May 2007

Quick Stats: Research Axiom Laboratory Equipment (Grant Building, Clinical and Research Use)

Thanks to Rebecca Fahrig, PhD, for compiling this list.

Stanford Radiology Shows the Highest NIH-Funding Growth of U.S. Radiology Departments

By Susan Kopiwoda, MS, MPH, and Julie Ruiz, PhD

Despite a flattening NIH budget, Stanford Radiology has shown the greatest growth of any major U.S. radiology program during 2002 to 2006. According to Stanley Baum's NIH-ranking data, funding to our Department has more than doubled, showing a 203% percent increase in growth between the years 2002 and 2006. Unlike the NIH-funding rankings from the Office of Extramural Research, Baum's rankings exclude radiation oncology and include Massachusetts General Hospital (MGH), Brigham and Women's Hospital, and Beth Israel [See chart A].

Of the top 15 radiology departments from 2006, Stanford and one other U.S. radiology department, Beth Israel in Boston, have shown a funding increase of greater than 100% from 2002 to 2006. Also, only Stanford and Hopkins have shown a positive percent change in NIH funding for all four fiscal years: 02-03, 03-04, 04-05, 05-06.

We have continued to achieve remarkable funding results despite a challenging funding environment. In part, our Department has benefited from the five-year doubling of the NIH budget between 1998 and 2003, which grew from $13.7 billion to nearly $27.1 billion. Since 2003, the NIH budget growth has flattened, totaling $29.2 billion in 2007. Consequently, the percentage of NIH-funded research proposals is expected to decrease to 21% in 2007, down from 32% in 2001 [see "NIH Budget: Boom or Bust" http://www.sciencemag.org/cgi/content/full/316/5823/356]. Our Department has experienced the impact of the flattening NIH budget, and some of our requested budgets have been reduced by as much as 30%. Yet 82% of our research is still supported by NIH funding.

Our departmental success is directly due to our outstanding faculty, resources, and leadership, which have enabled us to establish three NIH-funded Centers of Excellence: the National Center for Advanced Magnetic Resonance Technology (CAMRT); the In Vivo Cellular and Molecular Imaging Center at Stanford (ICMIC); and the Center for Cancer Nanotechnology Excellence Focused on Therapy Response (CCNE-TR).

Our research endeavors have directly translated into major technological and clinical achievements that should allow our NIH funding to continue to increase in the future. Our three largest center grants (CAMRT, ICMIC, and CCNE-TR) are funded until either 2010 or 2011. Each will provide a strong foundation as we launch one or two additional major imaging initiatives, which will link molecular imaging with nanotechnology and genomics to drive research in the early detection of cancer. In the NIH-funding rankings from the Office of Extramural Research, Stanford Radiology now ranks as the third highest NIH-funded radiology department among medical schools in the United States. We are positioning ourselves to achieve even greater NIH success in the future.

Awards and Honors: May 25, 2007

Pei-Lin Hsiung, PhD, postdoctoral scholar in the Network for Translational Research in Optical Imaging (NTROI), has received the American Cancer Society-Canary Foundation Postdoctoral Fellowship, which is awarded to the "best and brightest researchers" who specialize in early detection research. Her winning project is entitled "Development of Peptide Reagents for In Vivo Detection of Dysplasia in the Colon," which focuses on topically-applied reagents that can be used for the screening and the early detection of colon cancer. Dr. Hsiung's research combines the development of disease-targeting peptides with optical imaging and in vivo microscopy, with the goal of rapidly translating bench research into the clinical setting.

Announcements II: May 2007

Guide to NIH K Awards Training Workshop: May 30, 2007
Cardinal Walk /All Campus Walk: May 31, 2007
July 3rd Celebration with Big Bad VooDoo Daddy & Fireworks: July 3, 2007

Cardinal Walk /All Campus Walk (1.5 Miles): Thursday, May 31, 2007, at Roble Field, Santa Teresa Street, 12:05 PM to 1:00 PM. The festivities will begin at 11:30 AM in Roble Field; the first 2,000 walkers will receive free pedometers. There will also be free music and refreshments. At 12:00 PM, the Provost will give a welcome speech to all participants; the walk will begin at 12:05 PM and end at 1:00 PM. Participants will walk a 1.5 mile loop in Roble Field. For more information, please visit http://steppingout.stanford.edu/cardinalwalk/.

