September 2007

Mobile CT

By John Picard, FACHE, MPA, BSHA, RT(R)

On August 8, 2007, a mobile CT scanner located in the Stanford Hospital and Clinics (SHC) emergency room parking lot scanned its first patient. The scanner, a GE 16-detector Lightspeed from Mobile Interim Solutions, has since scanned over 450 patients within its first 30 days of operation.

The mobile scanner was brought in to provide supplemental outpatient-only scanning capacity while the Hospital replaces the CT Room 2 scanner with a 64-detector scanner. This replacement project will take approximately 15 weeks with an end date of mid-December 2007. The scanner is run by a registered technologist, registered nurse, and a dedicated technologist assistant. The hours of operation are 8 AM to 8 PM, Monday through Friday.

For more information, please contact John Picard, SHC radiology clinical director, at
(650) 725-6342.

Becoming a U.S. Citizen

By Galyna Pecherska, CPC-A

Have you ever wondered what it takes to become a U.S. citizen when it is not your birthright? First, you must be a legal, permanent resident of the U.S. for at least five years before you apply. Second, when it comes to the citizenship interview, you must demonstrate working knowledge of the English language, and you must pass a test on United States history and government. You will be asked ten questions, and at least six have to be answered correctly. Some questions are easy, such as the number of stripes or the color of stars on the U.S. flag. Some questions are harder; for example, you have to know the thirteen original states, or you have to be able to name the amendments that address voting rights.

After successfully passing the interview, you have to wait for an invitation to the naturalization ceremony. The ceremony I attended was not quite formal; it was, rather, emotional and cheerfully encouraging. It took place in the friendly Campbell Community Theater, which comfortably held 420 new citizens with their families and friends. Several speakers greeted the new citizens, and the most memorable moment was when one of the speakers presented his grandfather's citizenship certificate issued in 1942. Then the long-awaited moment arrived--everyone rose from their seats, facing the flag with their right hands over their hearts and took the U.S. citizenship oath. I took the oath, and I joined the choir of 420 new citizens singing the "Star Spangled Banner."

A pleasant surprise was waiting for me the next morning when I came into my office. My cubicle was decorated with small flags and flowers, and there was a greeting card signed by all my co-workers and friends. There was more! A big homemade cake with cream cheese and strawberry stripes and fifty blueberry stars was waiting for me in the office kitchen (a special big thanks to Elaine Standifer!). I was amazed and touched by my colleagues' attention and care. Thanks a lot, guys!

I have always felt a sense of family at Stanford: from the time I came to the Stanford emergency room as a volunteer in 2003; completed my medical coding internship in the Anesthesia Department; and, finally, was hired by Stanford Radiology. At Stanford, I have always been surrounded by very nice people who have shaped my professional skills, provided me with valuable advice, and who have been good friends. So, thank you for making this very important day of my life even more memorable and fun!

Elaine Standifer made a "flag" cake to celebrate Galyna's new title as a U.S. citizen.

From l-r: Maureen Wong, billing supervisor; Galyna Pecherska, coder; Elaine Standifer, coder; Sandra Bowers, coder; Deja Goodson, revenue specialist; Darryl Costales, reimbursement manager; Liliya Semernina, coder; and Jyotsna Mahindrakar, coder.

Travelogue: South Africa, Zambia, and Botswana

By Jackie Walker

After some 21.5 hours of travel and several time zones, we finally arrived in Capetown, South Africa! South Africa has approximately 47 million people of diverse origins, cultures, languages, and beliefs. The population is 79% African (Black), 9% European, 9% mixed, and 2.5% East Indian and Asian.

We visited the Cape of Good Hope, the southern most tip of the continent and Cape Agulhas where the Indian and Atlantic Oceans meet--an awesome experience! The Dutch (Boers) influenced the region with Dutch-style architecture, and the French (Huguenots) brought a flourishing wine industry. South Africa has a spectacular coastline (comparable to California's or the Almifi Coast in Italy), with waves shooting about 80 feet high. The mountain ranges are also quite spectacular. We crossed several mountain passes, as we traveled inland with stops in Durban, the Kingdom of Swaziland, and Zululand, where we stayed in traditional Zulu huts.

Next was our safari in Kruger National Park, one of the largest game parks in South Africa. In Kruger, we were fortunate and lucky to see the famous "Big 5": the lion, elephant, buffalo, rhino, and the elusive leopard. We were very excited to see a leopard dragging an impala (fresh kill) off to high ground. While in Kruger, we also saw zebras, wildebeests, impalas, rhinos, and a variety of exotic birds. From Kruger, we went on to Johannesburg and Pretoria, the capital.

