The Reading Room - Spring 2013 by Univ. of TN Graduate School of Medicine

UTMC Radiology’s Alumni Newsletter

Spring 2013, Issue 6

The Reading Room Note from Our Chair

Kathleen Hudson, MD Radiology Chair

reetings. It has been a busy and d productive d academic d and d clinical l l year. The search for a new radiology chairman is in progress with additional interviews in March. We have also been active in recruiting new faculty members. In July, we will welcome Dr. James McElmurray who is a fellowship-trained Interventional Radiologist with special interest in oncology interventions. Dr. Amanda Ingram, who completed her training at UTMCK in June 2012, will join us in August 2013. She is currently completing a fellowship in Breast Imaging at the University of Cincinnati. The new Cancer Institute opened in October 2012. The Breast Center, CT Imaging and PET/CT Imaging centers are located on the first floor of the building. The new spacious facility will allow us to increase our patient care activities. We would love to have alumni notes in future newsletters. Please share with us your news: where you are, what you are doing, news about your family, honors etc. I am sure that everyone will be interested in learning what you are doing now. Thank you, Kathy Hudson, MD

New Radiology Facilities

Cancer Institute Opens With New Radiology Centers

Medical Center officially opened the new Cancer Institute last fall in October 2012. As noted on UT Medical Center’s website “News”1, the opening completed a year long construction of our $23 million, 100,000+ sq ft building, designed with patient and community input, that “nearly triples the size of the medical center’s previous cancer care facility.” More

details about the Cancer Institute’s design and capabilities, as well as clinician and patient stories were recently elaborated in the latest “Winter 2013” issue of UT Medical Center’s Frontiers magazine, available online2. Pictures of our Chair Kathy Hudson and Radiology resident Austin Bourgeois are also featured on pages 5 and 13 regarding cancer diagnostics and education. [cont’d]

Cancer Institute Entrance’s “Wall of Hope” and Benefactors’ Names

New Breast Center Residency Program

2 3

Resident Research and Academics

The New Cancer Institute on UTMC’s North Entrance

4-5

Staff Notes & Trivia 2012 Holiday Party

6-7 8

UTMC Radiology’s Alumni Newsletter

Radiology Facilities itting adjacent to the Heart Hospital completed early in 2012 and across from our new multi-story “H” Parking Garage, the “Spring 2012” issue of The Reading Room showed pictures of the Cancer Institute’s construction in progress. This new outpatient Cancer Institute houses the full range of cancer treatment options in a convenient, central location. Included within the Institute is the relocation of the Department of Radiology’s Breast Center, CT, and PET/CT imaging centers from the previous building “D”, as well as the Radiation Oncology Department’s Cyberknife® and linear accelerators.

services such as acupuncture and massage therapy”1. The Cancer Institute will also provide opportunities to expand UTMC’s cancer research, clinical trials, and rapidly evolving treatment options by bringing even more specialists together in one facility.

Further, the facility also offers cancer patients “treatment and chemotherapy areas, a café, a boutique, a laboratory, clinical offices, conference rooms for staff and community support groups and space for supportive integrative health

Cancer Institute Supporter’s “Wall of Hope”

Below are some photos we took of the Breast Center’s interior patient consultation room and the Institute’s new lobby. More pictures from UTMC of the Cancer Institute’s interior features can also be seen online here: http://www.utmedicalcenter.org/cancer-institute-pictures UT Medical Center “News” online: October 16, 2012, “The University of Tennessee Medical Center Opens New Cancer Institute”

UT Medical Center’s Frontiers magazine:

http://www.utmedicalcenter.org/frontiers

Entry View of the Main Lobby & Registration Bays

These photos show in sequence what an imaging outpatient would see in the Institute’s ground floor from the entrance’s “Wall of Hope” art tiles (upper left), to the lobby and patient registration bays, to an Imaging Center’s entry, into an interior consult room (right), and finishing exit views (below).