Guide to NIH K Awards Training Workshop: Wednesday, May 30, 2007, at Fairchild Auditorium, Stanford University Medical Center, 9:00 AM to 12:00 PM. Stephen J. Korn, PhD, director of Training and Career Development, will provide an summary of the eligibility criteria for various NIH K Awards; the evaluation process; and the best practices for application development. There will also be a panel of K award recipients composed of mentors and proteges who will share their strategies for success. The topics covered will be as follows: "NIH K Series Eligibility Criteria & Application Process"; "How to Decide Which K Award is Right for Me" (Demonstrate NIH kiosk & offer guide to kiosk use); "NIH Proposal Evaluation Criteria, Process, Success Rates, & Scoring"; "Award Portability & Characteristics"; and "Career Options for Recipients & Mentoring" (Panel of Postdocs & Mentors). The sign in is from 8:15 AM to 9:00 AM at Fairchild Auditorium, and the workshop will begin at 9:00 AM and continue until 12:00 PM. Boxed lunches will be provided. There is no fee. Although registration is currently full, you can register for the waiting list at http://reggie.stanford.edu/NoAvailableSeats.asp?1564. Over fifty people from the waiting list will be allowed to attend the training workshop as "no seat" admissions. For more information, please contact Terri Hankes, program support coordinator, at thanks@stanford.edu or (650) 736-0129 and visit the website at http://postdocs.stanford.edu/events/guide_to_NIH_K_awards.html.

Awards and Honors: May 22, 2007

Luke Higgins, PhD, first-year medical student, has been awarded a Society of Interventional Radiology (SIR) Foundation Medical Student Research Grant. Through this grant, SIR encourages medical students to engage in cutting-edge research in interventional radiology that will likely translate to improved patient care. Funding criteria includes scientific merit, innovative quality of the research proposal, and relevance to interventional radiology. Dr. Higgins earned his PhD in biological chemistry from MIT and is now working with Lawrence "Rusty" Hofmann, MD, who is investigating the delivery of autologous adipose-derived multipotential stromal cells (ASCs) to treat peripheral arterial disease. Under Dr. Hofmann's mentorship, Dr. Higgins will be analyzing the capacity of human and rabbit MR-labeled ASCs to differentiate and express arteriogenic factors relative to unlabeled cells and will be comparing these expression levels to cells under stressed conditions.

Former Exorcist Movie Star, Dr. X, Tells All

By Julie Ruiz, PhD

Did you know that one of our very own physicians, Dr. X, is a former movie star? Dr. X had an important, although anonymous, role in The Exorcist (1973). His/her identity will also remain anonymous until readers identify him or her from the script that follows or from the movie clips we will include in the next Exorcist posting in the coming weeks.

This movie was nominated for ten Academy Awards in 1973 and won two, the Academy Award for Sound and the Academy Award for Writing Adapted Screenplay. It also won four Golden Globes, including the award for the Best Picture-Drama for the year 1974. The Exorcist was based on the novel by William Peter Blatty, Exorcist (1971), which spent 55 weeks on the New York Times Bestseller List. Blatty earned an Oscar and a Golden Globe for the screenplay adaptation of his book.

The Exorcist was directed by William Friedkin and starred Linda Blair as Regan MacNeil (the possessed girl); Ellen Burstyn as Chris MacNeil (the mother of the possessed girl); Jason Miller as Father Damien Karras (a priest and psychiatrist); and Max von Sydow as Father Lankester Merrin (an older priest adept at exorcisms). The theme music is a part of the composition called Tubular Bells by Mike Oldfield. The horror begins when a visiting actress in Washington, D.C., Chris MacNeil, notices drastic changes in the behavior of her 12-year-old daughter, Regan, who is abnormally strong and can levitate her whole body.

To find the source of her daughter's strange behavior, Chris takes Regan for an electroencephalogram (EEG), angiogram (performed by Dr. X), and pneumoencephalogram. When these tests show no abnormalities, Chris and Regan are sent to Father Karras, who is also a psychiatrist. Convinced that Regan is possessed, Father Karras and a second priest experienced with exorcisms, Father Lankester Merrin, try to exorcise the spirit from Regan before she dies.

Dr. X became involved in the filming of The Exorcist while completing his/her second year of a neuroradiology fellowship at New York University (NYU) Medical Center. As the senior fellow, s/he did lots of procedures such as angiograms, pneumoencephalograms, myelograms, etc. One day in the fall of 1972, as Dr. X was performing a carotid angiogram, his/her chairman, Dr. Norman Chase, came by to observe, with a stranger in tow. This was not unusual because important visitors were occasionally allowed to visit and evaluate their procedures, equipment, etc. NYU Medical Center was one of the leading neuroradiology centers in New York. Later that day, Dr. Chase told Dr. X that they would be making a movie, and asked if s/he would be interested in participating. Dr. X said "Yes sure," and promptly forgot about the incident.

Several months later in January of 1973, a whole film crew descended upon the NYU Radiology Department for two weekends. The film crew closed off part of the Department, utilized their angiography and pneumoencephalography suites, and proceeded to set up and film the (now famous) carotid angiography and pneumoencephalography sequences. To read about these scenes, please see the excerpt from The Exorcist script below.

