ICE Magazine October 2024

WOMEN IN MEDICAL IMAGING

LEADERSHIP FOR AN EMERGING LANDSCAPE PG. 36

PRODUCT FOCUS BREAST IMAGING PG. 27

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FEATURES

DIRECTOR’S CUT

Imagine being an imaging leader who gets things done, not one who reacts to every whim. Prioritization lets you do just that.

COVER STORY

Despite comparable graduation rates, men account for some 70 percent of applications to diagnostic radiology residency programs. Women comprise less than a quarter of all practicing radiologists in Canada and the United States, although men and women are almost equally represented in radiology in other countries.

RISING STAR

Jessica Sloss is a radiology site supervisor with JMH/UCSF Health-Berkeley Outpatient Center in Berkeley, California.

OCTOBER 2024

IMAGING NEWS

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

PRODUCT FOCUS

A look at breast imaging devices available for catching cancer early.

EMOTIONAL INTELLIGENCE

Laughter has been shown to strengthen immune systems, reduce stress hormones and improve blood vessel function.

JESSICA PFANNENSTIEL

FOCUS IN

BY ARLEEN BANDARRAE

For more than 20 years, Jessica Pfannenstiel, MS, RT(R)(CT), has seen first-hand how technology advancements continually transform radiology and biomedical imaging.

From her start as a computed tomography (CT) technologist, to her most recent role as director of imaging quality and technology at USCF, she has significant experience implementing tools that streamline processes, improve imaging quality and benefit patient care.

“Brought up in the small town of Munjor, Kansas, she recalls that ‘The town population was about 150 people. Life was good and full of family.’ She spent her high school and college years in Hays, Kansas, just a few miles from Munjor,” according to the UCSF website.

Looking back, Pfannenstiel attributes her career success to setting aside time to discern her goals, the website explains. “I went from being an English major to a pre-law then took a year off to figure out what I really wanted,” she says.

Her paternal grandfather was among her best supporters, offering essential advice in education planning. Around the same time, a friend was in the radiology tech program and her excitement piqued Pfannenstiel’s interest.

Pfannenstiel’s career at UCSF began in 2003. In 2007, she accepted a career position and by 2008 she took on the CT supervisor role, which led to the CT operations role in 2016 overseeing multiple sites.

Now, as Pfannenstiel steps into a new role – she was named interim director of imaging quality & technology at UCSF in April – she finds herself in a familiar situation, a place where her leadership talent naturally shines.

“I’m responsive to change and adapt quickly,” admits Pfannenstiel, as she reflected on her 21-year career in radiology at UCSF. “The rapid development of new tools and software has continually pushed me to adapt and learn, enabling me to streamline processes and improve the quality of my work significantly.”

As the interim director of imaging quality & technology, Pfannenstiel will partner with radiology faculty to advance UCSF’s leadership in implementing innovative technology. Her

Jessica Pfannenstiel is the director of imaging quality and technology at USCF.

role also includes protocol management and oversight of standardized processes for patient care, equipment management and staff development functions such as training plans and articulating technologist career pathways. Top priorities include building out the new director level positions as well as the roles for supporting managers and supervisors.

“My goal is to learn as much as possible from my colleagues and staff to better our department and provide quality care for our patients,” said Pfannenstiel, who is excited to continue collaborating with faculty leaders, Javier Villanueva-Meyer, MD, vice chair, quality and technology; Michael Ohliger, MD, Ph.D., MRI modality director; and Kimberly Kallianos, MD, CT modality director, as well as the new senior leadership team for UCSF Health Imaging Operations. “I want to do what’s best for our patients, our health care workers and our department.”

At the start of her career, Pfannenstiel was focused on technical skills working as a CT technologist. Over time, she developed an interest in project management and broadened her expertise to include management and team leadership.

“My previous role as manager of CT operations taught me how to prioritize, create a positive environment and patience,” said Pfannenstiel. “CT is a busy modality, so I did my best to emphasize patient care while meeting our financial goals.”

Under Pfannenstiel’s leadership, the CT team increased access for patients at UCSF Bakar Cancer Hospital in Mission

Bay by implementing automatic scheduling, which improved utilization for CT scanners. In addition, the CT team successfully cross-trained diagnostic X-ray technologists, a collaboration between seasoned CT technologists and health system leadership to offer and promote internal opportunities for career growth.

“The collaborative nature of my work has evolved beyond my expectations,” said Pfannenstiel. “Building strong relationships with colleagues and industry professionals has provided invaluable insights and has often led to innovative solutions that I wouldn’t have discovered on my own.”

Currently, she’s focused on handing off CT leadership to a team led by Will Sylvain, MBA, ARRT, RT (R), (CT), while familiarizing herself with current projects within a few modalities at a high level. Pfannenstiel will continue her lead role in the UCSF-wide MyTime project, a new system that aims to modernize timekeeping and scheduling processes into a single platform which will go live next year.

Pfannenstiel is always on the go and ready for what’s next. When she’s not running around the medical center, Pfannenstiel maintains a fast pace. Her happy place is a tennis court, and she also enjoys exploring new Bay Area hikes and trail runs.

“Change can be exciting,” advises Pfannenstiel. “UCSF is an exciting organization to work for, and the innovation here keeps my job interesting. I learn something new every day.” •

RISING STAR

JESSICA SLOSS

Jessica Sloss, RT(R)(F)(CBDT), is a radiology site supervisor with JMH/UCSF Health-Berkeley Outpatient Center in Berkeley, California. This rising star in the imaging world earned her Associate of Applied Science Degree in radiography from the University of Akron. She holds certification from ARRT.

Her journey from the Buckeye State to the Golden State included a layover in Cincinnati. ICE Magazine recently found out more about Sloss’s imaging career and why she is someone to keep an eye on in coming years.

Q: WHERE DID YOU GROW UP?

A: I grew up in Canton, Ohio and slowly crept west from Cincinnati to St. Louis. With my final big jump landing me in San Francisco, California.

Q: WHERE DID YOU RECEIVE YOUR IMAGING TRAINING/ EDUCATION?

A: I received my Associate Degree from the University of Akron. I did my clinicals at Summa Health Systems. After being registered as a radiologic technologist, I got a job at UC Health in Cincinnati, Ohio to further my level one

Jessica Sloss started her career in Ohio and now helps serve patients in northern California.

trauma experience. From there, I delved into outpatient orthopedic land at Barnes-Jewish Hospital in St. Louis and have been in an ambulatory setting ever since.

Q: HOW DID YOU FIRST DECIDE TO START WORKING IN IMAGING?

A: I have always had an artistic background, including photography. When I discovered that I could mesh my career and my passion into one by taking photos of human bones, I knew that this was the path that I wanted to choose. I have always enjoyed caring for other people, so a career in health care made sense for me.

Q: WHAT IS THE MOST REWARDING ASPECT OF YOUR JOB?

A: The most rewarding part of my job is watching my team work productively and independently, as I have been able to provide them the tools and knowledge to do so. We have an incredible team that works in a physically small outpatient facility. Supporting everyone while they work collaboratively within their different modalities is very rewarding. I also enjoy watching my team grow and learn as they expand their own knowledge and abilities.

Q: WHAT DO YOU LIKE MOST ABOUT YOUR POSITION?

A: I am currently in a unique role at UCSF that oversees many different modalities – XR, DXA, CT, MRI, ultrasound, mammography and PET/CT. It has been immensely educational learning about all of the differences in each modality and caring for the varying populations that frequent our halls. At our facility, we have the opportunity to take care of all of a patient’s imaging needs in a single outpatient center.

Q: WHAT INTERESTS YOU THE MOST ABOUT THE IMAGING FIELD?

A: Imaging is forever changing. There is always something new to learn. Imaging professionals are required to be chameleons, altering themselves to blend into any situation. I look forward to continuous learning and growth for the rest of my career.

Q: WHAT HAS BEEN YOUR GREATEST ACCOMPLISHMENT IN YOUR FIELD THUS FAR?

A: My greatest accomplishment has been watching a facility come full circle from construction plans to the day we see our first patient. So much work and preparation go into building a department and you can see how little decisions that you made will affect your

staff for the tenure of their career. I have also felt very accomplished when I am able to heal relationships with other health systems and community physicians via positive collaboration and communication.

Q: WHAT GOALS DO YOU HAVE FOR YOURSELF IN THE NEXT 5 YEARS?

A: I want to continue to grow and evolve in my current role at UCSF and within the next 5 years, I hope to have the opportunity to take on even more under my umbrella. I also want to further my education by obtaining my bachelor’s and eventually a master’s degree. •

FUN FACTS

FAVORITE HOBBY: Crafting ceramics by hand building or throwing on a wheel

FAVORITE SHOW: “Killing Eve”

FAVORITE FOOD: Tacos

FAVORITE VACATION SPOT: A staycation at home with my family and dogs

1 THING ON YOUR BUCKET LIST: To visit the Blue Lagoon in Iceland

SOMETHING YOUR CO-WORKERS DON’T KNOW ABOUT YOU: I am an avid LEGO builder. I love puzzles!

Rad idea

PRIORITIZE

WELLNESS FOR IMAGING PROFESSIONALS

BY PARISS JACKSON, MBA, RT(R)(MR), CRA, CPHQ, LSSGB

In the fast-paced and ever-evolving realm of health care, imaging professionals – including radiologists, sonographers, MRI technologists and others – are indispensable. Their expertise in diagnosing and monitoring a myriad of medical conditions is critical to patient care. However, the high-stakes nature of their work inevitably brings significant stressors. Addressing these stressors through a concerted focus on wellness is not just beneficial but essential.

Let’s delve into the importance of wellness for imaging professionals and offer practical strategies to combat stress, aiming to persuade health care institutions and professionals alike to adopt a proactive approach. Imaging professionals operate under a unique set of pressures:

• High Responsibility: The precision required in imaging directly impacts patient diagnoses and treatment plans, creating immense pressure to avoid errors.

• Demanding Workloads: The rising demand for imaging services often results in long hours and a high volume of patients.

• Technological Advancements: Keeping pace with rapid technological changes necessitates continuous learning, which can be daunting.

• Physical Demands: Prolonged standing or sitting and

repetitive motions contribute to musculoskeletal issues.

• Emotional Stress: Regular exposure to severe and chronic illnesses can lead to emotional fatigue and burnout.

THE IMPERATIVE OF WELLNESS

Ignoring the well-being of imaging professionals can have dire consequences, including decreased job satisfaction, increased absenteeism, and even compromised patient care. Thus, prioritizing wellness is not a luxury but a necessity. Here is how we can make a tangible difference:

ERGONOMIC SOLUTIONS:

• Optimize Workstations: Ensure that workstations are ergonomically sound with adjustable chairs, desks, and monitor stands to alleviate physical strain.

• Encourage Movement: Implement policies that encourage regular breaks for stretching and movement to prevent repetitive strain injuries.

MENTAL HEALTH SUPPORT:

• Accessible Counseling: Provide access to professional counseling services to help manage stress and emotional burdens.

• Support Networks: Establish peer support groups to foster a sense of community and shared coping strategies.

CONTINUOUS EDUCATION AND TRAINING:

• Ongoing Training: Regularly schedule training sessions on new technologies and procedures to reduce anxiety about keeping up to date.

• Time Management Skills: Offer workshops on time management and organization to help professionals handle their workload more effectively.

WORK-LIFE BALANCE:

• Flexible Schedules: Offer flexible work schedules to help professionals balance personal and professional commitments.

• Mandatory Time Off: Promote the use of vacation time and ensure adequate time off between shifts to prevent burnout.

MINDFULNESS AND RELAXATION:

• Mindfulness Programs: Incorporate mindfulness practices, such as meditation or yoga, to help professionals manage stress.

• Quiet Spaces: Create quiet spaces within the workplace for relaxation and reflection during breaks.