Reverse ‘Exit’ View of the Institute’s Main Lobby

Entrance to the PET/CT Imaging Center

A Patient Consult Room in the New Breast Center

Dr. Larry Kilgore Family Patient Resource Library

Hope Ribbon Light Seen Upon Exiting the Lobby

Spring 2013, Issue 6

Radiology Residency Program

Director’s Note

hange is rapidly occurring in Graduate Medical Education. In July 2013, the Accreditation Council for Graduate Medical Education will institute a new accreditation system. Radiology is one of the first specialties to participate in this process. Milestones have been developed by the RRC (Residency Review Committee) for radiology. The emphasis will be on a yearly reporting process rather than the old system which involved site visits every 4-5 years and a large amount of paperwork to be completed. All the reporting will be online and will involve the milestones as mentioned above, surveys of residents and faculty, volume indicators, procedure logs, scholarly activity, quality and safety

Academic Excellence S Senior Samuel Porter, scored in the P 1100th percentile oon the nationwide ACR Diagnostic A Radiology In-training R Exam (DXIT). This Samuel Porter E historic achievement makes him the first radiology resident at UTMC to achieve this high mark. The DXIT exam provides residents with useful information in evaluating their progress and provides directors with data used in analyzing and evaluating the residency program. Congratulations Samuel!

measures. This will allow a continuous evaluation process rather than the hectic site visits of old. At the same time, the American Board of Radiology is instituting a new board certification format as I have previously mentioned. The first group of residents to take the new computer-based core “qualifying” exam will be in October 2013. The last oral exam will be this June. I will be privileged to be a board examiner at this momentous occasion. I am sure all of the former residents remember their oral exam experience. Yes it is still at the same hotel, but the hotel is now a Crown Plaza hotel and they have updated the décor!

New Chief Residents Elected; “Thanks!” to Chang & Dupree

Ted Chang

Brian Dupree

A BIG “Thanks!” for your service to Seniors Drs. Ted Chang and Brian Dupree who hand over the reigns of Chief Resident to focus on their final board exams. New elections passed the torch to three new co-chiefs: Drs. Kevin Liaw and Lance Warren from the 3rd year class and to 2nd year resident, Austin Bourgeois. New next year, the program will elect one chief resident from the

4th year and one chief from the 3rd year to serve their classmates. This increased representation reflects the greater demand for communication between each of the year classes and with clinical and administrative staff.

Kevin Liaw

Lance Warren

Austin Bourgeois

Residency Program Request Please Show Your Support with a Gift

Ed Edward Buonocore, MD Radiology Endowment Fund

adiology d l research h and d scholarly h l l activity are vitall components of better residency training and future progress. UTMC Radiology needs your support and gifts to help us empower our residents to continue to build upon our academic legacy. We have two funds that both support this crucial mission.

This fund was established by faculty, friends, patients, alumni and family members to promote excellence in the radiology residency program. The Buonocore endowment honors Dr. Buonocore for his many years of dedicated patient care, devotion to teaching and desire for new knowledge through advanced technology and cutting-edge research.

Please make your donation today to either fund: Dept. of Radiology Research & Education Gift Fund This fund was established by interested friends of the Department of Radiology to provide the Chairman and faculty with additional resources to ensure continued excellence in programs of patient care, education, and research.

Use your smart phone with this QR Code to quickly donate to either fund! All donations are tax-deductible and can be made securely from this link at: http://www.utmedicalcenter.org/radiology-gift

UTMC Radiology’s Alumni Newsletter

Research & Academics 2012-13 2013 Academic Year Continues Productive Start

MC Radiology Residents continued a productive 2012-13 academic year since our summer newsletter. Seven poster abstracts were presented at ASHNR in October followed by six presentations in November at RSNA as posters, electronic slideshows and an in-depth lecture. The lecture (page 5) with lead author Ted Chang and given at RSNA by resident Ryan Owen, was a separate project from the article (right) published in the March 2013 issue of the Journal of Interventional Radiology.