Dr. X's participation was for two full days on the first weekend. According to Dr. X, "The other people in the angiogram scene with me are not actors; they are the radiologic technologist and nurse who actually worked with me every day. We duplicated exactly what we did for any carotid angiogram; I am most proud of the fact that even now, 30-plus year later, it holds up as a very realistic demonstration of the procedure." Dr. X claims that s/he was given the part because the chairman liked him/her: "He [the chairman] also is the only one who got film credits. His name appears at the end, not mine. (That's when I first learned that the radiology chairman always takes the credit!) :)" Dr. X's chairman, Dr. Norman Chase, is listed under the "Other Crew" section in the credits as follows: "Norman E. Chase. M.D. . . . . technical advisor."

Although the film was a huge international hit in 1973 and became the highest-grossing film of the year (see Wikipedia, http://en.wikipedia.org/wiki/The_Exorcist_%28film%29), Dr. X did not receive the lion's share of the profits. For his/her participation in the film, Dr. X was paid $200, which was a lot of money for a struggling fellow back in 1973! So far, The Exorcist has a total gross of $402,500,000 worldwide; if adjusted for inflation, this would be the top-grossing R-rated film of all time.

What were his/her fellows actors like? "As for the actors: I spent two solid days with Linda Blair who was an unknown thirteen-year old at the time; her mother was there too (actually has a bit part in the movie). Linda was very cooperative with all of us working on her. I remember she liked horses. I was able to meet the actress who plays the mother, Ellen Burstyn, too. The director, William Friedkin, was constantly directing us every step; he was incredibly professional and detail-oriented. So was the cinematographer, Owen Roizman, and the make-up guy who devised, with our help, the blood-spurting part of the sequence. I think he got on Oscar nomination for his work in the movie (think: pea soup and rotating heads!)."

When released in 1973, some theatre patrons reportedly screamed and fainted while viewing the film, requiring paramedics to be called to theaters. Theaters allegedly provided "Exorcist barf bags" (see http://www.findarticles.com/p/articles/mi_qn4158/is_20061104/ai_n16829894).

Dr. X's acting contributed to the nausea: "Again, I kind of forgot about the thing, figuring this was an interesting episode but one that would never see the light of day. Much to my surprise, in December of that year [1973], The Exorcist movie was released with tremendous impact. It was considered shocking, over-the-top, scary as the dickens, and the part that most sickened people was the angiogram sequence I had done!!! Go figure."

Other trivia buffs (see http://www.thefleshfarm.com/exorcist/exorcist1.htm) allege that due to death threats against Linda Blair, Warner Brothers had bodyguards protecting her for six months after the film's release. Some trivia facts websites (see http://imdb.com/title/tt0070047/trivia) claim that one filmgoer, who saw the movie in 1974 during its original release, fainted and broke his jaw on the seat in front of him. Claiming that the use of subliminal imagery in the film had caused him to pass out, he sued Warner Brothers and the filmmakers. The studio settled out of court for an undisclosed sum. Another unsuspecting moviegoer was Dr. X's identical twin sibling, who is also a physician. Dr. X forgot to tell his/her sibling about his/her role in the movie. When Dr. X's sibling and his/her significant other saw the movie, Dr. X claims that "they both freaked out!!!"

Today, Dr. X is comfortable talking about his/her acting debut, but that was not always the case: "For many years I never volunteered to people that I was in the movie. My career as an academic neuroradiologist was beginning, and I thought this would only be damaging to it, especially if one of my patients saw the scene. Now that I'm an old has-been, I admit to it if someone asks. But it's still not in my CV!"

While s/he hasn't had any further movie offers, Dr. X did get to meet Linda Blair many years later: "I did get to meet Linda Blair 25 years later as she was touring the country, promoting the 25th anniversary Exorcist DVD. So I decided to go see her at a bookstore. She looked great, I thought, and was as nice as could be, although I don't think she really remembered me. But she signed a cool Exorcist poster for me, with the words 'To Dr. X: what you did to my neck was a real head-spinning experience!' (Corny, but I like it)."

Can you name Dr. X?

CAST FOR THE ANGIOGRAM SCENE FROM THE EXORCIST:
Doctor: Dr. X
Regan MacNeil (Linda Blair): the possessed girl
Chris MacNeil (Ellen Burstyn): Regan's mother
Male Radiologic Technologist (RT)

Prior to the following scene, Regan's mother, Chris MacNeil, has consulted with a neurologist and a pediatric neurologist about her daughter's erratic behavior. They have recommended that Mrs. MacNeil have her daughter examined for a possible lesion in the temporal lobe of her brain. So, Mrs. MacNeil takes her daughter to Dr. X for an angiogram.

INTERIOR OF THE HOSPITAL, ANGIOGRAPHY SUITE, DAYTIME
[Regan is being wheeled on a bed to the angiography table. They place the bed next to the table and pull the siderails down.]

MALE RADIOLOGIC TECHNOLOGIST (RT): Regan, could you sit up and scoot over here?

[Regan does so, and she lies back on the angiography table. The RT pushes a button and the table begins to move forward.]

MALE RT: Regan, I'm just gonna move you down to the table okay?

[The table comes to a halt.]

MALE RT: Just for a short time.

[The RT and the female nurse loosen Regan's gown around the neck to prep her for the doctor. They place monitors on her arms.]

