ICE Magazine June 2024

MICROAGGRESSIONS IN MEDICAL IMAGING

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PRODUCT FOCUS NUCLEAR MEDICINE

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FEATURES

DIRECTOR’S CUT

One-on-one check-ins with staff provide many benefits, including some eureka moments.

COVER STORY

Microaggressions have a big impact on workplace culture and more.

RISING STAR

CT Scan Supervisor

Suzie Dodson’s interest in imaging began with a funny incident.

IMAGING NEWS

Catch up on the latest news from around the diagnostic imaging world.

PRODUCT FOCUS

This month, nuclear medicine devices are in the spotlight.

EMOTIONAL INTELLIGENCE Trust needs to be the cornerstone in every business, especially when working with and serving people.

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THE TOTAL PACKAGE HAS ARRIVED.

ROBIN EASTLAND

FOCUS IN

BY JOHN WALLACE

UT Southwestern Medical Center

Imaging Services Director Ambulatory Imaging Services Robin Eastland, RT(R)(M) (CT) CRA, holds a m aster’s degree in r adiology a dministration. Her imaging journey began in Amarillo, Texas.

“I grew up in Amarillo, Texas. It is also where I received the best radiography education foundation,” Eastland says. “I received my associate degree from Amarillo College in 1996. I moved out of Amarillo immediately after graduation from the radiography program. Later in my career (2012), I completed my Bachelor of Radiologic Science in the online program at Midwestern State University while still working full-time. Next, in 2014, I com -

pleted the Master of Science in Radiologic Science, Radiology Administration from Midwestern State University.

Her health care career began with the idea that she would serve in a different role.

“Initially I planned to go into nursing, but when I was waitlisted for the next group of nursing clinicals, I began to explore other options,” Eastland recalls. “A family member mentioned X-ray. I reached out to my academic advisor. Another student had just declined radiography clinicals at the 11th hour due to a pregnancy. She told me if I could get the program coordinators to sign off by end of day, I could start the program the following week. Challenge accepted!”

“I was admitted to the program with just a few days’ notice and no official application to the program. I feel this was absolutely the path I

Robin Eastland is a Texas native giving back to the state where she grew up.

was meant to take. I did not take the opportunity for granted. I rose to the top of the class with my academic and clinical performance and served as the class president,” she adds.

Her decision continues to pay dividends daily.

“I loved interacting with the patients and their families working to solve the mysteries within their bodies. Later as a supervisor, manager, and director, I enjoy solving problems. Sometimes the problem is refining a process to make things work better for all patients and other times it may be offering potential solutions to an employee that is looking for something new and more challenging,” Eastland shares. “I really like that every day is different and my job touches so many different aspects of how a health care institution operates. Some of those aspects are predictable, but others are things I did not expect to encounter like construction and how to operate and maintain an 18-wheeler for a mobile mammography program.”

She continues to enjoy her career choice.

“I like having the opportunity to share the things I have learned through my career and partnering with others to continue to make our department even better. We are always looking for ways to do things better,” Eastland says.

The imaging field itself is another amazing aspect of her career.

“Imaging is ever-changing. I enjoy the technolo -

gy and mechanical aspects of equipment,” she says. “Learning how the equipment works and about new emerging technologies and the ways new technology can help operations, patient access and improve patient outcomes.”

Advancing the role of imaging through research is among her greatest accomplishments.

“Earlier in my career, I had the opportunity to serve as a research technologist. In that role I was able to use some of the early 3D mammography and screening breast ultrasound equipment during FDA trial phases. I took pride in being able to offer feedback that could shape the final product that other techs might (and did) use in the future. Those devices have saved many women’s lives. I am glad to have been even a small part of the development,” Eastland says.

As an imaging leader, Eastland wants to pave the road for more imaging professionals to excel.

“I want to continue to grow and learn. My goal for the next 5 years is to be the best and most supportive leader for the team I serve,” she says.

“I approach leadership with humility and compassion. I don’t have all the answers. I often consult others and get feedback from front line staff,” Eastland says. “I like to challenge those around me to look at things from a different point of view and to always keep our focus on the patient. If we do what is best for the patient, we have always done the right thing.” •

ROBIN EASTLAND, RT (R)(M)(CT)

imaging Director at UT Southwestern Medical Center

1. What is the last book you read? “Fearless Organization” by Amy Edmondson

2. Favorite movie? “Step Brothers”

3. What is something most of your coworkers don’t know about you? I was a junior member of a professional ballet company in my teens and I love to assemble Ikea furniture. They are like giant puzzles to me!

4. What is one thing you do every morning to start your day? I like to start the day with positivity and mindfulness. I take the time to smell the fragrance of my shampoo, feel the warm water of the shower, appreciate the sunrise and, most importantly, the joy of that first drink of coffee!

5. Best advice you ever received? It’s good to be uncomfortable. You must be uncomfortable to grow. If you get too comfortable, you are complacent.

6. Who has had the biggest influence on your life? Honestly, my children. When they were younger, they were my drive to climb the career ladder to provide for them. Now as young adults, each of them push me to be a better person in different ways. They inspire me with their lives and their new ideas.

7. What would your superpower be? I would love to be able to see into the future.

8. What are your hobbies? I love all animals, but especially dogs. I like to hang out with my dogs and love to drop into shelters to love on those that are awaiting their forever homes. I also enjoy any type of renovation. Refinishing furniture, painting a room, or even some bigger projects like flooring and tile work or even replacing a toilet. I might have missed my calling as a construction worker.

9. What is your perfect meal? Tex Mex! Chips, queso and salsa any day!

RISING STAR

SUZIE DODSON, BA, RT (R)(CT)

University Hospital’s Cleveland Medical Center CT Scan Supervisor Suzie Dodson, BA, RT (R)(CT), says her rise in the imaging field starts with a funny story. Dodson’s journey began when she was an imaging patient as a child.

“It’s actually a funny story,” she says. “I’ve always been interested in the medical field, after having multiple radiology exams as a child, I always had an interest in imaging and how the human body works. When I was 13, I remember having an UGI exam and vomiting all over the table and the technologist. She was the sweetest woman ever, and I admired how she handled the whole situation.

While applying to radiography school, I got a job as a radiology tech aid in a community hospital. After learning the ins and outs of a radiology department, I knew becoming a technologist was what I wanted to do as a career.”

Dodson was born and raised in the suburbs of Cleveland, Ohio, where she still lives with her husband and their two boys, ages 1 and 3.

“I went to the University of Akron’s School

Suzie Dodson’s interest in imaging was sparked by a “funny” childhood incident.

of Radiography and earned my associate degree in applied science of radiology. After getting registered in radiography, I attended the Cleveland Clinic’s School of Diagnostic Imaging’s CT program and achieved certification in CT. After being promoted to supervisor, I enrolled at New Hampshire University earning my Bachelor of Arts in Healthcare Management with a concentration in communications.

Dodson enjoys her work.

“I love being able to help people. Whether that be a patient, a coworker, a provider or a complete stranger. People don’t typically enjoy coming to a hospital, so anything I can do to make their experi -

ence a positive one,” she says. “I like that every day is different. I may be going to the same place but there is never monotony. I like to solve problems and I feel like that’s a key component of being a supervisor.”

She is also excited about the future.

“The technology in our field is always growing. There is new research and technology being developed every day and I want to be the first to see it, learn about it and implement it,” Dodson says.

“Always continue to grow as a leader, technologist, coworker and human,” Dodson replies when asked about her goals for the next five years. “I am open to whatever opportunities come knocking.” •

FUN FACTS

FAVORITE HOBBY:

Crafting and spending time with friends and family.

FAVORITE SHOW:

“Grey’s Anatomy,” I’ve followed it since Episode 1!

FAVORITE FOOD: It depends on my mood. It could range from a simple piece of pizza to crab legs!

FAVORITE VACATION SPOT:

Aruba, I went on my honeymoon there and cannot wait to go back.

1 THING ON YOUR BUCKET LIST:

To be on a TV game show like “The Price is Right,” “Wheel of Fortune” or “Let’s Make a Deal!”

SOMETHING

YOUR COWORKERS DON’T KNOW ABOUT YOU:

After high school, I took the Emergency Medical Technician Basic test and became an EMT-B. I never worked in that profession, but I learned a lot about emergency medicine that helps me still to this day.

ICE DEBUT

Image One Medical is the only engineer-owned medical equipment service group that is fully dedicated to Florida’s amazing base of imaging centers, hospitals, and cancer treatment centers. The company’s mission is to self-perform in every aspect of its business. It specializes on PET/CT, CT and MRI. CEO Ric Arcadi and CTO Jeremy Hesser recently shared more information about the company.

Q: CAN YOU TELL US A LITTLE ABOUT YOUR COMPANY?

A: We specialize in the bigger iron in the DI industry. Our core strength is PET/CT and nuclear medicine. We sell and service PET/CT CT and nuclear medicine assets as well as provide white-glove full service programs keeping clients up and running with 24-hour monitoring.

Q: IS THERE SOMETHING YOU ARE EXCITED ABOUT RIGHT NOW?

A: Yes ... we like a challenge so we decided to direct our expertise into the most challenging modality to service. More importantly, the evergreening new-uses for PET/CT with the advent of cardiac scans, prostate scans, and the coming future with theranostics ensures our company will stay on the forefront of cutting edge patient treatment that will remain at the top tier for insurance reimbursements.

Q: HOW DOES YOUR COMPANY STAND OUT IN THE IMAGING SPACE?

A: Our ratio of engineers-to-contracted sites, and our ratio of parts inventory-to-contracted assets. We overtool with

manpower and parts to ensure our contracted sites stay up and running. In today’s market, it’s rare that a client raves about an ISO’s service. With the meltdown of so many larger ISOs in our market, we are fortunate to learn from their misteps. Following a quote from “Jerry McGuire”- “Fewer clients, Better Service.”

Q: WHAT IS ON THE HORIZON FOR YOUR COMPANY?

A: We are just finishing a state of the art facility in south Florida that was a former airplane hangar with an attached runway. We will house our team, a deep inventory of PET/CT and nuclear medicine scanners, as well as grow our mobile coach building business. Fun fact: as this building is an airplane hangar, we have the ability to open up a 60’ wide section of wall and bring in up to 3 mobiles at a time. We have been building mobile trailers for dealer/ friends in the industry, and we intend to expand those capabilities. But, our primary focus is our core offering of white glove service contracts and we intend to expand that by 35% in the next 2 years.

Q: IS THERE ANYTHING ELSE YOU WOULD LIKE ICE MAGAZINE READERS TO KNOW?

A: Well, I have already gloated on what we are about. And as cliched as it sounds, we have an amazing team of people at this company. All of us are super tight and are family. The Hesser family is the core base of our engineer team. Every new hire has to be a chemistry fit as well as a talent fit. But the proof is in the pudding, talk to our clients, they love us. •

For more information, visit image1group.com

ICE

ICE

A COOL SERIES FOR HOT TOPICS

ICE Webinars: The Series Everyone is Talking About

ICE Webinars: The Series Everyone is Talking About!

ICE Magazine connects with industry leaders to provide top-quality educational opportunities through its monthly webinar series. Reach key decision makers and imaging leaders with your company's message, while collecting important data for sales.

A COOL SERIES FOR HOT TOPICS

ICE Magazine connects with industry leaders to provide top-quality educational opportunities through its monthly webinar series. Reach key decision makers and imaging leaders with your company’s message, while collecting important data for sales.

For more information, visit icewebinars.live.

ICE Webinars: The Series Everyone is Talking About!

ICE Magazine connects with industry leaders to provide top-quality educational opportunities through its monthly webinar series. Reach key decision makers and imaging leaders with your company's message, while collecting important data for sales.