Publication: March 2013 Journal of Vascular and Interventional Radiology (JVIR) “Treatment Modification of Yttrium-90 Radioembolization Based on Quantitative Positron Emission Tomography/CT Imaging” Ted T. Chang, Austin C. Bourgeois, Anastasia M. Balius, Alexander S. Pasciak JVIR; March 2013 (Volume 24, Issue 3 Pages 333-337 DOI: 10.1016/j.jvir.2012.12.005)

Society of Nuclear Medicine Southeastern Chapter Meeting, Clearwater Beach, Florida, Sept. 22-25 Lecture Presentation: “Can Non-Cardiac Increased Uptake Cause Artifact in N-13 Ammonia and Rubidium-82 Myocardial Perfusion Stress Test?” Alireza Mojtahedi MD, J. Mark McKinney MD, and Dale Wortham MD

American Society of Head & Neck Radiology (ASHNR) 46th Annual Meeting, October 3-7, 2012, Miami Beach, Florida Poster Presentations: 1. “Multimodality Imaging of Mandibular Lesions with Pathologic Correlation” Ted T. Chang, MD (4th Yr); Austin C. Bourgeois, MD; Darrell A. Benton, MD; James W. Boyd, MD; Paul D. Campbell Jr, MD; and Michael McCoy, DDS 2. “MR Imaging of the Brachial Plexus: Techniques and Tips” Brian S. Dupree, MD (4th Yr); Ted T. Chang,, MD; Melissa L. Neveu, MD; James W. Boyd, MD; Paul D. Campbell Jr, MD; and Peter Petruzzi, MD

Dupree, Chang, Neveu, et al.

3. “More Than Meets the Eye: A Pictorial Essay of Ocular Lesions in the Adult” Samuel G. Porter, MD (4th Yr) and Paul Campbell Jr, MD 4. “Important Radiologic Landmarks in Squamous Cell Carcinoma of the Head and Neck” Kevin Liaw MD (3rd Yr), Ted T. Chang, MD; Lance Warren, MD; James W. Boyd, MD; Geoffrey G. Laing, MD; Eric R. Carlson, DMD, MD; and Paul D. Campbell Jr, MD 5. “MR Imaging of the Temporomandibular Joint: A Review of Technique and Basic Pathology” Lance A. Warren, MD (3rd Yr); Ted T. Chang, MD; Kevin Liaw, MD; James W. Boyd, MD; and Paul D. Campbell Jr, MD

Porter and Campbell

6. “Unpredictable Pathways of Metastasis in Primary Head and Neck Cutaneous Melanoma” Austin C. Bourgeois, MD (2nd Yr); Ted T. Chang, MD; Yong C. Bradley, MD; and Paul D. Campbell Jr, MD 7. “Imaging of Cystic Masses of the Neck –A Systematic Approach to Differential Diagnosis” Darrell A. Benton, MD (1st Yr); Austin C. Bourgeois, MD; and Ted T. Chang, MD and James W. Boyd, MD

Radiological Society of North America (RSNA) Annual Meeting November 25-30, 2012, Chicago, Illinois Poster Presentations: 1. “Review of Intra-axial Diffusion Restricted Brain Lesions: Common and Uncommon Examples” Kevin Liaw, MD (3rd Yr); Matthew Layman, MD; James W. Boyd, MD; Geoffrey G. Laing, MD; and Paul D. Campbell Jr, MD

Liaw, Chang, Warren, et al.

