Education

National Radiologic Technology Week: Nov. 8-14, 2009

By Rachel Silveria and Stanford Imaging Services

During National Radiologic Technology Week (NRTW), an annual recognition established by the American Society of Radiologic Technologists (ASRT), we celebrate the great advances in radiologic technologies that have been made since the discovery of the X-ray on November 8, 1895.

The week of November 8-14th, we proudly celebrate all employees of Stanford's world-renowned Department of Radiology for continually providing outstanding care. Offering the best diagnostic imaging services and expertise while utilizing state-of-the-art technology, this Department never fails to demonstrate extraordinary teamwork by all its dedicated medical professionals. For more than one-hundred years, Stanford Radiology has made a difference in the lives of patients and their families, while continuing to . . .

make important contributions to medical and surgical advances. This hardworking Department, in this ever-growing Stanford community, continues to lead imaging-based research, patient care, and education. This year in particular, the Stanford Radiology Department has pioneered transformations in several areas. These significant advances, along with our teamwork and excellence in patient care, make our Department unique among radiologic service providers and serve as an inspiration to our patients.

Furthering our clinical imaging enterprise, we unveiled two new outpatient centers this year: Stanford Medicine Imaging Center in Palo Alto and Stanford Medicine Outpatient Center in Redwood City. Focused on patient comfort, both of our Centers have been designed to ease the tensions associated with health problems through innovative approaches to reduce anxiety such as promoting a calming environment; utilizing beautiful architecture; and employing a patient-centric approach to healthcare delivery. With the added imaging capacity of both Centers, we have accelerated our delivery of outpatient care, while providing imaging services with the most advanced technology available. By constantly innovating, we have placed ourselves in a continual state of technological advancement.

Additionally, we have completely rebuilt our Nuclear Medicine Clinic on the 2nd floor of Stanford Hospital and Clinics (SHC). After years of planning, the anticipated opening of the Clinic is July 2010. In addition to two new state-of-the-art PET/CT 64 slice systems, the design also includes a Radiochemistry Lab and a Health Physics Workshop. The work flow of patients will dramatically improve with the centrally located design and features.

Stanford Radiology Imaging Services by Location:

Blake Wilbur

• CT


• MRI


• Comprehensive Diagnostic Digital Radiography


• PET/CT


• Ultrasound


• Mammography


• Fluoroscopy

Stanford Medicine Imaging Center, Palo Alto

• CT


• MRI

Stanford Hospital and Clinics

• CT


• MRI


• Magnetic Resonance Therapy


• Nuclear Medicine


• Comprehensive Diagnostic Digital Radiography


• Ultrasound


• Angiography/Interventional Radiology


• (PET/CT Planned for 2010)

• Comprehensive Diagnostic Digital Radiography


• Full-Field Digital Mammography


• Computer-Aided Detection Program for Screening Mammography


• Stereotactic Core Biopsy Program


• Ultrasound

Stanford Medicine Outpatient Center, Redwood City

• CT


• MRI


• Diagnostic Digital Radiography


• Ultrasound


• Bone Densitometry


• Fluoroscopy

Stanford Radiology Voted "Best Radiologist Training Program"

Voted the 2009 "Best Radiologist Training Program" by AuntMinnie.com, Stanford Radiology was recently recognized for excellence in radiological education.

Oldest Person Scanned at Stanford by Dr. Fahrig

(Images courtesy of Mark Riesenberger)

By Julie Ruiz, PhD

On August 20th, Rebecca Fahrig, PhD, directed the CT scanning of a 2,500-year-old mummy of the Egyptian Priest Iret-net Hor-irw. The high resolution CT scans were taken of the mummy in the AxiomLab and will be used . . .

to construct three-dimensional images of his skeleton to learn more about the mummy's life and death.

To acquire more information about the mummy's amulets, a second scanning procedure was completed at Stanford Medicine Imaging Center, Palo Alto, (SMIC) with a dual-energy CT scanner that differentiates between different materials. Through these scans, scientists hope to learn more about the substances used in the mummification process as well as in the composition of the amulets.

The mummy has been a resident of the Fine Arts Museums of San Francisco since 1917 and will be part of an upcoming show at the Legion of Honor Museum in an exhibition entitled, "Very Postmortem: Mummies and Medicine," which opens on Oct. 31, 2009. This exhibition is organized by the Fine Arts Museums of San Francisco with the cooperation of the Akhmim Mummy Studies Consortium, Stanford Radiology, and Stanford Medicine Imaging Center. Additional project assistance has been provided by the Stanford Division of Anatomy, eHuman Inc., and Fovia Inc. To read more about the mummy, please access "The Mummy Speaks: Detailed Scans at Stanford Help Reveal the Secrets of an Ancient Egyptian Priest" and "Mummy to Be Scanned at Stanford at Aug. 20."

This is Dr. Fahrig's second time scanning a mummy. In 2005, she led the team who scanned a 2,000-year-old mummy of a four- or five-year old girl (nicknamed Sherit, or "little one") from the Rosicrucian Egyptian Museum in San Jose. To read more about Dr. Fahrig's work, please access "Radiologists as Artists: Critics Love Mummy Scans"; "Mummy's Inner Secrets Revealed"; "The Latest in X-Rays: A 'Mummogram'?"; and "It's a Girl: Digital Unwrapping Reveals a Little Mummy's Secrets."

Research by Dr. Wu and Colleagues Induces Fat Cells to Become iPS Cells

In a recently published paper, "Feeder-Free Derivation of Induced Pluripotent Stem Cells from Adult Human Adipose Stem Cells," senior author Joseph Wu, MD, PhD, assistant professor of medicine (cardiology) and radiology, and his colleagues describe how they reprogrammed fat cells (collected from adults undergoing liposuction) to become pluripotent stem (iPS) cells for use in tissue regeneration and disease research. According to Dr. Wu, "Fibroblasts, or skin cells, must be grown in the lab for three weeks or more before they can be reprogrammed. But these stem cells from fat are ready to go right away"(from "'Liposuction Leftovers' Easily Converted to iPS Cells, Study Shows" by Krista Conger http://med.stanford.edu/ism/2009/september/fat-cells.html or Download file.

Please click here to access the full research article "Feeder-Free Derivation of Induced Pluripotent Stem Cells from Adult Human Adipose Stem Cells," (published in Proceedings of the National Academy of Sciences (PNAS) 2009;106(37):15720-15725 http://www.pnas.org/content/106/37/15720.full.pdf) by Dr. Wu and his colleagues, which include co-author Michael Longaker, MD, professor of surgery (plastic/recon surgery) and (by courtesy) of bioengineering and first author Ning Sun, PhD, postdoctoral scholar in the Cardiovascular Gene and Cell Therapy Lab.

Awards and Honors II: September 23, 2009

Scott W. Atlas, MD, professor and chief of neuroradiology and senior fellow at both the Hoover Institution and Freeman-Spogli Institute for International Studies, has received an international honor on September 12, 2009, at the Annual Meeting of the Sociedade de Radiologia de Pernambuco in Recife, Brazil, for his "important contributions to radiology and to education in Brazil."

