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2011 Fall Radiology Newsletter

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2011 Fall Radiology Newsletter THE MICHIGAN DIFFERENCE UNIVERSITY OF MICHIGAN DEPARTMENT OF RADIOLOGY THE MICHIGAN DIFFERENCE Department of Radiology AND University Hospital B1F510 1500 E. Medical Center Dr. Ann Arbor, MI 48109-5030 734-936-4338 NOTES www.med.umich.edu/rad/ NEWS NOTES ISSUE 4 FALL 2011 The Department of Radiology: Working Hard to Reduce Radiation Exposure The use of CT scans and other imaging tests has CT exams are the tool of choice because of their soared in recent years. In 1980, approximately speed and diagnostic accuracy. 3 million CT scans were performed in the U.S. Today, this number is estimated at 62 million Though a highly effective tool that has drastically (including at least 4 million for children), a twenty- reduced the need for exploratory surgery, CT scans fold increase. CT studies have skyrocketed in do carry risks. While no large-scale epidemiologic popularity because they are an extremely effective studies on cancer risks from diagnostic radiation tool in the diagnosis and management of disease: exist, data from the Japanese A-bomb survivors CT scans are utilized for everything from identify- exposed to low levels of radiation suggests that ing areas of the brain affected by strokes and head frequent exposure to the low levels of radiation injuries, to detecting abnormalities of the lungs, to associated with CT scans may increase a patient’s diagnosing abdominal diseases such as appendici- risk of eventually developing cancer, particularly if the patient is young. tis, to assessing coronary artery disease. In ERs, continued on page 3 Some members of the Department of Radiology working on minimizing radiation exposure (l to r): Manos Christodoulou, PhD; Peter J . Strouse, MD; Mitch Goodsitt, PhD; and Ella Kazerooni, MD, MS Letter from the Chair . page 2 Resident Profile . page 11 Research Spotlight . page 6 Alumni Profiles . page 12 Faculty Profiles . page 8 Faculty Member Wins Research Award . page 14 Faculty Awards + Recognition . page 10 Honor Roll . page 15 RADIOLOGY NEWS AND NOTES | ISSUE 4 | FALL 2011 WORKING HARD TO REDUCE RADIATION EXPOSURE LETTER FROM THE CHAIR continued from page 1 Dear Michigan Radiology Alumni, Friends, and Family: We have become accustomed Radiology residents are active in their own societies as to road closures. Usually the well. Shane Wells completed his service as president of closures are due to a student the American Alliance of Academic Chief Residents in “move-in” day or maybe road Radiology (A3CR2) this year. He was succeeded as A3CR2 construction. This fall the president by another Michigan resident, Matt Hammer. Department of Radiology was Dan Barr continues to serve as the resident member of the responsible for two of these Accreditation Council for Graduate Medical Education road closures—we brought (ACGME) Radiology Review Committee. three new magnetic resonance (MR) scanners into the new Research remains a high priority and our department Mott Children’s Hospital, ranks third among university radiology departments in which is scheduled to open NIH funding (Blue Ridge Institute). Imaging technologies December 2011. can now interrogate at the cellular level, making them useful for the investigation of basic physiology as well as The C.S. Mott Children’s and Von Voigtlander Women’s disease pathophysiology. Thus, imaging is now a signif- hospitals are located in a wonderful, state-of-the-art, icant part of research projects for many non-radiology 1.1-million-square-foot building that will enable us to investigators who have become important collaborators. continue our commitment to providing children with the best care possible. The radiology department will open The opening of the North Campus Research Complex with three MR and two CT scanners, with shelled space (NCRC) provides new space to expand our research pro- to add more. There are two angio suites dedicated to pedi- grams. We have had great success increasing our know- atric interventional procedures and a 1.5 Tesla magnet in ledge and understanding (discovery), but have been less the operating room for pediatric neurosurgery and poten- successful in applying this new knowledge to patient Peter J . Strouse, MD, director of pediatric radiology, with a patient . tially other applications. We anticipate that more chil- care (translation). Faculty in our Center for Molecular In the Department of Radiology, faculty such as an ultrasound or an MRI study, about a 10 percent extra dose to the dren will be referred to the new Mott Hospital than ever Imaging, who are working with Cancer Center faculty and staff are taking the issue of radiation which doesn’t involve ionizing radia- patient. “To eliminate this extra dose,” before and have recruited three of our recent graduates, to develop and evaluate new treatments, were among the exposure very seriously. Over the past tion,” says Peter J. Strouse, MD, profes- says Manos Christodoulou, PhD, diag- Jonathan Dillman, Deepa Pai, and Ethan Smith, to bolster