RSNA 2010: Embracing Personalized Medicine

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Clinical images courtesy of (from left): Philips Healthcare, Toshiba America Medical Systems and GE Healthcare
Radiology’s big show should be bigger than ever this year. Despite the sluggish economy, 60,000 radiologists, administrators and decision-makers are expected to descend on the Windy City in late November and early December. “It is the place to go for healthcare decision-makers,” affirms RSNA Chairman George Bissett, MD.

With more than 2,600 scientific presentations and posters covering the newest trends in radiological research and more than 1,800 educational and informatics exhibits, massive may be an understatement.

This year’s theme—Personalized Medicine: In Pursuit of Excellence—is both timely and forward-looking. Healthcare is on the cusp of personalized medicine, which brings medicine to the molecular level and offers a model that aims to improve care and contain costs by identifying appropriate treatments and limiting trial-and-error approaches. The incredibly data-driven model hinges on molecular imaging, with lab values, biomarkers, genetic testing and therapeutic monitoring all playing critical roles in realizing the promise of personalized medicine. IT provides the glue that holds the various pieces together and offers a way to assimilate, manage and leverage the data.

Over the last few months the Health Imaging & IT editorial staff has been hard at work, ferreting out the details about hot topics at this year’s RSNA meeting. What follows is an abbreviated preview to help you plan your visit to the show. Our print and online insider’s guides (register at HealthImaging.com) should prove especially valuable this year as RSNA is edging toward “paperlessness” with a lighter program that does not include the full listing of sessions. For in-depth overviews of key tracks, including a snapshot of the year in review and experts’ insights, please visit HealthImaging.com.

Informatics & IT

Healthcare Reform through Meaningful Use of Healthcare IT: Implications for Radiologists
Monday, Nov. 29, 12:30 – 2:00 PM
Healthcare reform demands meaningful deployment of health IT. Speakers are focusing on the complexities of meaningful use and related challenges and opportunities specific to the radiology profession.
Speaker Information:
  • Ramin Khorasani, MD, director, information management systems, Brigham and Women’s Hospital
  • David Avrin, MD, PhD, vice chair, informatics, University of California, San Francisco
  • Keith J. Dreyer, MD, vice chairman of radiology, Massachusetts General Hospital
  • David Mendelson, MD, chief, clinical informatics, Mount Sinai Medical Center

Decision Support in Clinical Practice
Tuesday, Nov. 30, 8:30 – 10:00 AM
The session is addressing the basics of decision support and its role in improving patient outcomes and showing how informatics models may be applied to predict diagnoses and outcomes.
Speaker Information:
  • Charles E. Kahn, MD, chief, division of informatics, Medical College of Wisconsin
  • Elizabeth S. Burnside, MD, associate professor, radiology, University of Wisconsin, Madison
  • Sandy Napel, PhD, co-director, radiology
  • 3D laboratory, Stanford University School of Medicine

Next Generation IT Requirements for Improving Quality & Safety for Radiology
Wednesday, Dec. 1, 10:30 AM – 12:00 PM
System changes that leverage IT are the basis of the transition to patient-centered, evidence-based care. The session is examining the role of IT and next generation IT requirements and reviewing case studies that focus on appropriate use, report quality and results communication.
Speaker Information:
  • Ramin Khorasani, MD, director, information management systems, Brigham and Women’s Hospital
  • David Avrin, MD, PhD, vice chair, informatics, University of California, San Francisco
  • Luciano Monte Serrat Prevedello, MD, research fellow, radiology, Brigham and Women’s Hospital

Health Policy & Quality Improvement

Quality Improvement: Controversies & Opportunities for Communicating Results
Tuesday, Nov. 30, 8:30 – 10:00 AM
The session is reviewing implications of failure to communicate abnormal results and addressing the role of IT in process improvement. It is examining the role of institutional policies and presenting a case study of radiology results communication policy in an integrated healthcare delivery system.
Speaker Information:
  • G. Scott Gazelle, MD, professor of radiology, Harvard Medical School