Dr. Atlas is recognized as a world leader in both education and clinical research and has been on the Nominating Committee for the Nobel Prize in Medicine and Physiology for several years. His research has centered on advanced applications of new MRI technologies in neurologic diseases, and he has authored more than 120 scientific publications in leading journals. Dr. Atlas is also the editor of the best-selling textbook Magnetic Resonance Imaging of the Brain and Spine, which was recently released in its 4th edition and officially translated from English into Mandarin, Spanish, and Portuguese. He is also editor, associate editor, and an editorial board member of numerous scientific journals, and he has been a member of the boards of many major national and international scientific societies over the past decade. In recognition of his leadership in the field, Dr. Atlas has received many awards and honors. He has been named by his peers in The Best Doctors in America every year since its initial publication, as well as in regional listings, such as The Best Doctors in New York, Silicon Valley's Best Doctors, and other similar publications. He recently received the Alumni 2008 Comeback Award from his alma mater, the University of Illinois in Urbana-Champaign.

In addition, Dr. Atlas' work includes investigations into the effects of the changing healthcare marketplace on technology-based innovations in medicine, and he has lectured throughout the world on a variety of topics, most notably advances in MRI of the brain, and the key economic issues related to the future of such technology-based advances. During the 2008 Presidential Campaign, Dr. Atlas was a senior advisor for health care and the coordinator of the Health Policy Team for one of the major U.S. presidential candidates. At the Freeman-Spogli Institute for International Studies, he has particular interests in the evolving healthcare system of emerging economies, and he recently received a Fulbright Award to collaborate with Chinese academic leaders on structuring healthcare solutions for China. Dr. Atlas has also participated with leaders from government and academia on the World Bank's Commission on Growth and Development, and he is an adviser to major industry leaders in medical technology.

To read his prior blog articles, please access "Awards and Honors: March-April 2007"; "Awards and Honors: September 29, 2008"; "Sanford/Atlas: Alternatives to Government Health Takeover"; "Dr. Atlas' Commentary on Our Healthcare System Featured in The Washington Times"; and "Commentary by Dr. Atlas: 'Mr. Health Care: Ted Kennedy's Lifelong Passion' and 'Why Are These Health Care Fixes Ignored?'"

Medical Students Need Earlier Exposure to Radiology According to Drs. Desser and Hovsepian

Although radiology still remains among the top 10 specialty choices, it has fallen from fifth to ninth, according to the National Residency Matching Program. In "Early Radiology Exposure Could Lure Medical Students to Specialty" from the August 2009 RSNA News, Terry Desser, MD, professor of radiology and residency program director, and David Hovsepian, MD, professor of radiology as well as chief quality and safety officer, describe the causes of decreasing interest in radiology while offering solutions.

According to Dr. Hovsepian, the diminished appeal of radiology as a career choice among medical students is due in part to "students' misperceptions about what radiologists actually do and the central role that we often play in patient care." One solution is to expose medical students early on to radiology, as Dr. Desser describes: "We need to be the ones teaching them anatomy and about imaging and manifestations of pathophysiology on imaging early on in their training, so they recognize what we do and what we contribute." To read the full article, please access http://www.rsna.org/Publications/rsnanews/August-2009/early_exposure_feature.cfm or Download file.

Medical Imaging: The Good, the Bad & the Ugly

Dr. Pat Basu's article "Medical Imaging: The Good, the Bad & the Ugly" was recently featured in Kaiser Health News and addresses the optimization of medical imaging. To read his article, please access http://www.kaiserhealthnews.org/Columns/2009/August/081309Basu.aspx or Download file.

2009 Fourth Annual Japanese Technologist Summer Training Program

By Mike Moseley, PhD

(photo courtesy of Mark Riesenberger)

From August 3rd-7th, Stanford Radiology held its fourth annual Japanese Technologist Summer Training Program, a joint educational program in partnership with the Japanese Society of Radiological Technology (JSRT). As in previous years, we had 24 JSRT participants visit for the week, with technical lectures in the morning; tours and workshops in the afternoon; and social activities such as Giants' baseball, a tour of SMIC, shopping, and biking. For the brave of the bunch, Dr. Deb Ikeda once again led a dawn charge up to the Stanford Dish. The lectures were well received (many thanks to everyone who participated!). The highlight of the week was the reception at the new Stanford Medicine Imaging Center, Palo Alto, which gave the JSRT members an opportunity to meet and speak with many of our technologists. The Summer Training Program is a great way to introduce ourselves to the international radiology community, while building strong collaborations and more efficient practices in radiology worldwide. Many thanks again to our speakers and to everyone who spent so much time and effort to make this an ongoing success.

New Residents for 2009!

We are excited to welcome our new residents, who began in July 2009! To learn more about our first-year residents, please find some of their biographies along with their photos below.

Ed Boas, MD, PhD
Veronica Cox, MD
Sarah Garaas, MD
Theodore Jerdee, MD
Tim Joseph, MD
Marnie Kremer, MD
Andreas Loening, MD, PhD
Nicholas Telischak, MD, MS
Jonathan Williams, MD

Ed was born in Taiwan and grew up in San Diego. He received his undergraduate degree from Harvard and then entered the Stanford MD/PhD program. After graduating, he spent a year completing a general surgery internship before starting in radiology. Ed likes to build things and loves the thrill of making something new and useful. Some of his recent projects include developing an algorithm for reducing metal streak artifacts in CT scans and creating a method for designing custom binding proteins. At Stanford, he plans to pursue interventional radiology and develop new medical devices.

Veronica is a lifetime Californian, who hails from the backwoods of rural Mendocino County. She grew up playing outside in the redwood forests and cooking-up amateur science fair projects in her backyard. Her "research" of "mudslides" brought home many prizes from the California State Science Fair, where she was also named "Most Promising Future Scientist." Veronica is very close to her three sisters, all of whom have also attended Stanford University at one time or another. Prior to entering the Radiology Residency Program at Stanford, she attended the University of California, Berkeley, as an undergraduate, followed by medical school at the University of California, San Diego. In her spare time, Veronica enjoys painting, listening to classic rock, and spending time with her new niece.

Tim Joseph is a true Californian. He attended the University of California, Los Angeles, for his BS, and then ventured northward where he attained his MD degree at the University of California, San Francisco. He returned to his hometown of San Diego to complete his internship, and made the return trip back to Stanford to complete his radiology residency. Tim is an avid sports fan (Lakers!), and traveler; he also LOVES eating all kinds of foods.

Marnie grew up in Fargo, North Dakota, and stayed in the Midwest to attain her bachelor of science degree in nutritional science from the University of Minnesota, Minneapolis. She went on to complete her medical degree at the University of Maryland School of Medicine in Baltimore, Maryland, where she also received her Certificate in Medical Sonography. This past year, she returned to Fargo, North Dakota, for her internship at the University of North Dakota. Marnie enjoys camping, hiking, running, volleyball, and travel.

Andy Loening (sounds like "Learning') grew up in Iowa City, and then headed to Boston to study electrical engineering at the Massachusetts Institute of Technology (MIT). After completing his undergraduate degree, he decided to check out the west coast, earning his MD/PhD here at Stanford. Continuing his slow westward migration, Andy finished his transitional internship at the University of Hawaii. He enjoys backpacking, guitar, fermented grain products, indie rock, and what he calls "dorking out" on his computer. Andy has also recently taken up surfing.