For more information, visit icewebinars.live.

I love that ICE webinars help me gain my CEUs, it also helps that they have some of the best presenters/lecturers!

- J.Sturm, Nuclear Medicine Technologist, Novant Health Brunswick Medical Center.

The content is always relevant and timely, very professional presentations.

– N. Godby, Director of Radiology, Cabell Huntington Hospital Inc.

Check out our YouTube channel for more information and exclusive content!

Learn about best practices and newer technology.

– K.Stich, Radiology Director,East Market, University Hospitals.

The content is always relevant and timely, very professional presentations.

– N. Godby, Director of Radiology, Cabell Huntington Hospital Inc.

YOUTUBE CHANNEL

Learn about best practices and newer technology.

– K.Stich, Radiology Director,East Market, University Hospitals.

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Rad idea

SELF-CARE FOR A SUCCESSFUL YOU

Resolving to commit to better self-care can happen any time of the year. The present is always the perfect starting point for developing new habits and a new approach to protecting your overall wellness. Self-care takes many forms. Maintaining a well-balanced diet and getting plenty of exercise are some ways to promote your physical health. When it comes to mental health, getting organized is a surprisingly effective way to manage stress and keep goals on track so you feel a sense of accomplishment.

Give yourself a boost toward tackling this year’s goals by getting organized. A planner can help you keep important information at your fingertips while making it easy to keep tabs on appointments, deadlines and more. You can even track progress against new habits or journal your way toward a heathier

diet. Some people prefer physical planners they can write in and update manually while others find a digital version in a smart device is more convenient. Speaking of healthier habits, let’s look at how to prepare for healthier eating habits.

Portion control is a common challenge when you kick off a healthier eating plan. One way to keep your meals on the modest side is preparing them ahead of time. Meal prep containers make it easy to have freshly prepared foods in moderate portions ready whenever you’re ready to eat. Look for compartments that let you enjoy a main dish and at least one side, and be sure the containers seal tightly to keep food fresh and prevent leaks.

Look for more lifestyle advice and helpful wellness tips at eLivingtoday.com. •

Share your RAD IDEA via an email to editor@mdpublishing.com.

Photo courtesy of Shutterstock

SPOTLIGHT

Clock Off THE

HEIKE E. DALDRUP-LINK, MD, PH.D.

BY MATT SKOUFALOS

When an inventory of computer chips is stolen from an elite university, radiologist Lily Pham leverages her anatomical knowledge to diagnose various bone fractures that are critical to the caper. When a young scientist is murdered after uncovering unethical research activities, it’s Pham again who digs into the mysterious circumstances around her death. And when a health insurance agent vanishes in San Francisco, ER-physician-and-undercover-CIA-agent Annya Segond is one of the first to connect the disappearance to the sudden approval of pending pediatric cancer insurance claims.

These are the characters at the center of a trio of novels published by Stanford University radiologist Heike Daldrup-Link, MD, Ph.D. Daldrup-Link, who directs pediatric molecular imaging and co-directs cancer imaging in the Stanford University radiology department, is a prolific writer in her field, having penned some 200 peer-reviewed research articles, 20 book chapters and editorials, 11 books, and six patents.

She’s also a member of the Pegasus group, a gathering of physician writers at Stanford who work on their own creative projects, which led to her creating the novels “The Stolen Brain Chip,” “Who Killed Nia Johnes” and “The Claim: A Medical Mystery.” The books are written under her pen name, Elisabeth Link, and published by Monasteria Press. Each aims to celebrate the distinct contributions of women in science and medicine, and places them in settings that allow her characters to set the courses of their own stories – much like Daldrup-Link, who herself imagined a career in writing from an early age.

“My earliest writings were to my grandmother, who lived alone in a forest in Albersloh,” Daldrup-Link recalled. “She had

10 children, and many of us, her children and grandchildren, lived in the same town. We couldn’t see her on a regular basis, but we were able to send her regular letters.”

“When I was a teenager, I started writing columns for a local newsletter that would be offered at our bakery,” she said. “I got a little pocket money for it, and that was great for me at the time. There I would tell stories about our neighborhood, often that involved my dog, Bobby.”

Early acknowledgment of her talents led Daldrup-Link to consider pursuing a career in journalism; however, the struggles of a friend who was on a similar path led her to reconsider. Instead, she redoubled her efforts in the sciences, and became more interested in medicine.

“I always wanted to become a pediatrician, and now I am a pediatric radiologist,” Daldrup-Link said.

During the novel coronavirus (COVID-19) pandemic, Daldrup-Link picked up her writing again, supported by the Pegasus writers. She’d always felt somewhat set apart from her colleagues, and began leveraging those impulses in the character dynamics of her writing.

“Every day as a physician and scientist, I’m entrusted with stories of patients and colleagues who work with them,” Daldrup-Link said. “I hear tales of struggle, resilience, and the unexpected twists of life, medicine and sciences.”

“The triumphs and struggles of brilliant women in science deserve a wider audience,” she said. “Their stories extend far beyond the hospital walls, offering relatable experiences, shining a light on inequalities, and sometimes presenting the wonderfully unexpected.”

Daldrup-Link was insistent that her works would be centered on strong female protagonists – “no damsels in distress,” she said – capable of unravelling mysteries, and whose experiences can be woven into the process.

“I try to show the breadth of different personalities who are out there,” Daldrup-Link said. “It’s fiction; I have a certain

experience, and then I play with the idea. There was some experience that I had in the real world, and then something totally different came out.”

A fan of mystery novels, Daldrup-Link also leaned on her knowledge of scientific academia to inspire plot scenarios, like her upcoming novel, which centers on highend technology and a villain who could create designer babies with it. Her stories are set in a fictional, elite, Silicon Valley university; “this community of very accomplished, perfect individuals.”

“As you engage in the community, there’s all these interactions going on just as in any other community,” Daldrup-Link said. “In the first novel, there is a radiologist (Pham) who is one of the major protagonists. I got feedback about a physician who is also an undercover CIA agent (Segond), so she became one of the other characters in the novel.”

Reader feedback is important to Daldrup-Link, whether it comes from her colleagues in the writing group, her husband or the broader audience who’ve encountered the stories. She is surprised at which of her characters the readers attach themselves. Junior ER physician Julius became a breakout character because he is constantly wilting under the expectations of his overbearing father, and makes more mistakes than his wealthy privilege can smooth out. Segond’s liaison, FBI agent Angus Weber, is a concession to her husband, Thomas Link, who asked for there to be one conventionally written male character that doesn’t function as a nemesis. Even those who cross Daldrup-Link’s path in an unwelcome way in the real world might find their way into the fictional one.

“I highly appreciate the feedback,” she said. “Now, when I meet a bully I think, ‘Thank you, I just got some new input for my next novel.’ And I try to weave in these little characters who maybe come in as a little surprise.”

Sometimes the stories form deeper connections with her readers. Daldrup-Link recounted signing one of her novels for a student who told her how Segond’s perseverance in the story inspired that student to stand up to critics, and to remain on their medical career track.

“Another student sent me a notecard that read: ‘I’m aware that I cannot control the barriers that enter my life, but, like water, I will never be broken. Medicine is an intellectual journey, and I’m determined to reach my goal of becoming the best doctor my patients will ever encounter,’ ” DaldrupLink shared.

“My heart swelled,” she said. “In that moment, I knew I wasn’t just writing mysteries; I was igniting a passion for science and medicine, one untold story at a time. Women in science and medicine change the world, as undeniable and bright as the colors in the sky.” •

Heike E. Daldrup-Link is a respected member of the imaging community and serves as the associate chair for diversity at Stanford University.

Childhood letter to her grandmother in Albersloh, Germany, was the beginning of Heike E. Daldrup-Link’s joy of writing.

Heike E. Daldrup-Link inspires women in real life and through her novels.

Imaging News

A LOOK AT WHAT’S CHANGING IN THE IMAGING INDUSTRY

RSNA HELPS BRING ADVANCED MAMMOGRAPHY TECHNOLOGY TO TANZANIA

The Radiological Society of North America (RSNA) and GE HealthCare recently announced a collaboration to provide mammography technology, training and educational tools to radiologists at Muhimbili National Hospital (MNH), part of the Muhimbili University of Health and Sciences (MUHAS), in Tanzania to improve access to screening and help clinicians lower the country’s breast cancer mortality rate.

MNH at MUHAS is a public hospital serving Dar es Salaam, the largest city in Tanzania, and did not have a working mammography machine. For women in Tanzania, breast cancer is the second leading cause of cancer mortality, with more than 80% of diagnoses happening at stage III or IV when the odds of long-term survivability are much lower. Additionally, the lifetime risk for developing breast cancer is approximately one in twenty, and approximately half of all women diagnosed with breast cancer in the country die of the disease.

Breast cancer is the most common cancer among women worldwide, affecting both developed and developing countries Its impact transcends borders, cultures, and socioeconomic backgrounds. To help improve radiology education and patient care around the world, RSNA developed the Global Learning Center (GLC) program that works to create learning centers with established radiology departments based in low- or middle-resourced countries, like Tanzania. Through this program, a team of RSNA members works with the institution over three

years to develop a customized curriculum with in-person, hands-on training, didactic lectures, conferences, online courses and other education offerings. MUHAS is part of the RSNA GLC program and is funded by a grant from the U.S. Department of Energy’s National Nuclear Security Administration (NNSA).

As part of the new agreement, GE HealthCare will install the Pristina Mammography Suite, which includes 2D and 3D digital breast tomosynthesis, Contrast Enhanced Mammography (CEM), CEM Biopsy capabilities and a Seno Iris workstation, at MUHAS, as well as provide maintenance of the system at no charge to the university.

Approximately 20 nurses, radiologists and techs will be involved with the mammography suite. Live trainings under the grant will cover operation of the system, image interpretation, patient care, video tutorials, case study learning, engagement of physicians in a peer learning network and, upon course completion, a GE HealthCare-issued certification.

In addition to improving the level of radiologic practice and breast care throughout the region, the collaboration between GE HealthCare, MUHAS and RSNA will also work to raise awareness about the importance of breast cancer screening and early detection among Tanzanians.

Since the RSNA GLC program’s introduction in 2020, RSNA has established sites in South Africa, Tanzania, Ecuador, Indonesia and Armenia.

AHRA ANNOUCES ‘LIVING OUR LEGACY’ CAMPAIGN

For over 50 years, the Association for Medical Imaging Management (AHRA) has been the premier professional organization that represents the voices of more than 5,000 medical imaging leaders in over 2,500 health care facilities. AHRA, aligned with its philanthropic arm the AHRA Education Foundation (EF), dedicated to educating, developing, and mentoring medical imaging professionals, is proud to announce the Living Our Legacy campaign. This multi-year effort will allow for sustainable growth, foster innovation, and position AHRA to better support the professional advancement of its members. AHRA’s Living Our Legacy campaign is inviting its stakeholders to come together and invest in empowering the current and future generations of medical imaging leaders.

“AHRA’s mission – to provide quality education, relevant resources and top-notch leadership training – supports not only our longtime members but creates a pipeline of well-trained leaders who are adequately prepared to tackle challenges in the ever-evolving healthcare field,” shared Living Our Legacy Co-Chair and Vice President of Radiology & Pathology at University Health System Jason Theadore. “Through this campaign, AHRA will have the ability to sustain and update its programs, extend the reach of its resources for medical imaging professionals and, ultimately, have a positive impact on the patients we serve.”

The funds raised through the Living Our Legacy campaign will focus on:

• Research, Benchmarking & Best Practices: To equip imaging leaders with insights to assess how their departments are performing relative to industry standards, identify and prioritize areas of improvement, and strengthen their voices when making the case for changes at their institutions.