Spring 2013, Issue 6

Radiological Society of North America (RSNA) Annual Meeting November 25-30, 2012, Chicago, Illinois Poster Presentations: 2. “Hepatic CT and MRI: The Importance of Appropriately Timed Arterial Phase for Lesion Detection and Characterization” Melissa L. Neveu, MD (2nd Yr); Ted T. Chang, MD and Peter T. Petruzzi, MD

Electronic Presentations: 3. “Interventional Treatment of Acute Bleeding Gastric Varices: Transjugular Intrahepatic Portosystemic Shunt or Splenic Embolization?” Yitong Fu, MD (2nd Yr) and Peter J. Kvamme, MD

FFu and dK Kvamme

4. “Survey of Online and Hard Copy Resource Use Among Radiologists and Trainees” Blake D. Niederhauser, MD1; Kevin Liaw, MD (3rd Yr); Robert J. McDonald, MD, PhD1; Kristen B. Thomas, MD1; Kathleen B. Hudson, MD; David F. Kallmes, MD1,2 [Depts. of 1Radiology and 2Neurologic Surgery, Mayo Clinic, Rochester,MN] 5. “Radiation Reduction Gloves: A Small Decrease in Dose to Your Hands Accompanied by a Large Increase in Dose to Your Patient” Melissa L. Neveu, MD (2nd Yr); Aravindhan Srihasan1, BA; Anastasia M. Balius, MD; Aaron K. Jones,PhD2 and Alex S. Pasciak, PhD [1University of Tennessee Health Science Center College of Medicine, Memphis and 2University of Texas MD Anderson Cancer Center, Houston] Neveu, et al. [Balius & Pasciak]

Lecture Presentation: 6. “18F-FDG PET/CT Provides Accurate Gross Tumor Volume Definition for Y90 Selective Internal Radionuclide Therapy” Ted T. Chang, MD (4th Yr); Presenter: Ryan W. Owen, MD (3rd Yr); Austin C. Bourgeois, MD; Anastasia M. Balius, MD; J. Mark McKinney, MD; and Alexander S. Pasciak, PhD

25th International Symposium on Endovascular Surgery (ISET) January 19-23, 2013, Miami Beach, Florida Poster Presentation: “P1 Segment Blister Aneurysm, A Novel Treatment Using Telescoping Stents” Lindsay Luttrell, MD (1st Yr); Ted T. Chang, MD; and Peter Kvamme, MD

American Society of Spine Radiology (ASSR) Annual Symposium February 21-24, 2013, Scottsdale, Arizona Electronic Presentations: 1. “A Rare Cause of Radiculopathy in Young Patients: A Report of Multilevel Discal Cysts and Literature Review” Austin C. Bourgeois, MD (2nd Yr); Kevin Liaw, MD; Scott Embry, MD; and Judson Gash, MD

Luttrell, Chang, and Kvamme

2. “Advances in the Diagnosis and Management of Intracranial Hypotension: Lessons Learned from Treatment of 30 Patients” Austin C. Bourgeois, MD (2nd Yr); Ted T. Chang, MD; and Geoffrey G. Laing, MD 3. “Increasing the Accuracy of Transpedicular Screw Placement in the Lumbar Spine with Three Dimensional Stereotactic Image Guidance” Austin C. Bourgeois, MD (2nd Yr); Judson Gash, MD; Rashad Daker, MD; Yong Bradley, MD; Patrick Barlow; Rupert Stanborough, MD; Ted T. Chang, MD; and William S. Reid Jr. MD 4. “Insight on the Clinical Significance of Baastrup’s Disease: from Kissing Spine to Interspinous Bursitis” Austin C. Bourgeois, MD (2nd Yr); Hunter Pearson; Patrick Barlow; Dwayne John; Ted Chang, MD; and Geoffrey Laing, MD

Bourgeois, Liaw, Embry, B b et al.l

UTMC Radiology’s Alumni Newsletter

Radiology Faculty Spotlight

Radiology Facilities

Dr. Allen’s Tutorial CD Goes to Memphis

New Rad Poster Displays

ony Allen’s Radiology Tutorial CD “Ordering X-Ray Tests: A Guide for the Busy Clinician” continues to reach new audiences. As of January, its latest incorporation is into the residency programs’ online New Innovations® resources of the Office of Graduate Medical Education at the University of Tennessee College of Medicine in Tony Allen, MD Memphis. Dr. Allen’s mission to further educate ordering physicians with this tutorial has continued now for several years with regular updates to the content. The 300+ slide, interactive Q&A tutorial covers a variety of concerns including the ‘test of choice’ to order using the ACR’s “Appropriateness Criteria”, when to order (and not order) imaging contrast, patient safety, radiation exposure and imaging cost issues. In its latest iteration, Dr. Allen has also added downloadable PDF reference notes for physicians to have convenient access to on their handheld electronic devices. Sr. Research Assistant, Mr. Shannon K. Campbell, who also designs this newsletter, remains proud to have helped since the start with the graphics and annual CD production, making well over 100 discs last year for distribution to all UTMC residents, rotating medical students, and other physicians.