Nick grew up in the Bay Area but left for New England to study mechanical engineering at Tufts University. He attended Dartmouth Medical School where he met his wife, Kristen. Having tasted life at Stanford while pursuing a master's degree in bioengineering, Nick has returned for his radiology residency. According to Nick, he "dragged his wife, a lifelong New Englander, kicking and screaming" to San Francisco where she is a surgical intern at the University of California, San Francisco. When he is not in a dark room, Nick is bicycling, running, swimming, or trying to find the perfect margarita.

Did You Know?

Number of Radiology Departments in Top U.S. Medical Schools in 1913
As ranked by the Council on Medical Education of the American Medical Association, only 4 of the top 18 U.S. medical colleges in 1913 recognized Roentgenology as a distinct "Department of Instruction": Northwestern University, Harvard University, Cornell University, and the University and Bellevue Hospital Medical College (from "Medical Colleges of the United States: Annual Presentation of Educational Data by the Council on Medical Education in J Am Med Assoc1913;61(8):569-598 and quoted in "Instruction in Roentgenology" by Adolph Henriques and Lodilla Ambrose, JAMA 1914;V.LXIII;N.8:651-653).

The Council chose the top or "A+" 18 U.S. medical colleges by . . .

rating all medical schools on a scale of 1,000 points based on 10 criteria each worth 100 points (please see criteria listed below). Class A+ colleges were those that earned an "acceptable" rating based on these 10 criteria (to read more, please access "Medical Colleges of the United States: Annual Presentation of Educational Data by the Council on Medical Education" in J Am Med Assoc 1913;61(8):598).

10 Criteria:
1. Showing of graduates before state boards and other evidences
of the training received.
2. Enforcement of a satisfactory preliminary educational requirement,
granting of advanced standing, and the character of records.
3. Character of curriculum, grading of course, length of session, and
time allowed for matriculation and supervision.
4. Medical school buildings: light, heat, ventilation, cleanliness.
5. Laboratory facilities and Instruction.
6. Dispensary facilities and Instruction.
7. Hospital facilities and Instruction, maternity work, autopsies, and specialties.
8. Faculty, number, and qualifications of trained teachers, full-time
instructors, and assistants, especially of the laboratory branches, organization, and extent of research work.
9. Extent to which the school is conducted for properly teaching
the science of medicine rather than for the profit of the faculty
directly or indirectly.
10. Possession and use made of libraries, museums, charts, and stereopticons.

Announcements: April 17, 2009

CCNE Nano-Bio Seminar Series Presents Donald E. Ingber, MD, PhD, "From Biological Design Principles to Bioinspired Nanotechnologies": Tuesday, April 21st; Seminar & Discussion from 4:30-5:30 PM; Reception from 5:30-6:00 PM; in the Clark Auditorium, S001, Clark Building at Stanford University.

Donald E. Ingber, MD, PhD
Director, Wyss Institute for Biologically Inspired Engineering
Judah Folkman Professor of Vascular Biology, Harvard Medical School and Children's Hospital
Professor of Bioengineering, Harvard School of Engineering & Applied Sciences

Abstract:
The burgeoning field of Nanotechnology offers exciting new approaches to attack fundamental questions in biology, create smart medical devices, and positively impact human health. Creation of biologically-inspired nanotechnologies also could revolutionize how materials are designed and manufactured for industrial, aerospace, and military applications. But the fields are constrained by a lack of understanding of how living cells and tissues are constructed so that they exhibit their incredible organic properties, including their ability to change shape, move, grow, and self-heal. These are properties we strive to mimic, but we cannot yet build manmade materials that exhibit these features, or develop devices to selectively control these behaviors. To accomplish this, we must . . .

uncover the underlying design principles that govern how cells and tissues form and function as hierarchical assemblies of nanometer scale components. In this lecture, I will review work from my laboratory and others, which has begun to reveal these design principles that permit self-assembly of 3D structures with great robustness, mechanical strength, and biochemical efficiency, even though they are composed of many thousands of flexible molecular scale components. We also are beginning to understand that biological materials are simultaneously "structure and catalyst": the molecular lattices that form the frameworks of our cells and tissues combine mechanical functions and solid-phase biochemical processing activities. In the course of the lecture, I also will describe how recently developed nanotechnologies have been used to create model systems for biological studies, and how they have led to new approaches to interface living cells with microchips, control mammalian cell and tissue development, and probe the process of mechanotransduction--how cells sense mechanical forces and convert them into biochemical responses. Finally, the more fundamental question of how nanoscale structural networks impact information processing (signal transduction) networks to control cellular "decision-making" also will be explored. Understanding of these design principles that govern biological organization is critical for any nanotechnologist who wants to harness the power of biology.

Sponsored by: Center for Cancer Nanotechnology Excellence Focused on Therapy Response(CCNE-TR) Program--NIH/NCI U54

Hosted by: Sanjiv Sam Gambhir, MD, PhD, and the Departments of Radiology and Bioengineering

"The Good, the Bad, and the Ugly" in Imaging: Radio Interview by Dr. Pat Basu

Pat Basu, MBA, MD, chief radiology resident, was recently interviewed on RSNA On-the-Air regarding the appropriate use of imaging examinations. Dr. Basu's interview was sent to several nationally syndicated radio stations and was derived from his presentation at the 2008 Radiological Society of North America (RSNA) Conference entitled, "Creating A Patient Centered Radiology Facility: An Imaging Center Where Radiologists Interact Directly with Their Patients." To listen to his radio interview, please click on the link below.

Awards and Honors: December 8, 2008

Geoffrey D. Rubin, MD, professor of radiology; chief of cardiovascular imaging; associate dean for clinical affairs; and vice chief of staff, has been awarded a 2008 "Minnie" as the "Most Effective Radiology Educator" from AuntMinnie.com, which annually recognizes two outstanding imaging scientists or physicians in this category with individual Minnies. With 147,000 members, AuntMinnie.com is the world's largest and most comprehensive online medical imaging community. For Dr. Rubin's prior award posting, please access http://radiology.stanford.edu/blog/archives/2008/10/awards_and_hono_58.html.

Molecular Imaging Program at Stanford (MIPS) Retreat 2008

At this year's MIPS retreat on October 8th, approximately 116 people gathered at the Fogarty Winery in Woodside, California, located on Skyline Drive. One of the retreat highlights was the "Words of Wisdom" session, in which faculty shared some of the lessons they have learned along their career paths. Chris Contag, PhD, introduced the key speaker, Stanford Professor of Chemistry Paul Wender, who is also a professor (by courtesy) of chemical and systems biology as well as a member of the Bio-X Program and the Cancer Center. Dr. Wender's address was entitled "The Molecular Revolution and Our Molecular Future." Opening and closing remarks for the one-day retreat were delivered by Sanjiv Sam Gambhir, MD, PhD, professor of radiology and bioengineering, director of the Molecular Imaging Program at Stanford, and chief of the Nuclear Medicine Division.

Other highlights included a special presentation on the new departmental section, ISIS (Information Sciences in Imaging at Stanford), by Sylvia Plevritis, PhD; a roundtable discussion; wine tasting; and a prize drawing.

To view retreat photos provided by courtesy of Fred Chin, PhD, please access http://share.shutterfly.com/share/received/welcome.sfly?fid=0f6271b12853bb07&sid=0AaNG7ZqzbN2LDvg. You can read the 2007 MIPS retreat posting by accessing http://radiology.stanford.edu/blog/archives/2008/01/2007_mips_retre_1.html.