first to occupy laboratory space at NCRC. Haile Tecle, a several years, they have pursued several sor of radiology and director of pediatric nostic physicist, “we’re working with our pediatric radiology faculty. medicinal chemist is working with Judith Leopold, Chris important measures to minimize radia- radiology. “All CT scan requests go technologists to restrict the range of the Whitehead, and Marcian Van Dort to develop small mol- tion exposure without sacrificing image through us for approval and if we have scanning to the area of interest.” Our faculty continue to be selected for leadership posi- ecules for the early detection of cancer. The ability to quality. These range from purchasing any questions, we’ll contact the physician tions in professional radiology organizations. A list of non-invasively diagnose and molecularly define an indi- new scanners that reduce radiation doses, making the request to make sure we’re A third key radiation-reduction strategy these positions and honors bestowed on our faculty are vidual’s tumor will enable the development of personal- to limiting the region of the body being performing the appropriate test for the U-M is pursuing is dose customization. included in this newsletter (see p. 10). I would like to ized therapies. scanned to the smallest possible area, to question being asked.” This strategy is particularly important point out that 41 of our faculty were selected as “Best customizing the scanning based on the with patients who undergo frequent Doctors” for 2011 and that our faculty are poised to GO BLUE!!! size and weight of the patient or on the Another relatively easy measure radi- scans, and with children, who are more become presidents of the AUR, ARRS, RSNA, and body part being scanned. Perhaps the ologists have taken to reduce radia- sensitive to radiation exposure than adults Michigan Radiological Society as well as many of our Regards, single most important step is the elimina- tion exposure is to confine CT scanning and who in the past were frequently subspecialty societies. tion of unnecessary CT examinations. to prescribed anatomical areas. Leslie scanned with adult CT settings, and Quint, MD, professor of radiology and thereby exposed to larger radiation doses “We always try to ask: Is this test really Mitch Goodsitt, PhD, professor of radio- than necessary. “Children have young, N. Reed Dunnick, MD indicated, or is there another examina- logical sciences have found that scanning rapidly dividing cells, which puts them tion we can use to diagnose conditions beyond the area of interest accounts for at a higher risk for developing radiation- continued on page 4 2 3 RADIOLOGY NEWS AND NOTES | ISSUE 4 | FALL 2011 WORKING HARD TO REDUCE RADIATION EXPOSURE CT protocols within the U-M Health says Goodsitt. He anticipates U-M will and Goodsitt recently received a $1.9M continued from page 3 System,” adds Kazerooni. have an even better method of image grant from the NIH (in collaboration reconstruction—the model-based image with GE Global Research) to develop Another dose-reduction feature on the reconstruction (MBIR) method—in the and evaluate image reconstruction algo- General Electric (GE) CT scanners in near future. Soon to be commercially rithms for low-dose CT scans used to U-M’s hospitals is Adaptive Statistical available, the MBIR method produces diagnose and monitor lung disease. “In Iterative Reconstruction (ASIR), a new high-quality CT images with up to a the future, radiation dose with a chest method of CT image reconstruction. 75 percent reduction in dose. Jeffrey scan using MBIR reconstruction will “By using ASIR in combination with Fessler, PhD, professor of radiology and be the same as for a chest X-ray,” says the standard filtered back projection biomedical engineering (principal inves- Kazerooni. “When that happens, radia- [FBP] method of image reconstruction,” tigator) and co-investigators Kazerooni tion exposure may very well become a U-M doctors have managed to cut radia- non-issue.” tion dose for CT studies by 30 percent, Physicists Manos Christodoulou, PhD, and Mitch Goodsitt, PhD, test all imaging systems to ensure they are very safe . related cancers,” says Strouse. “And they sures for smaller, less dense regions of fessor of radiology. “Having the latest also have a longer life expectancy than the body where X-ray penetration is not software and hardware is a top priority adults, resulting in a larger window of an issue.” here.” time for a radiation-induced cancer to develop. Because of these risk factors, we Goodsitt heads up a group—the Physics In 2010, Christodoulou also began devel- customize dose according to the child’s Quality Control Group—that works in oping a robust radiation exposure regis- weight, age, and the body part being conjunction with radiologists and tech- try, which when completed will provide scanned.” nologists to identify and purchase imag- benchmarks for determining the optimal ing systems with features that minimize level of radiation for a particular CT The new generation of CT scanners radiation dose.
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