• Cross Functional Education & Leadership Development: To help imaging leaders at all levels expand their perspectives and knowledge beyond the radiology department and sharpen their business acumen and leadership skills.

• Thought Leadership: To create forum(s) that connect AHRA members, industry partners, and other relevant stakeholders to share forward-thinking ideas and identify new potential opportunities to advance medical imaging management.

• Advocacy & Outreach: To ensure the collective voice of imaging leaders is heard when examining key topics affecting the field, elevate recognition of medical imaging management and the crucial role it plays in health care, and cultivate a vibrant and diverse talent pipeline for the future.

For more information, visit tinyurl.com/2cd9cuh9.

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- Dose Reduction

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CAPTION AI INTRODUCED FOR WIRELESS HANDHELD ULTRASOUND SYSTEM

GE HealthCare recently launched Caption AI artificial intelligence (AI)-driven software for rapid cardiac assessments at the point of care on Vscan Air SL. Now, with Caption AI technology, clinicians using Vscan Air SL handheld ultrasound will have access to real-time, step-by-step guidance to capture diagnostic-quality images and automated ejection fraction estimation to help inform clinical decisions across cardiac settings. Vscan Air SL with Caption AI made its debut at the 2024 American College of Cardiology (ACC) Annual Scientific Session & Expo.

Cardiovascular disease (CVD) is the leading cause of death globally, and the prevalence is expected to continue rising as people live longer and the population increases.1 Early detection of heart disease is critical to improving patient outcomes, but providing rapid echocardiographic assessments at the point of care can be difficult in resource-constrained facilities and practices. Vscan Air SL with Caption AI is designed to lower the threshold for healthcare professionals to be able to capture cardiac images so that even non-expert ultrasound users can take a quick look at patients’ hearts.

“With the increase of cardiovascular disease and shortage of sonographers around the globe, innovations like the Vscan Air SL with Caption AI are hugely transformative in cardiac care, supporting rapid and confident assessments at the point of care,” said cardiologist Jordan B. Strom, M.D., MSc. “AI guidance has enormous potential in ultrasound due to its ability to guide experts and relatively new users in retrieving diagnostic-quality information to make timely and accurate decisions and get patients on the right path sooner.”

Caption AI provides real-time visual guidance to prompt users on probe movements and includes a quality meter to ensure the user obtains the best possible images. Once an image is captured, the AutoEF feature automatically calculates a left ventricular ejection fraction (LVEF). In addition, users can efficiently scan with AutoCapture and Save Best Clip features to capture the best quality image from each view.

The ultraportable Vscan Air SL provides high levels of depth, resolution and sensitivity in imaging performance with an industry-leading single crystal transducer technology. The latest integration of Caption AI builds on GE HealthCare’s history and innovation in handheld ultra-

sound—having introduced the pioneering Vscan in 2010 as the first color, pocket-sized ultrasound device—and is helping to make next-generation ultrasound care accessible to even more patients.

“The integration of Caption AI with the Vscan Air SL handheld ultrasound opens an entirely new chapter for cardiac screening. This technology empowers users with guidance and tools for high quality ultrasound scans and supports earlier detection of cardiac disease,” said Roland Rott, president and CEO, Ultrasound, GE HealthCare. “The strategic acquisition of Caption Health in 2023 continues to expand the capabilities of our products and solidifies our leadership in ultrasound and the emerging artificial intelligence landscape.”

The launch of Vscan Air SL with Caption AI advances GE HealthCare’s vision and efforts to strengthen precision care, joining the approximately 60 AI-enabled medical device authorizations from GE HealthCare in the United States –more than any other medical device company. Of these, approximately 30 are AI-enabled ultrasound innovations.

In addition to Vscan Air SL, GE HealthCare will also showcase its suite of innovative products and solutions across the cardiology care pathway at ACC 2024, including CardioVisio for Atrial Fibrillation, a digital, patient-centric clinical decision support tool, which includes the most recent ACC guidelines. Telling the story of the heart with integrated cardiology technology, the comprehensive portfolio of cardiovascular solutions delivers across the full continuum of patient care from diagnosis and treatment all the way through post-treatment monitoring. •

FUJIFILM INTRODUCES OPIE TRANSDUCER

FUJIFILM Healthcare Americas Corporation recently announced the launch of its first-of-kind OPIE transducer for onpump intracardiac echocardiography (OPIE) for septal myectomy. The OPIE transducer is currently available in the United States and is pending regulatory requirements in Canada.

Traditionally, a cardiothoracic surgeon uses transesophageal echocardiography (TEE) before performing septal myectomy. Currently, TEE cannot be leveraged during cardiac bypass surgery. Instead, a surgeon views the patient’s septal thickness via TEE prior to performing open-heart surgery and would trim the septum – if necessary – without real-time guidance. However, with OPIE, a thin transducer is passed into the heart during the myectomy where images of the patient’s septal thickness can be seen in real-time.

A study featuring Fujifilm’s OPIE Transducer highlights that the system provides established imaging to aid in septal myectomy procedures compared to TEE and transthoracic echocardiogram (TTE). Real-time measurements of the interventricular septal thickness are crucial during septal myectomy to avoid creating a ventricular septal defect while resecting enough myocardium. The OPIE transducer is compatible with Fujifilm’s premium ultrasound system, the ARIETTA Precision.

“During septal myectomy, it is critical to correctly measure the patient’s septal thickness because it can directly impact the patient’s care pathway,” said Hideyuki Honda, vice president, ultrasound solutions, FUJIFILM Healthcare Americas Corporation. “Every day we pride ourselves on delivering what we believe is the highest quality ultrasound solutions, arming cardiologists and cardiothoracic surgeons alike with the visualization they need to eliminate guess work in the operating room. Early clinical results of our OPIE Transducer during a high-risk procedure like cardiac bypass surgery are impressive, and we’re proud that the technology is proving to provide high-quality, real-time feedback for the surgeon.”

GE HEALTHCARE AIMS TO ADVANCE WOMEN’S HEALTH IMAGING

GE HealthCare recently launched the Voluson Signature 20 and 18 ultrasound systems, which comprehensively integrate artificial intelligence (AI), advanced tools and an ergonomic design to speed exam time for clinicians while delivering a clearer picture of various conditions impacting women’s health. These latest systems combine high-performance hardware with flexible scalable software to help increase clinicians’ confidence in their diagnostic and treatment determinations.

Today, patient volumes are increasing and health conditions are becoming more complex – especially for women who face complications related to pregnancy, as well as other conditions impacting the female reproductive system. At the same time, workforce shortages continue to be a major challenge for health systems who are trying to meet these demands, with 42% of clinicians surveyed as part of GE HealthCare’s Reimagining Better Health study considering leaving the health care industry. To help address patient demand and reduce staffing burdens, clinicians across the board need tools, including innovative AI-enabled ultrasound technologies, that support a clear, quick and confident diagnosis.

“We’ve seen huge advancements in ultrasound technology, including the use of AI, resulting in a new era of ultrasound scanning. The new Voluson Signature series features innovative tools clinicians can rely on, and the automated functions help reduce work stress and improve workflows,” said Dr. Ben Csapo, a maternal fetal medicine specialist in Graz, Austria. “The most important part of our work is building connections with patients and not over-instrumentalizing work. Having a tool that helps clinicians work smarter, faster and easier is a good step forward for patients.”

The latest AI-powered capabilities on the Voluson Signature 20 and 18 enable a number of efficiencies across women’s health care settings.

• The new “Hey Voluson” feature allows users to operate the system using voice commands, saving time and keystrokes.

• SonoLyst, a suite of tools that leverage AI to identify fetal anatomy seen on standard views, then automatically annotates and measures

where applicable, and can reduce time to complete standard International Society of Ultrasound in Obstetrics and Gynecology (ISUOG) second trimester exams by up to 40%.

• SonoPelvicFloor simplifies assessments of the pelvic floor and speeds up exams by automating plane alignment and measurements for an up to 76% keystroke reduction.

• Fibroid Mapping uses AI to standardize and streamline fibroid documentation by mapping, measuring, and classifying fibroids.

• fetalHS simplifies and speeds fetal heart assessments by up to 48% by providing step-by-step, AI-driven guidance to help identify normal fetal heart anatomy.

In addition, a flexible wireless workflow is now a possibility with the integration of Vscan Air CL wireless dual probe with the new Voluson Signature systems, allowing for a wider range of motion because it is cable free.

“Next-level image clarity can help clinicians detect fetal abnormalities and hard-to-spot gynecological emergencies or conditions like endometriosis earlier, which can make a big difference in a patient’s treatment plan and overall health,” said Gerald Seifriedsberger, general manager, Women’s Health Ultrasound, GE HealthCare. “With proven time-saving AI-driven applications, and advanced automation features that simplify exams, we’re providing technology that can help enhance ease of use and provide clearer images – helping clinicians power through demanding workflows faster while delivering greater consistency and accuracy, ultimately helping deliver better health outcomes for women.”

These latest solutions build on GE HealthCare’s Voluson portfolio, which incorporate a legacy of innovation to deliver exceptional image quality, advanced clinical tools, and intelligent workflow to enable high quality, efficient care. For more information on the Voluson Signature 20 and 18 devices, visit https://www.gehealthcare.com/products/ultrasound/ voluson/voluson-signature20 and https://www. gehealthcare.com/products/ultrasound/voluson/voluson-signature18.

AI-GUIDED ULTRASOUND SYSTEM ENABLES RAPID DVT ASSESSMENT

Clarius Mobile Health, a provider of high-definition handheld ultrasound systems, and ThinkSono, a company specializing in ultrasound artificial intelligence (AI) guidance solutions, are introducing a new AI-guided ultrasound system in Europe, which will improve the efficiency of detecting deep vein thrombosis (DVT). ThinkSono Guidance, an AI App that pairs with Clarius ultrasound scanners, recently attained Class llb CE mark regulatory approval.

DVT is a blood clot found commonly in the leg and is a leading cause of preventable hospital death in Europe and the United States. Patients often wait for hours or days for test results performed by ultrasound-trained clinicians. ThinkSono Guidance enables non-ultrasound trained healthcare professionals to use the Clarius handheld ultrasound scanner to collect DVT exam data for a qualified clinician to review. This can speed up the diagnosis from several hours to as little as 15 minutes.

“Clarius has been an invaluable partner in helping us bring ThinkSono Guidance to market quickly to help non-ultrasound trained staff such as nurses improve the DVT pathway by scanning for DVTs at the bedside,” says Fouad-Al Noor, CEO and Co-founder of ThinkSono. “Our App integrates seamlessly with Clarius scanners through the research SDK, which sends streams of real-time data to the ThinkSono App that in turn providing instant guidance to users as they perform an ultrasound exam. Our partnership with Clarius has been vital in running our clinical studies.”

Further clinical studies are currently underway in the

United States at NYU Longone Health and Temple Health, these are based on the successful multi-site clinical trials held in Europe last year, which were used to obtain the Class IIb CE mark for the ThinkSono Guidance System.

ThinkSono purchased their first Clarius scanner in 2017 and were the first partner to use the Clarius Cast API, developed for researchers and AI companies to help bring technologies to market more quickly by leveraging easy access to real-time ultrasound data to train AI algorithms and deploy AI solutions. ThinkSono now uses Clarius’ Solum software development kit (SDK), enabling the company to create a bespoke solution tailored to their DVT application. ThinkSono will be marketing and selling the complete DVT solution including a Clarius ultrasound scanner directly starting in the UK, Germany and Greece.