Stanford Radiology Welcomes Associate Chair for Education Michael Federle, MD

By Julie Ruiz, PhD

As our new associate chair for education, Michael Federle, MD, is transforming our educational programs at all levels, from medical students to practicing radiologists, by channeling the excellent technical and personal resources in our Department and on campus.

Since he arrived at Stanford this fall, he has been excited about the outpouring of support from faculty: "There are so many faculty members in our Department who are already integrating new teaching methods into the classroom and who are eager to play an important role in transforming education. One of the enticements for coming here was the opportunity to work with such bright and supportive colleagues." Dr. Federle has already initiated weekly teaching sessions with the body imaging fellows, and he will be taking an active role in our Continuing Medical Education (CME) Program. He is also working to ensure that there is dedicated space for radiology as part of the Immersive & Simulation-Based Learning Center at Stanford's Li Ka Shing Center for Learning and Knowledge.

Medical student education is one area in which Dr. Federle is also making a significant impact:

"I really think that Stanford medical students are not getting as much exposure to radiology as they should, and I want radiology to be part of their curriculum from day one and to play an integral role throughout all four years of their medical education." Towards this end, Dr. Federle has met with the Medical Student Curriculum Committee and with faculty from departments such as Anatomy to discuss improving and updating medical student education. As a result, Dr. Federle will be teaching part of the Anatomy course and integrating different teaching methods into the classroom, such as virtual dissections and 3D modeling. Overcoming the pervasive campus culture weighted towards new research and technological developments will be another challenge he will face in his new role as associate chair: "I have to work to assure that the clinical and educational parts of our mission are given their due time and resources to keep everything in balance."

Dr. Federle brings a wealth of expertise to our Department and its mission of improving health through excellence in image-based patient care, research, and education. He completed his undergraduate degree in biology at Marquette University in Milwaukee, Wisconsin, and went on to graduate from medical school at Georgetown University in Washington, D.C. After finishing his internship in internal medicine at the University of Cincinnati Hospital in Ohio, he decided that radiology was more interesting. He applied to and was accepted at the radiology residency program of the University of Cincinnati.

At the completion of his residency, Dr. Federle began teaching at the University of California, San Francisco, (UCSF) as a clinical instructor and then as a professor. As a clinical instructor, Dr. Federle had the opportunity to interact with many of his current Stanford colleagues such as Drs. Barth, Glazer, Herfkens, Jeffrey, and Van Dalsem. During his 10 years at UCSF, he served in a variety of prominent positions including chief of radiology; vice chair of radiology; section chief of CT body scanning and GI radiology; and chief of the medical staff. Prior to coming to our Department, he was the director of abdominal imaging for 16 of his 19 years at the University of Pittsburgh, where he also served as the chair of radiology as well as the chief of quality process and improvement.

Dr. Federle's interest in teaching began when he was an undergraduate: "I really enjoy finding new knowledge and transmitting it to others. It doesn't matter what the content is. So I studied biology as well as English and philosophy as an undergraduate; I thought I would end up teaching English. I eventually decided on medicine as a career even though I had no role models in the field because I come from a long line of farmers from southern Indiana." Throughout his career, his teaching duties have spanned the spectrum from teaching beginning medical students to teaching the most sophisticated subspecialty radiologists, and he has enjoyed the unique challenges of educating such a variety of audiences.

His numerous awards attest to his teaching talents. Dr. Federle has been awarded Teacher of the Year multiple times throughout his career. In 2007, the residents at the University of Pittsburgh created an award in his honor, the Michael P. Federle Mentorship Award. The residents developed this award to recognize Dr. Federle not only for his remarkable teaching but also for his service as a role model and mentor to future radiologists. In addition to his teaching, Dr. Federle's research accomplishments include 238 peer-reviewed journal articles and 17 books.

Dr. Federle is also a co-founder of Amirsys, which is a company that produces radiology textbooks to provide decision support to radiologists and to guide them in making diagnoses. He established the company along with Rick Harnsberger, MD, and Anne Osbourn, MD, neuroradiologists from the Radiology Department at the University of Utah, Salt Lake City. Each series that Amirsys publishes is based on the experiences of authors from around the country: "Our series of textbooks cover the entire spectrum of every specialty in radiology, and each have become the bestsellers in their field. Our online decision-support product, STATdx, is now used in several thousand radiology departments across the country including the great majority of training programs." Dr. Federle and his colleagues have just finished a new Expert Differential Diagnosis Series, which will be coming out at the 2008 Annual Conference of the Radiological Society of North America (RSNA). His contribution will be a section on the abdomen: "Writing for Amirsys is both a vocation and avocation; I really, really enjoy the whole process from gathering interesting cases to writing them up. I can lose myself for hours doing that."

After 19 years, Dr. Federle is excited to be back in the Bay Area and at Stanford: "I greatly admire my colleagues in Radiology. This is a satisfying and stimulating environment." Although he has been away from Stanford for many years, Dr. Federle's older son, Andrew, attended Stanford as an undergraduate. Andrew and his wife now live in Toronto, where he is an Episcopal priest. Dr. Federle's younger son, Tim, has performed on Broadway in New York, where he was part of the original cast of "The Little Mermaid." He is currently the choreographer and associate director for a new Broadway play, "The Prairie," which is based on the book series by Laura Ingalls Wilder.

When he's not in his office, you will probably find Dr. Federle on the Stanford golf course. At his golf course in Pittsburgh, he made a hole in one at the 15th hole from 165 yards away. He hopes to improve his shot at Stanford.

The Radiology Interest Group at Stanford (RIGS) "Meet and Greet" will include a panel discussion, a light dinner, and informal socializing with the faculty. Please bring your questions about radiology and life as a radiologist. Faculty from both diagnostic and interventional radiology at Stanford as well as residents and fellows will be present. Please RSVP to Bhargav Raman (ramanb@stanford.edu).

RIGS supports "interest in the field of radiology and provides advice to those who wish to pursue radiology as a career. RIGS holds events to provide medical students a better idea of what radiology is and what the various imaging specialties are, to guide those applying to residencies in this field, and to encourage women and minorities to consider a career in radiology; these events also allow medical students the opportunity to meet radiology physicians and residents. In addition, RIGS is a resource for those interested in research opportunities in the field of radiology" (from the RIGS Web site at http://rigs.stanford.edu/). Please contact Harpreet Dhatt (harpsd@gmail.com) for more information.

To read prior Radiology Interest Group at Stanford (RIGS) postings, please access http://radiology.stanford.edu/blog/archives/2007/11/radiology_inter_1.html and http://radiology.stanford.edu/blog/archives/2007/08/inside_terroris_1.html.

