur who was a Professor of Chemistry and Liberty Plan Select/Liberty Plan PPO GHI Oxford HMO Select/Freedom Network Radiology at Stony Brook in the 1970s and 80s. HMO and PPO National Oxford HMO Select/Liberty Network Dr. Lauterbur is renowned for his work in developing HMO Value Plan Freedom Plan Metro magnetic resonance imaging (MRI) technology and HMO Value Plan Direct Access Oxford USA shared the 2003 Nobel Prize in for this PPO Flex Select Sierra accomplishment. Medicare Choice PPO Category “D” Suffolk Health Plan One of the exciting new areas is the formation of a Transit Workers Champus Cardiovascular Section in the Department. Drs. Hong Guardian United Healthcare Meng, John Ferretti, William Moore, Erica Posniak and Healthfirst Child Health Plus Plan Marlene Zawin are working together as a team to HMO Family Health Plus provide excellent care for our cardiovascular patients. Healthfirst 1199 United Medicare Complete It is planned that the next issue of the Radiology Letter Medicaid Americhoice Child Health Plus Plan will include an article on CT cardiac angiography. Child Health Plus Family Health Plus Family Health Plus Plan We are looking forward to a successful year and Health First N.Y. (COMM) Medicaid United providing our patients with the best possible care. Health First (65) Plus Healthnet (all plans) USI (Select Pro) Tricare Prime Remote and Standard Program Vytra HIP/HIP Access II HMO HMO Suffolk County Vytra/PPO Healthcare Partners/IPA East End Health Plan (Vytra PPO Plan) HIP Select (EPO, PPO) Direct Access HMO VIP (Medicare) Central Suffolk Hospital THE RADIOLOGY LETTER Prime (Peconic Health Corporation) Medicaid Southampton Hospital The Radiology Letter is published by the Department of Child Health Plus Southside Hospital Radiology, School of Medicine, University at Stony Brook, CHP Smart Start Stony Brook, New York 11794 (631) 444-2480 Family Health Plus Neighborhood Network Plan (EPO) DCN Suffolk Employees Donald P. Harrington, M.D., M.A., F.A.C.R. Chairman Greater New York School Health Plan (SSEHP) Michael J. Cortegiano Administrator Horizon Vytra Medicaid Christine R. Hubbard Editor and HMO PPO Cost Sharing Plan Staff Writer Vista Health Worldwide/SUNY Students Vista Plus

2 S PRING 2007 New Faculty Paul C. Lauterbur Dies Won Nobel Prize for MRI

s Andrei Kranz, M.D. joined the faculty staff as e c i v r an Assistant Professor of Clinical Radiology e

S Paul Lauterbur, Ph.D., who shared a i in the Division of Interventional Radiology. d e the 2003 Nobel Prize in Medicine

M Dr. Kranz received his at , e l for his work in developing l i the Institute of Medicine and in v e

N magnetic resonance imaging

e Cluj-Napoca, Romania. He completed a n

n (MRI) technology while a member a

e three-year Surgical residency at Wyckoff J

© of the Stony Brook University Heights Medical Center in Brooklyn, New faculty in the 1970s and 80s, York, followed by a Radiology residency at the Nassau University passed away on March 28, 2007. Medical Center in East Meadow, New York. Dr. Kranz completed Dr. Lauterbur was a Professor of Chemistry and a a Vascular and Interventional Radiology at the Paul C. Professor of Radiology at Stony Brook when he began Lauterbur Montefiore Medical Center/Albert Einstein College of Medicine in using magnetic resonance spectroscopy to study living receiving his the Bronx, New York. Dr. Kranz previously worked at Southside Nobel Prize from organisms. He eventually learned that, by placing an Hospital, Huntington Hospital and Brookhaven Memorial His Majesty organism inside a constant magnetic field then applying Hospital. He is a member of the American Medical Association, King Carl XVI a second magnetic field of varying strength, he could Medical Society of the State of New York, Society of Interventional Gustaf of Sweden produce sharper images of the different tissues in the at the Stockholm Radiology and the American College of Radiology. organism than previously possible. Concert Hall, December 2003. The MRI went on to revolutionize s Cliff S. Bernstein, M.D. completed a fellow- e c i diagnostic medicine in the latter v r ship in Breast Imaging at Stony Brook and e