adiology’s main hallway rennovations were completed this fall with the addition of four new research poster display cases and a photo gallery area. The minimalist designed system is made of lucite frames with brushed metal mounts and braided-steel cable suspension. Installation looks great and completed just in time for the Residency applicant interview season.

Radiology Call A Call for Alumni News!

lease share with us your news: where you are, what you are doing, news about your family, honors etc.

Tutorial Disc Label and Example Slides

Did you happen to see? Amanda Ingram, 2012 graduate, had her photo republished this Winter in two RSNA magazines, RSNA News and 2012 RSNA Grants and Awards. “Mandy” will be joining UTMC Radiology staff soon after completion of her fellowship in Breast Imaging at the University of Cincinatti.

Thanks and hope to hear from you soon! Kathy Hudson Please ‘Give us a Shout!!’ Shannon K. Campbell skcampbe@utmck.edu (865) 305-9693 or Debbie Jarvis djarvis@utmck.edu du u (865) 305-8685

Dr. Amanda Ingram Receiving the 2012 RSNA Resident Research Award from Drs. Kathy Hudson [L] and J. Mark McKinney [R]

Radiology Graduate Amanda nda Ingram’s Photo Published in RSNA Magazines

Spring 2013, Issue 6

Radiology Staff Trivia Fun How Well Do You Know Your Residents and Attendings? Answer Key at the bottom; NO Peeking! 1. Who in high school, who won a Shakespearean acting contest for her performance of a monologue from Taming of the Shrew? (Incidentally, she was portraying Kate, the “Shrew”) Lindsay Luttrell (1st Yr)

Brian Dupree (4th Yr)

2. Who worked at Ft. Sanders Hospital in Knoxville as a dishwasher scrubbing pots and pans trying to earn enough money to buy a stereo? Hint: this was even before ‘boom boxes’ came out!  3. Who worked at Sonic during high school and got robbed at gunpoint? The thief locked him in the freezer before fleeing. It was later reported that someone witnessed the thief dropping several chili con carne dogs on the way out!

Dr. Ken Rule

Matt Layman (1st Yr)

4. Who was sent home from kindergarten with a note for being too bossy? Hmm… 5. During his Radiology residency, who once hit 183 consecutive free-throws? His only claim to fame… or so he says!

Kate Frederick (2nd Yr)

6. Who spent an entire summer in the Galapagos Islands teaching English at a high school. The host family had dirt floors and no running water; it was definitely an interesting and humbling experience!

Joanna Blankner (2nd Yr)

7. Who had a baby large-mouth bass as a pet until it grew too large for its tank, then had to release it into the wild?

KEY: 1. Kate Frederick-Dyer 2. Will Pflanze 3. Josh Medina 4. Joanna Blankner 5. Ken Rule 6. Lindsay Luttrell 7. Brian Dupree 8. Matt Layman

Josh Medina (4th Yr)

8. Who as an 8th grader spent a month living as an exchange student in rural Japan. And tried eating jellyfish when there, but was not a big fan at all!

Dr. Will Pflanze

Spring 2013, Issue 6

UTMC Radiology’s Alumni Newsletter

Radiology Events A big “Thanks!” to Dr. Laurentia Nodit of UTMC Pathology, seen at right with her husband neurologist Dr. Dino Nodit, for taking so many great photos of our 2012 Winter Holiday Party at Gettysvue Country Club.