MALE RT: Very sticky.

[The doctor approaches Regan with a cup of Betadine and puts a sponge into the cup.]

DOCTOR: Now Regan, you're going to feel something, a little bit cold and wet.

[S/he dabs the sponge onto her neck making it a light brown color. The doctor then picks up a hypodermic needle and syringe and moves toward her. We see Chris and Dr. Klein, a pediatric neurologist, in the viewing room.]

DOCTOR: Okay, now you're gonna feel a little stick here. Don't move.
[The doctor inserts the needle into Regan's neck and injects local anesthetic.]

DOCTOR: Good.

[S/he then picks up a carotid angiogram needle and moves toward her.]

DOCTOR: Okay, you're gonna feel some pressure here, now don't move.

[The doctor places the carotid needle into her neck. Regan is quietly yelping in pain, and Chris is in pain watching her daughter suffer.

The doctor takes the stylet from the needle, which squirts pulsating blood, and fastens a tube onto the needle's hub. We see the blood rush from Regan's neck through the tube. The male RT then tapes Regan's chin down to prevent her from moving. The RT then wheels in a huge machine (the film changer), with parts on either side of Regan's head and a piece above.

The lights fade out, and all we can see is Regan's face illuminated by this huge machine above her.]

DOCTOR: Hook up.

[We see a finger flip a switch and the machine comes to life. Another RT in the view room pushes another button and the machine lets off several loud bangs. In the angiography room, we can see Regan crying.]
END OF ANGIOGRAM SCENE

The X-ray films from Regan's cerebral angiogram are normal. The doctors recommend that Regan have a pneumoencephalogram in a last attempt to locate the suspected lesion.

The results from the pneumoencephalogram are also negative.

Awards and Honors: May 21, 2007

Weibo Cai, PhD, postdoctoral scholar in the Molecular Imaging Probe Laboratory, has been awarded the Benedict Cassen Postdoctoral Fellowship from the Society of Nuclear Medicine (SNM), which is granted to recipients who have an excellent record and exceptional research ability. He has also received the 1st place 2007 SNM Young Professionals Committee Best Basic Science Award for his abstract "Quantitative RadioimmunoPET of EphA2 Expression in Xenograft-Bearing Mice," submitted to the 2007 54th Annual Meeting of the SNM in Washington, D.C. His research focuses on the development of novel peptides, proteins, growth factors, antibodies, antibody fragments, and nanoparticle-based tracers for PET, SPECT, optical, and MRI imaging in small animal disease models and, potentially, in cancer patients.

Lucile Packard Pediatric Radiology Participation at the Society for Pediatric Radiology

By Beverley Newman, MD

Established in 1958 with the goal of improving pediatric health care through medical imaging, the Society for Pediatric Radiology (SPR) recently held its 50th annual meeting in Miami, Florida. This is the major academic society and annual meeting for pediatric radiologists. This year the Society also put together a specific program to support their junior pediatric radiologists, which included a luncheon, small group lectures focusing on clinical and professional issues, and a social outing at one of Miami Beach's popular spots.

I attended the conference with a large contingent of pediatric radiology faculty from Lucile Packard Children's Hospital including Drs. Richard Barth, Frandics Chan, Patrick Barnes, Erika Rubesova, and Hans Ringertz as well as several current and former fellows: Drs. Shreyas Vasanawala, Michael Krasnokutsky, and Dorothy Gilbertson-Dahdal. Dr. Chan and I participated in the postgraduate course and gave talks entitled "Pediatric Cardiovascular CTA: Applications" and "Cardiac Manifestations of Systemic Disease in Children," respectively. I also presented a paper entitled "Imaging Pulmonary Venous Obstruction" and was the senior author on a paper entitled "Coronary Artery CTA in Children," presented by Dr. Alexander Towbin from the Children's Hospital of Pittsburgh.

In addition, Dr. Barnes and I presented pediatric radiology workshop sessions in neuroradiology and pediatric chest, respectively. Dr. Krasnokutsky presented two papers on which Dr. Barnes was the coauthor: "Cerebral Venous Thrombosis: A Mimic of Non-Accidental Injury" and "Spinal Cord Injury without Radiographic Abnormality (SCIWORA)--A Mimic of Non-Accidental Injury (NAI)."

Our faculty and fellows also presented or co-authored multiple other scientific papers at the Society for Pediatric Radiology. Dr. Dorothy Gilbertson-Dahdal presented "Three Newborns with Malrotation and Midgut Volvulus Mimicking Duodenal Atresia on Plain Film," which was co-authored by Drs. Laura Varich and Richard Barth. Dr. Shreyas Vasanawala presented "MR Voiding Cystography, Evaluation of Vesicoureteral Reflux" while Dr. Erika Rubesova delivered a paper entitled "Third Trimester Fetal MRI: Can We Reduce Post-Natal Imaging." Both papers were co-authored by Dr. Richard Barth.