S quarter of the 20th Century and a i joined the faculty as an Assistant Professor . d 3 e remains one of the most important 0 M

of Clinical Radiology in the Division of 0 , 2 e l developments in medical technology. l B i Breast Imaging. Dr. Bernstein received his v A e

Dr. Lauterbur received the Nobel for b N e

e medical degree from the State University of W n n i l l e n Medicine and returned to Stony Brook h b a e o

e New York at Stony Brook and completed a J M with his Nobel Medal in September N © s © Radiology residency at the Harlem Hospital n t a

2004 to deliver a lecture and meet with h H g i Center. Dr. Bernstein is a member of the American College of : r o y students. He was honored in a t p o o Radiology, the Radiological Society of North America, and the h P campus ceremony attended C Society of Breast Imaging. Dr. Bernstein is Board Certified in by many of his early col- Diagnostic Radiology. leagues. His original MRI device remains on display in the University’s Chemistry Building along In Memory with a replica of his Nobel Medal – the first one ever Jack S. Deitch, M.D., who was Chief awarded to a faculty mem- of Diagnostic Radiology and Head of ber for research conducted Mammography from 1979 until 1999, while at Stony Brook. passed away on January 4, 2007. He was one of the founders of the Lauterbur’s breakthrough Department of Radiology at Stony was in realizing that by varying the strength of the magnetic field and analyzing Dr. Lauterbur Brook. Prior to coming to Stony lectures at the frequency of resulting radio signals, he could use Brook he worked at the Veterans Stony Brook nuclear magnetic resonance to create a two or three- Administration Medical Center in Northport, New York. University. dimensional picture. This laid the foundation for what Dr. Deitch will be dearly missed by his family, friends eventually became the MRI. and colleagues. The research began in 1971 when Lauterbur watched as colleagues used nuclear magnetic resonance (NMR) to examine tissue from a cancerous tumor. Two years later, Morton A. Meyers, M.D., Jack S. Deitch, in 1973, the British scientific journal Nature published M.D., Donald P. an article by Lauterbur describing an NMR technique for Harrington, M.D. taking three-dimensional pictures of body organs and (left to right) vessels, without the use of ionized radiation or toxic dyes. It was this technique that was used as the basis for MRI equipment.

T HE R ADIOLOGY L ETTER 3 Co-registration in Molecular Imaging

Robert Matthews M.D., William Stanley C.N.M.T., and Nand Relan Ph.D.

Figure 1. Fusion imaging has been increasingly employed over the Comparing new past few years, especially with the introduction of hybrid PET scan (A) with prior PET scan (B) PET-CT cameras. PET and other molecular imaging can be an arduous techniques used in demonstrate and time consuming task for the nuclear functional or physiological bio-mechanisms, while CT and medicine , other anatomical imaging modalities provide structural especially in patients detail. In the evaluation of malignancies with PET, current where there is both progression and and prior studies are often referenced for comparison. regression of individ- Newly developed software applications not only allow ual lesions. This patient has multiple co-registration of functional and anatomical images, but lesions in both the allow a variety of fusion combinations. PET-PET fusion neck and lungs. imaging offers an innovative approach for assessment of malignancies in Figure 3. PET-PET fusion subtraction combines the new and prior studies patients with prior and displaying worsening lesions in yellow/green while regressed lesions in purple. Lesions that have not changed in volume or SUV remain in gray. follow-up studies. These topics were subtraction was the neck region where patients tended to discussed in a paper change the position of the heads between old and new entitled “Evaluation of PET studies. Overall, average distance of misalignment Co-registration in was observed only to be 1.01+0.15 centimeters in all Molecular Imaging: anatomical regions. PET-PET Fusion” pre- sented by three nuclear PET-PET fusion with subtraction technique proved to be medicine technologist an efficient and accurate diagnostic tool for evaluating the students, Jamie different stages and status of malignancies. But for Bevilacqua B.S., subtraction technique to be effective, good quality of Jasmine Guevara B.S., co-registration is important. Under optimal conditions, and Joseph Weiss B.S. PET-PET fusion subtraction method can provide greater at the Greater New York confidence for the physician in the final interpretation of Society of Nuclear PET studies. Medicine Symposium held in Atlantic City. University Medical Center at Stony Brook offers a 40-slice PET CT. Appointments can be made by calling Fourteen cases, each (631) 444-1880. with old and new PET scans, were evaluated for overall quality of fusion, quality of lesion co-registration, and changes in both standard uptake value (SUV) and tumor volume. A PET-PET