How Payment Policy Will Impact Technology Development in the 21st Century
Tuesday, Nov. 30, 8:30 – 10:00 AM
In this interactive session, faculty members from the American College of Radiology’s (ACR) Commission on Economics are providing an overview of the processes for obtaining coverage for new technology and reviewing how the coverage process factors into the technology development process.
Speaker Information:
  • Daniel Picus, MD, chief, diagnostic radiology, Washington University School of Medicine in St. Louis
  • James Vincent Rawson, MD, chairman, radiology, Medical College of Georgia
  • Robert K. Zeman, MD, chairman, radiology and radiation oncology, George Washington University Hospital
  • Geraldine B. McGinty, MD, medical director, radiology, Montefiore Medical Center
  • Bibb Allen, MD, chair, ACR Commission on Economics
  • Richard Duszak, MD, Mid-South Imaging and Therapeutics
  • Christopher George Ullrich, MD, chair, ACR Managed Care Committee and Network

CT

Practical Approach to Optimizing Radiation Dose for Body CT
Tuesday, Nov. 30, 8:30 – 10:00 AM
This session is addressing current and cutting edge techniques, benefits and trade-offs for radiation dose reduction in chest and abdominal CT and neuroradiology imaging.
Speaker Information:
  • Sanjay Saini, MD, professor, radiology, Harvard Medical School
  • James A. Brink, MD, professor, diagnostic radiology, Yale University School of Medicine

Radiation Dose: Can It Be Too Low?
Wednesday, Dec. 1, 4:30 – 6:00 PM
Speakers are discussing the balance between radiation dose and image quality and exploring controversies and risks related to radiation dose in medical imaging.
Speaker Information:
  • Richard Morin, PhD, professor, radiologic physics, Mayo Clinic (Fla.)
  • Cynthia McCullough, PhD, professor, radiologic physics, Mayo Clinic (Minn.)
  • John Boone, PhD, vice chair, research radiology, University of California Davis Medical Center
  • Andrew Einstein, MD, PhD, assistant professor, radiology, Columbia University Medical Center
  • David Brenner, PhD, director, Center for Radiological Research, Columbia University

Radiation Oncology

Imaging Challenges for Radiation Oncology: Imaging for Treatment Assessment—Are We Doing Any Good?
Tuesday, Nov. 30, 8:30 – 10:00 AM
This session is focusing on the role and the limits of CT, MR and PET imaging in radiation oncology. It also is exploring the use of FDG and other molecular imaging markers to assess response to treatment.
Speaker Information:
  • Robert Jeraj, PhD, assistant professor, biomedical engineering, University of Wisconsin, Madison
  • Katja M. Langen, PhD, department of radiation oncology, MD Anderson Cancer Center (Orlando)
  • Edward F. Jackson, PhD, deputy department chair, imaging physics, MD Anderson Cancer Center (Houston)

Is More Better? Which and How Much Imaging in Radiation Oncology?
Wednesday, Dec. 1, 4:30 – 6:00 PM
Imaging in radiation oncology is increasing in frequency and complexity with various purposes and goals. The speakers are addressing economic, workflow, radiation dose and patient care considerations related to imaging and offering strategies for the development of a balanced imaging model.
Speaker Information:
  • Nina A. Mayr, MD, department of radiation oncology, Ohio State University
  • John Breneman, MD, radiation oncology, University of Cincinnati Barrett Cancer Center
  • Minesh P. Mehta, MD, chairman, human oncology, University of Wisconsin, Madison
  • Anca Ligia Grosu, MD, department of radiation oncology, Technical University Munich, Germany
  • Dianna Cody, PhD, professor, imaging physics, MD Anderson Cancer Center (Houston)