Then we flew to Zambia to see Victoria Falls, whose African name is Mosi-oa-Tunya or "The Smoke That Thunders." It is truly one of the natural wonders of the world. The highlight of our trip was a one-day safari in Chobe National Park, Botswana. We saw large herds of elephants, giraffes, hippos, lions, impalas, monkeys, crocodiles, and exotic birds to name a few.

Overall, our vacation/safari was educational and exciting! In two and a half weeks we covered about 2,242 miles of travel by coach and plane. This was by far one of my favorite and exotic vacations, filled with wonderful memories and pictures that I hope you all enjoy as you view them at http://www.flickr.com/gp/11700805@N07/0tVX7f.

Awards and Honors: September 14, 2007

Roland Bammer, PhD, assistant professor (research) of radiology, has earned two honors, both from the National Institute of Biomedical Imaging and Bioengineering (NIBIB). He has successfully completed a competitive five-year renewal for his "Improving SENSE MRI for Spiral and Echo-Planar Imaging" R01 grant, which has been funded since 2003. Dr. Bammer has also been awarded an R21 grant for his research project, "Real-Time MRI Motion Correction System." Dr. Bammer's study, "Improving SENSE MRI for Spiral and Echo-Planar Imaging," is designed to demonstrate that spiral and echo-planar imaging (SENSE) can be combined with diffusion-weighted imaging/diffusion-tensor imaging (DWI/DTI) to significantly improve the evaluation of patients with signs or symptoms of cerebral ischemia. His research on real-time MRI motion correction explores the potential to use an alternative MRI motion compensation approach. The success of this project will significantly improve MR exams, particularly for pediatric and geriatric patients, by reducing the overall scan time and improving the diagnostic capacity of the images.

Seeing Patients Through: Improvements to Imaging Services

By Lori Hart

In response to the results of the 2006 physician survey, the Imaging Services Department of Lucile Packard Children's Hospital has significantly augmented its program to provide better responsiveness to patients and improved convenience in scheduling procedures.

Packard Children's Imaging Services Department is dedicated to providing state-of-the-art imaging that offers highly focused, personalized care to every patient and the timely reporting of the results by specialty radiologists. Members of the Imaging Services Team include Lori Hart, administrative director for imaging services; Patrick Barnes, MD; Anita Honkanen, MD; and their multidisciplinary PI teams. Over the last year, our team has addressed challenges with scheduling, authorizations, and optimizing through-put. Together, we facilitated the implementation of a centralized scheduling model; an automated call-distribution system to track the program's responsiveness; a televox automated patient-reminder call system; patient reminder letters sent with directions to all families; and appointment cards available for clinical use.

Our team also concentrated on streamlining the exam protocol process and improving modality turnaround time. Hours of operation for MRI services were expanded to include on-site staffing for weekends and to provide convenient appointment times for non-general anesthesia cases for outpatients and inpatients. Expanded ultrasound technologist coverage on weekends was also added to provide care for urgent inpatients.

As a result of these improvements, over 80 percent of calls to our main scheduling number, (650) 497-8376, are answered in person seven days a week from 7:30 AM to 4:30 PM. Now, more than 80 percent of patients calling for an outpatient MRI are scheduled for a procedure within 48 hours. This is an enormous improvement compared to last year's average 10-day turnaround time.

Packard Children's Imaging Services Department continues to grow to meet the increasing demands for imaging. A newly renovated fluoroscopy/general diagnostic suite will be completed in the first quarter of the 2008 fiscal year. At the same time, construction will begin on a new suite that will include induction and holding rooms, as well as an additional 3T MRI scanner.

The Department of Imaging Services is pleased to provide state-of-the-art imaging with compassion to all of our patients and efficient responsiveness with subspecialty image interpretation. To facilitate complex scheduling scenarios, offer feedback, or obtain assistance with any other operational matter, please contact me by email at lhart@lpch.org or by phone at (650) 497-8975.