Figure 2. Fusion fusion subtraction subtraction method, developed by MIM Vista, was subsequently technique is applied implemented to evaluate the progression or regression of combining the new PET images (first individual lesions. Quality of subtraction was rated based row) with the prior on changes in volume and SUV of the lesion. Jamie Bevilacqua, B.S. (center), Jasmine Guevara, B.S. (left) and Joseph PET images (second Weiss, B.S. (right) won second place for their presentation entitled row). In this case, When gross quality of fusion was rated high, rating of “Evaluation of Co-registration in Molecular Imaging: PET-PET Fusion” at the PET-PET fusion the Annual Greater New York Chapter Symposium of the Technology images (third row) individual lesions during the subtraction method also were Section of the Society of Nuclear Medicine. demonstrates that rated high. The most challenging anatomical region for cancer in the liver has regressed. 4 S PRING 2007 Figure 2. A 68 year old Dynamic MR Imaging of female s/p hysterectomy. At rest (left), normal position of pelvic floor by Hong Meng, M.D. and Jamil Rehman, M.D. Pelvic organ prolapse is diagnosed primarily via pelvic structures and organs Department of Radiology and Department of examination. Imaging is useful for patients when clinical (B-bladder, S-small bowel). At maximal diagnosis is uncertain and/or for pre-surgical planning. MR straining during graded With the installation of our state-of-the-art 1.5 Tesla and 3 imaging has an advantage over other imaging techniques in Valsalva maneuver, Tesla whole body magnets in the spring of 2004, the evaluating pelvic organ prolapse due to its lack of ionizing midline sagittal image from cine movie Department of Radiology at Stony Brook University Medical radiation, excellent depiction of pelvic organs and pelvic acquisition (right) Center has been able to broaden the clinical applications floor soft tissue, and multiplanar and dynamic imaging reveals a mild C- for body imaging to assist clinicians from various specialties capability. Also, contrast administration is not needed. and large S-. in diagnosis and management of benign or malignant dis- eases. One of the more specialized imaging techniques is For patients with dynamic magnetic resonance (MR) imaging of pelvic organ clinical concern of prolapse, which assists the urologist and gynecologist in the pelvic organ prolapse, management of patients suffering from varying degrees of dynamic MR imaging pelvic floor weakness and dysfunction. sequences are added to our routine female Pelvic organ prolapse is a relatively common condition pelvic imaging proto- S primarily affecting women. It can be debilitating as well as col. The patient is in B B embarrassing and significantly impacts their quality of life. a supine position with S It may involve one or multiple pelvic organs including knees mildly flexed. urethra, bladder, uterus, vault, rectum, and small The phase-array body coil is tightly placed over the pelvic region to cover the pelvic floor structure at the center of the imaging B U field of view. The U B U patients are carefully U B coached to collabo- B rate with graded R straining, mimic R laboring or defeca- tion. Real time imaging is acquired Figure 1. A 46 year old female with pelvic organ prolapse. At rest (left), at 2-3 image frames/second for about 100 dynamic images Figure 3. A 54 year normal position of pelvic floor structures and organs (B-bladder, U-uterus, old female with stress R-rectum). At maximal straining during graded Valsalva maneuver, midline during patient’s graded Valsalva maneuver, from rest to incontinence. At rest sagittal image from cine movie acquisition (right) reveals severe pelvic floor maximal straining. These images are reviewed in cine (left), normal position weakness and all three organ prolapse with associated cystocele, uterine movie mode for real-time assessment of pelvic floor of pelvic floor struc- prolapse and . movement and organ descent, and static images are used tures and organs (B-bladder, U-uterus). for measurement of pelvic floor landmarks and organ At maximal straining prolapse (figure 1-3). during graded Valsalva bowel. Patients may present with pain, pressure, urinary maneuver, midline and , constipation, and Patient appointment can be made by calling sagittal image from defecatory dysfunction. Pelvic organ prolapse has a (631) 444-6919. Dr. Meng (Radiology) can be reached at cine movie acquisition significant impact on society. alone (631) 444-8192. Dr. Rehman (Urology/Urogynecology) can (right) reveals a large C-cystocele and affects 10 million women in the United States at an annual be reached at (631) 444-3641. Dr. Budnick (Urology/ U-uterus prolapse. health care cost of approximately ten billion dollars. Urogynecology) can be reached at (631) 444-4686.