“Working closely with ThinkSono since the inception of their company, when they utilized our first-generation high-performance scanners, has been a delight,” says Kris Dickie, Chief Technology Officer at Clarius. “Seeing unique AI tools like theirs being developed for commercial use on our platform truly validates the technology beyond the already broad clinical segments that Clarius currently serves.”

The Clarius SDK suite empowers third party developers to seamlessly integrate AI-powered ultrasound software with Clarius handheld ultrasound systems, the Clarius App, and the Clarius Cloud exam management platform. It provides a set of tools enabling developers to quickly take their solution from code directly to the clinician’s hand without creating custom hardware. •

OPTO-ACOUSTIC IMAGING TECH EXPLAINED

STAFF REPORT

The recent ICE webinar “Opto -Acoustic Imaging a New Modality in Breast Cancer Diagnostics” sponsored by Seno Medical is approved for 1.0 ARRT Category A CE credit by the AHRA.

In this session, Marc Inciardi, MD, discussed how opto-acoustic imaging uses light, sound and artificial intelligence to better diagnose breast cancer by providing functional information in and around a mass. The learning objectives included the benefits patients and clinicians receive from this novel technology that will streamline this care pathway reducing the need for many follow-on exams and biopsies.

Approximately 80 imaging professionals registered for the webinar and attendee Cindy Winter of JPS Health Network in Texas won an ICE gym bag.

Attendees were asked, “Why do you join ICE webinars?”

“Variety of topics, very well organized,” said Jessica Chambers, regional service line director of imaging, SSM Health St Louis.

“ICE always provides timely important messages and education,” said Nancy Godby, director of radiology, Cabell Huntington Hospital Inc.-Marshall Health Network.

“Excellent speakers and offer CEs,” said Lisa Wood, executive director diagnostic imaging, Hancock Health.

Inciardi is an associate professor of radiology at the University of Kansas Health System and specializes in breast imaging and intervention. He earned his medical degree and completed a diagnostic residency at the University of Oklahoma Health Sciences Center. He completed a fellowship at the Los Angeles County/

USC Medical Center. After working 2 years as assistant professor of radiology at the University of Missouri, Kansas City location, he joined a local private practice group in Kansas City, where he was instrumental in establishing the first community breast center in the Kansas City area. In 2005, he left private practice to assume a full-time breast radiology position at the University of Kansas Health System.

Inciardi was an early adopter of automated breast ultrasound technology (ABUS), participating in the SomoInsight Trial. He has published articles, given various regional/national presentations, and has served as a peer educator for automated breast ultrasound.

Seno Medical Instruments Inc. is a San Antonio, Texas-based medical imaging company committed to improving the efficiency – and reducing the complexity – of breast cancer diagnostics through its new modality: opto-acoustic imaging. Approved by the FDA in January 2021, with supplemental approval in June 2022, Seno’s Imagio Breast Imaging System is a new modality combining light, sound and integrated AI to provide information not previously available to the breast imager. The result is substantially improved confidence in diagnostic results that leads to real-time assessments, streamlined care pathways, and reductions in false positive biopsies. The company was recently recognized by Frost & Sullivan with its 2023 Enabling Technology Leadership award for its innovative approach to diagnostic imaging. •

For more information, including upcoming webinars, visit ICEwebinars.live

Market Report

NUCLEAR MEDICINE MARKET TRENDING UP

STAFF REPORT

Several research organizations currently have reports available that predict continued growth of the nuclear medicine market.

According to SNS Insider’s research, the nuclear medicine market is experiencing significant growth due to several key drivers that underscore its expanding importance in the medical landscape. It is projected to reach $24.20 billion by 2030, with a notable compound annual growth rate (CAGR) of 12.8% during the forecast period from 2023 to 2030.

One primary driver is the increasing prevalence of chronic diseases, particularly cancer and cardiovascular disorders, globally. As these conditions continue to rise, the demand for accurate and early diagnostic tools provided by nuclear medicine procedures has surged.

Additionally, technological advancements in imaging equipment and radiopharmaceutical development have enhanced the precision and efficiency of nuclear medicine, further driving market growth.

The growing aging population is another crucial factor contributing to the expansion of this market, as older individuals often require more extensive and precise diagnostic procedures.

Furthermore, the continuous research and development efforts in nuclear medicine, aimed at exploring new applications and improving existing technologies,

are fostering innovation and attracting investments.

Precedence Research states, “The global nuclear medicine market size accounted for $10.65 billion in 2023 and is projected to surpass around $31.44 billion by 2033, expected to grow at a CAGR of 11.45% during the forecast period 2024 to 2033.”

Grand View Research also predicts growth.

“The global nuclear medicine market size was estimated at $10.02 billion in 2023 and is expected to grow at a compound annual growth rate of (CAGR) 11.8% from 2024 to 2030. The market is witnessing growth due to the presence of a robust product pipeline and favorable government initiatives to improve access to nuclear medicine,” the firm states.

Fortune Business Insights expects growth, as well.

“The global nuclear medicine market size was valued at $7.53 billion in 2022 and is projected to grow from $8.42 billion in 2023 to $29.35 billion by 2030,” according to the report.

Global Market Insights reports, “Medical imaging market size was worth $40 billion in 2022 and is poised to grow at 5.5% CAGR from 2023 to 2032, driven by the incremental innovations and advancements in medical imaging technology.”

“Technologically improved imaging equipment aids in the early and precise detection of underlying ailments, allowing physicians to provide timely treatment to patients. To that end, top market companies are investing and prioritizing R&D for breakthrough technologies to deliver better treatment alternatives,” according to Global Market Insights. •

PHILIPS Smart Quant Neuro 3D Product Focus Nuclear Medicine 1

A combination of AI reconstruction technology and quantitative MR, this latest MR technology from Philips is designed to allow users to perform fast and high-quality MR imaging of neuro with a single quantification scan to increase diagnostic confidence. The latest AI-based quantitative brain imaging software advances neurology care for patients. This is particularly important when dealing with traumatic brain injury patients, and to enhance decision support in brain diseases like MS and dementia. Smart Quant Neuro 3D combines Philips’ AI based SmartSpeed image-reconstruction technology, Philips 3D SyntAc clinical application and Synthetic MR’s SyMRI NEURO 3D quantitative tissue assessment software. The combined offering gives health care providers powerful tools for greater diagnostic confidence ultimately benefiting patients. Philips’ exclusive agreement with SyntheticMR makes it the only company currently able to offer SyMRI NEURO 3D capability on MR scanners.

*Disclaimer: Products are listed in no particular order.

SIEMENS

GE HEALTHCARE StarGuide with Effortless Workflow

GE HealthCare is expanding effortless workflow to now include StarGuide SPECT/CT, which can help clinicians monitor therapies with a 12 CZT detector design that not only scans patients in 3D to provide more information to clinicians but is also optimized for certain theranostics procedures, which in turn helps clinicians pinpoint the size, shape and position of lesions with exceptional accuracy. The result is an offering that helps improve technologist efficiency as well as exposure to radiation from patients with:

Automated Patient Setup: Can help operators minimize their occupational radiation exposure due to time spent in close proximity to the patient; and Works in concert with advanced automation robotics, intuitive bedside display, table ruler, and Optical Scout’s real-time mapping of the patient’s entire body habitus to enable adaptive, consistent and optimized camera setup and scanning that not only enables short setup, but also allows for safe and fast transitions between bed

Biograph Vision.X PET/CT Scanner

The Biograph Vision.X is a positron emission tomography/computed tomography (PET/CT) scanner with a time of flight (TOF) of 178 picoseconds (ps). The next-generation system builds on the established performance of the Biograph Vision family of scanners. The scanner’s Optiso Ultra Dynamic Range (UDR) detector technology contains silicon photomultipliers (SiPMs), which enable the use of small 3.2 mm x 3.2 mm lutetium oxyorthosilicate (LSO) crystal elements. These tiny crystals provide higher spatial resolution than larger crystals. Leveraging these very small LSO crystals that are 100 percent covered by SiPMs, the Biograph Vision.X delivers high 48-mm volumetric resolution and an industry-best temporal resolution of 178 ps. For these reasons, the scanner can deliver a 20% performance improvement (TOF gain) that can improve patient throughput as well as reduce patient radiation exposure and radiotracer cost. The built-in AIDAN intelligent imaging platform of the Biograph Vision.X uses artificial intelligence (AI) to increase operational efficiency and accelerate patient workflow. Its unique methodology is built on over 700 machineand deep-learning patents from Siemens Healthineers, which pioneered AI-powered applications in PET/CT scanners. FlowMotion AI, a hallmark feature of AIDAN that is optional on the Biograph Vision.X, combines the continuous bed motion of Siemens Healthineers PET/ CT scanners with anatomical AI to enable the user to standardize and personalize image acquisitions with one click.

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SPONSORED BY:

DIRECTOR’S CIRCLE

This month, ICE Magazine asked several imaging leaders to share their insights regarding nuclear medicine. This is an exciting modality with lots of advances and new technology. Participants in the Director’s Circle article are:

• Misty Bartolotti, lead technologist, nuclear medicine at Tripler Army Medical Center

• Meredith Henderson, CNMT, nuclear medicine supervisor at Cabell Huntington Hospital

• Rylie Pattison, radiology technologist-breast health, MRI, Nuclear Medicine and Ultrasound at St. John Medical Center; and

• Patrick F. Wojtylak, MSHA, CNMT, radiology system manager-nuclear medicine at University Hospitals of Cleveland.

Q: WHAT ARE SOME OF THE LATEST ADVANCES IN NUCLEAR MEDICINE?

Bartolotti: The most exciting advances in nuclear medicine right now are directed at theranostics. Oncology has been leading the way with PSMA which is used for castration-resistant prostate cancer. Although there is a potential for neurology, cardiology, inflammatory and infectious diseases to all utilize the combination of radionuclide imaging and therapy. There is a lot of research for new isotope options on an international level going on right now. I anticipate the majority of nuclear medicine studies in the future will be geared towards theranostics. While the cost of the therapy can be on the high end, the opportunity to zone in on a specific cancer just enhances the patient’s treatment plan with the possibility to provide substantial results. An opportunity to live a healthy life is priceless.

Henderson: Advancements of radio gland therapies such as the new therapies for PSMA prostate and neuroendocrine cancers.

Pattison: The wonderful thing about nuclear medicine is that there are many advancements being made every day. Nuclear medicine has found itself to be a very crucial field that with time and research will only grow. It was not too long ago that PET/CT was just a research procedure, and now it is a basic protocol of cancer treatment. There is constant research being conducted to figure out which radioisotopes can effectively achieve the results intended, whether it be accurate imaging or therapies that are more efficient. There will always be a need to improve camera function and a need to develop better, more effective radioisotopes. There have been several developments of treatments that target prostate cancer that have promising results. PET/MRI is also improving and helps to reduce the percentage of biopsies for prostate cancer patients.

Wojtylak: Theranostics is a rapidly growing field that combines diagnostic imaging and targeted therapy. The theranostic agents are designed to both diagnose and treat patient’s cancer by delivering radioactive isotopes directly to diseased cells. This method allows for personalized treatment plans tailored to individual patients. Prostate-specific membrane antigen (PSMA) is a protein found at high levels on prostate cancer cells. PSMA-PET imaging, which utilizes radiotracers targeting PSMA, offers enhanced detection of prostate cancer lesions compared to traditional imaging modalities like CT or MRI. This technology helps in more accurate staging and treatment planning for prostate cancer patients. Also, this has a therapy to go along with it, a theranostic. On the research side, Alpha-emitting radionuclide therapy. Alpha-emitting radionuclides have high linear energy transfer and short path lengths, making them effective for targeting and destroying cancer cells while minimizing damage to surrounding healthy tissue. We are part of many clinical trials that have shown promising results in the treatment of many different cancers.