Interventional Radiology

CT & MR Imaging—Advanced Applications (Navigation & Robotics)
Tuesday, Nov. 30, 4:30 – 6:00 PM
Speakers are discussing state-of-the-art technology in the interventional environment including uses of and advantages and disadvantages of navigation and robotics tools during interventions such as biopsy, radiofrequency ablation and endovascular procedures.
Speaker Information:
  • Willi A. Kalendar, PhD, director, Institute of Medical Physics, University of Erlangen, Germany
  • Edward F. Jackson, PhD, deputy department chair, imaging physics, MD Anderson Cancer Center (Houston)
  • U. Joseph Schoepf, MD, professor, radiology, Medical University of South Carolina
  • Thorsten R. C. Johnson, MD, associate professor, radiology, University Hospitals, Munich
  • Kevin R. Cleary, PhD, professor, radiology, Georgetown University Medical Center
  • Leonard F. Berliner, MD, chief, vascular/interventional radiology, New York Methodist Hospital

Cardiac Imaging

Evaluation of Acute Chest Pain: Is it Feasible and Safe?
Monday, Nov. 29, 8:30 – 10:00 AM
The speakers are examining clinical perspectives of coronary artery disease and the role of coronary CT angiography and other diagnostic studies, safety and efficacy of coronary CT in the emergency department and the risks and benefits of cardiac CT and triple rule-out studies.
Speaker Information:
  • Monvadi B. Srichai, MD, assistant professor, radiology, New York University Medical Center
  • Harold Ira Litt, MD, PhD, chief, cardiovascular imaging, Hospital of the University of Pennsylvania
  • Ethan J. Halpern, MD, professor, radiology, Thomas Jefferson University

CT Technology Update: The Cutting Edge
Wednesday, Dec. 1, 8:30 – 10:00 AM
This refresher course is covering techniques for 256-slice CT cardiac imaging, the basics and potential applications of 320-slice technology, dual-source CT angiography protocols and advances in high-definition coronary CT angiography.
Speaker Information:
  • Martin H. K. Hoffman, MD, department of diagnostic radiology, University Hospital, Ulm, Germany
  • Marc Dewey, MD, department of radiology, Charite Medical School, Humboldt University, Berlin
  • U. Joseph Schoepf, MD, professor, radiology, Medical University of South Carolina
  • Jonathan Avrom Leipsic, MD, assistant professor, radiology & cardiology, University of British Columbia

Practice Management

Radiology’s Changing Dynamics
Wednesday, Dec. 1, 8:30 – 10:00 AM
Speakers are addressing the implications of healthcare reform for radiologists and radiology practices including the socioeconomic impact and need to adopt quality and safety metrics.
Speaker Information:
  • Claudia A. Murray, principal,
  • CMC Consulting
  • William A. Sarraille, partner,
  • Sidley Austin LLP
  • James P. Borgstede, MD, professor, radiology, University of Colorado, Denver

Patient-centered Radiology: It’s Good Business
Monday, Nov. 28, 2:00 – 3:00 PM
It is essential for radiologists to provide personal and patient-friendly services, according to the ACR. Speakers are sharing strategies to educate patients about the role of radiologists and the value of radiology and highlighting the ACR’s Face of Radiology campaign.
Speaker Information:
  • Mary Mahoney, MD, director, breast imaging, University of Cincinnati   
  • Michael Brant-Zawadzki, MD, medical director, radiology, Hoag Memorial Hospital
  • Gary Glazer, MD, chair, radiology, Stanford University School of Medicine
  • Harvey Neiman, MD, professor, diagnostic radiology, University of Pittsburgh  

Ultrasound

High-Intensity Focused Ultrasound: Myth or Reality?
Monday, Nov. 29, 7:15 – 8:15 AM
Experts are discussing fundamentals of MR-guided focused ultrasound ablation and methods for the treatment of bone lesions, breast cancer and uterine fibroids. Speakers are exploring potential benefits, indications, patient selection and possible complications.
Speaker Information:
  • Christopher E. Comstock, MD, breast imaging service, Memorial Sloan-Kettering Cancer Center
  • Majid Maybody, MD, interventional radiologist, Memorial Sloan-Kettering Cancer Center
  • Anne C. Roberts, MD, professor of clinical radiology, University of California, San Diego