Dr. Basu Completes the 2008 J.T. Rutherford Government Relations Fellowship

(From left to right: Congressional Representative Bono, Dr. Basu, and Congressional Representative Mack)

This past summer, Chief Resident Pat Auveek Basu, MD, MBA, spent one week meeting with congressional members (please see a few of their photos below) as well as representatives of federal regulatory agencies in Washington D.C. as a Fellow in the J.T. Rutherford Government Relations Fellowship from the American College of Radiology (ACR). This fellowship exposed him to state and federal legislative and regulatory processes that directly affect the future of radiology. Dr. Basu described his fellowship as "a unique educational experience, an enriching professional opportunity, and a very productive endeavor." He summarized his experience as follows:

"Despite interning in Congress and working on a senate campaign, this was the deepest I have been immersed in the politics of the nation's Capitol. I met with lobbyists about issues we face in our practice; briefed an investment firm on my economic outlook for the industry; and attended seminars on policy and legal matters in radiology. However, the highlight was meeting with close to a dozen congressional representatives and senators to discuss matters pertaining to healthcare policy and economics. The discussion revolved around the recent passing of H.R. 6331, which prevented a drastic cut to physician salaries, mandated accreditation for performing CT and MRI scans, and defined appropriateness criteria for medical imaging. We also had detailed discussions on health reform and the importance of radiology in modern medicine. Recently, I arranged for Congresswoman Anna Eshoo to visit the Department of Radiology this fall.

My interactions with U.S. congressional representatives reminded me how critical it is to maintain and support government relations as our legislators can make broad sweeping changes with only a limited amount of information because they are dealing with such a broad range of issues. In many of my interactions with Congress and the Senate, I felt that I was providing new information to them. For example, several were not familiar with the fact that radiologists do NOT self refer and, thus, have little power over imaging growth. In addition, I educated them on the fact that radiologists have replaced many archaic diagnostic and therapeutic exams, which has led to cost savings and better health outcomes.

I believe that political advocacy is paramount for all radiologists and, that in the future, their patients' health may depend on such vigilance."

For prior blog entries regarding Dr. Basu's awards and honors, please access the following postings: Awards and Honors II: July 15, 2008; Awards and Honors: February 2007; Awards and Honors: August 13, 2007; and "Our New Chief Residents for 2008-2009."

(Dr. Basu and Congressional Representative Bean)

(Dr. Basu and Congressional Representative Davis)

(Dr. Basu and Congressional Representative Jackson)

(Dr. Basu and Congressional Representative Sullivan)

Stanford University Graduation 2008!

(Images courtesy of Aya Kamaya, MD)

On Sunday, June 15th, several of our radiology faculty (Drs. Gabi Gayer, Aya Kamaya, Justus Roos, and Geoff Rubin), along with Dr. Neetu Ahluwalia from Anesthesia, marched in Stanford University's 117th commencement ceremony in which Oprah Winfrey served as the commencement speaker. In front of 4,666 graduates and a crowd of 25,000, she delivered a 30-minute commencement address centered on "three lessons" dealing "with feelings, with failure, and with finding happiness" that have had the greatest influence over her life. To read the transcript of her address, please access http://news-service.stanford.edu/news/2008/june18/como-061808.html.

The breakdown of degrees for Stanford's Class of 2008 was as follows: 1,702 bachelor's degrees; 49 dual bachelor's degrees; 134 combined bachelor's and master's degrees; 2,017 master's degrees; and 947 doctoral degrees. Of the undergraduates, 90 graduated with multiple majors, and 407 completed minors. In terms of awards and honors, 340 undergraduates received departmental honors and 268 graduated with distinction. 83 of the undergraduates were from 37 different countries, and 940 of the graduate students came from 76 different countries (see "O in '08" by Adam Gorlick http://news-service.stanford.edu/news/2008/june18/com-061808.html).

Awards and Honors: July 9, 2008

Zongjin Li, PhD, MD, postdoctoral scholar in the Cardiovascular Gene and Cell Therapy Laboratory, is the recipient of five honors: a Travel Award to attend the 2008 International Society for Stem Cell Research (ISSCR) Annual Meeting; an American College of Cardiology Foundation (ACCF)/Bristol-Myers Squibb Travel Award from the American College of Cardiology; a finalist for the Young Investigators Awards Competition of the American College of Cardiology; an honorable mention in the Young Investigator of the Year Award Competition from the Stanford University School of Medicine Cardiovascular Institute; and a Mitzi and William Blahd, MD, Pilot Research Grant. Sponsored by the Education and Research Foundation for the Society of Nuclear Medicine, the Mitzi and William Blahd, MD, Pilot Research Grant is designed to support innovative ideas in clinical and basic research and is awarded to the highest-ranked proposal.

Dr. Li received his PhD degree from Peking Union Medical College in Beijing, China, and his MD degree from the Norman Bethune University of Medical Sciences in Changchun, China. At the Rizhao Hygiene College in China, he completed both his internship and residency in internal medicine and served as an attending physician in the Department of Cardiovascular Medicine. In September of 2005, Dr. Li joined Dr. Wu's Cardiovascular Gene and Cell Therapy Laboratory, where he researches the molecular imaging of stem cells for cardiovascular applications.

Awards and Honors: July 3, 2008

Priti Balchandani, PhD, postdoctoral scholar in the Radiological Sciences Laboratory (RSL), was a finalist for the I.I. Rabi Young Investigator Award at the 2008 International Society for Magnetic Resonance in Medicine (ISMRM) Annual Meeting. Named after Nobel Laureate Isidor I. Rabi, the Rabi Award honors "achievements in basic scientific research, especially focusing on novel technical developments." Out of the 38 abstracts on basic research, Dr. Balchandani's abstract was 1 of 3 chosen as a finalist. Her abstract featured her research in adiabatic RF pulse design. Along with her colleagues, Dr. Balchandani has developed the slice-selective tunable-flip adiabatic low peak-power excitation (STABLE) pulse. To read more about her award and research, please access "Young Investigator Awards Add Luster to MRI's Scientific Stars" featured online in the "Diagnostic Imaging ISMRM Conference Reporter." Dr. Balchandani's research interests include the development of high-field MR anatomic and spectroscopic imaging tools and novel RF pulse design for positive-contrast imaging of cells labeled with SPIO nanoparticles and sodium imaging of the brain at 7T.

Dr. Balchandani received her BS in computer engineering from the University of Waterloo, Waterloo, Canada, and completed her MS and PhD in electrical engineering at Stanford.

Welcome New Residents

By Teresa Newton

The Radiology Department is pleased to welcome our new first-year residents, who will begin on July 1st. We are also excited to announce the additions of Chivonne Harrigal, MD, and Bao Do, MD. Chivonne will be entering our second-year resident class, starting on July 1st. Bao has already joined our current second-year resident class and, on July 1st, will begin his third year of residency.

Our first-year residents are

Stacey Crawford Keel, MD, MBA
Albert Hsiao, MD, PhD
Michael Kim, MD
Deborah Lee Abelson, MD
Jared Narvid, MD
Srihari Sampath, MD, PhD, MPhil
Srinath Sampath, MD, PhD, MPhil
Anobel Tamrazi, MD, PhD
Amy White, MD

(For additional information on our new first-year residents, please see "Match Day, March 15, 2007")

Please join us in warmly welcoming our new residents, and lending a hand to help them feel at home here at Stanford.

To read their biographies and view their photos, please click on the link below.

Stacey Crawford Keel, MD, MBA

Stacey comes to us from Ohio, where her father is a radiologist, which may have sparked her interest in this field. After a successful career at Northwestern, she completed her medical education at Dartmouth Medical School while simultaneously pursuing her MBA at the Tuck School of Business. She plans to pursue a career influencing medical education by integrating the organizational behavior and general management skills of the MBA into the curriculum for physicians-in-training. In her free time, she indulges in her love of animals by volunteering at her local humane society, as well as taking care of her own dog and two cats. She is a big fan of outdoor sports and enjoys traveling, especially to visit her extended family.