Q: WHAT ARE THE 2 OR 3 OF THE MOST IMPORTANT

FACTORS WHEN SELECTING A NEW NUCLEAR MEDICINE DEVICE?

Bartolotti: Three of the most important factors when selecting a nuclear medicine device specific for a military treatment facility is security number one, a valid ATO is critical followed by reliability, and versatility. Even though we are a military facility, we have such a diverse range of patients that we need equipment that we can depend on for patients from age 0-99. We have zero interest in putting anyone of our active-duty military, family members, dependents or VA at risk.

Henderson: Deciding what best fits your department’s needs is the starting point. Because price is usually going to be the deciding factor, purchasing a piece of equipment that will work well with your existing, older equipment is helpful. Can I get a comparable machine that is refurbished? Will it work with our current processing software? Another big factor I have to consider is whether or not it will fit in my space.

Pattison: The number one priority in any nuclear medicine device is patient safety. A dose calibrator is expected to relay accurate dose information, which is crucial for administration to a patient. A GM meter must be able to accurately relay measurements of rem. A camera must provide conclusive imaging while being safe and practical. SPECT/CT has proven to be a great usage in nuclear medicine. When selecting a new camera, one with SPECT/ CT capabilities is preferred.

Wojtylak: Here are the important factors:

• Image Quality and Performance – One of most important factors of any nuclear medicine device is to produce high-quality images for accurate diagnosis and treatment planning. There are different factors such as spatial resolution, sensitivity, contrast resolution, and image acquisition speed that are critical in assessing image quality. The system should be capable of providing clear and detailed images while minimizing artifacts and noise. Additionally, consider the device’s ability to perform a wide range of imaging studies and its compatibility with various radiotracers and imaging protocols is another factor when selecting systems.

• Workflow Efficiency and Integration – Efficiency and workflow optimization are essential for maximizing productivity and throughput in a clinical setting. This is very important to make sure the department chooses a nuclear medicine system that offers intuitive user interfaces, streamlined workflows, and automation features to simplify image acquisition, processing, and interpretation. In reality, you are looking for future proofing so the system can grow with the hospital or practice. Also the system must

be able to integrate with existing hospital information systems (HIS), picture archiving and communication systems (PACS), and electronic medical records (EMR) seamlessly. This is crucial for data management and communication across departments in the hospital system.

• Safety and Radiation Dose Management – Patient safety is paramount in nuclear medicine practice as in any radiology department. When purchasing systems, we look for devices equipped with advanced radiation dose reduction technologies, such as dose modulation algorithms, iterative reconstruction techniques, and patient-specific dose optimization tools. This is to make sure you are giving the lowest amount of radiation to the patients, monitoring the amount of radiation given and creating the best images with the most up to date processing tools. The system should adhere to established radiation safety guidelines and regulatory requirements to ensure safe and appropriate use of ionizing radiation. Also consider dose monitoring and dose tracking capabilities to minimize radiation exposure for both patients and health care providers.

Q: WHAT ARE SOME TIPS FOR CREATING AN EFFICIENT NUCLEAR MEDICINE WORKFLOW?

Bartolotti: Some tips for creating an efficient nuclear medicine workflow start with our reception desk. The support staff is responsible to get all our patients scheduled with proper prep instructions and checked in on a timely manner. We have organized a scheduling template that has allowed us to maximize the use of our radiopharmaceuticals and camera availability for each day. Teamwork makes the dream work here in the nuclear medicine department at Tripler Army Medical Center.

Henderson: Good scheduling is the easiest way to create an efficient workflow. Because most of our studies have different circulating times and not all exams require imaging, some tests can be scheduled at the same time.

Pattison: Workflow can be difficult to navigate at times, especially when issues arise such as a camera being down or numerous add on in-patients. Truthfully, working as a team and being willing to help and each play a part can help to make the day go smoothly. Writing out a general outline of the day with plans of what times patients will need to be injected or imaged and in what rooms each part will be happening can help to balance out the day and know exactly when and where things need to be, helping to avoid overload and delay. Having an outlined schedule can help to navigate when any add on can be accounted for. Knowing that patient safety is always a number one priority, taking it one patient at a time and focusing on the task at hand rather than being stressed about all that needs to happen will also provide a positive

workflow. Being too overwhelmed will only cause more mistakes which will cause more work and can be harmful to patients. Communicating with patients the time their exam will take and if any disturbances in that time occur will provide a healthy environment to work.

Wojtylak: First and foremost are standardized protocols and procedures. Establish standardized protocols and procedures for each type of nuclear medicine study. This includes patient preparation, radiopharmaceutical administration, image acquisition parameters, and image processing techniques. Standardization helps reduce variability, improves consistency, and enhances the efficiency of the workflow. Another important part of making an efficient workflow is pre-appointment preparation. Providing clear instructions to patients regarding preparation requirements for specific nuclear medicine studies, such as fasting, medication restrictions, and hydration protocols is essential. Another important part is educating patients. Having clear instructions about the procedure, including potential risks and benefits, to ensure compliance and minimize delays on the day of the appointment. Last, but not least, is continuing to improve your process. Regularly monitor key performance indicators (KPIs) such as patient throughput, wait times, and study turnaround times to identify bottlenecks and areas for improvement. Collecting feedback from staff and patients to identify workflow inefficiencies and implement targeted interventions to address them is key. Continuously review and refine processes to optimize workflow efficiency and enhance overall departmental performance. Adopting a systematic approach to workflow optimization, nuclear medicine departments can enhance efficiency, improve patient satisfaction, and deliver high-quality care effectively.

Q: WHAT ROLE DO YOU SEE AI PLAYING IN NUCLEAR MEDICINE?

Bartolotti: There is a future for AI in nuclear medicine. It is already playing a role in processing software

capabilities. The possibility for improved algorithms for disease detection, with increased accuracy in analyzing the data in a shorter time frame has always been the focus of new product development, aiding in better sensitivity and resolution. Our team could also foresee AI playing a significant role in nuclear medicine in the near future because it’s application could significantly reduce imaging time on both planar and SPECT acquisitions which could lead to an increase in patient volume and lower patient dose. It could help with faster processing and early diagnosis and prognosis by predicting where a lesion might appear or where it would spread. AI could perform mock trials with different treatment scenarios improving therapeutic effects. AI could be trained to predict equipment errors and or detect patterns that could help improve clinic processes and minimize equipment downtime.

Henderson: I think the role of AI will most affect planning and post processing. It is already present, and it is important that we learn to grow the role of AI in the future.

Pattison: AI could be a huge advantage to nuclear medicine. The technology that AI provides could help to make diagnosis and treatment more accurate and improve the efficacy of nuclear medicine studies. It will also change the landscape and allow us to improve on other areas of medicine.

Wojtylak: The roles we see for AI in nuclear medicine are image reconstruction, therapeutic response and dosimetry of individual therapies. AI algorithms can improve the quality of nuclear medicine images by reconstructing raw data with higher resolution and reducing noise and artifacts. Deep learning techniques can enhance image clarity and improve diagnostic accuracy, particularly in low-dose imaging studies. Another spot we see AI growing is in beta and alpha particle treatments. AI algorithms can analyze pre-treatment imaging data, genetic profiles and clinical parameters to predict patient response to specific therapeutic interventions done by radionuclide

CABELL HUNTINGTON HOSPTIAL

MEREDITH HENDERSON

ST. JOHN MEDICAL CENTER

RYLIE PATTISON

TRIPLER ARMY MEDICAL CENTER

MISTY BARTOLOTTI

UNIVERSITY HOSPITALS OF CLEVELAND

PATRICK WOJTYLAK

therapy. By identifying patients who are most likely to benefit from treatment, AI-driven predictive models can optimize treatment selection and improve patient outcomes. Lastly, is looking at the dose delivered to a patient having these treatments or the dosimetry of the treatment dose. AI algorithms can assist in personalized dosimetry calculations by integrating patient-specific anatomical data, radiotracer kinetics and imaging parameters. These models can predict radiation dose distributions within tissues and organs, guiding treatment planning and optimizing therapeutic efficacy while minimizing the risk of radiation toxicity to healthy tissues. As AI continues to evolve, its integration into routine clinical practice holds promise for improving patient care and advancing the field of nuclear medicine.

Q: HOW CAN NUCLEAR MEDICINE BEST ACHIEVE ALARA GOALS?

Bartolotti: The best way to achieve ALARA still to this day is through: time, distance and shielding.

• Time: Being proficient enough to handle radioactive material as fast as you can without compromising safety and quality.

• Distance: Knowing how far away you need to be from a radioactive source and still remain effective.

• Shielding: Using available resources in your work area i.e. lead shields, and lead aprons to protect yourself from unnecessary exposures from radioactive materials.

Posting clear and effective signs and labels on all radioactive material or spaces can also help achieve ALARA goals. Lastly is continuous education and training.

Henderson: Time, distance and shielding! By minimizing the amount of time we spend close to our radiation sources, (doses or patients) as well as using tools to create a barrier between ourselves and the radioactive source, we can greatly decrease our radiation exposure.

Pattison: Time, distance, shielding. One of the very first things you learn in nuclear medicine is time, distance and shielding. Patient care is always a priority, however, limiting the time standing right next to a patient after administration might feel wrong to do, but is crucial in limiting occupational exposure. Any time there is a usage of a radioisotope or CT usage, proper shielding should be used, without exception.

Wojtylak: As we all know in radiology ALARA is crucial. It stands for “As Low As Reasonably Achievable,” which is a principle in radiation safety aimed at minimizing radiation exposure to patients, health care workers and the public while maintaining the necessary diagnostic or therapeutic benefits. One way nuclear medicine fol -

lows ALARA is by optimizing protocols. Tailor imaging protocols to achieve diagnostic quality while minimizing radiation exposure is key. Use appropriate radiopharmaceutical doses and imaging parameters based on clinical indication and desired image quality. We also employ low-dose imaging techniques, such as iterative reconstruction algorithms and dose modulation on the CT side, to reduce radiation exposure without compromising image quality. Another way is we have a systemwide radiopharmaceutical dosing chart used by all technologists. This will ensure accurate dosing and precise radiopharmaceutical administration by technologists who will follow the established protocols and guidelines. We use standardized procedures for radiotracer preparation, dose calculation and injection techniques to minimize errors and variability. Employing these dose optimization strategies, such as patient-specific dosimetry calculations, to tailor radiopharmaceutical doses to individual patients while maintaining diagnostic efficacy.

Q: WHAT ELSE SHOULD ICE MAGAZINE READERS KNOW ABOUT CT?

Bartolotti: As technology advances the nuclear medicine imaging systems are now more commonly being utilized as hybrid SPECT/CT systems. There are also systems being designed as strictly SPECT/CT cameras without the option of planar imaging and they have capabilities of full body SPECT/CT. It is an exciting time to be a part of so many multi-modality imaging options.

Pattison: Nuclear medicine is an extremely awesome field that provides several large advantages. It is incredible to see how far nuclear medicine has come and to know that there is still so much growth. Working in nuclear medicine does not feel like work at all. It is fun and exciting and working with people to help them navigate their health journey. Nuclear medicine is unique and differs from other imaging modalities. It focuses more on the physiology of the body rather than the anatomy. There are so many fascinating factors and attributes that nuclear medicine contributes and I feel very blessed to work in a field that makes me excited daily.

Wojtylak: I really think most has been covered by the questions above. I feel overall that the future of nuclear medicine looks promising, with continued innovation, collaboration and investment driving advancements in clinical practice, research and patient care. We see many companies now harnessing the power of molecular imaging, targeted therapies and advanced technologies. Nuclear medicine is poised to play a pivotal role in shaping the future of health care. The future looks bright for nuclear medicine. •

MICROAGGRESSIONS IN MEDICAL IMAGING

BY MATT SKOUFALOS

In every social encounter, there’s an opportunity to connect, and a risk of miscommunication and of being misunderstood. Social interactions carry the weight and differences of class, race, gender and sexuality, age, and ability level between speakers.