Overall, there was a great representation of our pediatric radiology faculty at this important pediatric scientific meeting, and they are to be congratulated.

CODING CORNER: Dictation Standards

By Darryl Costales
(Image courtesy of Mark Riesenberger)

Did you know that radiology dictation plays an important role in being reimbursed appropriately? Of course, patient care is our primary focus when we talk about the contents of a dictation. But we also need to be aware that if a report does not support the charge, then payment could be delayed or denied. Internal (and external) auditors could require us to refund any payments if the report does not support the charges.

Question: Do you know what the American College of Radiology (ACR) recommendations are for a standard radiology report dictation?

Answer: Effective communication is a critical component of diagnostic imaging. Quality patient care can only be achieved when study results are conveyed in a timely fashion to those ultimately responsible for treatment decisions. An effective method of communication should: (a) be tailored to satisfy the need for timeliness; (b) support the role of a diagnostic imager as a physician communication; and (c) minimize the risk of communication error.

The following are the suggested components of a dictation report from the ACR web site:

1. Demographics
a. The facility or location where the study was performed.

b. Name of the patient and another identifier (MR#).

c. Name(s) of referring physicians or other healthcare provider. If the patient is self referred, that should be stated.

d. Name or type of exam.

e. Date of exam.

f. Time of the exam, if relevant (e.g., for patients who are likely to have more than one type of a given exam per day).

g. Inclusion of the following additional items is encouraged.
--Date of dictation
--Date and time of transcription
--Birth date or age
--Gender

2. Relevant clinical information and ICD-9 code, if available

3. Body of report
a. Procedures and materials. The report should always include a description of the studies and/or procedures performed and any contrast media (including concentration, volume, and route of administration when applicable), medications, catheters, or devices used, if not recorded elsewhere. Any known significant patient reaction or complication should be recorded.

b. Findings. The report should use appropriate anatomic, pathologic, and radiologic terminology to describe findings.

c. Potential limitations. The report should, when appropriate, identify factors that may compromise the sensitivity and specificity of the examination.

d. Clinical issues. The report should address and answer any specific clinical questions. If there are factors that prevent the answering of a clinical question, this should be reported.

e. Comparison studies and reports. Comparison with relevant examinations and reports should be part of the radiologic consultation and reported when appropriate and available.

4. Impression
a. Unless the report is brief, each report should contain an "impression" section.

b. A precise diagnosis should be given when possible.

c. A differential diagnosis should be rendered when appropriate.

d. Follow-up or additional diagnostic studies should be suggested when appropriate.

e. Any significant patient reactions should be reported.

5. Standardized computer-generated template reports. Standardized computer-generated template reports that satisfy the above criteria are considered to conform to these guidelines.

Richard M. Lucas Center Expansion Receives Design Award from the San Francisco American Institute of Architects (AIA)

(Image courtesy of Gary Bunton)

By Julie Ruiz, PhD

The Lucas Center Expansion has received the 2007 Design Honor Award: Excellence in Architecture from the American Institute of Architects (AIA), San Francisco Chapter (http://www.aiasf.org/Programs/Awards_Program/Design_Awards.htm). The design of the Lucas Center was a collaborative effort between the Perkins+Will Architecture and Design Firm (formerly MBT Architecture) and a radiology departmental team composed of our chairman, Gary M. Glazer, MD, and Wendy Baumgardner, RVT, LATg; Mary Bobel, MBA; Donna Cronister; Sanjiv Sam Gambhir, MD, PhD; Gary Glover, PhD; John Reuling; David Russel; Anne Sawyer, BS, RT (R) (MR); Susie Spielman; and Julia Tussing, MBA (who is now the managing director of finance & administration in the School of Medicine).

Our facility was one of five projects to earn the 2007 Design Honor Award, which is the highest award given in the awards program. The Lucas Center Expansion was evaluated based on its quality of design, innovation, thoughtfulness, and technique. Evaluators commented that the Expansion's "clever design solved the problem of lighting in a below-grade building and the workspaces exceed the expectations of the clients and visitors." You can view the Lucas Center Expansion on the AIA website at http://www.aiasf.org/Programs/Awards_Program/Design_Awards/110.htm. The award was presented during the 2007 Design Awards Gala on April 19, 2007, at the Julia Morgan Ballroom in San Francisco. All winning projects will be featured in California Home and Design. The Lucas Center Expansion has also been entered in a competition at the state level.

(Image courtesy of Mark Riesenberger)

Completed in 2005, the Lucas Center Expansion is not only beautiful but has inspired great work. Serving as an epicenter of innovation, the Lucas Center facilities have allowed our Department to expand our research programs markedly, and we are now home to three National Centers of Excellence: the Center for Advanced Magnetic Resonance Technology (CAMRT); the In Vivo Cellular and Molecular Imaging Center (ICMIC); and the Center for Cancer Nanotechnology Excellence Focused on Therapy Response (CCNE-TR). In July of 2006, our facility was featured in an article entitled "Richard M. Lucas Center Expansion, Stanford University: Light Court and Curtainwall Illuminate a Subterranean Lab," which was published in the "Building Type Study" section of Architectural Record focusing on college and university labs. To access the article, please go to http://www.architecturalrecord.com/projects/bts/archives/labs/06_lucasCenter
_Stanford/.