Bao Do, MD

Bao comes from the University of Iowa but grew up in Silicon Valley, where he was heavily influenced by technology. However, he chose to study biochemistry and economics at the University of California, Davis, over electrical engineering and computer science at the University of California, Berkeley, because the last thing he wanted to do was sit in front of a computer all day. Alas, fate has caught up to Bao as he pursues radiology. Ironically, he is currently developing a "negation" search algorithm with his friend Andrew Wu that explicitly finds the exact opposite of what a user wants. Bao's other interests include web programming, the NBA, and sushi. Bao will be joining our third-year class in July.

Chivonne Harrigal, MD

Chivonne was born in New Orleans and also grew up in Bakersfield, Denver, and Dallas. She earned her BS and MD degrees from the University of Pittsburgh. She began her residency at the University of Arizona, but she is transferring to our program to complete it. Chivonne will join us July 1, 2008, as a second-year resident. When she has time, she pursues her interests in running, scuba diving, cooking, and traveling.

Albert Hsiao, MD, PhD

Albert is happy to join his radiology colleagues after a year of general surgery internship at Stanford. After studying science and engineering at Caltech, he chose to enter medical school at the University of California, San Diego, where he completed a PhD program in bioengineering. He spent much of this time studying math, physics, and computation, visiting his soon-to-be wife at Stanford, training in martial arts, playing tennis, and surfing. He eventually completed medical school, got married, adopted cats, and spent a productive year learning general and subspecialty surgery.

Michael JJ Kim, MD

Michael was born and raised in Nutley, New Jersey, where he stayed close to home for his undergraduate career at Rutgers University, graduating summa cum laude with a degree in genetics. Afterwards, he attended Weill Medical College of Cornell University in New York City, where he developed his interest in radiology and met his fiancee. "JJ" recently became engaged, surprising his fiancee with a loudspeaker balcony proposal where they first met at Barnes and Noble in Nutley. For fun, Michael enjoys many sports including tennis and golf, sharing new experiences with friends and family, and learning about public policy issues.

Deborah Lee Abelson, MD

Debbie, from southern California, went to the University of Southern California for her undergraduate degree. She received her medical degree from the University of California, Los Angeles, David Geffen School of Medicine. When not working, Debbie enjoys spending time with family, exploring the Bay Area, travelling abroad, and learning guitar.

Jared Narvid, MD

Born in California, Jared attended Yale University as an undergraduate. He earned his medical degree at the University of California, San Francisco. When not involved in research, Jared entertains himself by bicycling, playing tennis, roasting coffee, and playing jazz guitar.

Srihari Sampath, MD, PhD, MPhil

Srihari is a southern Californian. He completed his BA and MD degrees at Cornell University; his MPhil at the University of Cambridge; and his PhD at the Rockefeller University in New York. He is now excited to return to the Palo Alto underground, where he plans to pursue his interests in radiology, the Lakers, and indie rock. Srihari joins us at Stanford with his twin, Srinath Sampath, who is also in radiology.

Srinath Sampath, MD, PhD, MPhil

Srinath, a native Californian, earned his BA at Cornell University. He went on to complete his MPhil at Cambridge University in the United Kingdom; his PhD at the Rockefeller University in New York; and his MD at Cornell University Medical College. When asked to describe himself, Srinath offered the following: "When not actively having my life's dreams appropriated by my brother, I like to relax listening to classic and indie rock--either that or surfing PubMed. And though I don't always drink beer, when I do, I prefer Dos Equis." Srinath is here with his twin, Srihari Sampath, who is also in radiology.

Anobel Tamrazi, MD, PhD

Anobel started out in the Bay Area and attended San Jose State University for his BS. He earned his PhD from the University of Illinois at Urbana-Champaign, and his MD from the University of Illinois College of Medicine. He did his internship on the East Coast before returning to California for his radiology residency. When he gets a break in his schedule, he enjoys traveling and photography.

Amy White, MD

Amy is a returning California native. After earning her BS at the University of California, Santa Barbara, she studied for her MD at Georgetown University School of Medicine. She is sure to find a welcome home for her interests here, as both she and her husband are avid cyclists. In her remaining spare time, she enjoys practicing yoga.

Awards and Honors: June 24, 2008

Dr. Sanjiv Sam Gambhir, MD, PhD, director of the Molecular Imaging Program at Stanford (MIPS), professor of Radiology and Bioengineering, and head of the Nuclear Medicine Division, has received two honors: the Tesla Medal and induction into the American Society of Clinical Investigation (ASCI). Dr. Gambhir was awarded the Tesla Medal from the United Kingdom Royal College of Radiologists (RCR) for his research in the multimodality molecular imaging of living subjects. Established in England, the RCR can trace its beginnings to the Roentgen Society, which was founded in 1897. The Royal College of Radiologists (RCR) has approximately 7,600 members and Fellows all over the world whose goal is to advance the science and practice of radiology and oncology. Dr. Gambhir received his second honor at the one hundred year anniversary of the American Society of Clinical Investigation (ASCI) in 2008. At this anniversary meeting, Dr. Gambhir was inducted as a member of the ASCI, which is an honor society for physician-scientists. Election to the ASCI is an "extraordinary honor in academic medicine and industry" and is bestowed upon those who have achieved "significant accomplishments at a relatively early age." The ASCI is dedicated to advancing the research of human disease and to mentoring future generations of physician-scientists.

Dr. Gambhir has over 20 years of experience in molecular imaging in both animal models and patients. He has an active laboratory, with over 20 postdoctoral fellows and graduate students, that focuses on developing molecular imaging assays in small animal models for translation into clinical applications. Dr. Gambhir also has over 270 publications in the field of molecular imaging and leads several large NCI-funded programs, such as the In Vivo Cellular Molecular Imaging Center (ICMIC); the Center for Nanotechnology Excellence Focused on Therapy Response (CCNE-TR); and the Stanford Molecular Imaging Scholars (SMIS) Program. Dr. Gambhir is a member of the NCI Scientific Advisory Board; is past president (2006) of the Academy of Molecular Imaging; and serves on the board of several other societies. He is also on the editorial boards of several journals.

Awards and Honors: June 23, 2008

Joseph Wu, MD, PhD, assistant professor of medicine (cardiology) and radiology, has been selected as a 2008 Baxter Faculty Scholar. The Donald E. and Delia B. Baxter Foundation Faculty Scholar Program Awards provide support to new assistant professors to help in the early stages of their research careers. To learn more about Dr. Wu's research, please visit his lab at http://mips.stanford.edu/research/lab?lab%5fid=2883.

Awards and Honors: June 23, 2008

Michael Zeineh, MD, PhD, neuroradiology fellow, has been awarded a research fellow grant from the Radiological Society of North America Research and Education Foundation for his project, "Ultra-High Resolution Clinical Imaging of the Human Medial Temporal Lobe with 7T MRI." Dr. Zeineh has just finished his radiology residency in our Department. He completed his internship as well as received his medical and graduate degrees at the University of California, Los Angeles, (UCLA). Dr. Zeineh is also a GE Radiology Seed Funding Recipient and received the 2003 Emil Bogen Research Prize in recognition of his work. His current research interests include the development and application of ultra-high resolution 7T MRI of the human medial temporal lobe with clinical applications to Alzheimer's disease and epilepsy.