In any circumstance where the power dynamics among both parties are significantly differently weighted – such as in the workplace – one party enters the interaction at a disadvantage. When that disadvantage is exploited, whether intentionally or unintentionally, it can have the effect of reframing the discussion in terms defined by the higher-status individual, be they a supervisor, coworker, or simply a member of a majority class to which the other party does not belong.

In simple terms, these can be understood as institutional or unconscious biases; when these biases inform remarks that harm, slight, or undercut another person on the basis of their individual identity, they are referred to as microaggressions. Micro, because they’re smaller or more insidious than an overt insult or attack, and aggressions because they nonetheless put one party on the defensive from another.

The phrase “microaggressions” was defined in 1977 by Harvard University psychiatrist Chester M. Pierce in a study critiquing how Black Americans were depicted in TV commercials at the time. Pierce’s writings on the subject described the “subtle and stunning” ways in which presumptive language had been used to denigrate Black Americans, including himself.

That work is regarded as a seminal piece of research in the field, upon which additional writings by other researchers on the subject have built over the intervening decades, including those of Jessica Leschied, associate professor of radiology and radiological sciences at Vanderbilt University Medical Center in Nashville, Tennessee.

Leschied is a diversity, equity and inclusion (DEI) advocate who worked on the Justice, Equity, Diversity and Inclusion (JEDI) Taskforce for the Graduate Medical Education office at Henry Ford Hospital in Detroit, Michigan, where she also headed a networking group for women in radiology. Leschied said she’s experienced different treatment as a woman in a field that’s dominated by white men.

“I think I was pretty naïve in terms of how few women and minorities go into radiology,” Leschied said.

In mentoring some of the woman residents at Henry Ford, Leschied said she discovered that she

and they all had comparable experiences of different treatment than their male peers. Some of them endured comments about their cultural backgrounds, others about whether they were presenting as friendly enough to the group, or whether they should “smile more.” A third-generation American medical student of Asian heritage was complimented on how well she spoke English. Leschied, an international medical graduate, was told, “you’re not our usual candidate.” Other men struggled to remember their female peers’ names, called them by the names of other women in the group, or by their first names, when they would refer to their male counterparts by their surname and doctor honorifics.

“These are microaggression, which are subtle –sometimes not-so-subtle – comments that make the recipient feel that they don’t belong or that they’re unusual in that specialty,” Leschied said. “It’s part of our unconscious bias, but if you become educated on what your unconscious biases are, you can become more aware of them, and change the things you say and do.”

Leschied said that she believes the educational health care space is “often a couple years behind the business world” in terms of culture change, and that it may take more time to see improvements in these areas, especially among older health care professionals whose viewpoints may include turns of phrase that have become unacceptable in the workplace.

“They’re very commonplace, and they can have disastrous consequences for an individual in our profession,” Leschied said. “The worst case is that the [victims] leave our profession, and take their unique perspectives with them, when what we need is them to have a seat at the table.”

Her solution is for people to develop a comfortability with self-advocating in the moment; letting their colleagues know when their comments have become degrading, insulting, or ignorant, and giving them a chance to acknowledge their mistake.

“I have said to colleagues before, ‘Maybe you can be more intentional about changing your behavior, and acknowledge how it affects the recipient,’” Leschied said. “We don’t focus on the intention of the aggressor; we focus on how the comment affected the recipient.”

“None of us is perfect; we all make mistakes,” she said. “We are not here to spend time on these mistakes. I think one of the ways that I find effective in teaching this is admitting that I’m not perfect, and saying, ‘I made that mistake before.’ There’s lots of

COVER STORY

ways of doing it without becoming accusatory; the problem is if it becomes repeated behavior, you have to escalate the reporting to higher-ups.”

Leschied also encourages people to seek out whether their organizations have put language around DEI values into their mission or vision statements; things like, “We want to be a workplace that’s inclusive of everyone’s viewpoints, or creates a sense of belonging,” and whether those aspirations are put into practice in the culture of the workplace.

“One of things I pushed for is a good, anonymous reporting tool for residents, so people feel like they at least have an avenue for reporting their grievances,” she said. “Power dynamics makes reporting very challenging. It also makes it easier for these things to happen.”

Above all else, Leschied said it’s important to remember that behavior change comes slowly, but that with constant guidance, intentionality, and coaching, it is achievable.

“Patients, too, are not immune to the impact of microaggressions,” she noted: “biased language and assumptions regarding their background, their medical history, or conditions frequently occur. This often erodes trust from them in the health care world.”

- NICOLE DHANRAJ

“We need to acknowledge that we can be better, and we’re works in progress,” she said. “The small things that happen every day, if we can all find our courage to say, ‘I

didn’t like that comment,’ or, ‘You might not have meant this, but,’ we can make some changes.”

“Ultimately, people want to come to work in a place where they can be their authentic selves and voice opinions, and if you don’t create a workplace that allows for those things, it can lead to bad patient outcomes, and detrimental emotional health issues in our trainees or the recipient,” she said.

Health care operations consultant Nicole Dhanraj, an expert on microaggressions, said that although their effects reverberate throughout the profession, she is particularly concerned about how quietly they persist.

“While those on the receiving end may recognize and internalize these microaggressions, the broader health care community often fails to acknowledge their presence or significance,” Dhanraj said. “I think this occurs because not enough people on the receiving end speak up about it to truly make a movement of change on this.”

“While some individuals may vocalize their experiences, these conversations frequently lack understanding, perpetuating misunderstandings, and exacerbating tensions between employees,” she said.

When those on the receiving end of microaggressions remain silent, often out of a fear of retribution, or a desire to keep the peace in the workplace, the negative treatment persists; when they speak up, such discussions may be emotional to the point of being unproductive, Dhanraj said.

“Patients, too, are not immune to the impact of microaggressions,” she noted: “biased language and assumptions regarding their background, their medical history, or conditions frequently occur. This often erodes trust from them in the health care world.”

“I was a victim of microaggres -

sions probably for the first 10 years of my career,” she said. “Always a comment about being female, an immigrant, my skills, my race; so many things. I didn’t speak up for various reasons, but as I became more confident in myself, I started educating people about their comments.”

The only way conditions may improve, Dhanraj said is through improved education and awareness on the subject, “and a commitment to promote a culture of inclusivity and respect.”

“I think sometimes we think we know what those two words mean, but they are often far from a common understanding,” she said. “In the work environment, when people are educated, they are able to call out the behaviors. The recipient should also be aware of what they are experiencing – oftentimes people tell me they thought this was in their head!”

As imaging operations manager at the Dallas, Texas-based UT Southwestern Medical Center, Tricia Trammell, CRA, aims to eliminate microaggressions in the workplace by creating an institutional culture of psychological safety. Trammell believes that by helping her staff feel psychologically safe enough to bring their true, authentic selves to work every day, it fosters an environment of acceptance, which eliminates microaggression.

“It takes constant work, not just from leadership, but commitment from the team,” she said. “It has to be taught to the team, it has to be modeled, and it has to be a constant reminder. I cast a vision for what I want our work culture to be, and I’m constantly reminding them what I want our culture to be.”

Trammell’s trainings focus on fostering civility in the workplace by helping her team to embrace who they are at their core, and support their colleagues in doing the same.

“Obviously, we all have different versions of ourselves,” she said. “We have various emotions that we engage with at work, but the true heart is feeling truly genuine. I want everyone to behave in a way that feels truly genuine for them instead of behaving in a way that feels superficial.”

“I think people do know what it’s like to be themselves,” Trammell said. “I think the truth is, most of the time, people don’t necessarily feel comfortable to be themselves because they feel like people will reject that. You have to be pretty vulnerable to be your authentic self.”

“What I’m encouraging in my workplace is that you’re safe to be who you are,” she said. “Be that person, and come to work, and work with people who care about you.”

Trammell believes that the various attitudes and emotions that people embrace in the workplace may be derived from fear, anxiety, or a desire to not be seen as the weak link of their teams. Sometimes that behavior is superficial; in many workplace cultures, there’s an attitude that leadership compels aggressive behavior to instill compliance and stifle dissent, for example. Trammell said it requires constant work from both staff and their bosses to remind their teams

HEALTH CARE OPERATIONS CONSULTANT

that everyone is safe and can be their authentic selves.

“Ultimately, people want to come to work in a place where they can be their authentic selves and voice opinions, and if you don’t create a workplace that allows for those things, it can lead to bad patient outcomes, and detrimental emotional health issues in our trainees or the recipient.”

- JESSICA LESCHIED

“We can trust each other, and we’re all going to accept each other at face value, as whatever you are,” she said. “That doesn’t mean that rude behavior is acceptable, but if someone is an introvert, an extrovert, a silly person, we’re going to accept that; we’re not going to change anybody. The diversity on the team creates a really beautiful and fun culture. It makes it really interesting.”

In the two years that Trammell

has honed her approach with her current work group, the team appears to be performing as a cohesive unit. Employee engagement surveys show vast improvement in engagement scores for the workgroup. In 2022, the first-year engagement was measured after Trammell started working with this team, the overall engagement score increased 12 points from the prior year, which was 10 points over the institutional benchmark. The biggest increase came in how her team members rated their ability to “speak my mind” at work, which climbed 32 points from the prior survey, and 17 points over benchmark.

“That’s important because ‘speak my mind’ is one of the measures that many health care organizations struggle with, so we have made it one of our focuses,” Trammell said.

In 2023 when engagement was measured in the same workgroup, the overall engagement score showed marked improvement again, significantly over the institutional benchmark. It was the highest engagement score of all imaging work groups in the organization.

“I’ve been working on this approach with this workgroup for about two years,” she said; “I’ve found it to be extremely effective.” •

NICOLE DHANRAJ

VANDERBILT UNIVERSITY MEDICAL CENTER

JESSICA LESCHIED

TRICIA TRAMMELL

CODING & BILLING

BY MELODY W. MULAIK

OI WANT TO BREAK FREE: OBLs vs. ASCs

ne of the hot topics of discussion for many organizations is whether to open a free-standing center to perform interventional procedures. And , to take it one step further, should the free-standing center be an outpatient-based lab (OBL) or an ambulatory surgery center (ASC) ? The answer really does depend on the organization’s goals, resources and needs.

Regardless of which type of center you decide to operate there are crucial decisions that must be made prior to making legal decisions and expending capitol dollars. First, are there any non-compete contracts in place that would limit your operations? On April 23, 2024, the Federal Trade Commission (FTC) announced a ban on noncompete agreements nationwide; however, that does not automatically mean that any agreements currently in place are null and void. Additionally, there were immediate legal challenges to the ruling that may ultimately change the FTCs final rule, so it is important that you consult regulatory legal counsel to review any legal obligations.

For the successful launching of any new initiative, it is important that you have a robust and realistic go to market strategy to ensure that you will have a strong referral pipeline with corresponding reimbursement from payers for the services that you will provide. Details such as determining if an existing tax ID will be utilized or if a new one will be needed, will drive the amount of contracting and credentialling required for the organization.

How you will staff your organization is another key detail to address during the planning phase. Will existing staff be able to cover the free-standing location or will you need to hire new people? The answer to that

question may depend upon the procedures that you plan to provide, and the mix of staff required to support these services.

And last, but not least, is what equipment will be needed to perform your planned procedures. Equipment is the biggest expense for any organization so planning wisely is a critical key to financial success. Understanding the return on investment (ROI) for any piece of equipment is a must in the planning process.