(Image courtesy of Mark Riesenberger)

Awards and Honors: September 12, 2007

Suzanne Campanile, CRT, ARRT, R, M, BS, mammography and breast sonography technologist, received the June Stanford Hospital and Clinics Radiology Wingspread Award from the former recipient, Teresa Nelson, CRT. Ms. Campanile was awarded the June Wingspread Award for her outstanding work in mammography and breast sonography. The award is given by one employee to another who has proven that he or she is a "special performer" by demonstrating exemplary performance in areas such as job knowledge; work ethics; communication skills; inter- and intradepartmental relationships; versatility; and judgment. Born in Burlingame, California, Ms. Campanile resides in Belmont with her husband and three children. In 1983, Ms. Campanile graduated with honors, receiving her AS degree from Canada College's Radiology Technology Program where she was awarded the Samuel Elkins Award for academic achievement. Ms. Campanile worked at Kaiser Permanente in Redwood City for four years before beginning her career at Stanford in July of 1987. After working for a brief time in diagnostic radiology, Ms. Campanile became the lead technologist in the gastrointestinal section. She then completed CT training and became the initial X-ray technologist for the Cowell Student Health Center, which is now the Vaden Health Center. After passing her mammography boards in 1994, Ms. Campanile shifted her focus to mammography. She has recently passed the ARRT board exam in breast sonography, and she is currently a mammographer and breast sonographer in the breast imaging section. The Wingspread Award gives employees the opportunity to recognize who among them has gone above and beyond the fulfillment of his or her usual duties. Wingspread awardees can keep the award for as long as they wish or until they discover another "special performer." Monthly awarding of the Wingspread honor is encouraged as part of the SHC departmental staff meetings.

Travelogue: New York City

By Andrew Kloak

On my vacation, I went to New York City and New Jersey. After spending most of my life in Chicago, I began this trip with a healthy skepticism that the biggest apple in the bushel of American cities is the best. This was the Kloak family reunion, and we had fourteen in attendance out of a possible twenty-five people. I figured this was not a bad turnout for being on the East Coast.

Most New Yorkers probably wouldn't consider their city to have a comparable counterpart anywhere in the country, Los Angeles and Chicago included. I came into this like a pugilist taking on the heavy-weight champion in Madison Square Garden. I wouldn't challenge this monster of U.S. finance and culture straight up. That's a strategy that would get me knocked to the canvas in the first round. My approach would be to concentrate my efforts with quick short jabs on the inside.

My brother, George, and wife, Liz, live in Ridgewood, NJ, in the Bergen County suburbs of NYC, so that was our base of operations for the six days we were there. That was great because we were finding a lot of hotels in Manhattan that were charging $500 per night.

Yes, New Jersey like Chicago doesn't get much respect, but there are good things to see there, too. We toured the Hermitage in Ho-Ho-Kus, NJ. The Revolutionary War-era house was closed that day, but they gave us a private tour after seeing that we were admiring it from the outside. It was great to see. George Washington stayed at the house with his army camped all around the site after the Battle of Monmouth in 1778.

NYC has its share of early American history, too. We learned that the stronger English forces made the Big Apple its stronghold for most of the Revolutionary War, so it was no small gesture that that the Founding Fathers made the city our first capital until moving it to the District of Columbia. I was surprised to see that Washington was inaugurated as the first president on the steps of Federal Hall in 1789 in the heart of present-day Wall Street.

We took a three-hour Circle Line Boat Tour around Manhattan. The place is so organized that they even have official titles for the people who sell you water while you are waiting in line to get on the boat. There was a Water Hawker 1A, 2A, 3A, etc. We went past all five boroughs (Manhattan, Bronx, Harlem, Queens, and Staten Island) on this exciting journey. All told, we passed under twenty bridges as we circumnavigated Manhattan.

The city of NY is doing a lot with piers just like San Francisco. Our guide, John, explained their ambitious plans for piers. They are tearing down all the cargo piers and currently constructing thirteen new ones with restaurants and hotels on them. He said they towed about one-thousand cars that morning alone to the city-owned Pier 76 where the owners could retrieve them after paying their $283. And if they didn't pick them up in a day, they would be pushed into the Hudson. What humor these New Yorkers have.

My favorite building on the New York skyline was the seventy-seven story high Chrysler Building with its art deco style. It's not far from the Empire State Building and looks like it. This skyscraper's spike and bluish-black coloring reminded me of Batman's Gotham City.

NYC's Wall Street took a blow after September 11 when a number of financial firms moved across the Hudson to New Jersey. You can see that on the boat tour, especially since a number of those firms moved to Jersey City. That town's skyline has grown by an impressive 25% since 9/11, according to our other tour guide, my brother George.

When our cruise boat passed the Statue of Liberty, I was seeing what my grandparents saw one-hundred years ago as they passed through Ellis Island, arriving from Bohemia (present day Czech Republic). Our guide said this gift from the French people to the United States was copper colored in the early years. My grandmother and my grandfather met in New York and were married in Palisades Park, NJ.