Awards and Honors: April 30, 2008

Rebecca Fahrig, PhD, assistant professor of radiology, has been selected as one of sixteen School of Medicine Faculty Fellows for 2008. Over the next year, the Fellows will meet monthly for leadership meetings with invited faculty who will serve as role models. In addition, they will attend small mentoring groups led by senior faculty mentors and will devise a career development plan. The Faculty Fellows were nominated by their departmental chairs and were ranked by the Faculty Fellow Review Committee based on their "leadership potential and demonstrated commitment to building diversity."

Before joining our Department as an assistant professor, Dr. Fahrig completed her PhD in medical biophysics at the University of Western Ontario and a postdoctoral fellowship at Stanford University. She has won numerous awards including the Greenfield Award for the Best Paper (nonradiation dosimetry) published in Medical Physics in 2005; the Fellowship Research Trainee Prize (along with Zhu, PhD, candidate) from the Radiological Society of North America (RSNA) Physics Subcommittee; and the Faculty Scholar in Translational Research Award from the Baxter Foundation. Dr. Fahrig's research focuses on imaging for guidance of minimally invasive procedures. She works on software and hardware that permit the use of a C-arm system for both fluoroscopy and CT imaging, and she has extended the applications of C-arm CT to retrospectively gated 3D/4D cardiac imaging in the interventional suite. She is also developing an MR-compatible X-ray fluoroscopy system, including a new rotating-anode X-ray tube for use in the fringe fields of 1.5T and 3.0T magnets.

New Faculty Hires and Promotions: April 24, 2008

Debra Ikeda, MD, director of the Stanford University breast imaging section, has been promoted to full professor of radiology. For 16 years, Dr. Ikeda has served as the director of the breast imaging section. Prior to coming to Stanford, she received her medical degree from the University of Connecticut, Farmington, and completed her internship and residency in radiology at the University of Michigan, Ann Arbor. After completing fellowships at the University of San Francisco Medical Center and Malmo General Hospital in Sweden, Dr. Ikeda came to Stanford to build our breast imaging section into a state-of-the-art center. She has developed and led two of the leading CME courses in the world of breast imaging, each attended by over 300 participants. She has also been very active in teaching our residents and fellows and was awarded "Teacher of the Year" for her efforts. Her achievements include chairing the American College of Radiology (ACR) BIRADS Lexicon Committee, which resulted in the publication of the ACR MRI BIRADS text that is used to report breast MRI throughout the world. Dr. Ikeda's research focuses on the roles and limitations of breast cancer detection and imaging using X-ray methods, ultrasonography, and MRI. New research involves imaging of Asian women, evaluation of breast density, imaging of accelerated partial breast irradiation, optical imaging, and digital mammography with CAD.

(Image courtesy of Mark Riesenberger)

Announcements: March 3, 2008

Dr. Alexej Jerschow to Deliver Talk Entitled "23Na and 1H CEST MRI: Contrast in Cartilage and Intervertebral Disc": Friday, March 7th, at 10:00 AM in the Clark Center Auditorium. Associate Professor Alexej Jerschow, from the Department of Chemistry at New York University (NYU), will be visiting Stanford on March 7th to give a talk on his novel work at high field. He will be visiting the Lucas Center afterwards to see our facilities and to meet our scientists over lunch. For more information, please see his abstract below and/or contact Dr. Garry Gold.

ABSTRACT:
Glycosaminogycan (GAG) plays numerous vital functions in the human body. GAG concentration [GAG] in vivo is a sensitive biomarker indicative of both osteoarthritis (OA) and intervertebral disc (IVD) degenerative diseases. By exploiting the exchangeable protons of GAG, we demonstrate that one can directly map the localized GAG concentration in vivo using a chemical exchange saturation transfer (CEST) method. This gagCEST approach is presented on both human cartilage and animal discs. We also show the observation of the Nuclear Overhauser Effect (NOE) from macromolecules in tissue, which contributes significantly to the CEST/MT contrast mechanism in MRI and may lead to further diagnostic abilities. GAG contrast may also be enhanced by employing intermolecular multiple-quantum coherences.

Monitoring the bound sodium pool can be an important tool for assessing the onset of tissue disorders. Practical clinical 23Na MRI methods, furthermore, often do not allow one to use sufficiently small voxel sizes such that only the tissue of interest is seen, and a large signal contamination can arise from sodium in synovial fluid. Methods are presented for the clean separation between the signal from bound or ordered 23Na over that of free 23Na, which is particularly important and can greatly enhance the potential of 23Na-MRI as a diagnostic tool. 23Na MRI also offers the possibility of monitoring local anisotropic motion. 3T and 7T in vivo volumetric 23Na images are presented. Monitoring GAGs via 23Na or CEST can also be important for assessing heart valves or corneae.

References:
W. Ling, R. R. Regatte, G. Navon, A. Jerschow, Assessment of Glycosaminoglycan Concentration in Vivo by Chemical Exchange Saturation Transfer (gagCEST). Proc. Nat. Acad. Sci. USA, in press 2008, http://www.pnas.org/cgi/content/abstract/0707666105v1.

W. Ling, R. R. Regatte, M. E. Schweitzer, A. Jerschow. Characterization of Bovine Patellar Cartilage by NMR. NMR Biomed., in press 2008, http://www3.interscience.wiley.com/cgi-bin/abstract/114294661/ABSTRACT.

Awards and Honors: March 3, 2008

(Drs. Ganguly and Pelc)

Arundhuti (Arun) Ganguly, PhD, research associate, received an Honorable Mention Award for her poster entitled "On the Angular Distribution of Bremsstrahlung" at the 2008 Society of Photo-Optical Instrumentation Engineers (SPIE) "Physics of Medical Imaging" Conference in San Diego in February of 2008. She co-authored this poster and an associated conference paper with Professor Norbert Pelc. Only five candidates were selected for this award out of 120 submissions. Working with Professors Rebecca Fahrig, PhD, and Norbert Pelc, PhD, Dr. Ganguly has been a research associate in Radiology since 2004. She has also received the Sylvia Sorkin Greenfield Co-Author Award for the Best Paper in Medical Physics (2005), and she was a co-recipient of the Young Investigator Award from the Association for Advancement of Medical Instrumentation (AAMI) in 2004. Prior to becoming a research associate, Dr. Ganguly was a postdoctoral fellow at Stanford working with Professors Fahrig and Pelc. Dr. Ganguly received her doctoral degree from the State University of New York (SUNY) Buffalo, New York, in physics. While at Stanford, she has participated in the development of a truly hybrid X-ray/MR system at Stanford. Her primary interest is in the development of image-guidance technologies for minimally invasive procedures. Her current research includes the development of imaging protocols using a C-arm CT system, the synthesis of novel targeted imaging contrast agents, and X-ray detector development work.

The Richard M. Lucas Center for Imaging Celebrates Over 15 Years of Service

The Richard M. Lucas Center for Imaging in 1992 (left) and 2008 (right).