RECOGNITION AND REWARDS:

• Acknowledge Contributions: Regularly recognize and reward the hard work and dedication of imaging profes-

sionals to boost morale.

• Career Development: Provide opportunities for career growth and professional development to enhance motivation and job satisfaction.

INSTITUTIONAL RESPONSIBILITY

Health care institutions must take a proactive stance in fostering wellness among imaging professionals. Creating a supportive work environment, promoting open communication, and prioritizing the health and well-being of staff are critical steps. Institutions that invest in the wellness of their imaging professionals not only enhance employee satisfaction but also improve patient care outcomes.

The well-being of imaging professionals is integral to the overall efficacy of health care services. By addressing the physical, mental and emotional challenges these professionals face, we can ensure they remain capable, compassionate, and committed to excellence. It’s time for health care institutions and professionals to recognize that a holistic approach to wellness is not just beneficial but essential. Let’s create a work environment where imaging professionals can thrive, ensuring the highest standard of care for all. • Share your RAD IDEA via an email to

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SPOTLIGHT

Clock Off THE SAVANNAH SOSSAMON

BY MATT SKOUFALOS

Ultrasound technician Savannah Sossamon is a recent addition to the staff at Children’s Hospital New Orleans, but her commitment to caring for children extends beyond the workplace; beyond even her own community, to those in the under-resourced country of Mozambique.

Children comprise more than half the population of the south African coastal country, and they are severely under-resourced. Child marriage and violence towards children are prevalent, according to global humanitarian agency UNICEF, and children in Mozambique frequently do not complete more than a third-grade education.

The country is young and growing, but nonetheless benefits from the charity and contributions of those across the globe, including from Healing Place Church of Baton Rouge, Louisiana, the church in which Sossamon was raised. When she returned there a few years back, Sossamon become more greatly involved with its outreach work, and began contemplating a mission trip. She heard Healing Place was planning a mission to Mozambique centered on International Children’s Day, and decided she wanted to join up.

“My two favorite things about my church is that it’s home – it’s a big church – and everybody knows everybody,” Sossamon said. “Their main mission is to serve your community, serve your city and then serve your world. My

favorite thing is spreading the gospel all over the world.”

“In other countries, International Children’s Day is a special occasion for children to be celebrated for themselves,” Sossamon said. “We were there for 10 days, and the Saturday that we were there was the day that we did the children’s international festival.”

The trip began inauspiciously. After leaving from New Orleans, their group was stranded by a storm for 19 hours in the Dallas, Texas airport. They flew back to New Orleans, stayed overnight in a hotel, and then left the next day directly for Johannesburg. From there, after another overnight they traveled to Maputo, Mozambique. Ten strong, the group had checked at least half of the 26 bags they left Louisiana with, and three of the travelers didn’t get their luggage until they returned to the United States.

On their first day, the mission group performed outreach to local special needs populations. Many children in Mozambique face chronic malnutrition, stunted development, and economic deficits, but those born with developmental disabilities face additional social stigma.

“We in the church say we love you as you are, so we invited a bunch of special needs kids to come and play, heard their stories, did a message for them, and cooked a meal for them and their families,” Sossamon said.

The group also visited widows in the community, reaching out to deliver gifts, groceries and words of comfort. One of the women on the trip contributed $200 to the pastor to establish running water for a widow in the community, which Sossamon said can be a tremendous obstacle

in a country where utility infrastructure is not standardized.

Most of the economic activity in the area where she stayed took place in local markets, which were accessible via dirt roads. Public transit systems comprised of white vans packed with two dozen or more people.

“Most people live in a one-room stone and brick building,” Sossamon said. “Air conditioning is not common; electricity is not all that common. Soap and deodorant is a luxury. Their stoves and sinks are outside; there’s no washer or dryer or shower.

“Education is a really big thing too,” she said. “The average dropout is third grade in their country; they’ll go to work, and the money comes home to mom and dad. The kids that become involved in the church will eventually get to a point where they’ll get back into school.”

Healing Place Church has four campuses in Mozambique; its main campus is electrified and air-conditioned. It houses a preschool with a feeding program that sometimes may provide one of the only meals those children enjoy for the day. It was in that spirit of charity that the missionaries hosted their International Children’s Day celebration.

“We had 2,800 kids come for that one day, and just talked to them about Jesus, played games and gave them a meal,” Sossamon said. “The whole day I was thinking about the verse where Jesus said, ‘Let the little children come to me.’ I appreciate all the children for who they are and what

they are, and they’re valuable in their own little ways.”

“In America, it’s easy because the kids are taken care of and prioritized,” she said. “But in other countries, where it’s not about how wealthy can you get, and hustle and bustle, they love their family, they love their children, and they’re all going to take care of each other.”

“I think at the end of the day, the point was to spread the gospel, and get people to fall in love with Jesus and live for Him,” Sossamon said. “We would love to see them taken care of and safe through the night.”

Afterwards, the group held an appreciation day for its volunteers, with gifts to thank them for their coordination efforts, and a message to let them know that their work was valued. Before returning home, Sossamon and her fellow travelers got to visit Krueger National Park for a safari day.

Even upon returning home, Sossamon said, she thinks on her trip nearly daily.

“I started serving on the homeless team before I went to Africa, and just serving the homeless people alone will show you,” she said. “It’s definitely eye-opening. I’ve challenged myself to be grateful for what I have, but stepping into someone’s tent in the woods will put perspective on what you have. I came home and donated at least a third of my stuff because I didn’t even need it. There’s such a big need across the world, and I think when you see it, it makes your wheels start turning on how you can do more.” •

Kids Fest at the main campus included 2,300 kids raising their hands to say “Yes” to Jesus.

ICE DEBUT AMIRIX IMAGING

Amirix Imaging is at the forefront of innovation in medical imaging technology for diagnostic X-ray tubes. With over 100 years of combined experience in the medical imaging sector, its engineers are dedicated to advancing diagnostic capabilities. The flagship product, the Amirix Imaging LM33-T mammography X-ray tube, is a prime example of the company’s commitment to enhancing imaging accuracy and reliability. Designed as a direct OEM replacement for the M-113T, the LM33-T is compatible with Hologic systems, providing extended durability, superior performance and a competitive price point. This product marks the beginning of a new era in mammography imaging.

Amirix Imaging President Michael Amiri recently shared more information about the company and how it stands out.

Q: WHAT DISTINGUISHES AMIRIX IMAGING IN THE COMPETITIVE IMAGING INDUSTRY?

Amiri: What sets Amirix Imaging apart is the strength of our engineering team and our dedication to delivering superior solutions. The LM33-T stands out with its durable metal construction, advanced heat dissipation technology and efficient filament emissions. These innovations ensure enhanced performance and

longevity, offering unmatched value to health care providers. Our engineering team’s deep expertise allows us to continuously push the boundaries of what’s possible in diagnostic imaging.

Q: WHAT CAN WE EXPECT NEXT FROM AMIRIX IMAGING?

Amiri: With the successful launch of the LM33-T, Amirix Imaging is gearing up to release more cutting-edge X-ray tubes within the diagnostic imaging sector. Our goal is to continually raise the bar for imaging quality and reliability, helping medical professionals achieve better diagnostic outcomes. Our focus remains on expanding our portfolio and maintaining our reputation as a leader in the diagnostic replacement X-ray tube market.

Q: WHAT FINAL MESSAGE WOULD YOU LIKE TO SHARE WITH ICE MAGAZINE READERS?

Amiri: At Amirix Imaging, we’re more than just a product provider – we’re your partner in elevating diagnostic imaging. With a robust engineering team at our core and decades of experience, we are committed to supporting health care professionals with exceptional replacement X-ray tubes, customer service and technical expertise. Our industry-leading warranty and comprehensive support reflect our dedication to your success. •

For more information, visit amiriximaging.com.

Imaging News

A LOOK AT WHAT’S CHANGING IN THE IMAGING INDUSTRY

GE HEALTHCARE COLLABORATES TO ELEVATE WOMEN’S IMAGING

GE HealthCare has announced a collaboration with the University of California San Diego School of Medicine to investigate advanced magnetic resonance imaging (MRI) protocols and techniques for female-specific diseases and conditions of the pelvis and develop comprehensive educational materials for clinicians. The goal of the project is to elevate women’s pelvic health, filling an important gap in medical research and care. Its results have the potential to enable clinicians to make more informed decisions, diagnose diseases and conditions faster and provide increased access to quality pelvic care for women.

The Center for Translational Imaging and Precision Medicine (CTIPM) at the University of California San Diego School of Medicine will be the collaborating site to conduct the project. The project will be led by Rebecca Rakow-Penner, MD, Ph.D., associate professor of radiology and bioengineering at UC San Diego and Deputy Director for CTIPM.

The project encompasses a wide spectrum of diseases of the female pelvis, including better visualization of endometriosis and ovarian cancer using MRI techniques in both clinical and academic research settings.

“We aim to democratize advanced imaging for women and increase access to high quality care in the San Diego community and beyond,” said Rakow-Penner. “Women’s care requires a personalized approach and we hope to advance care solutions for women by improving the diagnosis and management of female pelvic conditions, both benign and malignant. The results of the collaboration will have the potential to help improve the patient experience and equip clinicians with a toolset to deliver a higher level of care that

every woman deserves access to.”

The project plans to create training and educational materials alongside the protocols, all of which could be available as resources for GE HealthCare MRI users around the world, in the hopes of creating a lasting impact in regional and global communities. Increasing access to advanced imaging techniques for clinicians can help drive effective diagnosis and management of pelvic diseases and conditions for female patients.

NEW HOSPITAL EXPANDS ACCESS TO QUALITY PEDIATRIC HEALTH CARE

Families in Arizona’s West Valley now have better access to top-ranked pediatric health care with the opening of Phoenix Children’s Hospital-Arrowhead Campus on August 7. Located in Glendale, this state-of-the-art, 175,000-square-foot hospital offers a comprehensive range of services, including inpatient care, a 24/7 emergency department, surgical care and advanced imaging services.

The new hospital will treat up to 72,000 patients annually and answers a pressing need for high-quality pediatric services in the West Valley.

“Our expansion plans in the West Valley have been decades in the making,” said Robert L. Meyer, president and CEO of Phoenix Children’s. “Today’s opening is the culmination of years of effort to build a comprehensive campus that addresses the unique needs of children and ensures West Valley families can access the care they need, much closer to home.”

Phoenix Children’s Hospital-Arrowhead Campus provides 24 inpatient beds with plans to expand to 48 beds in early 2025, a 24/7 emergency department with 30 treatment rooms, six operating rooms, two minor procedure rooms, an onsite laboratory and a full suite of imaging services. The campus represents an investment of $195 million and the creation of more than 400 jobs.

The opening of the hospital marks the completion of Phoenix Children’s Hospital-Arrowhead Campus. In November 2023, the health system opened a 45,000-square-foot multispecialty clinic

at this campus, providing care in more than 20 high-demand pediatric subspecialties. This includes 10 specialties not previously available in the Northwest Valley such as psychology, neuropsychology and a neurodiagnostic sleep and electroencephalogram laboratory.

Phoenix Children’s Hospital-Arrowhead Campus is part of the health system’s long-term expansion strategy to bring world-class care closer to home for Arizona families. Phoenix Children’s-Avondale Campus, located 20 miles south of the new Arrowhead campus, opened last summer and provides a 24/7 pediatric emergency department and a large multispecialty clinic for Southwest Valley families.

On the other side of the Valley, construction continues at Phoenix Children’s Hospital-East Valley to answer the needs of families in that region. In addition, the health system recently completed a series of expansion projects at Phoenix Children’s Hospital-Thomas Campus, adding 97 new patient rooms, 88,000 square feet of clinical space and a newly designed Level IV neonatal intensive care unit.