Imaging Center Opens

Continued from cover

Medical Director, Dr. Elaine Gould, Assistant Director Dr. Maryanna Mason, Technical Director, Charles Mazzarese, Charles as well as all the attending radiologists, technologists and Mazzarese, M.P.S., R.T., staff have contributed to the Center’s success. Patient and Karen appointments can be made by calling (631) 444-1880. O’Toole, R.T

T HE R ADIOLOGY L ETTER 5 News in the Department s

e Congratulations to Iakavos Drs. Mohit Naik and Iakavos (James) Koutras assisted c i v r

e (James) Koutras, M.D. who in coordinating the 2006 Unknown Cases Ultrasound S a i Project for the Radiological Society of North

d was appointed Chief e

M America’s Annual Meeting in December 2006 .

, Resident. Welcome to e l l i The five cases used and their posters and v our new Clinical Research Clinical Trial e N presentations were the result of the collective efforts e Associate, Aimee Minton. n n

a of many members of the Department. Included are

e Aimee will serve as a A phase II clinical trial J © Co-Research Coordinator Drs. Nancy Budorick, Jared Dunkin, Ekta Gupta, sponsored by ActivBiotics has Iakavos (James) Iakavos (James) Koutras, Amer Naeim, Mohit Naik, Koutras, M.D. named with Veronica Geronimo. Vaibhav Mangrulkar, Erica Posniak, Hsiu Su, Nandita been recently approved by the Chief Resident. Congratulations to Erin Wadhwa, and Marlene Zawin. Dr. Harris L. Cohen was s

e McCormack, Ph.D. who c i the faculty coordinator of the project. The excellent University IRB Committee and v r

e defended her Ph.D. thesis

S work on a similar RSNA project in 2005 by Drs. a recruitment has begun. i in d

e Mohit Naik and Amit Patel and a similar SRU project

M entitled “Quantitative ,

e coordinated by Dr. Kal Al-Dulaimy, was given by the This project is lead by the l l i

v Measurements of

e RSNA as the reason for the project being re-offered N

principal investigator Dr. Hong e Intracranial Cerebrospinal

n to Stony Brook in 2006. n

a Fluid Dynamics: Methods e Meng in the Department of J © to Evaluate Changes in the s Dr. Harris L. Cohen was a e c Aimee Minton joins i Radiology in collaboration v participant of the organized Biomechanics of the Brain r the Department as e S Radiology’s Editors Forum Co-Research Coordinator. a

in the Presence of Disease”. i

with the co-investigator d e held at the RSNA offices in s Dr. McCormack will be M e , c i e l v Dr. Apostolos Tassiopoulos l Chicago in September 2006. i r staying on as a postdoc e v e S The Organization includes the N a

i for another year. from the Division of Vascular e d n e Editors-in-Chief of key radiolo- n M Christina Rivera, Radiology a e , J e