My 33 Years of Service at the Digital Image Library

By Carla Crivello, Digital Image Librarian
(Image courtesy of Mark Riesenberger)

It was a hot October day in 1973 when I started working in what is now called the Digital Image Library of the Stanford Radiology Department. I knew nothing about X-rays because I had been working for four years in the Outpatient Medical Records Department at Silas B. Hayes Army Hospital at Fort Ord, California. The Radiology Department was much smaller than it is today. The whole Department was located in what had been "Radiology South." The building where Radiology North is today had not been built.

There was no ultrasound, computed tomography, magnetic resonance imaging, or mammography. I had to learn about the different reading rooms where each kind of X-ray was read. There was also no computer system of any kind. The reception area contained a large, rotating machine called a rand where index cards on each patient were kept in alpha order. One of my main jobs was providing old comparison X-rays along with the new X-rays for the radiologist to read. This has been one of my main job duties throughout my career. About 10 years later, Radiology built its own computer system; in 1991, this system was upgraded to a system that allowed the film librarians to use a bar code to check X-ray films in and out of the library, which was also part of my job duties.

No analog X-rays are taken anymore. All studies are now digital and can be viewed by the radiologist on a Picture Archiving and Communications System (PACS) workstation along with older digital X-rays that were taken in 2003 or later. The new PACS digital system makes it much easier for the radiologists to read their studies. I routinely sent the paperwork for the new chest X-rays to the reading room to alert the radiologist to read that X-ray from the worklist on PACS. If I needed to release an X-ray to a patient, doctor, or clinic, I would print a hard copy or burn a CD of the X-ray using PACS.

My last day of work on April 3, 2007, was a fun day! My son, Chris, surprised me by arriving at my workplace with balloons and a large box of bagels for everyone in the Digital Image Library! My fellow librarians held a potluck for me that included food from the Olive Garden, and it sure was good! In addition, the Radiology Department gave me a party with a luscious strawberry cake, refreshments, and a beautiful crystal piece to go in my collection. It was wonderful to see so many people there to wish me well. Some of my former colleagues whom I had worked with many years ago attended my party as well. Several people gave very nice speeches while others expressed their kindness with lovely cards and gifts.

Thanks to the fine leadership of Deborah Williams, digital image library supervisor, and Tori Shannon, business systems analyst, my 33 years of working in the Digital Image Library has been a stimulating and rewarding experience! I have enjoyed working with my fellow librarians, X-ray technologists, schedulers, doctors, and everyone else I have interacted with over the years. I will miss you all.

My husband, Horace, is already retired, so we will be spending quality time together. We will complete projects around our house and yard, watch DVD movies, catch up on our reading, and just relax. Stanford Hospital has been a great place to work! I will always have fond memories, and I will come back to visit often.

Thank you!

Announcements I: May 2007

Wellness Fair: May 9, 2007
Stanford Baseball: Faculty and Staff Free on Fridays: May 11, 2007
Stanford Spring Faire: May 11, 12, and 13, 2007
Stanford Graduate Summer Institute (SGSI): Deadline to register is May 18, 2007
Multicultural Springfest: May 24, 2007
July 3rd Celebration with Big Bad Voodoo Daddy & Fireworks: July 3, 2007

Stanford Graduate Summer Institute (SGSI): Register by May 18, 2007 (http://sgsi.stanford.edu/). To encourage interdisciplinary thinking, the Office of the Vice Provost for Graduate Education has developed the Stanford Graduate Summer Institute (SGSI), which offers courses taught by Stanford faculty and outside experts from a wide variety of disciplines. All six classes offered by the SGSI are non-credit bearing and are open to currently registered Stanford graduate students and postdoctoral researchers who will be continuing in the fall quarter of 2007. Most courses are free of charge and are taught in intensive, all-day workshops. For more information and/or to access the online application before the May 18th deadline, please go to http://sgsi.stanford.edu/.

The following is a brief description of the courses from the website http://sgsi.stanford.edu/:

1) Summer Institute for Entrepreneurship
Monday, June 18, to Friday, July 13, 2007
Apply online. Application deadline: May 18, 2007
Discover what it takes to develop an idea into a successful venture through an intensive four-week business management program for graduate students in non-business fields. There is a $600 registration fee and a $40 application fee for this course.

2) Virus!
Monday, September 10, to Friday, September 21, 2007
Apply online. Application deadline: May 18, 2007
Course size limit: 16
No fee
A global approach to a global threat: predicting, preventing, and responding to emerging infectious diseases using avian flu as a paradigm (Professor John Boothrooyd). Contact Bonda Lewis, llewys@stanford.edu, for more information.