US Elastography: Is It in Our Future?
Thursday, Dec. 2, 3:00 – 4:00 PM
The session is focusing on different forms of elasticity imaging, advantages and disadvantages of each, current application models and strategies for integrating ultrasound elastography into clinical practice.
Speaker Information:
  • Jonathan Matthew Rubin, MD, PhD, associate director, medical services, Medical College of Wisconsin
  • Mark Palmeri, MD, PhD, assistant research professor, Duke University Biomedical Engineering

Women’s Imaging

Emerging Technologies in Breast Imaging
Wednesday, Dec. 1, 8:30 AM – 12:00 PM
Presenters are reviewing the full gamut of emerging technologies. They are sharing information about: diffusion-weighted imaging and noncontrast MR imaging, digital tomosynthesis, elastography and quantitative breast MR imaging. Participants will learn about methods, techniques, advantages and disadvantages and potential future applications of various emerging breast imaging technologies.
Speaker Information:
  • Christopher Comstock, MD, breast imaging service, Memorial Sloan-Kettering Cancer Center
  • Robyn Birdwell, MD, director, breast imaging, Dana Farber Cancer Institute

Tailored Breast Cancer Screening  
Tuesday, Nov. 30, 4:30 – 6:00 PM
Speakers are discussing current screening recommendations, prevention options for high-risk women, new treatment paradigms and more. Other topics include screening beyond mammography and a review of the controversies surrounding the United States Preventive Services Task Force guidelines.
Speaker Information:
  • Olufunmilayo I. Olopade, MD, director, cancer risk clinic, University of Chicago Medical Center
  • D. David Dershaw, MD, director, breast imaging, Memorial Sloan-Kettering Cancer Center
  • Daniel B. Kopans, MD, director, breast imaging, Massachusetts General Hospital

MRI  

MR Contrast Agents: What Is Their Value?
Thursday, Dec. 2, 3:00 – 4:00 PM
This session is examining the cases for and against Gd-EOB-DTPA and Gadofosveset and offering insights into Gadobutrol. Speakers also are presenting on-label applications, off-label possibilities and opportunities for using new agents in clinical practice.
Speaker Information:
  • Elmar Merkle, MD, department of radiology, Duke University
  • Neil Mitchell Rofsky, MD, chief, MRI, Beth Israel Deaconess Medical Center

MR-based Assessment of Therapy    
Thursday, Dec. 2, 4:30 – 6:00 PM
Speakers are addressing principles, applications and examples of dynamic contrast-enhanced MR imaging in clinical trials and oncologic imaging; metabolic and prognostic data available using MR spectroscopy and principles and applications of diffusion MR imaging.
Speaker Information:
  • Willi Kalender, PhD, director, Institute of Medical Physics, University of Erlangen, Germany
  • Edward Jackson, PhD, deputy department chair, imaging physics, MD Anderson Cancer Center

Molecular Imaging

Lifecycle of an Imaging Biomarker: From Validation to Dissemination
Thursday, Dec. 2, 10:30 AM – 12:00 PM
Speakers are sharing perspectives on the use of quantitative imaging as a biomarker in clinical trials and providing examples of best practices.
Speaker Information:
  • Jeffrey Yap, PhD, senior diagnostic physicist, Dana-Farber Cancer Institute
  • Neil Rofsky, MD, chief, MRI, Beth Israel Deaconess Medical Center
  • Simon Warfield, PhD, director, computational radiology laboratory, Children’s Hospital

Imaging Modalities for Molecular Imaging
Wednesday, Dec. 1, 8:30 – 10:00 AM
The speaker is focusing on the preclinical and clinical roles of PET and optical imaging and discussing molecular and cellular MR imaging.
Speaker Information:
  • John Gore, PhD, director, Vanderbilt University Institute of Imaging Science