“Our goal with this expansion is to improve access, comfort and care for families throughout our fast-growing metro,” said Meyer. “It’s not just about opening new sites; it’s about fulfilling our promise to bring the highest-quality pediatric health services to the communities where our patient families live and work. It’s health care they need and deserve.”

CLINIC EXPANDS CARDIAC CARE ACCESS WITH PHILIPS INNOVATIONS

Royal Philips and Carilion Clinic, a not-for-profit health care organization serving more than one million people in Virginia and West Virginia, recently announced Carilion will adopt the Philips cardiovascular care ecosystem of solutions at the future home of its Cardiovascular Institute at Crystal Spring Tower. Carilion’s new facility will have 11 specialized Philips interventional suites, allowing physicians to treat patients with complex cardiovascular conditions closer to home while optimizing the clinical, operational and overall performance of the health system’s cardiovascular service line. This investment illustrates Carilion’s commitment to empowering its clinicians with innovative technology to provide quality care for its communities.

Carilion’s comprehensive hospital network, primary and specialty physician practices and other complementary services deliver high-quality, patient-centered care. The flagship hospital, Carilion Roanoke Memorial Hospital, totals 718 beds. The Carilion Clinic Cardiovascular Institute will relocate to this new facility and provide state-of-the art heart, lung and vascular services to the region. Services include inpatient nursing care, cardiovascular ORs, cardiac catheterization and electrophysiology labs.

Along with caring for the local community, Carilion Roanoke Memorial Hospital is the major referral center and only Level 1 Trauma Center for patients in the region who require specialized medical care. It also has the only hybrid operating rooms available in Southwest Virginia. Equipped with these new Philips solutions, the highly

skilled medical staff will be able to continue handling complex cases or procedures that may not be available at surrounding healthcare facilities.

“At Carilion Clinic, we are committed to improving the health of the communities we serve. We know that collaboration is an essential component to realizing this vision,” said Marguerite Underwood, Vice President for the Carilion Clinic Cardiovascular Institute. “Working with Philips ensures that we will be able to set the standard in cardiovascular care, not only today, but well into the future.”

The new labs are the foundation of the integrated Philips ecosystem of solutions for cardiovascular care and include the Philips Azurion Image-Guided Therapy System, along with EPIQ CVx cardiology ultrasound system with ultrasound enabled AI capabilities, IntraSight with SyncVision for IVUS imaging and physiology and interventional tools. Furthermore, Carilion will be able to leverage ongoing clinical education for its staff.

“For many years, Carilion has been recognized for delivering exceptional cardiac care. Maintaining the highest standard of care means continuous growth and innovation, making healthcare delivery more efficient and effective,” said Jeff DiLullo, Chief Region Leader, Philips North America. “The Crystal Spring Tower expansion illustrates Carilion’s commitment to its staff and patients, giving clinicians access to world-class technology while providing a level of care not available anywhere else in the region.”

AHRA ANNOUNCES NEW BOARD OF DIRECTORS

AHRA: The Association of Medical Imaging Management announced the appointment of its new AHRA and AHRA Education Foundation board of directors. Presented on Wednesday, Aug. 7 during the AHRA 2024 Annual Meeting in Orlando, the president, president-elect, finance director and the directors for both boards were chosen by AHRA membership.

“The AHRA membership is thrilled to welcome this dedicated group of imaging professionals to lead the organization and the imaging profession toward another year of promising growth,” said AHRA Executive Director Jason Newmark. “As AHRA looks toward 2025, we’re excited to continue to support our mission to educate, develop, mentor, and provide resources for medical imaging professionals.”

The 2024-2025 AHRA Board of Directors includes:

• President: Mario Pistilli, CRA, FAHRA, Director of Imaging Services at Children Hospital Los Angeles (CHLA)

• President-Elect: Wesley Harden, CRA, FAHRA, Director of Imaging Services at Lexington Medical Center in South Carolina

• Past President: Becky Allen, CRA, VP of Operations at UC Health in Cincinnati, Ohio

• Finance Director: Paul Dubiel, CRA, FAHRA, Associate Director of Shared Service at UT Health Austin in Texas

A complete list of board members is available at tinyurl.com/2kf3srf4.

FDA CLEARS CARDIOVASCULAR ULTRASOUND SYSTEM AND 4D ICE CATHETER

Siemens Healthineers announces the Food and Drug Administration (FDA) clearance of the ACUSON Origin, a new dedicated cardiovascular ultrasound system powered by artificial intelligence (AI) features. These features can help physicians perform cardiac procedures more efficiently in the areas of diagnostics, structural heart disease, and electro physiology. Available exclusively with the ACUSON Origin, the new AcuNav Lumos 4D ICE (intracardiac echocardiogra phy) catheter provides advanced imaging for complex heart procedures.

“With its advanced AI features and potential to enhance diagnostic accuracy as well as patient care, the ACUSON Origin is positioned to reshape healthcare’s approach to cardiovascular imaging,” said David Zollinger, head of cardio vascular ultrasound at Siemens Healthineers. “And the AcuNav Lumos is the latest milestone in our 24-year history with ICE. Since 1999, our ICE catheters have helped more than 2 million patients, reducing the need for anesthesia during procedures.”

The ACUSON Origin addresses the entire continuum of cardiovascular patient care, including diagnostic, structural heart, vascular, electrophysiological, and pediatric procedures. It minimizes the cognitive and ergonomic workload of cardiac exams and procedures, allowing for greater consistency, reproducibility, and user efficiency. Its suite of AI-pow ered features for measurements, view recognition, and imaging assistance builds on the company’s rich history of AI innovation, which dates to the late 1990s. These AI features have been trained on one of the world’s largest image databases, which contains over 2 billion annotated images. The features can save the user time on echocardiography procedures by providing automated measurements that are accurate and reproducible. Capable of more than 5,600 AI-powered measurements on transthoracic echocardiography (TTE) and transesophageal echocardiography (TEE), the ACUSON Origin enhances diagnostic accuracy and streamlines workflow. The system is the first to provide real-time cardiac view recognition. AI Assist, a new feature for TTE, recognizes cardiac structures immediately and automatically positions color and spectral Doppler regions of interest when the transducer makes contact with the chest wall. For 12 standard echocardiogram views, AI Assist has a 99% accuracy rate for proper view classification and Doppler placement on 23 anatomical and hemodynamic targets.

The ACUSON Origin also provides automated contouring and quantification of all four cardiac chambers without the need for an electrocardiogram (ECG) via the 2D and 4D HeartAI features. 2D HeartAI enables auto tracking on contrast images—a feat no other commercially available system can perform. It has a 99% accuracy rate for detecting left-ventricular end-diastolic volume (LVEDV) and left-ventricular end-systolic volume (LVESV). 4D HeartAI is a dual modality advancement for 4D auto contouring of all four chambers of the heart in 4D TTE and both ventricles in 4D TEE, averaging up to five beats with or without an ECG. 4D HeartAI boasts a 98% multiplanar reconstruction (MPR) identification and alignment accuracy. The system is the first to provide real-time cardiac view recognition.

Several features debuting on the AcuNav Lumos fourth-generation 4D ICE ultrasound catheter enhance procedural guidance for better patient care. The catheter enables interventional cardiologists and electrophysiologists to treat patients who otherwise would be unable to undergo structural heart interventions, including patients with TEE or general anesthesia contraindications, and patients with tricuspid regurgitation. The AcuNav Lumos offers improved MPR biplane imaging – with or without an ECG – for more accurate anatomical assessment and device guidance as well as improved leak detection with real-time 4D color Doppler. Three-dimensional calipers label cardiac anatomy and provide accurate 3D measurements. •

Market Report

BREAST IMAGING MARKET GROWTH CONTINUES

STAFF REPORT

According to the World Cancer Research Fund (WCRF), the number of cases of breast cancer is likely to reach about 2.1 million before 2030. Also, as per the World Health Organization report on breast cancer released in March 2021, over 2.3 million women globally were diagnosed with the disease in 2020, with approximately 685,000 dying as a result of its severity. Breast imaging is the primary method of diagnosis for a vast majority of breast cancer patients globally. This aspect is expected to contribute to the growth of the market during the forecast period.

Two reports from Grand View Research predicted continued growth in the breast imaging market.

“The global breast imaging market size was valued at $4.7 billion in 2022 and is projected to expand at a compound annual growth rate (CAGR) of 8.6% from 2023 to 2030. Factors such as the rising prevalence of breast cancer, technological breakthroughs in the domain of breast imaging, and investment from several organizations in breast cancer screening programs drive the market,” one report reads.

The same report states, “Several significant market companies are also concentrating on mammography for breast cancer diagnosis. For example, in August 2021, Fujifilm Medical Systems unveiled the ASPIRE Cristalle mammography system, which will use ScreenPoint Medical’s Transpara powered by Fusion AI for 2D and 3D mammography. The use of artificial intelligence in breast cancer screening might assist to lessen the workload of health care personnel. Such advancements in mammography for breast imaging are expected to contribute to the growth of the breast imaging market over the forecast period. Furthermore, various advances in the area have reduced over-diagnosis and improved sensitivity to identify tiny carcinomas. These constant improvements in this sector are anticipated to boost segment growth.”

The second report from Grand View Research states that the “global mammography market size was valued at $2.35 billion in 2023 and is projected to grow at a CAGR of 8.87% from 2024 to 2030.”

“The rising prevalence of breast cancer and increasing demand for early-stage diagnosis amongst patients are some of

the key factors anticipated to drive demand for breast cancer diagnostic devices over the forecast period,” the report continues. “Increased access to breast cancer screening systems and growing government initiatives to support clinical interpretation are some of the pivotal factors expected to propel market growth. The demand for mammography screening services is on the rise due to the increasing prevalence of breast cancer among the geriatric population. Furthermore, as the world’s population is growing, a large proportion of women might reach the age of 60 years or older. Women over the age of 60 years account for about 78% of all breast cancer-related fatalities.”

“Breast cancer has a high incidence and fatality rate in this age range, indicating a significant unmet demand for breast cancer diagnostics. The need for mammography is likely to rise as the number of events and fatalities rises,” it continues.

New technology is also sending the market higher.

“With the introduction of new 3D-based technology called Digital Breast Tomosynthesis (DBT), obtaining a 3D image of the breast is possible. This allows radiologists to scan the breast slice by slice and identify abnormalities, which would be obscured in 2D images. Furthermore, the high demand for mammography screening services can be attributed to the improvement in accuracy and efficiency provided by advanced technologies, such as digital mammography, 3D mammography (tomosynthesis), and computer-aided detection (CAD),” Grand View Research states. “For instance, in November 2023, GE HealthCare unveiled a new product, the MyBreastAI suite, at the RSNA 2023 conference in Chicago. The AI-powered suite aims to streamline radiologists’ workflows and aid in the early detection of breast cancer. These advancements in mammography technology drive the demand for mammography products.”

The breast tomosynthesis technology segment is expected to witness the fastest CAGR from 2024 to 2030, according to the report.

“Digital breast tomosynthesis is a high-resolution limited-angle tomography technology that uses X-rays to create a 3-dimensional image of the breast. It is a new technique that aids in the identification of breast cancer in its early stages,” the report states. “Digital breast tomosynthesis is very useful in analyzing dense breasts and can enhance the ability to detect breast cancer. It minimizes the number of false-positive readings (readings that identify normal tissue as abnormal) and the necessity for a biopsy. It is especially good for examining dense breasts.” •

Product Focus

Breast Imaging

*Disclaimer: Products are listed in no particular order.