Surgery. This study is for l gy publications in the United l i Librarian, has done a © v e States and abroad. Dr. Proto N phenomenal job in Harris L. Cohen, M.D., randomized evaluation of e

n seen displaying his of Radiology and Dr. Olmsted n

a organizing The Morton A.

e work as co-editor of the J of RadioGraphics helped short-term Rifalazil treatment American College of © Meyers, M.D. Department Radiology PSE test organize the 2006 meeting. on carotid atherosclerosis using Erin McCormack, Ph.D. of Radiology Library. defends Ph.D. thesis and and syllabus 51st text Dr. Cohen was there as stays on as Post-doc. in the third series - 3 Tesla high-resolution MR . Editor-in-Chief of the American College of imaging of the carotid wall Radiology’s Syllabus (PSE) series. Dr. Proto was a and atherosclerotic plaques. former Editor-in-Chief of the PSE series. The s e c

i American College of Radiology published the 51st v r

Any patient who has significant e

S text in its PSE Syllabus series in December 2006. a i

d The book, entitled Neuroradiology III was edited by atherosclerotic disease in any e M

, Drs Mauricio Castillo (University of North Carolina, e l l part of body including coronary i v

e Chapel Hill), James G. Smirniotopulis (Uniformed N

e Services University of Health Sciences, Bethesda) artery disease, peripheral n n a

e and Harris L. Cohen (University Medical Center at J and cere- © Stony Brook, Stony Brook). A new text, Chest VI is Christine Rivera, Radiology Librarian, proudly displays the being coordinated with Dr. Jeffrey S. Klein (Fletcher brovascular disease may be catalogued books in the Radiology Library. Allen Health Care, Burlington, Vermont), his eligible for participation. For Associate Editor and Dr. Cohen with an expected s e

c Jerome Liang, Ph.D. received date of publication, Dec 2007. additional information and i v r e the IEEE Long Island S a patient enrollment, please i

d Section’s Fellow Award at the e M IEEE Long Island Section s , e e contact Eileen Finnin at c l i l v i r

v Annual Awards Banquet on e e S (631) 444-5454 and Aimee N a

e Friday, April 13, 2007 at the i n d e n

a Huntington Hilton in Melville, M e J

Minton at (631) 444-2471. , e l © New York. The citation on l i v e

the Award is “For contribu- N e n

tions to medical imaging reconstruction and virtual n a e colonoscopy.” Congratulations Jerome! Michael J. J Cortegiano was appointed President of AAARAD © Iakavos (James) Koutras, M.D., Harris L. Cohen, M.D., Mohit (Association of Administrators in Academic Naik, M.D. (left to right) pose at the Annual 2006 Radiological Radiology) for 2007 - 2008. Society North America (RSNA) Meeting.

6 S PRING 2007 Lectures Vincent J. Vigorita, M.D., Professor of Abraham Dachman, M.D., Professor of Mark Murphey, M.D., International & Orthopaedic Surgery, Radiology, Director Tomography at the Course Director, Chief, Musculoskeletal Director of Research, Chairman University of Chicago presented a Grand Section, Department of Radiologic Emeritus, Department of Pathology at Rounds on “Virtual Colonoscopy” on Pathology, Armed Forces Institute of the Lutheran Medical Center, Brooklyn, Wednesday, March 7, 2007. Pathology, Baltimore, Maryland present- New York presented a Grand Rounds on ed a Grand Rounds on “MR Imaging of “Osteosarcoma and Its Variants” on Mark Ruschin, Ph.D., Department of Muscle Abnormalities” on Thursday, Wednesday, February 7, 2007. Medical Radiation Physics, Lund March 8, 2007. University, Malmö University Hospital, Ronald S. Adler, Ph.D., M.D., Chief, Malmö, Sweden presented a Grand Arra Suresh Reddy, M.D., Chief, Section Division of Ultrasound and Body CT, Rounds on “Improved In-plane of Interventional Neuroradiology, Radiology and Imaging at the Hospital Visibility of Tumors Using Breast Department of Radiology, Beth Israel for Special Surgery presented a Grand Tomosynthesis” on Wednesday, Deaconess Medical Center and Harvard Rounds on “Musculoskeletal March 7, 2007. , Boston, Massachusetts Ultrasound” on Tuesday, presented a Grand Rounds on February 20, 2007. “Minimally Invasive Cranial & Spinal ” on Friday, April 27, 2007.