So, back to the question of OBL or ASC. The issue that best drives the answer is the complexity of the procedures to be performed and the level of anesthesia that will be required to perform the defined procedures. Procedures that require moderate sedation can be performed in either setting but procedures that require deep anesthesia may only be performed in an ASC. Second is the issue of ownership. OBLs are limited to ownership by physicians or medical professionals, adhering to the corporate practice of medicine laws in certain states. Conversely, ASCs can be owned by non-medical professionals or corporations, potentially presenting a higher barrier to entry due to associated costs and potential Certificate of Need (CON) requirements (if applicable).

Ultimately, the decision to establish an OBL or an ASC requires a thorough consideration and evaluation of various factors. Understanding the distinctions between ASCs and OBLs concerning procedure selection, ownership models, reimbursement structures, patient experiences, and anesthesia is essential for informed decision-making. While both settings offer advantages over traditional hospital environments, OBLs and ASCs offer patients a better patient experience for outpatient procedures where that setting is appropriate for the patient. By weighing these factors carefully, health care providers can optimize their practices to deliver exceptional patient care in the most suitable setting. •

INSIGHTS

PACS/IT/AI

BY MARK WATTS

IAI THROUGH GPT CAN HELP PROVIDE BETTER HEALTH CARE

challenge you to invest 20 minutes interacting with OpenAI GPT. Below is an example of an interaction I had. The real-world example of improving communication with non-English speaking patients. This is a growing issue for us all.

Health care providers became required to provide translation services to ensure effective communication with patients who have limited English proficiency or who speak languages other than English. This requirement stems from various factors, including legal mandates, ethical considerations, and the recognition of disparities in health care access and outcomes among linguistic minority populations.

The following are key milestones and reasons for the implementation of translation services requirements in health care:

• Civil Rights Act of 1964: Title VI of the Civil Rights Act prohibits discrimination on the basis of race, color, or national origin in programs and activities that receive federal financial assistance. This provision has been interpreted to require language assistance services for individuals with limited English proficiency to ensure meaningful access to health care services.

• Executive Order 13166: Issued by President Bill Clinton in 2000, Executive Order 13166 requires federal agencies and federally funded recipients to take reasonable steps to provide meaningful access to services for individuals with limited English proficiency. This order has significant implications for health care providers who receive federal funding.

• Health Care Disparities and Patient Safety: Recognizing the impact of language barriers on health care disparities and patient safety, health care organizations and regulatory bodies have emphasized the importance of providing language access services. Effective communication is essential for accurate diagnosis, informed decision-making and adherence

to treatment plans.

• Ethical Imperative: Health care providers have an ethical responsibility to ensure that all patients receive equitable and high-quality care, regardless of their language proficiency. Providing language assistance services aligns with principles of patient-centered care, cultural competency and respect for diversity.

• Risk of Legal Liability: Failure to provide adequate language assistance services can expose health care organizations to legal liability, including allegations of discrimination or violations of patients’ rights. Legal mandates and regulatory requirements underscore the importance of implementing language access policies and procedures.

Overall, the requirement for health care providers to provide translation services reflects a commitment to addressing language barriers and promoting health equity for linguistically diverse populations. By ensuring effective communication, health care organizations can enhance patient safety, improve health outcomes and advance health care quality for all individuals.

I asked GPT “What are strategies that could be used to enhance the discharge instructions for a Spanish-speaking individual with an 8th-grade education who needs to complete a course of antibiotics?”

GPT: “Certainly! Using GPT to assist in providing discharge orders for a Spanish-speaking female with an 8th-grade education who needs to take antibiotics until completion can be achieved with a thoughtful approach. Here’s how I would approach it:

• Language and Cultural Sensitivity: Ensure that the instructions generated are culturally appropriate and in Spanish, considering nuances and idiomatic expressions that may be more familiar to a Spanish-speaking audience.

• Simplicity and Clarity: Given the recipient’s education level, it’s crucial to keep the language simple and straightforward. Avoiding medical jargon and using plain language is essential to ensure comprehension.

• Step-by-Step Instructions: Break down the instructions into clear, concise steps to make it easy to follow. For example:

• Start with a greeting and acknowledgment of the patient’s condition and treatment.

• Clearly state the name of the antibiotic, dosage, and frequency of administration.

• Explain the importance of completing the full course of antibiotics even if the symptoms improve.

• Provide instructions on how to take the medication (e.g., with food, without food, specific times of the day).

• Clarify any potential side effects and what to do if they occur.

• Encourage the patient to contact their health care provider if they have any questions or concerns.

• Use Visual Aids: Incorporate visual aids such as illustrations or diagrams to supplement the text and enhance understanding, especially for individuals with lower literacy levels.

• Interactive Communication: Consider incorporating interactive elements such as simple yes/no questions or multiple-choice options to ensure comprehension and engagement.

• Provide Contact Information: Include contact information for the health care provider or clinic in case the patient needs assistance or has questions.

• Feedback Loop: Offer an opportunity for the patient to confirm their understanding or ask questions. This can be done through a follow-up phone call or a brief questionnaire included with the discharge instructions.

By following these steps and customizing the instructions to meet the specific needs of the patient, GPT can assist in providing clear and effective discharge orders for a Spanish-speaking individual with an 8th-grade education who needs to complete a course of antibiotics.”

I want you to please note that GPT will answer your next question with awareness of the context of the last question.

I asked GPT, “Give example of visual aids and interactive communications you would use for this example.”

ChatGPT: “Certainly! Here are examples of visual aids and interactive communication strategies that could be used to enhance the discharge instructions for a Spanish-speaking individual with an 8th-grade education who needs to complete a course of antibiotics:

Visual Aids:

• Medication Schedule Chart: Create a simple chart illustrating the days of the week and the corresponding times when the medication should be taken. Include visual cues such as icons or color-coding to indicate when the antibiotic should be taken with food or without food.

• Pill Bottle Labels: Provide labels for the medication bottles with clear instructions in Spanish, including dosage information, frequency of administration, and any special instructions. Use large, easy-to-read fonts and simple graphics to enhance comprehension.

• Symptoms Tracker: Create a symptom tracker worksheet where the patient can record their symptoms daily. This visual aid can help them monitor their progress and understand the importance of completing the full course of antibiotics even if their symptoms improve.

Interactive Communication:

• Yes/No Questions: Include yes/no questions throughout the instructions to ensure understanding. For example:

• “¿Entiende usted cómo tomar este medicamento? (Do you understand how to take this medication?)”

• “¿Ha experimentado algún efecto secundario desde que comenzó a tomar el medicamento? (Have you experienced any side effects since you started taking the medication?)”

• Multiple Choice Questions: Incorporate multiple-choice questions to assess comprehension and reinforce key points. For example:

• “¿Cuántas veces al día debe tomar este medicamento? (How many times a day should you take this medication?)”

• A) Una vez al día (Once a day)

• B) Dos veces al día (Twice a day)

• C) Tres veces al día (Three times a day)

• Fill-in-the-Blank Exercises: Include fill-in-the-blank exercises to encourage active participation and reinforce learning. For example:

• “Recuerde tomar este medicamento ___________ las comidas. (Remember to take this medication ___________ meals.)”

• A) antes de (before)

• B) después de (after)

• C) durante (during)

These visual aids and interactive communication strategies can help make the discharge instructions more accessible and engaging for a Spanish-speaking individual with an 8th-grade education, improving comprehension and adherence to the prescribed antibiotic regimen.”

This is an example of how GPT can bring expertise to help solve real world problems. I would ask you to please invest your time and help me create a better, compassionate and adaptive health care for our patients.

I look forward to hearing your feedback and the uses you discover. •

Mark Watts is an experienced imaging professional who founded an AI company called Zenlike.ai.

BY BETH ALLEN

ITHANK GOODNESS FOR EXCITING EUREKA MOMENTS

have been thinking lately about the conversations that we have that lead to inspiration. It may just be a casual comment made by a teammate that makes the lightbulb go on and leads us to the solution we have been looking for.

It is so exciting when this happens. These “Eureka!” moments that I am talking about often come when we are not even discussing the problem we are trying to solve. It may come through those natural conversations I have while still working out an issue in the back of my mind. I am continuously multitasking, even if it isn’t obvious to anyone else. I am so grateful when they happen organically like that.

Because this is the way I work through the “algebra” of some of my responsibility, it helps me to have weekly one-on-one conversations with my team. I try to let these conversations be fluid and open to any subject, but purposeful. It is a check in with them personally and an opportunity to address anything they may need my help with. I did these less often for a while, but then realized it seems to be more beneficial to have them more frequently but for a shorter duration.

Often, we have a lot to accomplish on pressing topics. Sometimes our conversation can wander to what we would like to implement if we had the time. Rarely, we have nothing to discuss.

While considering these conversations, I remembered a document that one of our human resources partners shared with us regarding meaningful one-onone time by Chris Kelley. It was a list of powerful questions to ask in order to get to know your team member better and drive a productive conversation. Sometimes it is difficult to know where to start. It is most important to listen to the answers to the questions and build the conversation around them.

The first question on the list asks the team member about their strengths. What do they perceive that they are good at? It is helpful to have information prior to this conversation or if you already are aware of where

they excel. It is interesting to figure out if you share the same opinion.

The next question is always the one I prioritize. What is on their plate? What are the major tasks they will be working on in the next few weeks. This is where knowing where their strengths lie can be beneficial. If the work doesn’t fit their strengths, maybe we can find some help.

The next two questions work together. What are they the most excited about? This is fun to hear about what they are most energized to do and the positive way they present it. Conversely, of course, we want to know what they are the least excited about. If they are not looking forward to doing it, will it get done? This is an opportunity to discuss the true priority of that task. Maybe it isn’t important right now or maybe someone else would be more excited to accomplish it.

What’s in your way? We have heard this put differently from our leader as, “What are the rocks in your shoes?” What is stopping us from achieving our goal? Who can help us remove those rocks?

Next, the document suggests that we exchange feedback. It is important to listen to the feedback being given and also the feedback that is being requested. Work to understand the point of view being delivered and do not challenge their perception.

The last question is in regard to how your team member would like to receive praise or feedback. This is different for everyone so to know this from the first conversations sets us up for success. Some people prefer to be in the background with a private acknowledgement for a job well done and others appreciate a more public announcement. We publicly praise and privately coach.

All in all, the “rocks in our shoes” can be removed through collaboration, creativity and teamwork.

Thanks for all you do. •

Beth Allen CRA, RT(R)(CT), is the director of clinical operations

for Banner Imaging.

DIRECTOR’S CUT

ROMAN REVIEW

WARE YOU SMARTER THAN AVERAGE?

hile performing my usual “research” on the wonderful WWW, I ran across an inc. com article on the 7 questions that sort of test your smarts. The title of the article is “If You Say Yes to Any of These 7 Questions, Science Says You’re Definitely Smarter Than Average.” Even though most run against conventional wisdom. (Which in itself is a sign of intelligence, since conventional wisdom is so often wrong.)

The article states that Jeff Bezos says the number one sign of high intelligence is a willingness to change your mind a lot. He looks for people who can admit they are wrong and readily change their opinions.

It also says, “… like the famous survey where more than 80 percent of respondents said they were above-average drivers, which is mathematically impossible, and all the respondents had been injured in car accidents, which is pretty darned ironic, most of us think we are willing to change our minds when better data, better evidence or a better point of view comes along.”

I, of course, immediately tested myself, however, first let’s see what the questions are.