FUJIFILM

ASPIRE Cristalle 3D Mammography System

Fujifilm’s ASPIRE Cristalle is an advanced, 3D mammography system that is FDA-validated as superior across all breast densities*. The system’s Intelligent Automatic Exposure Control (iAEC) technology employs morphological analysis of the pre-exposure, adapting to individual feature recognition characteristics of fibroglandular and adipose tissue, pectoral muscle, and implants. It then isolates the densest regions and maps exposure conditions to optimize the image quality of glandular tissue. Additionally, to ensure consistent image quality across a wide range of patients and breast types, the ASPIRE Cristalle incorporates Fujifilm’s Dynamic Visualization II (DVIIm). DVIIm utilizes AI feature recognition to identify individual characteristics of structures within the breast. With Fujifilm’s patented Comfort Paddles, patients will experience a more comfortable exam without compromising tissue distribution and image quality. The Comfort Paddles 4-way pivot and flexible surface design gently adapts to the individual breast and distributes pressure evenly.

* Digital Breast Tomosynthesis: U.S. FDA PMA approval January 2017 (P160031)

KONING

Vera Breast CT

The Koning Vera Breast CT (KBCT) is a state-of-the-art true 3D breast imaging device designed to enhance the accuracy and comfort of breast cancer exams; it is the only FDA approved device of its kind and is commercially sold around the world. Unlike traditional mammography, which relies on compression, KBCT utilizes cone beam technology to provide real 3D images of the breast, offering exceptional spatial resolution without the need for painful compression. This device significantly improves how clinicians visualize and evaluate breast tissue, ensuring a more comfortable exam experience for patients. With a rapid 7-second scanning time per breast, and radiation doses comparable to standard mammography, KBCT represents a significant advancement in breast imaging technology, making it a valuable tool in the early detection and diagnosis of breast cancer.

SIEMENS HEALTHINEERS MAMMOMAT B.brilliant

Mammography System

The new MAMMOMAT B.brilliant mammography system from Siemens Healthineers offers full-field digital (2D) mammography, breast biopsy, and TiCEM (contrast-enhanced mammography). Standard on all MAMMOMAT B.brilliant units is a complete ComfortPackage that includes ambient lighting, intelligent personalized compression, and curved compression paddles to reduce patient discomfort, and improve breast positioning, and enable more consistent image quality. The ComfortPackage also benefits the technologist through automatic tube movement that can reduce repetitive workplace injuries, a prominent display that places exam information at eye level, and a laser positioning guide that aids in optimal positioning. The optimized face shield angles back toward the unit, so the patient can be positioned to lean into the unit for improved visualization of posterior tissue. Also, Siemens Healthineers has filed a Premarket Approval application for the system’s new PlatinumTomo¹ 3D technology, which will acquire the tomosynthesis volume at the same angular range of 50° — the widest angle available — as the company’s current system for a high level of depth resolution and tissue separation.

¹ The planned 3D tomosynthesis option for the MAMMOMAT B.brilliant is currently under FDA review. Actual results may differ materially from anticipated results and may be subject to change.

HOLOGIC 3Dimensions Mammography System

Hologic’s 3Dimensions system is designed to provide high quality 3D images for radiologists, an enhanced workflow for technologists, and a more comfortable mammography experience for patients. The system features the unrivaled performance of the Genius 3D Mammography exam, the only mammogram that’s FDA approved as superior for women with dense breasts compared to 2D alone. The 3D exam is more accurate than conventional 2D mammograms, detecting 20-65% more invasive breast cancers. Available on the 3Dimensions system is the Hologic Clarity HD high-resolution 3D imaging technology, which integrates a breakthrough detector and advanced 3D imaging algorithm to deliver exceptional 3D images, regardless of breast size or density. This technology leads the industry with the fastest and highest resolution 3D images with the same 70 micron pixel size as full field digital mammography. The 3Dimensions system also features Hologic’s Genius AI Detection solution. Using deep learning technology, this solution is designed to mark lesions likely representing breast cancer with a meticulous search of each pixel of each slice of the tomosynthesis image set with a high sensitivity of 94%. This software is fully integrated on the 3Dimensions acquisition workstation and can help aid workflow. Additionally, the 3Dimensions system incorporates the SmartCurve breast stabilization system to provide patients with a more comfortable mammogram without compromising image quality, exam time, dose or workflow.

DELPHINUS MEDICAL TECHNOLOGIES

SoftVue Breast Ultrasound Tomography (UST)

Delphinus Medical Technologies developed the SoftVue Breast Ultrasound Tomography (UST). SoftVue UST is an imaging modality designed specifically to find more cancer in women with dense breasts and is an ultrasound-based breast imaging system that is FDA-approved for same-day screening as mammography. Delphinus designed the system as an adjunct to mammography for women with dense breasts to address the fact that breast cancer screening with mammography alone reduces mortality by 41% in women with non-dense breasts but reduces mortality by only 13% in women with dense breasts.

DIRECTOR’S CIRCLE

The World Cancer Research Fund expects the number of breast cancer cases to reach about 2.1 million globally by the end of this decade. Breast imaging is the primary method of diagnosis for a vast majority of breast cancer patients globally.

ICE Magazine reached out to imaging leaders to find out the latest on breast imaging. Participants in this Director’s Circle article on breast imaging are:

• Dr. David Bodne, radiologist, Advanced Southern Imaging

• Richard Reaven, M.D., scientific advisory board member, Koning Health

• Amy Reed, mammography supervisor and regional QA/ QC coordinator, University Hospitals Tripoint Medical

• Michele Robbins, BA, CRA, RDMS, RVT, associate director of women’s imaging at Banner Imaging

Q: HOW HAS BREAST IMAGING CHANGED OVER THE YEARS?

Bodne: The goal for breast imaging has remained constant, find cancer early to have a positive outcome from treatment. Over time, the technology has also remained fairly consistent, using compression to hold the breast in place while an image was formed by the interaction of breast tissue and X radiation. The major change has been in the development of protocols to make and work up findings. The other change has been the increasing involvement of groups pushing for increased availability and compliance. The “find a cancer as small as the period at the end of a sentence” campaign was very effective. With increasing compliance, the detection rate of early-stage cancers has increased over time. The change from film to digital allowed us to manipulate images to help us detect subtle findings, with improved detection. Tomosynthesis, essentially polytomography of the breast, helped us better detect a certain finding. More significantly, it was supposed to decrease our false positive rates. This last point is very operator dependent. It does seem our diagnostic schedules have dramatically increased since the inception

of DBT. An interesting side note is the public misconception about DBT requiring less compression, the Holy Grail of breast imaging. Unfortunately, compression will always be necessary for upright breast imaging. With the introduction of MRI, we found improved sensitivity with some loss of specificity, leading to increased call backs for findings. Scanning prone, of course, didn’t require compression to maintain a fixed position. Ultrasound also developed as an indispensable tool in our armament, becoming the workhorse for both supplemental imaging and procedures. The current mammographer is overwhelmed with the growth in numbers of exams, the complexity of the patients, the growth and variety of procedures performed, and the non-interpretive work done, such as speaking with patients and referring physicians and our technologists. No wonder new technologies are looked at with a cynical and weary eye.

Reaven: The fundamental technologies of breast imaging have not changed that dramatically over the last 15-20 years. We are still using mammography (X-ray), ultrasound and MRI primarily. With the advent of tomosynthesis (so-called 3-D imaging, which is a misnomer), the same underlying mammographic technology is used. The only difference has been the added ability to tilt the detector 15 or so degrees in one projection and then the other. This has allowed radiologists to peek around the corner, similar in fashion to a now outdated technology used in chest X-rays to peek up around the clavicle to look at the lung apices. We all know that mammography has its limitations, and tomosynthesis is no exception. An innovative technology that I think can change the game is dedicated computed tomography using a mammographic detector to ensure that radiation dose is in line with traditional mammography. This can allow true 3-dimensional imaging as opposed to projectional data, which can dramatically improve spatial resolution similar to the difference between a chest X-ray and cross-sectional chest CT. We all use chest X-ray to evaluate for pneumonia, effusion or pneumothorax, howev-

DAVID BODNE

ADVANCED SOUTHERN IMAGING

RICHARD REAVEN

KONING HEALTH

er when we want to evaluate for potential lung cancer we rely exclusively on cross-sectional chest CT examinations.

Reed: We have had many exciting changes in breast imaging since I began doing mammography in 2006. I would have to say the biggest change was moving from film to digital imaging, and that has brought its own advancements such as CAD and tomosynthesis. Not only have these changes allowed us to increase our department productivity, but also we have been able to enhance the patient experience by reducing the time from a 30-minute screening exam to just under 15 minutes.

Robbins: Breast imaging has undergone significant advances over the years including digital mammography, tomosynthesis (3D mammography), contrast enhanced mammography (CEM) and utilization of AI for enhanced mammography interpretation.

Q: HOW CAN AN IMAGING DEPARTMENT STAY CURRENT ON THE LATEST GUIDELINES FOR MAMMOGRAPHY?

Bodne: By providing appropriate staffing and technology for the radiologist, the physician is able to monitor the center while performing the myriad tasks confronting us daily. Burnout, however, is always possible, and is the growing concern currently. With a diminished workforce and a growing demand, there needs to be exploration into ways to meet current goals and guidelines more efficiently. One area might be use of mid-levels such as APPs or NPs to perform appropriately assigned tasks. Newer technologies are being explored to address some of the ongoing challenges such as screening dense breasts and cost-effective high-risk screening. It would also be helpful to test effectiveness of guidelines over time to avoid piling on of ineffective ones and on the fly ability for improvement in order to better achieve the common goal of early treatment for early disease.

Reaven: Attending national and international meetings can allow radiologists and imaging professionals to maintain current recommendations and become aware of current trends. Reading journals, attending journal clubs and speaking directly with colleagues can also help us remain aware of recent devel-

REED

UNIVERSITY HOSPITALS: TRIPOINT MEDICAL

opments in the field. It is always important to frame the new information obtained in a clinical setting and to ensure these trends can be adapted to the clinical workflow. Teaching our referring physicians, providers and the public about the benefits of breast imaging remains a central role for our profession.

Reed: I think it takes a team to stay current on the latest guidelines for mammography and breast imaging. We have bi-weekly lead tech meetings that include representation from the 27 sites that perform breast imaging in our health system. The techs bring anything they want to discuss to the Zoom call. We take anything that cannot be solved at that meeting to a breast imaging TRIAD that meets monthly that consists of directors, managers, supervisors, radiologists and physicists to discuss any policy or protocol changes. Having the routine input from such a wide network of people gives us the ability to learn from each other.

Robbins: With 17 Banner Imaging sites ACR accredited in performing mammography including our 7 ACR designated Comprehensive Breast Centers we rely heavily on our lead QC mammographer to ensure we are aware of any guideline changes and remain in compliance.

Q: WHAT TIPS CAN YOU SHARE TO HELP CREATE AN EFFICIENT WORKFLOW DURING BREAST CANCER AWARENESS MONTH AND THROUGHOUT THE YEAR?

Bodne: Find a way of cloning the radiologist, at least in number of useful hands-on deck. Appropriate utilization of mid-levels, for example. Also, technologies to help us improve compliance while enhancing our efficiency. If we can find a way to better improve our confidence in normal findings, we might be able to decrease our false positive screeners and increase effective utilization of diagnostic slots. If we can find a way to more readily assess screening findings at the time of the diagnostic exam, it should decrease the time spent coming to a conclusion and providing a recommendation for the patient. The workflow is only as efficient as the radiologist and the technologist doing the work.

Reaven: Communication is key. Many women think about breast imaging only during Breast Cancer Awareness Month.

AMY

BANNER IMAGING

MICHELLE ROBBINS

We need to reframe the conversation in order to ensure that more women think about breast health throughout the year and that they are regularly imaged in order to detect breast cancer at its earliest and most treatable stage. Staffing can also be an issue, so making sure there will be adequate staff before, during, and after Breast Cancer Awareness Month is imperative. Compliance is also an issue nationwide. We know from MQSA and Medicare data that only around 55% of eligible women regularly receive breast imaging evaluation. Offering various options and innovative, FDA approved technologies can dramatically improve compliance. We know that cancers are out there (1 in 8 women in their lifetime), our job is to find them early so they can be treated effectively.