Cardiovascular Section Team

(Left to right) Shane DeCamp, R.T., Hong Meng, M.D., Chief, Cardiovascular MRI, Gary Leisner, R.T., Scott McVicker, R.T., Louis Guerriero, R.T., Louis Caronia, R.T., Erica Posniak, M.D., Marlene Zawin, M.D., Chief, Cardiovascular CT Imaging, William Moore, M.D., and John Ferretti, M.D.

Digital Breast Tomosynthesis Continued from cover have confirmed that lesions are much more conspicuous was detected only on their tomosynthesis unit. on the tomosynthesis images (perhaps as much as four times for an equivalent x-ray dose). The overall radiation There are many questions that remain unanswered dose is comparable to standard Two-Dimensional mam- about this exciting new technology. They include how mography, but the exposure time is significantly longer best to obtain the images, how best to process them, (approximately 12 seconds on our prototype unit). The and even how best to compress the breast for the longer clinical trials will offer us insight into the stringent time demands for image acquisition. We will examine demand for breast immobilization for such a long how often this new research tool detects cancers missed exposure and will help illustrate how well our patients at by the currently used mammography modalities. Just as The Carol Baldwin Breast Center can tolerate the importantly, we will examine how many “false alarms” tomosynthesis exams. are generated by tomosynthesis. Stony Brook Radiology will remain at the forefront of research to answer these The cover image shows a single slice from a tomosyn- and other questions, as we gain experience in this thesis study, performed at Duke recently. The woman’s exciting new technology of breast tomosynthesis. mammogram was read as normal, while a small cancer

T HE R ADIOLOGY L ETTER 7 RADIOLOGY LETTER

A Radiologist’s Approach to Imaging Vistas I State University of New York at Stony Brook

DEPARTMENT OF RADIOLOGY Room 120, L4 Health Sciences Center State University of New York at Stony Brook Stony Brook, New York 11794–8460