3) The d.school Experience: Adventures in Design Thinking
Sunday, September 16, to Friday, September 21, 2007
Apply online. Application deadline: May 18, 2007
Adventures in Design Thinking is an experiential workshop offered to all Stanford graduate students through the Stanford Graduate Summer Institute and the d.school, which is officially known as the Hasso Plattner Institute of Design at Stanford (Professors Liz Gerber, Bernie Roth, and Terry Winograd).

4) Music and Human Behavior: A Multidisciplinary Investigation
Sunday, September 16, to Friday, September 21, 2007
Apply online. Application deadline: May 18, 2007
Music is a curiously pervasive human behavior. This course will look at music listening and music performance from cognitive and neuroscience perspectives (Professors Jonathan Berger, Vinod Menon, the St. Lawrence String Quartet, and friends).

5) Managing Groups and Teams
Monday, September 10, to Friday, September 14, 2007
9 AM to 12 PM, M-F
Apply online. Application deadline: May 18, 2007
Managing Groups and Teams is a short course on the theory and practice of making teams work. It has two primary goals: first, to provide a conceptual framework for understanding group dynamics and their effects on team performance, and second, to provide opportunities to reflect on and develop your ability to build and manage effective groups and teams (Professors Deborah Gruenfeld and Dale Miller).

6) Global Warming: Good Science or Bad Politics?
Sunday, September 16, to Friday, September 21, 2007
Apply online. Application deadline: May 18, 2007
The class will begin with a fast tutorial of the physical and biological scientific basis for concerns about global warming, as well as the contours of the debate among economists, sociologists, ethicists, ecologists, business, and environmental stakeholders and policy makers (Professors Stephen Schneider and Terry Root).

July 3rd Celebration with Big Bad Voodoo Daddy & Fireworks: Tuesday, July 3, 2007, 7:30 PM (gates open at 5:30 PM) at the Frost Amphitheater, Stanford University. The Grammy-nominated swing band Big Bad Voodoo Daddy will be playing at the annual pre-Independence Day concert, which will culminate in a fireworks display. Tickets are $44, but youth 15 and under are half price. There is also special pricing for students and Stanford faculty and staff. For more information, please visit http://livelyarts.stanford.edu/event.php?code=JUL3.

Lifetime Achievement Award: Dr. Matilde Nino-Murcia

(Image courtesy of Mark Riesenberger)

By Julie Ruiz, PhD

In November of 2006, Dr. Matilde Nino-Murcia received the Inspirational Immigrant Professional of the Year (IIPY) Award from Upwardly Global at the Commonwealth Club of California in San Francisco. Founded in 1999, Upwardly Global is a nonprofit organization that helps highly qualified immigrant professionals, who are also permanent residents, write resumes, refine interviewing skills, and develop professional networks. Many of the immigrants who use the services of Upwardly Global were doctors, lawyers, and engineers in their former country. However, most have to work as waiters, taxi drivers, etc. until they can get a U.S. license or degree because their licenses and degrees are often not valid in the U.S. As a volunteer and mentor, Dr. Nino-Murcia works with immigrant professionals interested in medicine: "I review their resumes and talk to them about the opportunities that exist here and guide them on how to validate their medical licenses."

Because of her dedication and commitment as a volunteer and a mentor, Dr. Nino-Murcia was one of many nominees selected nationwide for the IIPY Award: "Being the recipient of this award meant the world to me because it is a recognition of what I've tried to do throughout all these years: help others to succeed. It is also a recognition of my mentors, Drs. Gerald Friedland and Brooke Jeffrey, who have guided and supported me throughout my academic career here at Stanford. As the saying goes, when you walk through the jungle, you need to do what you can to clear a path through the trees so that others can follow. It is this process that I have found to be the most rewarding in my career."

The challenges she has faced as an immigrant are not the only obstacles she has had to overcome in her lifetime. She was born in a very small town about 200 miles from Bogota, the capital of Colombia. While her mother was not able to give her children wealth, she was able to give them an education. As a young girl, Dr. Nino-Murcia originally wanted to be a nurse, but her mother encouraged her to become a physician because she knew her daughter could succeed. And she did. Graduating from high school at sixteen, Dr. Nino-Murcia went on to medical school at the National University of Colombia in Bogota where she was one of only seven women in a class of 90 students. By the time she graduated from the National University of Colombia School of Medicine, she ranked second in her graduating class.

After their internships and one year of service, she and her husband, a medical school classmate, decided to immigrate to the United States. Dr. Nino-Murcia was a twenty-six year old Colombian medical school graduate, wife, and mom when she first arrived in the United States in 1975. "We had professors who had trained in the United States. They were our role models in medical school," she explained to me. "We came here to get better training and preparation to bring back to our medical school in Colombia. However, we stayed, in part, because the political situation in Colombia had become very unstable due to guerrillas and drug trafficking."