Reed: Efficient workflow during Breast Cancer Awareness Month and throughout the year can be a struggle at times but can be best approached by taking the time to look at your schedules ahead. Do not wait until you have a backlog to add extra timeslots, open the extra before you get to October. We check our scheduling templates every Monday to see how many days we are out and make adjustments as needed. Think outside of the box when you staff for these times of the year.

Robbins: Support staff is critical to maintaining an efficient workflow. Our support staff consists of our breast coordinators, IR schedulers, medical imaging assistants and front desk team members.

Q: WHAT NEW TECHNOLOGY HAS YOU EXCITED ABOUT THE FUTURE OF BREAST IMAGING?

Bodne: Something I was briefly introduced to many years ago seems to be coming into its own. Breast CT has been capturing my imagination since I started being involved with it earlier this year. A perfect storm of personal situations brought me back in contact. What I’ve found, so far, is it helps me be more confident in making BI RADS 1 and 2 calls on screening. It helps me quickly locate findings at call back, improving my efficiency for diagnostic exams. It helps me also quickly make the findings for procedures, many performed with CT guidance. The ability to give IV contrast is proving to be comparable in diagnostic abilities to what I’m reading contrast mammography is able to provide. I’m able to evaluate implants on exams, possibly becoming a replacement for MRI for this indication. IV contrast exams have also revealed small cancers in dense breast tissue. Since attenuation seems to be comparable to tissue density, perhaps CAD or AI might prove useful in aiding us in diagnosing these women more effectively at the time of their screening exam. And the possibilities are likely to be as endless as what we’ve found over the years with CT used for imaging other areas of anatomy. Let’s see where our academics might take this as it’s introduced into the global women’s centers. Did I mention, women might have found their Holy Grail, hopefully increasing compliance?

Reaven: The Koning Vera dedicated breast CT imaging device is the most exciting breast imaging development in recent

history. This compression-free imaging can be used without or with contrast, is biopsy capable, does not involve breast compression, uses radiation dose equivalent to mammography, and offers improved cross-sectional imaging quality. No other imaging modality offers these things in one package.

Reed: Contrast enhanced mammography has been exciting to learn about for the future of breast imaging! We will have 4 locations performing this new technology by the end of September. CEM finds cancer that could be missed on regular mammograms or ultrasounds. It is a safe, fast and effective alternative to breast MRI and breast MRI with contrast when the patient cannot tolerate an MRI. We are working on getting the information shared with the providers in our area.

Robbins: The advancements in AI and potential applications of artificial intelligence in breast imaging are exciting in both areas of interpretive AI (cancer detection) and non-interpretive AI such risk assessment, density quantification and image quality assessment.

Q: WHAT ELSE SHOULD ICE MAGAZINE READERS KNOW ABOUT BREAST IMAGING?

Bodne: It’s the area where I believe we’re going to see the dreams of the forefathers and foremothers of breast imaging realized.

Reaven: Breast imaging has the ability to impact lives in profound ways. Without early detection and intervention, breast cancer can be a devastating disease with profound morbidity and mortality implications. When found early in its most treatable stages, women, men and their families can be offered a new lease on life. The happiness that early detection can deliver and the positive impact that can have on families is truly inspiring. Those of us who work every day in the breast imaging space can be and should be proud of those efforts.

Reed: Breast imaging has very compassionate technologists that are committed to their roles and their patients from the minute they walk in the door in the morning until sometimes even at the grocery store on the weekends! To have a former patient come up to you and thank you personally for your care, for finding their cancer or even for taking extra time with their mother is the best feeling in the world.

Robbins: With mammography remaining the gold standard in breast cancer screening the current recommendation of the Society of Breast Imaging is that woman at average risk for breast cancer begin annual screening mammograms at age 40. •

For more information, visit koninghealth.com. You can also reach us at info@koningcorporation.com or 888-558-5228 ext 800.

CHANGING THE NARRATIVE

CHANGE

Through innovation we want to change the perspective in the imaging space.

CONTROL

We want to put the control back in the hands of the decision makers.

COST SAVINGS

We understand our customers goals and we are developing a clear pathway to measurable savings.

Dan Faulkner, CT Tech

Dan has been with Tri-Imaging for 11 years!

WOMEN IN MEDICAL IMAGING

LEADERSHIP FOR AN EMERGING LANDSCAPE

BY MATT SKOUFALOS

Diversity in leadership remains a persistent and widespread challenge in the medical imaging space. In a June 2024 study in the Journal of Breast Imaging, researcher Jean M. Seely spoke about the disparity in representation among women in radiology. Despite comparable graduation rates, men account for some 70 percent of applications to diagnostic radiology residency programs. Women comprise less than a quarter of all practicing radiologists in Canada and the United States, although men and women are almost equally represented in radiology in other countries.

“In leadership roles in radiology, the percentage of women is even lower,” Seely continued, noting that women radiologists from racial or ethnic groups that are underrepresented in medicine face additional hurdles.

“Underrepresented in medicine medical students shoulder burdens of microaggressions or overt racism, which can precipitate stress responses that may interfere with their ability to function in a work environment,” Seely wrote. “The intersectionality of being female and a UIM physician compounds the challenges.”

Part of those challenges includes better establishment of benchmarks to achieve in diversifying leadership, from entry-level positions to those in the C-suite, and better opportunities for advancement.

Seely’s report summarizes what many women working in the medical imaging space have observed for years, which is largely that “gender diversity … is good for the bottom line,” having been shown to increase employee satisfaction, challenge status-quo thinking, and improve patient outcomes. However, the process of developing opportunities for women to hold leadership roles, contribute to shaping policy, and mentor their colleagues, feels farther off from being fully implemented.

In 25 years as a medical imaging professional, Tricia Trammell, imaging operations manager at UT Southwestern Medical Center at Moncrief Cancer Institute in Fort Worth, Texas, said she has seen many changes in the landscape of imaging leadership.

For a start, there are far more women working as imaging leaders today than there were when Trammell began her career, and they are more than willing to lean on one another for support in the workplace. She said the latter point feels as important as the former when health care organizations aspire to high-reliability goals, and employees are encouraged to self-disclose mistakes to mitigate their recurrence.

“I think the whole landscape of leadership is changing, and I think that’s a good thing because diversity brings strength to our teams,” Trammell said. “In health care, we have been conditioned to think that errors are bad. Everyone has a fear of being perceived as if they do not know what they are doing. But as many health care organizations transition to become high-reliability organizations, transparency and psychological

safety become increasingly more important.”

“My whole team happens to be women,” she said. “I feel strongly that the women on my team feel empowered and are incredibly supportive of each other, and that is evident by the high employee engagement of the team.”

“I have a remarkably diverse group of women with diverse cultures and backgrounds. Everyone appreciates that about each other,” Trammell said. “We celebrate each other. I meet with the people on my team and find out what their goals are; my goal is to help them reach their goals. We win together!”

When leadership is diversified and focused on psychological safety, Trammell said, it facilitates an environment focused on correcting mistakes rather than punishing the people who have made them; on connecting with employees to create a workplace in which people can thrive and develop self-confidence and trust in their colleagues. Trammell said that her own participation in a mutual mentorship program facilitated between her employer and the Association for Medical Imaging Management (AHRA) helped demonstrate the value of non-hierarchical professional coaching while simultaneously underscoring the challenges that other women similarly face in the workplace.

“I took part in a mentorship program where I was both a mentor and mentee, and that gave me an opportunity to help someone else, and also to be helped,” Trammell said. “I mentored a young woman who is not in imaging, but in health care. Ironically, the struggles that she was going through were related to how she was being treated by her boss. The reason she signed up for the mentorship program was she really wanted someone to talk to about how to navigate incivility in the workplace.”

“This is a very big and ongoing problem, and people are getting mentors and executive coaches just trying to figure out how to navigate incivility in the workplace or an uncivil boss,” she said.

The phenomenon of workplace incivility is becoming better documented in recent years, specifically in health care – and, according to Trammell, women are getting the worst of it, often from other women. She described feelings of insecurity driving behaviors of jealousy and intimidation that can result in withholding information and other forms of subtle sabotage or microaggressions.

“More women experience incivility than their male-counterparts, and they are often experiencing it at the hand of their female colleagues. Women can have problems with jealousy and insecurity that drives negative work behavior such as intimidation and withholding information,” she explains.

Trammell believes that such behaviors are rooted in insecurities that can be compounded within the organizational structure of a business, and that addressing those insecurities requires “a straight-up culture of civility” that overcomes any other entrenched routines. She talks about creating a work-

COVER STORY

place where a diversity of employees can thrive within an atmosphere of psychological safety. To facilitate that environment, Trammell said, she turns her attention to her own behavior first.

“You have to walk the walk and talk the talk,” she said. “Even though we have an overall vision and mission that is set forth by our organization, there are still individual cultures within the organization based on how the individual leaders lead. That is why two clinics within the same organization can have a different culture.”

“I teach civility and how important it is in our workplace,” Trammell said. “I teach psychological safety, and about how important it is to bring your authentic self to work every day. I want my diverse team of women to feel safe enough with me and each other to bring their authentic selves to work every day. This kind of culture takes work and a transparent leadership style.”

After more than 20 years in medical imaging, radiology administrator Nicole Dhanraj, who owns the professional education group South Texas Associates of Radiology and the veterans transitional coaching program Service to Success, established 424 Business Group Inc., a consultancy that leverages her doctorate in organizational management and decades of industry expertise.

Dhanraj’s resume comprises a dozen academic degrees and professional certifications. She operates multiple businesses. And yet her experience in medical imaging – as well as in other health care settings – has been that even highly qualified women still face various obstacles that are couched in heteronormative gender differences and social power dynamics.

“From a very high level, it’s the same things – pay, promotion, biases – that happen everywhere else,” Dhanraj said. “Culture, socioeconomic status, education: all of that influences anyone’s interactions with you. People formulate their inter-

pretations based on culture, and we have additional layers that add to the whole problem.”

In her experience, Dhanraj said that women in radiology may tend to take on “the worst jobs” for want of opportunities and may be more likely to hang in with a difficult assignment to demonstrate their capabilities to their colleagues, or simply to keep a title that might be the only one available to them. She said that women seem to bear the brunt of organizational dysfunction in distinct ways that mirror their experiences in a broader social context.

“Women are more likely than the men to stay and put up with the nonsense to keep the title and the salary because they’re not getting selected elsewhere,” Dhanraj said, “whereas a man would either leave the job or put boundaries in place.”

“I also think women who come into an environment that’s chaotic want to fix everything,” she continued. “They’re doing so much, and they feel like if they don’t juggle it all, then they’re going to be looked at as incompetent. There’s less forgiveness and less room to breathe in a very chaotic operation.”

Dhanraj was also quick to point out that whether men or women hold leadership roles, gender disparities in the workplace can persist if they are institutionally reinforced within the overall structure of the organization. She spoke about participating in a hiring panel that landed on familiar conversations about whether a woman would be a suitable candidate for a particular job role based on her status as a parent.

“The real stereotypes of pregnancy, children, ‘What is she doing outside of work?’ – that haunts women still,” Dhanraj said. “To be successful as leaders, we need people to be open to improving their workplaces and their understanding of individual cultures, and to support their staff.”

When women do attain leadership roles, Dhanraj said again that she has observed them falling victim to gender biases. The resultant stereotyping may result in women leaders hardening their exterior outlook because they feel it’s necessary to get their work done, or to command respect, especially if such strategies helped them attain the positions they hold.

I WANT MY DIVERSE TEAM OF WOMEN TO FEEL SAFE ENOUGH WITH ME AND EACH OTHER TO BRING THEIR AUTHENTIC SELVES TO WORK EVERY DAY.

