Radiology

The Department of Radiology provides a full spectrum of imaging services as well as minimally invasive image-guided procedures to all clinical divisions at Connecticut Children’s. The department participates in the Image Gently Alliance, seeking to minimize radiation while utilizing best practice standards and American College of Radiology (ACR) Appropriateness Criteria® to provide optimal diagnostic imaging for children.

Imaging modalities range from digital radiography to complex magnetic resonance imaging. The department is accredited through the American College of Radiology in Ultrasound, CT and MRI. Image-guided procedures are performed on site at Connecticut Children’s with support from the divisions of Anesthesia and Sedation improving delivery of care in a pediatric-friendly environment. Interventional radiologists perform these diagnostic and interventional services on a 24/7 basis, providing uninterrupted care to the children we treat.

Covid-19 presented challenges to hospital systems throughout the country. The division of Radiology at Connecticut Children’s in conjunction with the divisions of Infectious Diseases and Quality and Safety proactively followed best practices to keep our Imaging Department safe and accessible to our patients. Radiology was able to seamlessly transition without interruption from only urgent elective imaging back to elective imaging.

Our priority is always focused on balancing optimal image quality with dose reduction strategies throughout the department. Digital radiography and low-dose imaging equipment, such as the EOS scoliosis technology in our Orthopaedic department, help us achieve these goals. This year we were able to retrofit our last analog radiographic room, which is located in Glastonbury, to digital technology with a marked improvement in reducing dose. The Ultrasound division offers extended appointments at our Hartford campus on weekdays and on the weekends to meet the needs of our patients and their families. Ultrasound imaging by our subspecialty-trained sonographers is also available at our Farmington and Danbury locations, allowing the community greater access to these expertly performed examinations. Contrast-enhanced ultrasound using microsphere bubbles assists our radiologists in the evaluation of vesicoureteral reflux or characterization of lesions in the liver without the need for radiation or sedation.

Fluoroscopy is an important modality used in radiology to assist pediatric providers in the assessment of their patients. This examination is performed at the Hartford campus using a Siemens flat-panel fluoroscopy unit with pulsed fluoroscopy, allowing for significant radiation dose reduction with improved image quality. This equipment is in alignment with our philosophy to “Image Gently and Step Lightly” to allow our team to provide appropriate imaging while reducing as much as possible the patient’s exposure to ionizing radiation. This year allowed us to add dose metrics for fluoroscopy exams to our dose monitoring software, Radimetrics.

Computed Tomography continues to have a significant role in children with orthopaedic, neurologic, pulmonary or abdominal conditions. Every child is different and our CT scanning techniques are monitored to ensure dose optimization for children of all sizes. When feasible, the techniques are modified to allow imaging without the need for sedation or general anesthesia. We continue to participate in the American College of Radiology Dose Index Registry, which enables us to benchmark our CT doses with other facilities.

The MRI department offers state-of-the-art facilities with both 1.5T and 3T field strength units at Connecticut Children’s Hartford campus. The availability of a 3T MRI system provides advanced cardiac imaging and neuroimaging (functional imaging, diffusion tensor imaging, and perfusion imaging of the brain). Liver fat and iron quantification and stiffness assessment (elastography) as well as advances in whole body imaging and vascular imaging and specialized imaging of the bowel and urinary tract (MR enterography and urography) have been optimized for our pediatric patients. Child friendly movies allow children to undergo their MRI study comfortably without sedation whenever possible and decrease the need for sedation or anesthesia. For more technically challenging or lengthy studies and procedures, the Sedation Service, Department of Anesthesia, and the Child Life Team offer outstanding resources to help our children undergo MRI or CT examinations.

Education is a major component of the activities of the Division of Pediatric Radiology. Residents from the Hartford Hospital, University of Connecticut, and St. Vincent’s Hospital Bridgeport radiology residency programs receive pediatric radiology training in our department. We also host elective rotations for UConn pediatric residents and pediatric subspecialty fellows as well as UConn and Quinnipiac University medical students. Additionally, the department engages in the education of sonography and radiography technology students. Didactic lectures and case presentations provide teaching to our residents, medical students, and radiology staff. Clinical care and teaching conferences are held in collaboration with the divisions of Pulmonary Medicine, Gastroenterology, Endocrinology, General Surgery, Hematology-Oncology, Orthopaedic Surgery, Rheumatology, Urology/Nephrology, and Critical Care. Through these activities, the Department of Radiology seeks to deliver optimized, patient- and family-centered care to the children we serve.

PUBLICATIONS

Lepus CA, Karasik MS, Moote D, Hyams J. Electrocautery incisional therapy for an atypical esophageal stricture in a previously healthy patient. J Pediatri Gastroenterol Nutrit. 2020 Oct. Epub ahead of print. doi: 10.1097/MPG.0000000000002971.

Sharma I, Moote D, Campbell BT. Concussion of the colon: paediatric patient with traumatic cecal haematoma. BMJ Case Rep. 2020 Dec; 13(12):e236066, doi: 10.1136/bcr-2020-236066.

Montgomery AB, Dukleska K, Balarezo F, Moote D. Cervical thymic cyst: a rare cause of neck mass in a female adolescent. J Pediatri Surg Case Rep. 2020 Jun; 59:101529 doi: 10.1016/j.epsc.2020.101529.