Terry M. Button, Ph.D. Alan B. Bennie, M.D. Roxanne B. Palermo, M.D. Faculty & Staff Associate Professor of Clinical Radiology Assistant Professor of Clinical Radiology Assistant Professor of Clinical Radiology Director of the Medical Physics Track Division of Angiography and Interventional Radiology Division of Breast Imaging and Cross-sectional Imaging in Biomedical Engineering Director Medical Imaging Technology Program Cliff S. Bernstein, M.D. Erica J. Posniak, M.D. Donald P. Harrington, M.D., M.A., F.A.C.R. Assistant Professor of Clinical Radiology Assistant Professor of Clinical Radiology in School of Health Technology and Management Professor and Chairman Division of Breast Imaging Division of Cross-sectional Imaging Professor of Biomedical Engineering Paul R. Fisher, M.D. Radiologist-in-Chief Associate Professor of Clinical Radiology and Surgery Corazon J. Cabahug, M.D. G. Lucy van de Vegte, M.D. Division of Diagnostic Radiology and Breast Imaging Assistant Professor of Clinical Radiology Assistant Professor of Clinical Radiology Harold L. Atkins, M.D. Director, Breast Imaging Director, Division of Nuclear Medicine Division of Cross-sectional Imaging Professor Emeritus of Radiology Gene R. Gindi, Ph.D. Bruce M. Chernofsky, D.O. Paul L. Vitulli, D.O. Assistant Professor of Clinical Radiology Assistant Professor of Clinical Radiology Dvorah Balsam, M.D. Associate Professor of Radiology and Professor of Radiology Electrical Engineering Division of Neuroradiology Division of Angiography and Interventional Radiology Chief, Pediatric Radiology Elaine S. Gould, M.D. Sheri L. Ford, M.D. Mark E. Wagshul, Ph.D. Associate Professor of Clinical Radiology and Orthopaedics Assistant Professor of Clinical Radiology Assistant Professor of Clinical Radiology Nancy E. Budorick, M.D. Director, Core/Orthopaedic Radiology Division of Breast Imaging Director of MRI Research Professor of Clinical Radiology Administrative Director MR Division of Cross-sectional Imaging Medical Director, Imaging Center Dinko Franceschi, M.D. Barbara Wajsbrot-Kandel, M.D. Assistant Professor of Clinical Radiology Assistant Professor of Clinical Radiology Harris L. Cohen, M.D., F.A.C.R. Seth O. Mankes, M.D. Division of Nuclear Medicine Division of Breast Imaging and Cross-sectional Imaging Professor of Radiology Associate Professor of Clinical Radiology Division of Cross-sectional Imaging Margaret Johnstone, M.D. Zengmin Yan, M.D. Associate Chair for Research Activities Assistant Professor of Clinical Radiology Assistant Professor of Clinical Radiology Director of Body Imaging James V. Manzione, M.D., D.M.D. Division of Breast Imaging Division of Neuroradiology and Cross-sectional Chief, Ultrasound Associate Professor of Clinical Radiology, Surgery Imaging Chief, Pediatric Body Imaging and Neurological Surgery Andrei Kranz, M.D. Division of Neuroradiology Assistant Professor of Clinical Radiology Marlene L. Zawin, M.D. John A. Ferretti, M.D. Division of Angiography and Interventional Radiology Assistant Professor of Clinical Radiology and Surgery Professor of Clinical Radiology and Surgery Steven Perlmutter, M.D., F.A.C.R. Division of Cross-sectional Imaging Associate Professor of Clinical Radiology Maryanna Mason, M.D. Associate Chair, Quality Assurance Chief, Cardiovascular CT Imaging Medical Director, Department Clinical Service Assistant Professor of Clinical Radiology Chief, Computed Tomography Director, Angiography and Interventional Radiology Division of Diagnostic Radiology and Division of Diagnostic Radiology Cross-sectional Imaging Assistant Director, Imaging Center Arie E. Kaufman, Ph.D. Director, Residency Program Professor of Radiology and Computer Science Robert Matthews, M.D. ADMINISTRATIVE STAFF Clemente T. Roque, M.D. Assistant Professor of Clinical Radiology Jerome Z. Liang, Ph.D. Associate Professor of Clinical Radiology, Division of Nuclear Medicine Professor of Radiology and Computer Science Michael J. Cortegiano Neurosurgery and Administrative Officer Division of Neuroradiology Hong Meng, M.D. Morton A. Meyers, M.D. Assistant Professor of Clinical Radiology and Surgery Patricia George Professor Emeritus of Radiology Solomon Spector, M.D. Division of Cross-sectional Imaging and Medical Practice Plan Administrator Associate Professor of Clinical Radiology Diagnostic Radiology Zvi H. Oster, M.D. Division of Diagnostic Radiology Chief, Body MRI and Cardiovascular MRI Anthony Indelicato Professor Emeritus of Radiology Chief, GI/GU, Emergency Associate Hospital Director of Radiology William H. Moore, M.D. and Robert G. Peyster, M.D. Wei Zhao, Ph.D. Assistant Professor of Clinical Radiology Professor of Radiology and Neurology Associate Professor of Research Radiology Division of Diagnostic Radiology Maria Wolfe, R.T. Division of Neuroradiology Medical Physicist Chief of Thoracic Imaging Hospital Director of Radiology and Cardiology