KIND OF CULTURE TAKES

Women’s job performance may be judged more harshly than that of their male counterparts, and their mistakes chalked up to their gender, simply because of the strength of these entrenched social hierarchies. All of that weight adds to the challenges of effective leadership, to say nothing of the effort that’s already necessary to create psychologically safe workplaces in which to facilitate staff professional development.

“I think there’s less forgiveness when it comes to women,” Dhanraj said. “The only way to confront these negative behaviors toward women is to drag them into the open – women sharing as well as others calling out the behaviors – and to shed light on their impact on the

workforce. Identifying problematic behaviors is a start; supporting others who are willing to speak up about them reinforces the practice.”

“We’ve got to speak up,” Dhanraj said. “Women need to have the courage to address the behaviors. Pull someone aside, and say, for example, ‘When you’re talking to me in meetings, I notice that you continuously cut me off, and to me, it means that you have no respect for me.’ ”

“Women need to speak up, and I think they may need coaching to do so,” she said. “When I talk to others experiencing this, they are thinking it’s all in their head. What they’re feeling and experiencing, they’re thinking this is all on them; that it’s their fault.”

“The main solution is having that psychological safety,” Dhanraj said, “but the ‘Mean Girls’ club, we perpetuate it. We should not tolerate this anymore because we need staff. We need to break all of these negative behaviors. It’s unfortunately a nasty, perpetuating cycle in health care.”

“Who’s going to do this?” she said. “I think it is us women leading this change.”

Karen Anderson leveraged her 19-year background as a radiographer and breast center manager at Parkland Health and Hospital Systems in Dallas, one of the biggest public health systems in the country, to champion women’s health causes in the medical imaging space.

Today, Anderson works as a key opinion leader, engagement leader, and scientific marketing manager for Women’s Health at Siemens Healthineers North America, and for the past two years, has volunteered to perform mobile mammography studies with the nationwide Siemens Healthineers breast cancer screening van initiative.

As a discipline, mammography is an imaging space with a majority of women in key roles because the modality caters nearly exclusively to women’s health needs. Yet Anderson came up in a health care industry almost entirely run by men. When she arrived at Parkland in 1987, Anderson said she was “shocked at the amount of patients, policies – everything in upper leadership was run by men.”

“How does that help me grow and get into leadership roles?” she asked. “I went back and got my master’s degree. I dug in and learned all aspects of Parkland Hospital and what it meant for the community. I found mentors who showed me how to grow and lead, including Eloise Shelley, Parkland’s first female African-American associate director of radiology. I then landed as an X-ray QC manager on the 11-7 shift.”

“Male doctors thought they were it: ‘You do what I say,’ ” Anderson remembered. “As I grew into my role, this was about how we serve patients. I started to really focus on the goal of Parkland Hospital, which was to serve the people of that community. I started doing mammography as a technologist, and I left the management role.”

When she was given the opportunity to lead her department, Anderson said she felt the stress of working in leadership, from parlaying with advocacy groups, to fundraising, to forming strategic partnerships. She said the work compelled

her to proceed with the national breast cancer program to grow it into what it is today, and that it was personally taxing to pursue. The unspoken danger of failing to address gender disparities in the workforce creates the false choice that so many in health care must someday confront – put up with an unsustainable professional culture to pursue a moral or personal passion, or prioritize self-protection and leave the work in the hands of others who may be less dedicated or capable.”

“Burnout is a real thing,” Anderson said. “When women start to experience that burnout, they have so much knowledge, so much expertise, that they don’t want to leave that knowledge on the table.”

Rather than working against her in the mammography space, Anderson said that that her gender and cultural identity as a Black woman have enabled her to connect more deeply and more frequently with women in the demographics that are most critically underserved by breast cancer screenings. When she walks them through the procedures, she is also answering questions about her career pathway, and what of her efforts could be reproducible for their children. The generosity of Anderson’s accumulated skill and wisdom enables her not only to coach patients through the intimate sensitivities of mammography with compassion and grace, but also to reveal underlying concerns that a less thoughtful approach would overlook.

“Some of the things you need to be able to do for this particular career is be passionate; be empathetic,” she said. “You have to have concern for that patient, and you have to speak their language. I gained that skill over time of speaking to people where they are over time.”

Anderson takes a similar approach to her work as an imaging leader, placing emphasis on what she can do to help advance the careers of the people working alongside and under her.

“If you’re in a center together, everyone has to grow,” she said. “You can’t leave one person behind. That’s how I approach my group when I’m in leadership. You can overcome working with a group if you’re able to relate one-on-one.”

She advised women in medical imaging to consider their options, clinical environments, instructional opportunities, work with federal agencies or non-governmental organizations, or joining a private-sector business as a skilled technical liaison.

“You don’t have to be stuck,” Anderson said. “You don’t have to feel like you’re in a career that has no pathway. I stay in this industry because I’m a patient-centered person. The only way I can keep that focus is to perform mammography parttime at a local hospital, which I’ve done for the past five years.”

“I have an overwhelming passion to support women, I have a technical expertise of 37 years total in this industry, and I don’t want to let that go, because I’m so focused and passionate about this industry,” she said. “Learn the fundamentals and become an expert. There are applications for growth. Although I’m working for a Fortune 500 company today, where I can continue to support women, I still enjoy the clinical side, and this is the primary reason why I continue doing mammography on the weekends.” •

ANNUAL MEETING EXCITES & EMPOWERS

AHRA: The Association of Medical Imaging Management’s 2024 Annual Meeting attendees left Orlando, Florida excited and empowered. Educational opportunities combined with access to more than 120 exhibiting companies in the Gathering Place exceeded expectations.

The awards presentation at the AHRA Annual Meeting remains a popular event. AHRA announced its award recipients for their achievements in medical imaging management, healthcare administration and the professional association. In each of the respective achievement awards, fellow designations and scholarships, AHRA recognized medical imaging professionals for their impact on the field as well as their meaningful contributions to AHRA.

“This year’s AHRA award recipients showcase an incredible lineup of innovative pioneers in medical imaging management,” new AHRA President Mario Pistilli, FACHE, CRA, said. “We want to thank everyone for their valuable contributions and support to make AHRA an inclusive and robust community that fuels the vital progress towards shaping better patient care and the advancement of modern medicine.”

The 2024 AHRA Achievement Awards were presented to 23 recipients for achievements and contributions to AHRA and the field of medical imaging. The association recognized AHRA past-president Chris C. Tomlinson, CRA, FAHRA, with the Jim Conway Gold Award, which is AHRA’s highest honor, conferred for his significant contributions to the profession of imaging and healthcare administration. A complete list of award winners is available at tinyurl.com/w9hpyr99

The appointment of the new AHRA and AHRA Education Foundation board of directors also happened at the annual meeting. The president, president-elect, finance director and the directors for both boards were chosen by AHRA membership.

“The AHRA membership is thrilled to welcome this dedicated group of imaging professionals to lead the organization and the imaging profession toward another year of promising growth,” said AHRA Executive Director Jason Newmark. “As AHRA looks toward 2025, we’re excited to continue to support our mission to educate, develop, mentor and provide resources for medical imaging professionals.”

The 2024-2025 AHRA Board of Directors include: President Mario Pistilli, CRA, FAHRA, director of imaging services at Children Hospital Los Angeles (CHLA); and President-Elect Wesley Harden, CRA, FAHRA, director of imaging services at Lexington Medical Center, Lexington, S.C. Pistilli addressed the growth and excitement surrounding AHRA. “We have also had the largest attendance for an AHRA Annual Meeting in a very long time, with the most first-time and new member attendees in our history,” he said. “This shows that AHRA members are eager to network, collaborate, dive in and support the work ahead. Our theme for the coming year is centered on harnessing the collective strength of our community to drive the field of leadership in medical imaging forward.” Meeting highlights included:

• Sunday Golf Scramble

• CRA® Exam Workshop

• Executive Leadership Workshop

• President’s Welcome Reception

• Daily Keynotes

• Vendor Symposia

• CRA Alumni Reception

• Closing Party

The AHRA 2025 Annual Meeting is set for the Paris Las Vegas Hotel from Sunday, August 3 to Wednesday, August 6. Save the date now and prepare for an event filled with cutting-edge educational sessions, networking opportunities and all the energy and excitement one can expect to in Las Vegas! •

Photo credit: AHRA: The Association for Medical Imaging Management.

BY KIRSTEN LINCOLN

GBEYOND MAMMOGRAPHY: THE ROLE OF ULTRASOUND IN BREAST HEALTH

rowing up, I wasn’t informed about the various options available for managing breast health. As I progressed in my career in diagnostic imaging—starting on the patient care side and eventually transitioning to the technical side—my perspective broadened. Initially, I believed Mammography was the only option, but I’ve since learned that ultrasound also plays a crucial role in breast health. Working with Avante Health Solutions as their first female Field Service Engineer has provided me with invaluable opportunities to expand my knowledge in the diagnostic imaging field.

An ultrasound exam is a noninvasive diagnostic imaging procedure that uses high-frequency sound waves to form an image. These sound waves are produced by the ultrasound probe, also known as a transducer. The sound waves travel from the probe through the ultrasonic gel into the body. When the waves bounce off breast tissue, the transducer collects them to create an image of the entire breast. This process occurs continuously throughout the scan, producing a real-time representation of the breast’s structure and movements. Additionally, ultrasound dopplers can detect the presence and flow of blood within the breast tissue. Because breast ultrasounds do not use radiation, they are safe for individuals who are pregnant, nursing, or allergic to contrast dye. The scan can also detect leaks or ruptures in breast implants, offering a wide range of uses and benefits.

If a physician feels any lumps during a physical examination, they may recommend further investigation. Breast ultrasounds can detect lumps within the breast tissue and help determine whether they are solid, fluid-filled, or a combination of both. A fluid-filled lump is classified as a cyst, while solid lumps could be an overgrowth of ducts, fibroadenomas (benign fibrous growths), lipomas (benign fatty growths), or

tumors. When a lump exhibits both solid and fluid characteristics, it is known as a complex breast cyst. If either a solid lump or complex breast cyst is detected during the ultrasound, the physician may recommend an ultrasound-guided breast biopsy. Because ultrasounds provide real-time imaging, allowing physicians to locate the area of interest, evaluate the lump in greater detail, and determine the best course of action. This makes ultrasound an ideal tool for guiding the needle to the precise location needed to collect the most accurate specimens.

Even if a patient has already recieved a mammogram or breast MRI, a breast ultrasound may be suggested if abnormalities are present. Mammograms and MRIs can sometimes miss lumps or fail to provide sufficient detail on specific areas of concern. Diagnosing irregularities based on a mammogram alone can be particularly challenging, especially for individuals with dense breasts. Dense breast tissue contains a higher concentration of ducts, glands, and fibrous tissue, with less fat. Additionally, some individuals may not be able to undergo an MRI due to certain medical implants, claustrophobia, or an allergy to contrast dye. In such cases, a breast ultrasound offers the most accurate results without compromising safety.

Understanding the various options for breast health is crucial for making informed decisions about your care. While mammography has long been the standard, the role of ultrasound in detecting abnormalities and guiding further treatment cannot be overlooked. With advancements in diagnostic imaging, tools like ultrasound provide safe, detailed, and real-time insights into breast health, making them an essential component of comprehensive care. By staying informed about these options, you can better advocate for your health and ensure that you receive the most accurate and effective care possible. •

For more information about Avante’s field service capabilities, call one of our experts at 800-979-6142 or visit avantehs.com.

DIRECTOR’S CUT

BY NICOLE DHANRAJ

OSTOP THE CHAOS, START PRIORITIZING

K, I know you feel it. That constant pressure, the feeling you just can’t stretch the day long enough to be the imaging leader you envision. You care deeply – about patient experience, your team, the whole department. But the never-ending requests leave you stretched thin and, frankly, burnt out.