YOU LIKE TO SPEND TIME ALONE

Research on people 18-28 who socialize more tend to be happier. This is not true for the highly intelligent. Socializing will not increase how satisfied you are with your life. It will actually make you less happy. Apparently the smarter you are, the more focused you will be on longer-term goals and socializing will be a distraction. You may not be a loner, you may just be smarter than most.

YOU OFTEN THINK YOU’RE WRONG

Some people take a position and refuse to consider any other options and points of view, they just know that they are right. (You know who you are, don’t you?) This is something called the Dunning-Kruger effect which is a type of cognitive bias. People believe they are smarter and more skilled than they actually are and lack self-awareness. This is a lack of wisdom to know that there may be much you don’t know and that rather than demanding to be right, you look for what is right. If you do not fear being wrong and are willing to admit it, saying

“I think” rather than “I know” then you might be smarter than most.

YOU DON’T GET UP EARLY

According to the Wall Street Journal, the most productive time of day may be 4 a.m. (Yikes!) However, research shows that night owls are more likely to have more intelligence, better jobs, and larger incomes than the “early birders.” Just be mindful to be sure your wake-up time is productive for you.

YOU CAN DELAY GRATIFICATION

Research demonstrates a relationship between intelligence and self-control. If you can weigh a couple of options and be patient for the better one, you might possess high intelligence.

YOU PROCRASTINATE

Science author Adam Grant sees procrastination as a key to innovation. As Grant says, “The time Steve Jobs was putting things off and noodling on possibilities was time well spent in letting more divergent ideas come to the table, as opposed to diving right in with the most conventional, the most obvious, the most familiar.” Procrastination to just put off what you don’t want to do, may have some value in causing you to perform other needed tasks. This is not the procrastination that is being covered here. They are talking about delaying because you don’t think you have yet found the best solution, path, option or the smartest approach.

ONLINE TEST

For the 7th test you must go online to inc.com and search the site for the article.

It is a short video of moving lines. And is worth the extra effort. Regarding my honest and objective evaluation of my answers to the test, my answers indicate that I am highly intelligent, especially the not getting up early and the procrastination ones. My lovely wife, Ruth, thinks that I am the world’s greatest procrastinator since I always say, “I told you I will get to it, you don’t need to keep reminding me every six months.” She says I’m intelligent, but lazy. •

Manny Roman, CRES, is association business operations manager at Association of Medical Service Providers.

MANNY ROMAN

EMOTIONAL INTELLIGENCE

BY DANIEL BOBINSKI

TBUILDING A TRUSTING WORKPLACE

he cultural landscape around us is becoming increasingly impersonal and disjointed. We’re seeing an expanded use of automated and impersonal service methods, such as unmanned fast-food locations and self-service grocery checkouts. Many online services provide zero options for talking with a real person, and technologies such as text and email may be efficient, but they remove the human touch.

As the world becomes more detached and disconnected on a personal level, trust can begin to dissipate. This is not healthy. Because a workplace is actually about working with and serving people, trust needs to be the cornerstone in every business. Trust is fundamental to human relationships, as it forms the basis of our sense of security. It provides depth of meaning in our interactions, and its presence also fosters mutual respect and collaboration.

And yet, with the rise of our increasingly impersonal culture, I predict creating and maintaining workplace trust in the coming years will become increasingly difficult. With that, allow me to review several time-tested actions that build trust.

1. Encourage transparency. When individuals, workplace departments or even the various management levels engage in what I call “silo thinking,” barriers are established. Conversely, when people know how their work impacts other people or departments, they can make better decisions to increase quality. Share information. Provide updates. Give feedback. Listen to others with the purpose of genuinely trying to understand. Done with honesty and integrity, such actions are great for building trust.

2. Demonstrate empathy. The saying, “People don’t care how much you know until they know how much you care” is commonly attributed to Theo -

dore Roosevelt, the 26th president of the United States. Some debate exists about the exact origin of the saying, but the meaning holds true. Empathy and compassion are key components for having a genuine concern for others. Therefore, developing and expressing a sincere interest in the ideas and interests of your coworkers and clients are meaningful actions for building and maintaining trust.

3. Be supportive. Being supportive goes beyond demonstrating empathy. Whereas having empathy and compassion help people feel valued, this aspect moves into looking for ways to serve others actively. We can support others’ ideas, initiatives and professional development goals by asking a simple question: “How can I help?” Obviously, one must be careful not to be stretched too thin, but when people realize that others are willing to go beyond verbal encouragement and actually invest time and resources to help them achieve their goals, they often receive an internal boost of confidence because they know they’re not in it alone.

4. Be reliable . When you or your work team or department make a commitment, be sure to follow through. In fact, getting things done ahead of deadlines does wonders for demonstrating dependability. When coworkers recognize that you and your team deliver on your promises, it not only reduces their anxiety, their confidence in your abilities gets strengthened. This results in a boost in esprit de corps, which rubs off on everyone, including the recipients of your organization’s services.

5. Maintain confidentiality. Although it’s healthy to be transparent, it’s equally healthy to maintain confidence. Sensitive information must be respected. This is extremely important for building and maintaining trust. A word of wisdom here. If someone shares confidential information with you and you are later asked by others to share what you might know, you can keep your principle of being

transparent while still maintaining confidentiality. Multiple methods exist, but one way to respond is by saying you are aware of some of the details regarding the question, but because of the nature of the matter, you are not at liberty to discuss it. To simply claim ignorance in an attempt to not discuss the matter is patently dishonest, and when others learn that you denied knowing something, trust is greatly diminished. Not what you want.

6. Admit mistakes, but learn from them. Everyone makes mistakes, but it weakens the fabric of trust when a person attempts to hide a personal mistake or a blunder made by one’s team. It’s better to acknowledge mistakes and take responsibility. Nobody likes doing that, but it goes a long way toward maintaining integrity. From there, one can help restore trust by openly discussing and implementing improvements based on what was learned from a mistake. Demonstrating humility and making a commitment to growth are excellent components in the equation for building and maintaining trust.

7. Collaborate and share credit. Rarely does success occur only because of one person. Collecting and implementing ideas from others goes a long way toward building both teamwork and trust, but be sure to give credit where credit is due. When discussing progress on a plan or when celebrating the completion of a project, be sure to acknowledge everyone who’s given input and assistance.

Harry S. Truman, our nation’s 33 President, is often credited with the phrase, “It’s amazing how much gets done when nobody cares who gets the credit.” No doubt many others have made such a statement over the years, but it underscores that remarkable results can occur when selfless collaboration and teamwork are part of the mix.

Therefore, recognize human nature for what it is. People like being acknowledged when they contribute their time, talent, ideas, or resources, so build trust and commitment by sharing the credit.

The world around us might be getting divided and impersonal, but in our own circles, we have a lot of say in how the weather works. Through our actions we can create trusting, productive relationships, or we can let contemporary trends demoralize and divide us. As with most things, the choice is up to us. •

Daniel Bobinski is author of the best-selling book, “Creating Passion-Driven Teams,” and president of Leadership Development, Inc. He’s been helping organizations of all shapes and sizes since 1989. Reach Daniel with questions at www.eqfactor.net or at 208649-6400.

Digital Imaging, X-Ray Sales and Service Company

MEDICINE FOR THE SOUL

5 NUTRITIONAL POWERHOUSES TO EASILY ADD TO YOUR DIET

Now is a great time to look at our diet and see if there is something we can add to make us healthier. We get plenty of information about what to remove from our diets, which can be difficult because we are creatures of habit, but adding a few powerful things can help boost our health and be convenient. Improving our nutritional intake doesn’t have to be boring or difficult; it comes down to knowing which items pack a powerful nutritional punch.

“Let’s take a break from trying to remove things and focus more on adding in some healthy foods,” explains Jennifer Scherer, a registered dietitian nutritionist, medical exercise specialist, certified personal trainer and owner of Fredericksburg Fitness Studio. “Getting the right nutrients into the body can help in a variety of ways, and it is something that everyone can do.”

According to the Centers for Disease and Prevention, adults who eat a healthy diet live longer and have a lower risk of obesity, heart disease, type 2 diabetes and certain cancers. Healthy eating can also help manage chronic diseases. Additionally, research published in the journal Nutrients reports that nutrient inadequacies can impair immune function and weaken immune response. Macronutrients, including vitamins A, C, D, E, and zinc, help with having a healthy immune system.

Focusing on adding some nutritional powerhouses to the diet can be a simple way to meet more nutritional needs without feeling like people are making big sacrifices or getting rid of foods they love. Nutritional powerhouses can add a lot by providing macronutrients and antioxidants to the diet.

Here are 5 nutritional powerhouses to add:

• Dark chocolate. Need we say more? Most people love chocolate, but they don›t realize that it’s a nutritional powerhouse when they opt for the dark variety. According to the Harvard School of Public Health, dark chocolate contains 50-90% cocoa, compared to milk chocolate, which contains 10-50% cocoa. They report that it provides iron, copper, magnesium, zinc, and antioxidants, which may help

protect the heart. Opt for dark chocolate that is 70% or more cocoa to get the most benefit.

• Beans. Adding more beans and legumes to the diet can have some great benefits. A study published in the journal Nutrients reports that phytochemicals found in beans and legumes are considerably beneficial in improving blood cholesterol levels and glycemic status, providing vascular protection, and reducing markers of chronic inflammation. They help to improve the gut microbiome, which is linked to everything from losing weight to brain health.

• Ginger. Adding ginger to the diet can help in various ways, and it can be as easy as making a batch of ginger shots once a week and consuming one daily or adding it to oatmeal or chia seed pudding. According to the National Institutes of Health, ginger root improves immune system action and acts as an antibacterial/viral agent, antioxidant, anti-inflammatory agent and anti-cancer agent.

• Green tea. Tea, whether black or green, provides antioxidants that can help protect the body from free radicals. According to research published in the journal Chinese Medicine, the high amount of polyphenols and potent antioxidants in green tea may help reduce the risks of many chronic diseases. The researchers report that green tea may also help lower blood pressure, which can help reduce the risks of stroke and heart disease.

• Kimchi. This fermented Korean food can easily be purchased in the produce section of most grocery stores. Keeping a jar in the refrigerator and eating a tablespoon or more daily can provide health benefits. A research study published in the journal Medicine reports that studies have shown that the biological compounds of kimchi stimulate immune function and reduce pro-oxidants, free radicals, certain cancers, cardiovascular disease, metabolic syndrome risks and aging.

“If you feel all five of these are simple enough to add, then go for it,” Scherer added. “If you are not yet ready for something like that, pick one or two. Adding one or two of these to your routine will be beneficial, and you can always add more later.” •

ICE Break

ACROSS

1 Consortium of healthcare leaders aiming to operationalize AI principles to improve the quality and safety of AI in health, abbr.

4 Preferred SI unit of magnetic flux density

8 Small jaw joint in front of the ear, abbr.

9 Started

10 Website address

12 The N in ENT

13 Had some food 14 Steady

15 Airport security company, abbr.

18 See 6 down

20 Cathode abbr.

21 Masters degree, abbr.

23 Mine contents

24 Father’s pride

25 Grab a stool

27 Type of imaging using ultrasound to produce real-time images of almost undetectable noise

31 Rapid in the onset of a disease or condition

32 Initial stage

Likely

Warning sound or image 35 Pressure

1 Metal used in the production of many medical devices 2 Changes to adapt to different conditions

Fastener

Rotate

____ echo imaging

Process of making the magnetic

field on an MRI more uniform by adjusting the currents in the shim coils- see 18 across- 2 words

7 As regards digital images this refers to unnecessary or repetitive information such as duplicated patterns, colors or textures

11 Took an Xray again, e.g.

16 It’s a mix of O2, N2 and CO2

17 Passive component used in most power electronic circuits to store energy in the form of magnetic energy when electricity is applied to it

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