Deep down, I like to think of myself as a battler descended from a clan of battlers from the south side of Chicago, but as each day passed on this trip, I started to see that our story goes back even further, to the Statue of Liberty and New York City itself.

Ground Zero was just as awe inspiring as the Statue of Liberty. We went to a subway platform and looked down into it from that elevated position. It was hard to believe that this was the spot where two jetliners going six-hundred miles per hour slammed into these buildings and caused them to collapse and virtually shut down the southern tip of Manhattan for six months. There is a road that goes down four levels to an earthen pit that is still very much a work in progress.

While on Central Park West Avenue, we saw the Plaza Hotel that Paul Hogan in Crocodile Dundee walked out of while looking for the subway on his first morning in NYC. I remembered that our guide on the boat had said that Catherine Zeta-Jones lives on Central Park West Avenue, too.

The food was great. We went to Chinatown and had dinner at a restaurant that has the best wonton soup in the country according to the New York Times. The Times was right; it was great. Now, if I could only remember the name of the place.

This area was tremendous to see. NYC (and even New Jersey) earned my respect, and, while I didn't make it through fifteen rounds (six days wasn't quite enough), I would definitely return again to this heavy hitter of American cities.

A typical house in Ho-Ho-Kus, NJ

The Kloak's on the steps of NY's Federal Hall

Front row: Andrew; second row (L-R): father, George Kloak; Mariana; mother, Therese Kloak; and wife, Teofila, holding Cassandra

The Chrysler Building of Batman lore

Statue of Liberty from NY Harbor

Ground Zero

2007 RSL Retreat at Asilomar

2005 RSL Retreat

By Julie Ruiz, PhD

At the first Radiological Sciences Laboratory Retreat in 1999, our keynote speaker was Ronald Bracewell, PhD, from the Department of Electrical Engineering at Stanford. Dr. Bracewell received the Institute of Electrical and Electronic Engineers' Heinrich Hertz Medal in 1994 for his pioneering work in antenna aperture synthesis and image reconstruction as applied to radio astronomy and to computer-assisted tomography. Scientists use Bracewell's algorithm, developed for radioastronomical reconstruction from fan-beam scans, to reconstruct tomographic images on commercial CT scanners.

2006 RSL Retreat

Last year, our keynote speaker was Herb Abrams, MD, emeritus professor of radiology at Stanford. He is a world-renowned authority in diagnostic radiology and the impact of ionizing radiation and nuclear weapons. Dr. Abrams was the founding vice president of International Physicians for the Prevention of Nuclear War, which received the 1985 Nobel Peace Prize. At our retreat, he spoke about the biological effects of ionizing radiation. We also attended a workshop on "The Art of Negotiation"; a discussion about the "State of the Lab"; and a "Town Hall Meeting." In addition, each RSL group also developed their own introduction. To view Dan Spielman's group introduction, P.I.M.P. (Person into More Than Protons), please go to http://www.stanford.edu/~pritib/PIMP.wmv. Of course, our retreat would not have been complete without our BBQ and challenging "Jeopardy Game"--complete with categories such as "Name That Patent."

Our keynote speaker this year will be Thorne Lay, PhD, professor in the Earth Sciences Department and director of the Center for Studies of Imaging and Dynamics of the Earth at the University of California, Santa Cruz. He will be speaking on geophysics and geophysical imaging. Our second speaker will be Kelly Skeff, MD, PhD, professor of medicine (general internal medicine) who will discuss various ways to evaluate teaching skills as an introduction to a larger program that his group offers on good teaching practices. Dr. Skeff received the Abraham Flexner Award for Distinguished Service to Medical Education, which was established in 1958 by the Association of American Medical Colleges (AAMC) "to recognize extraordinary individual contributions to medical schools and to the medical education community as a whole."

This year's retreat will be from Wednesday, September 19, through Thursday, September 20, at Asilomar: 800 Asilomar Ave, Pacific Grove, CA (http://www.visitasilomar.com/destination.aspx). After a bag lunch on the beach on Sept. 19th, the retreat will begin at about 1:00 PM, and it will adjourn at about 3:00 PM on the 20th. There is a bonfire a scheduled for Wednesday night at 8:30 PM.

About 45 people attended our first retreat and the largest group we have had so far was in 2005 when the staff, faculty, and students of the Molecular Imaging Program at Stanford (MIPS) joined us, and we totaled 115 people! For 2007, 90 people plan to attend so far.