Here’s the hard truth: you can’t please everyone, and that’s OK. As Simon Sinek says, “Trying to please everyone ends up pleasing no one, least of all ourselves.”

I used to be there too. But I learned something powerful: prioritization isn’t about becoming heartless, it’s about focusing your energy strategically.

Imagine being an imaging leader who gets things done, not just reacts to every whim. Prioritization lets you do just that. Here’s how:

LASER FOCUS, MAXIMUM IMPACT

To escape feeling scattered, I solidified my department’s core values and aligned everything we did with the department’s mission. We should be known for delivering exceptional, efficient care. So, what initiatives directly improve that? Faster scheduling? Cutting-edge wait-reducing technology? Absolutely. Staff training? Of course, but we prioritized programs that directly impacted our goals, such as patient interaction and efficient care. Everything else took a backseat.

EMPOWERED TEAMS

Clearly communicating our priorities and goals helped the team understand why some initiatives weren’t underway as well as empowering them to take action on the “supporting tasks” to ensure improvement in our prioritized initiatives. Tackling things together, along with empowering the team to take action, frees up a lot of time. Techs can identify workflow bottlenecks, schedulers can analyze peak appointment times, and physicians can help brainstorm ideas around process improvement. Suddenly, we’re a team driving solutions, not passengers on a chaotic train.

REDUCED STRESS, ENHANCED WELL-BEING

This eliminates the feeling of being overwhelmed. Prioritization frees up time and energy for what truly matters, leading to a happier, healthier you. Remember that constant email ping-pong? Prioritization lets you set specific email check times, freeing up your day for higher-level tasks. You’ll be less stressed and more present when interacting with your team and patients – a win-win.

PRIORITIZATION BLUEPRINT

Here are some tactics you can develop to stop the chaos and start prioritizing.

1. Clearly define your department’s core goals. Every initiative you take on should impact these goals. Everything else is on hold or delegated.

2. The Eisenhower Matrix can help. This tool categorizes tasks based on urgency and importance. Use it to differentiate between critical tasks (think patient safety concerns) and those that can be delegated (scheduling non-urgent exams) or eliminated (unnecessary paperwork).

3. Boundaries and Saying No. This is a hard one, but trust me. It’s OK to say no to requests that don’t align with your department priorities. Setting boundaries isn’t selfish; it empowers you to be fully present for the things that matter most for your fiscal year.

4. Batching. Want to gain some time back? Batching similar tasks and setting realistic deadlines can maximize your prioritized efforts.

Remember, prioritization is an ongoing process. We need to regularly reassess our department and organization’s strategic goals and adjust our focus as needed.

Let go of the need to please everyone and focus on what truly makes a difference and impact in our imaging department. By embracing prioritization, we can become leaders who achieve impactful results, empower our team, and thrive in the demanding and chaotic world of imaging services. •

Nicole Dhanraj, Ph.D., SHRM-SCP, PMP, GPHR, CPSS, CRA, R.T(R)(CT)(MR), is an experienced imaging director.

IINSIGHTS

BY MARK WATTS PACS/IT/AI

FALL PREVENTION AND AI

t was June 22,1997. I still remember the sound of the patients head hitting the floor even though it has been 27 years. I tell this story over and over again. If I can prevent one patient from falling it will be worth the effort.

All hospitals have falls. I will cover what an effective fall prevention program should take into consideration and how AI could be applied to provide assessments and alerts before the head hits the floor.

Here are some tailored preventive measures to effectively prevent falls in a hospital:

MEDICATION MANAGEMENT:

Medication Review: Regularly review medications, especially those that can cause dizziness, sedation or orthostatic hypotension. Adjust dosages or switch to safer alternatives when possible.

Medication Timing: Administer medications that can cause sedation or dizziness at times when the patient is less likely to be mobile.

POST-SURGICAL CHANGES:

Assess Mobility: Conduct frequent assessments of the patient’s mobility and strength post-surgery. Consider physical therapy if needed.

Gradual Movement: Encourage gradual movement, such as sitting up in bed before standing, and provide assistance during the first few movements post-surgery.

WEAKNESS DUE TO DEHYDRATION:

Hydration Monitoring: Ensure the patient is adequately hydrated, especially after surgery or during recovery periods. If they are on NPO (nothing by mouth) status, use IV fluids to maintain hydration.

Regular Assessment: Check for signs of dehydration, such as dry mouth or low urine output and address these promptly.

NPO STATUS:

IV Fluids: If the patient is NPO, monitor IV fluid administration closely to ensure proper hydration and electrolyte balance.

Nutritional Support: Provide nutritional support through IV or other means to maintain strength and prevent weakness.

GLYCEMIC STATUS:

Blood Glucose Monitoring: Regularly monitor blood glucose levels, especially in diabetic patients or those at risk of hypoglycemia. Adjust insulin or medication doses accordingly.

Symptom Awareness: Educate staff to recognize symptoms of hypo- or hyperglycemia that can increase fall risk, such as dizziness or confusion.

IV POLES AND OTHER EQUIPMENT:

Safe Equipment Use: Ensure that IV poles and other medical equipment are securely positioned and do not obstruct the patient’s path.

Assistance with Mobility: Provide assistance when the patient is moving with equipment, such as IV poles, to prevent tripping or imbalance.

RESTROOM URGENCY:

Prompt Assistance: Ensure timely assistance is available for patients needing to use the restroom, particularly those with limited mobility.

Commode Placement: Place a bedside commode for patients with high restroom urgency or those who have difficulty reaching the bathroom.

NEW SLEEP LOCATION:

Orientation: Orient the patient to their new environment, including the location of the bed, call button and restroom.

Night Lighting: Provide adequate night lighting to help the patient navigate unfamiliar surroundings safely.

Bed Positioning: Ensure the bed is at an appropriate height, with side rails up if necessary, to prevent falls during the night.

GENERAL PREVENTIVE MEASURES:

Fall Risk Assessment: Conduct regular fall risk assessments and update care plans accordingly.

Education and Communication: Educate staff and patients on fall risks and preventative strategies. Communicate any changes in the patient’s condition that might increase fall risk.

Use of Alarms: Consider using bed or chair alarms for highrisk patients to alert staff when a patient is attempting to stand without assistance.

By addressing these factors, you can significantly reduce the risk of falls in a hospital setting and enhance patient safety.

AI can play a crucial role in creating alerts that raise awareness and prompt health care providers to implement fall prevention measures.

Here’s how AI can be leveraged to generate and manage these alerts:

CONTINUOUS MONITORING AND DATA COLLECTION:

Wearable Sensors and IoT Devices: AI can integrate data from wearable sensors (e.g., heart rate monitors, motion sensors) and IoT devices (e.g., smart beds, IV poles with sensors) to continuously monitor the patient’s physical state, movement, and environment.

EHR Integration: AI systems can pull data from Electronic Health Records (EHR) to analyze patient history, medication, and recent changes in condition (e.g., post-surgery status, NPO status).

RISK ASSESSMENT ALGORITHMS:

Predictive Analytics: AI can use predictive analytics to assess the likelihood of a fall based on collected data, such as changes in mobility, vital signs, or medication effects. This can include real-time analysis of factors like dehydration, glycemic status or sudden changes in posture.

Risk Scoring: AI can generate a fall risk score for each patient, updating it continuously as new data is collected, and flagging high-risk patients for immediate attention.

REAL-TIME ALERTS:

Automated Alerts: AI can automatically send alerts to healthcare providers through various channels (e.g., hospital dashboards, mobile apps or pagers) when a patient’s fall risk increases. For example:

Medication-Induced Dizziness: Alert when a new medication known to cause dizziness is administered.

Post-Surgical Weakness: Notify staff to assist with mobility following surgery.

Dehydration Signs: Trigger alerts if hydration levels drop below a safe threshold.

Predictive Warnings: AI can issue predictive warnings based on trends, such as a gradual increase in dehydration or a pattern of high blood glucose levels, prompting preemptive actions.

CUSTOMIZABLE AND CONTEXTUALIZED ALERTS:

Context-Specific Alerts: AI can tailor alerts to specific situations, such as reminding staff to assist with restroom use for patients with limited mobility or providing extra supervision at night for those in a new sleep location.

Customizable Parameters: Health care providers can customize the AI system to prioritize certain types of alerts or adjust sensitivity based on the patient population (e.g., higher sensitivity for elderly patients).

FEEDBACK AND LEARNING:

Machine Learning: AI systems can learn from feedback provided by healthcare providers. For example, if a provider acknowledges an alert and takes action, the system can track outcomes and refine its algorithms to improve future alert accuracy.

Learning from Patterns: AI can identify patterns in fall incidents and adjust alert protocols accordingly. For instance, if falls are more common at a specific time of day or in certain hospital areas, AI can prioritize alerts in those contexts.

INTEGRATION WITH HOSPITAL WORKFLOW:

EHR and Workflow Integration: AI can seamlessly integrate with EHR systems and hospital workflows, ensuring that alerts are delivered in a way that aligns with the daily routines of healthcare providers.

Alert Management: AI can prioritize and manage alerts to prevent alarm fatigue, ensuring that the most critical alerts receive immediate attention while lower-risk notifications are queued appropriately.

PATIENT AND FAMILY ENGAGEMENT:

Patient Education: AI-driven platforms can also be used to educate patients and their families about fall risks, providing tips and reminders through apps or bedside devices.

Interactive Alerts: For patients capable of interacting with technology, AI can deliver personalized warnings or advice, such as reminders to call for assistance before getting out of bed.

By using AI to create real-time, contextualized alerts, hospitals can enhance fall prevention efforts, ensuring that health care providers are continuously aware of potential risks and can act swiftly to mitigate them. This approach not only improves patient safety but also optimizes the efficiency and effectiveness of care delivery.

I remember thinking they are going to fire me over this accident. It is important to practice “Just Culture “ to facilitate reporting and documentation of near misses

Be safe •

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

BY NICOLE DHANRAJ

SHATTERING STIGMAS: COMMITTING TO FAIR HEALTH CARE FOR SEX WORKERS

As I reflect on the recent influx of Venezuelan immigrants into Trinidad, driven by the unrest in their homeland, I am struck by the challenges many face, including those who have resorted to sex work as a means of survival. This situation has led me to contemplate their health care needs and the barriers they encounter, which are not unique to Trinidad but are also prevalent in the United States.

VENEZUELAN EXPERIENCE IN TRINIDAD

In Trinidad, the arrival of Venezuelans seeking refuge has highlighted both the compassion and the challenges within the health care system. Many Venezuelans find themselves in vulnerable situations, and those who turn to sex work face compounded difficulties.

Discrimination, stigma and barriers to essential health care services exacerbate their struggles. Language barriers, fear of legal repercussions, and a lack of awareness about their rights contribute to their isolation and reluctance to seek help.

PARALLELS IN THE UNITED STATES

These challenges resonate with similar issues faced by undocumented immigrants and underserved populations in the United States. Fear of discrimination, legal consequences and limited access to health care create significant obstacles for these individuals and their families. The cycle of vulnerability and fear underscores the urgent need for a more inclusive and supportive health

care environment.

COMPREHENSIVE APPROACH TO COMPASSIONATE CARE

Addressing the health care needs of sex workers and their families is complex, and I really can’t say I know what the answers are, but I know it’s crucial to acknowledge this societal issue and our role as health care professionals to help mitigate these challenges.

We must continue to build environments where individuals feel safe and respected in seeking care. This involves building partnerships with organizations that support marginalized communities and enhancing our cultural and linguistic competency to better understand the unique challenges these populations face.

At an organizational level, we can have initiatives to empower sex workers with knowledge about their rights and available services, and by offering holistic care that includes mental health and general wellness, we can begin to make a difference.

Incorporating patient feedback into our Gallup surveys – asking questions like “Do you feel respected?” and “Were you treated with dignity?” – will help us identify areas for improvement and guide us in our efforts to provide compassionate, patient-centered care for all that we serve.