Today, the United States feels like her home, but it was not always that way. Learning a new language and culture were challenging, but having someone to learn it with helped: "When I came here, my older daughter was about two and half years old, so I used watch Sesame Street with her--Big Bird, Bert, Ernie, and the Cookie Monster were some of the most effective language instructors of my daughter and me. You can learn amazing things when you must do so to survive, and when your teachers can make you laugh while learning."

Even after she proved her proficiency in English by passing the Test of English as a Foreign Language (TOEFL), Dr. Nino-Murcia was devastated to receive only rejections to the fifty letters she sent out to teaching hospitals along the eastern seaboard who told her, "This program does not accept FMGs [foreign medical graduates]." Finally, Dr. Nino-Murcia picked up the phone and called four local hospitals. The fourth hospital was Thomas Jefferson University Hospital in Philadelphia. They had an opening and wanted her to start that week.

Becoming a medical resident in the United States was a major success, but it is not among Dr. Nino-Murcia's proudest achievements. These are personal. Her most significant accomplishment is her daughters. Beaming, she told me, "I am so proud of them. They both went to Stanford. The older one majored in English literature and then went to Berkeley and got her master's in education. She's a high school teacher. My younger one got her undergraduate and master's in earth systems. She works in San Francisco as a consultant for mining companies in South America and Africa, developing strategies to preserve the environment and well-being of the people impacted by the mining industry. They are both very passionate about their work and giving back to the community."

Her second greatest achievement is being a professor in the Stanford Department of Radiology: "It is truly a privilege to be a member of such a great Radiology Department. The people in our Department are very talented, accomplished, and very friendly. It is great to work at a place where you are constantly learning and surrounded by people you look up to." Dr. Nino-Murcia has been at the VA since 1984, where she specializes in applying multidetector computerized tomography technology for the diagnosis, classification, and staging of pancreatic cancer; using positron-emission tomography to evaluate genitourinary tumors; and evaluating gastrointestinal motility disorders in patients with spinal cord injuries.

As she acknowledged in her acceptance speech for the IPPY award, being a foreigner has its advantages: "My background growing up in a rural community outside of the United States and my struggles to learn English and understand a new culture all gave me awesome problem-solving skills, as well as a heightened appreciation for those who mentored me and a strong belief that I should give back to those who follow."

And throughout her professional career, she has given back. Dr. Nino-Murcia has mentored college students interested in health careers, and she continues to serve disadvantaged students by actively participating in the Stanford Health Careers Opportunity Program; the Clinical Shadow Experience for Minority and Disadvantaged College Students; and the School of Medicine Minority Orientation Weekend.

New Finance Class Offerings

By Joe Hubbard
(Image courtesy of Mark Riesenberger)

It is with great pleasure and enthusiasm that I announce a new training opportunity in our world of Stanford Radiology! Our Finance Team, composed of Mary Bobel, Yun-Ting Yeh, Luis Alcazar, Stefan Pavlovic, Jackie Walker and me, has been feverishly working to put together a collection of classes designed to aid our administration in the service of their designated faculty. You will find that our classes cater equally to the beginning user as well as to the more seasoned or experienced users in our fine Department. Our current list of class topics will provide a much-needed resource for all of us and will serve as a template that other departments can draw from in developing their own ideas.

Our list of upcoming classes includes:
1. PCard--Procedure, Policy, and Common Problems
2. Introduction to ReportMart Financial Statements
3. Intermediate ReportMart Financial Statements
4. Advanced Financial Statements: Contracts and Grants
5. iOu Reimbursements--Procedure, Policy, & Common Problems
6. iProcurement--Procedure, Policy, & Common Problems
7. Grant Submission Preparation: An Administrative Assistant's Guide

Our classes will be held once a month, typically at 8:30 AM on Thursdays. We will send out e-mail announcements for the classes offered each month. We held our first two classes, "PCard" and "Introduction to Financial Statements," in March and April 2007. The next class offering will be "iProcurement" in late May. For more details regarding the content of our classes, please attend the next class or e-mail our Finance Office personnel for a copy of the presentation and relevant information/handouts.

In addition to these stated classes, the Finance Team will also be hosting an Open House session every final Thursday of the month. These sessions will usually last one hour, with the exact time and location to be sent out within a week of the scheduled date. No official RSVP is needed to attend. Simply come by, and we will help you solve any matters that are proving to be problematic. Our first session will be held this Thursday, May 3rd, from 10:30 AM to 11:30 AM in S-084 of the Grant Building. Please, take this opportunity to speak one-on-one with a dedicated Finance officer. Together, we will be able to solve all those lingering concerns that have been left unanswered.

Most classes will be open to every staff member and attendance is encouraged. Each class will provide you with new knowledge and skills that your faculty will appreciate. Relevant class materials will be provided in hard copy format so that each participant will have something to reference both during and after the training/review session. Now is the perfect time to enhance your professional development by acquiring new skills that will surely be reflected in the quality of your work. Don't allow yourself to be left behind!

The Radiology Finance Team looks forward to your attendance.