Sayej WN, Isakoff MS, DiGiuseppe JA, Moote D, Balarezo F, Finck C, Hyams JS. Primary cutaneous follicle center lymphoma in a 16-year-old boy with Crohn disease exposed to infliximab and methotrexate. J Pediatr Gastroenterol Nutr. 2019 Dec;70(2):e49-e50.

STAFF

Douglas Moote, MD, Division Chief Timothy Brown, MD Shanshan Bao, MD Director of Body Magnetic Resonance Imaging Johanna Chang Assistant Director of Body Magnetic Resonance Imaging Stacey Bass, MD Director of Interventional Radiology Ronald Rosenberg, MD Director of Nuclear Medicine and Molecular Imaging Ryan Kaliney, MD Director of Sports Medicine and Musculoskeletal Imaging Gregory Wrubel, MD Director of Neuroradiology Robert Hynecek, MD Director of Functional Neuroimaging David Zimmerman, MD Director of Head and Neck Imaging Martin Ollenschleger, MD Director of Neurointerventional Radiology Frederick Conard, MD Steven Poole, MD Michael O’Loughlin, MD Michael Hallisey, MD Josh Kallen, MD Molly Mable, PA-C, RT(R)

ACADEMIC AFFAIRS & RESEARCH

Connecticut Children’s strives to encourage, support, and recognize the academic activities and achievements of its Departments of Pediatrics and Surgery faculty and staff. The mission of our Academic Affairs office is to empower faculty, medical learners, and community providers to succeed in their academic, professional development, research, and quality improvement pursuits by providing critical and timely administrative, technical, and educational support. The office encompasses Academic Administration, the Office for Faculty Development, Medical Education, Research Operations and Development, and the Office of Sponsored Programs (OSP).

From the moment in March of 2020 when Covid-19 was officially declared a global pandemic, our staff across all academic departments including Academic Affairs, Fellowship Education Programs, Office of Continuing Medical Education, Office of Sponsored Programs, Research & Development, and Clinical Trials faced challenges unlike any other in the history of the health care industry. Over the course of the ensuing nine months, staff members would contend with individual heartbreak, sadness over our collective loss of time with extended family, fear over changes to our world as we knew it, and more. But throughout this period, our teams demonstrated remarkable resilience and a determination to adjust and adapt to new and ever-changing realities. Within the first few weeks of the pandemic, we had transitioned to a remote work model, learned to remain close to our teams via Zoom, and weaned ourselves from paper files to electronic files that we could easily access from home.

What resulted from the hard work and positive can-do attitude exhibited by our staff can be seen in the many successes and achievements listed in the pages that follow. Throughout each academic pillar (Research, Education, and professional wellness and faculty development) across our Departments of Pediatrics and Surgery, we moved the needle in meaningful ways on our three-year academic strategic plan, Our Journey to Excellence. To name just a few accomplishments, we kicked off business planning for the future state of our Connecticut Children’s Research Institute, accelerated the evolution of innovations and technology that support our undergraduate and graduate medical education, and established our Office of Faculty and Professional Development, which successfully provided 43 events and activities in 2020.

The wonderful work detailed throughout this section of our 2020 academic annual report is directly attributable to our team members and to the leaders who supported and steered them through the many bumps and turns over the year. My sincere thanks to the following dedicated leaders and colleagues for their dedication and hard work that enabled us to achieve so much during a time of prolonged adversity: Elizabeth Anderson, BS, Neal Breen, MBA, Michael Brimacombe, PhD, Stacy Chandna, MS, CIP, Marianne Custer, BS, C-TAGME, Kim Davey, MBA, Kathy Herbst, MS, Jessica Hollenbach, PhD, Stephanie Johnson, MT, MPH, Garry Lapidus, PA-C, MPH, Esperanza Lesmes, Alison Oville, CCRC, CHRC, and Julie Vigil, MS, CHC, CHRC. Individually and collectively, this leadership team guided our academic teams with confidence, empathy, and focus. Of course, for leading all of us, my sincere thanks to Surgeon-in-Chief Christine Finck, MD, FACS, and Physician-in-Chief Juan Salazar, MD, MPH, for their tireless leadership, expertise, and guidance during a year we will not soon forget.

With gratitude to all leaders and staff members,

Annamarie Beaulieu, MPD, BBA Senior Director, Academic Affairs, Sponsored Programs, Research Operations and Development, Continuing Medical Education, Fellowship Programs

STAFF

Annamarie Beaulieu, MPH, BBA Senior Director, Academic Affairs, Sponsored Program, Research and Development, Continuing Medical Education, Fellowship Programs

Staci Brown Administrative Assistant III

Kimberly Davey, MBA Director, Office for Sponsored Programs

Garry Lapidus, PA-C, MPH Director, Research Operations and Development

Esperanza Lesmes Senior Program Manager

Alison Oville, CCRC, CHRC Director, Clinical Trials

Department of Pediatrics at UConn

Julie Vigil, MS, CHC, CHRC Administrative Director

Laurie Papacs Administrative Officer

Allyson Martincheck Administrative Assistant, Department of Pediatrics and NICU