BUILDING TRUST & OVERCOMING STIGMA

Building trust between health care providers and sex workers requires a nuanced approach to addressing barriers and stigmas. Even as we work through

uncertainties, being proactive is essential. For instance, active listening means engaging with sex workers in a non-judgmental manner, acknowledging their specific fears and experiences. If a sex worker is hesitant to seek care due to past discrimination or fear of legal consequences, validating their concerns and offering reassurance about the confidentiality of their visit can foster trust. This includes explicitly stating that their status as a sex worker will not affect the quality of care they receive.

Creating a welcoming environment includes using inclusive language and ensuring that services are culturally sensitive. This might involve training staff to use respectful terminology and avoiding judgmental language. For example, not using terms like “sex worker” or other stigmatizing terms shows respect and understanding.

Addressing biases within our staff is crucial for providing equitable care. This equitable care can be achieved through specific training programs that focus on the challenges faced by sex workers, such as understanding the impacts of stigma and legal fears on their health. For instance, workshops that highlight the importance of providing non-judgmental care and educating staff on how to support

sex workers compassionately can reduce implicit biases.

While finding a perfect solution may be challenging, acknowledging these specific issues and making dedicated efforts to improve is essential.

MOVING FORWARD TOGETHER

Reflecting on the health care needs of Venezuelan sex workers in Trinidad and similar populations in the United States, it’s clear that meaningful change requires our collective commitment.

If you serve these populations in your area, pledge to advocate for their needs by actively working to improve their access to quality care. This means forging solid partnerships with community organizations, addressing and overcoming biases, and creating an inclusive, supportive environment.

We all can make a tangible difference in the lives of sex workers and their families. Together, let’s build a health care system that truly serves all communities. •

Nicole Dhanraj, Ph.D., SHRM-SCP, PMP, GPHR, CPSS, CRA, R.T(R)(CT)(MR), is an experienced imaging director.

EMOTIONAL INTELLIGENCE

BY DANIEL BOBINSKI

FIS LAUGHTER OK AT WORK?

or decades now, the Reader’s Digest publication has included a feature called, “Laughter is the Best Medicine.” Although it might not qualify as the best medication available, it’s certainly priced right. And yes, benefits do exist. Laughter has been shown to strengthen immune systems, reduce stress hormones and improve blood vessel function.

Granted, in stressful jobs where life and death decisions are made, humor must be used carefully. However, studies show humor goes a long way toward reducing workplace tension. Jeff Justice, a motivational humorist, says the ability to take your job seriously but yourself lightly goes a long way in the battle against stress. It doesn’t mean telling jokes all the time, but rather lightening up.

Research has revealed that workplaces with too much negativity or constant nose-to-the-grindstone thinking experience higher than normal turnover and more people taking sick days. Justice suggests that such workplaces could benefit from developing a lighter tone. He says, “A sense of humor can be used for stress reduction, problem solving, team building and improving communications.”

Humor has also been shown to increase employee engagement and productivity. Scott Friedman, a popular speaker and author on workplace issues, says “Humor creates an instant bond.” He says humor removes negative, non-productive feelings and creates a fresh new approach to situations. According to Friedman, the idea is to laugh about a situation while it’s happening because it keeps oxygen flowing to the brain, and that helps people think more clearly.

I happen to agree with Friedman. Even in stressful situations where humor expressed outwardly would be inappropriate, I’ve found I can deal with the situation better if I think of something humorous and keep it to myself.

KEEPING HUMOR BALANCED

In many situations, it can be wise to think of humor as a type of salt. A little can be good; too much can be bad. Also, when humor is used matters much. Sometimes a witty comment would be phenomenally hilarious, but also quite inappropriate.

As the English poet Samuel Butler once said, “It is tact that is golden, not silence.”

Butler’s admonition is important, because too much humor becomes a burden. One small business owner I know had an employee who worked hard to insert a joke or a pun into every situation. At times his humor was appropriate, but it seemed he worked harder at trying to be funny than he did doing his job.

Eventually his excessive humor distracted the other employees from being productive. Whenever they interacted with him, they felt they were wasting time dealing with his puns and wisecracks. It was clearly too much of a good thing.

TIPS FOR WORKPLACE HUMOR

Dr. Joni Johnston, the founder and CEO of the consulting firm Work Relationships, offers a few tips for using humor at work:

• Pay attention to clues about your co-worker’s mood

• Trust your intuition

• Take yourself lightly

• Use humor as the icing, not the cake

• Avoid playful insults

Johnston says that humor must be used at the right time, in appropriate amounts, and shouldn’t make fun of an individual. The idea is to always make light of the situation – never a person.

A good example of using humor to make light of a situation is offered by Jeff Justice. He tells the story about a female employee who grew tired of her boss continually rejecting her budget – always sending it back and

telling her it needed to be smaller. When she finally got her budget down to absolute bare bones, he still rejected it. Knowing that she couldn’t make it any smaller and still do the work required of her, she took her paperwork over to the copy machine and literally reduced her budget to the size of a postage stamp. When she took it back to her boss they both had a good laugh and her boss approved her budget.

Workplaces benefit a lot when managers use humor, because it’s managers and leaders who set the tone for any workplace. In fact, Dwight Eisenhower, the Supreme Allied Commander in World War II and two-term president of the United States once said, “A sense of humor is part of the art of leadership, of getting along with people, of getting things done.”

My guess is that if you think back over your career, you probably enjoyed working for managers who employed a light, balanced sense of humor.

HUMOR’S ROLE IN TRAINING

Humor also has much value in employee training, as the very act of laughing is usually a sign of learning. Think about it: We laugh when we “get” a joke – when we are connecting two or more pieces of information in a new, unique way. But once that connection is made, we don’t laugh anymore because we’ve already learned – we already “got the joke.”

Yet for all of its benefits, it bears repeating that the use of humor must be balanced. And let me add that those in positions of authority must exercise extra caution to avoid offending people.

For those who remain skeptical about the value of humor in the workplace, let me close by reviewing just a few of the workplace benefits that have been validated through research. Using humor at work:

• improves decision-making and aids in creative problem-solving

• reduces absenteeism, increases engagement and improves productivity

• diffuses conflict, builds trust and strengthens teamwork

So, here’s my challenge: Identify any issue in the above list and then determine one thing you can do differently to improve that area through an increase in workplace humor.

It’s kind of like what Jeff Justice says: “He who laughs – lasts!” •

Daniel Bobinski, who has a doctorate in theology, is a best-selling author and a popular speaker at conferences and retreats. For more than 30 years he’s been working with teams and individuals (1:1 coaching) to help them achieve excellence. He was also teaching Emotional Intelligence since before it was a thing. Reach him by email at DanielBobinski@protonmail.com or 208-649-6400.

MEDICINE FOR THE SOUL AMERICANS

WANT CLOSER FRIENDSHIPS

American adults may typically have more friends than indicated by other recent surveys, with fewer Americans having no friends at all – though many would like closer friendships. Natalie Pennington of Colorado State University and colleagues present these preliminary findings from the ongoing “American Friendship Project” in a study published July 30, 2024, in the open-access journal PLOS ONE.

Having more and higher quality friendships is linked with greater happiness and life satisfaction. However, research suggests that more and more American adults are facing loneliness and spending less time being social. Nonetheless, evidence conflicts as to whether the number and quality of friendships among Americans are actually in decline.

To get a clearer picture of American friendship, Pennington and colleagues launched the American Friendship Project, an ongoing, multi-year survey study. In 2022 and 2023, they gathered baseline data by surveying nearly 6,000 American adults about their friendships and wellbeing.

This initial data suggests that an American adult has an average of four or five friends, similar to numbers reported in previous research from 1970 to 2015. Approximately 2 percent of participants reported being friendless, which is also in line with data from prior decades.

These findings suggest that recent concerns about increasing friendlessness may be inaccurate. However, while participants generally reported satisfaction with their

friendships, many indicated a desire for more time spent with their friends or for higher quality friendships.

The analysis also suggests that participants often talk with friends in person, though phone calls and texting are also common. A subset of participants who were college students were more likely to report meeting new friends at school and tended to maintain friendships for briefer time periods than a general adult subset of participants.

While analyzing the baseline data, the researchers also evaluated the methodology and limitations of the American Friendship Project, considering such questions as people’s varying definitions of “friend” and whether friendships reported in surveys may be reciprocated or not by the other parties.

Overall, the researchers say the project shows promise for shedding new light on friendship and wellbeing over time, which could inform efforts to increase and improve such relationships.

The authors add: “Americans long for greater closeness with friends; although over 75% were satisfied with the number of friends they had, 42% felt they were not as close to their friends as they would like.”

Read the freely available article in PLOS ONE at https:// journals.plos.org/plosone/article?id=10.1371/journal. pone.0305834 •

Citation

Pennington N, Hall JA, Holmstrom AJ (2024) The American Friendship Project: A report on the status and health of friendship in America. PLoS ONE 19(7): e0305834. https://doi.org/10.1371/journal.pone.0305834

ICE Break

ACROSS

1 Optical device used in some imaging systems

7 Special radiologic exam of the urinary tract, abbr.

8 Number of pixels per square inch

10 Dull pain

11 Medical professional, abbr.

12 Frame of a CT with a large opening for the patient

14 Degree, abbr. 15 Enjoyment

16 Stomach muscles, gym term

18 See 14 down

19 Morning time, abbr.

21 Critical 22 Bridle part

23 Half, prefix

“Don’t be afraid of hard work. Nothing worthwhile comes easily. Don’t let others discourage

25 Savings account, abbr.

28 Carry out

29 It’s often measured with a DEXA scan, 2 words

31 ___ tract

32 Use of high frequency sound waves to view inside the body

1 Mobile medical imaging device using X-ray technology, 2 words 2 Kind of beam

3 Unwell 4 Weakening in intensity

5 Sales abbrevaition, abbr.

6 Organ that produces cells involved in immune responses

9 Aye’s opposite 11 Small amount 12 Nitrous oxide, e.g.

13 Magnitude or frequencey in relation to time

14 Remnant radiation that exits a patient’s body and then bounces off the film towards the X-ray tube, goes with 18 across

15 At no cost

17 Stating

20 Removal of tissue for diagnostic purposes

22 Type of waves used in MRI

24 Doctor title, abbr.

26 Email address intro 27 Echelon 29 ____ data (computing term)

30 Talk a lot

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SCRAPBOOK

AHRA: The Association for Medical Imaging Management is the professional organization that has represented management at all levels of hospital imaging departments, freestanding imaging centers, and group practices for 50 years. The AHRA offers a complete slate of professional development programs including a comprehensive selection of educational conferences

1. AHRA attendees network at the Drinks on ICE party sponsored by KMG.

2. ICE Magazine Group Publisher Megan Cabot and Sales Executive Emily Hise pose for a quick photo with the Amirix Imaging team at ICE booth on day 2 of the AHRA Gathering Place.

3. The KMG team is all smiles at the Drinks on ICE event. ICE Magazine sends a “big thank you to their team for sponsoring a wonderful evening!”

and seminars, networking opportunities, award-winning publications, and the Certified Radiology Administrator (CRA) credential. AHRA’s 2024 Annual Meeting was recently held in Orlando, Florida. The Annual Meeting empowered attendees to connect with the latest innovations in medical imaging technology and best practices.

4. A little rain did not ruin the attendees’ time at AHRA this year.

5. The ICE Magazine raffle winner, Chuck Mitchell, was thrilled to take Chill home with him!

6. ICE Magazine Sales Executive Emily Hise has awesome conversations with attendees inside the AHRA Gathering Place.

7. ICE Magazine Group Publisher Megan Cabot interviews Beekley Medical’s Garrett Guite about the company’s new product CaraClip Wire Protector on display at AHRA. 1 2 3 6 7 5 4