By Julie Ruiz, PhD
(Images courtesy of Mark Riesenberger)

At the dedication of the Richard M. Lucas Center for Magnetic Resonance Spectroscopy and Imaging on May 19, 1992, the Nobel Prize winner in chemistry from Zurich, Switzerland, Professor Richard Ernst, envisioned no limits to MR technology: "The only property of the body that one hasn't found with MR is the soul." While we still haven't imaged the soul, our imaging technology has greatly advanced since the opening of the Lucas Center 15 years ago.

The Lucas Center emanated from Dr. Gary Glazer's vision of creating a premier imaging research program to enhance the clinical research efforts of the Department. When he became chair of Stanford Radiology in 1989, the diagnostic radiology offices and research space were limited to one basement corridor in the Grant Building. Dr. Glazer invited Drs. Gary Glover, PhD, and Norbert Pelc, PhD, to Stanford to form a basic science team. They initiated the beginnings of the Radiological Sciences Laboratory (RSL), which was first housed in the Grant Building and then moved to the Lucas Center upon its completion in 1992. Donna Cronister was hired in 1990 as the RSL administrative services manager and became the administrative director for the Lucas Service Center in 1992.

Construction of the Lucas Center began in 1990 funded by the Richard M. Lucas Foundation. Don Lucas, venture capitalist and Stanford graduate, had started the foundation in honor of his older brother, Richard, who died of cancer in 1981. The Lucas Center was finished by 1992, adding approximately 12,500 square feet to our Department. Scientists at the Lucas Center in 1992 conducted 30 research studies using one 1.5T MRI scanner (human); one 4.7T MRI (animal); and one 9T MRI scanner (tissue). The total NIH funding in 1992 was about $1 million.

(Don, Mary, and John Lucas with Peter Bing (L) at the 1992 dedication ceremony for the opening of the Lucas Center. John, Mary, and Don (R) in front of the bust dedicated to Richard M. Lucas.)

By 1993, RSL had doubled the number of its faculty by adding Sandy Napel, PhD, in 1991 and Michael Moseley, PhD, in 1993. Dan Spielman, PhD, joined RSL as a research affiliate in 1990 and became an assistant professor in 1993. There were also two postdoctoral fellows and six scientific staff members including Tom Brosnan, PhD; Lori Pelc, PhD; and Anne Marie Sawyer, RRT.

In the years following its opening, the Lucas Center experienced unprecedented growth. In 1995, Dr. Glover received funding from the National Cancer Institute (NCI) to launch a full-scale academic radiology training program at the Lucas Center: the Center for Advanced Magnetic Resonance Technology at Stanford (CAMRT). Funded through 2010, the CAMRT joins the resources of RSL with those of the Electrical Engineering Department's Magnetic Resonance Systems Research Laboratory. From 1997 to 1998, the Lucas Center was expanded, adding 5,000 square feet to its facilities. As part of this expansion, the 3D Medical Imaging Laboratory, which had been in the Grant Building, moved to the Lucas Center, and we became one of the first research programs to install a 3T MR magnet.

(Pictures from the first expansion.)

The second expansion of the Lucas Center occurred between the years 2003 to 2005 and added an additional 20,000 square feet of space, making our Center one of the world's largest academic centers for medical imaging. With the second expansion, the Lucas Center also acquired a 7T whole-body magnet; a cyclotron to produce isotopes; more wet labs and offices for developing our Molecular Imaging Program at Stanford (MIPS); and a unique education center equipped with the latest technology for fully interactive imaging seminars. Because of its high quality and innovative design, our Center 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).

(2004 view of the Lucas Center from the roof during the second expansion.)

After fifteen years and two expansions, the Richard M. Lucas Center for Imaging now houses 15 faculty members in RSL; 2 radiology faculty members in the Molecular Imaging Program at Stanford (MIPS); and over 70 graduate students and postdoctoral scholars. During the past year, our scientists conducted over 300 studies on our three magnets (a 1.5T, 3T, and 7T). With the remarkable increase in scanning speed and resolution of the 7T, we are imaging brain structures that have not been visualized before. We have also initiated two new research programs: high-intensity focused ultrasound and hyperpolarized C13 MR.

Since the opening of the Lucas Center, we have expanded our scope beyond MRI to include cellular and molecular imaging, moving us into the era of nanotechnology. To reflect the extension of our scope, the Lucas Center was renamed the "Richard M. Lucas Center for Imaging" in 2007. The Richard M. Lucas Center has also grown into a major resource for service in medical imaging. From January 1, 2006, to February 28, 2007, the Lucas Center supplied imaging services to over 70 projects and to 45 principal investigators (PIs).

Those who were present at the inception of the Lucas Center shared their impressions. Dr. Glover remembers standing in his Grant Building office just before the move into the new Lucas Center in 1992 and talking with Gary Glazer, MD, who asked him, "Did you ever think we'd get this big?" Gary Glover responded, "No, not to the point of needing a new building." In fact, shortly after the move into the Lucas Center and after each expansion, the Lucas personnel quickly outgrew their space. "The enthusiasm and excitement surrounding our research is fueled by having the best faculty and students in the world and incredible support from Gary Glazer," Gary Glover remarked. "Most radiology research programs do not have the support our lab has received from their Department chairs. Gary has made it easy for me and my colleagues by fostering such a large investment in research. Indeed, he has been the driving force behind the success of our Department's research enterprise. One result of his vision and enthusiasm for research is that we have retained all but one of our faculty over the past 18 years."

Gary Glover has tried to grow the RSL and Lucas Center and still retain a community: "It's harder maintaining cohesion with 90 people as opposed to 10 people, but I think we have succeeded in keeping comradery and closeness." Reflecting back on his years as part of RSL, Tom Brosnan, PhD, also remembers how small the lab was in 1991: "There weren't enough people for a softball team, but every Friday at 5 PM we had a party and everyone brought food. We even had an annual lab ski trip, but the lab is too big for that now." When RSL moved from the Grant Building to the Lucas Center in 1992, Dr. Brosnan thought, "We'll never fill up all of this space!" The biggest change for him has been the significant growth in personnel and in the nature of his projects: "There are more projects to do now, and they are more complex. In retrospect, the work I did initially for RSL seems simpler than what I'm doing now."

In the future, we anticipate "Lucas Three," the third expansion of our Center to support growth in anatomic imaging, molecular imaging, and nanotechnology. We will continue to promote interdisciplinary translational research through our recent "Academic Initiatives": the Stanford Center for Early Neoplasia Detection; the Aging Brain and Cognitive Disorders; and Image-Guided Therapy. Our investments in our translational research efforts have already resulted in the establishment of three NIH-funded centers that complement the efforts of the Lucas Center: 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). As we continue to build better tools for imaging structure and function, we hope to make a large impact on medicine and biology.

Awards and Honors: February 12, 2008

The Journal of the American College of Cardiology (JACC) recently featured research from the Multimodality Molecular Imaging Lab (MMIL) and the Yock lab on the cover of their February 5, 2008, V. 51:5 issue. To view their abstract from this issue on the noninvasive imaging of reporter genes after percutaneous delivery in swine, please access http://content.onlinejacc.org/cgi/content/full/51/5/595. Members of MMIL are developing imaging assays to interrogate cells for mRNA levels, cell surface antigens, intracellular proteins, and protein-protein interactions using technologies such as micro positron emission tomography (microPET), bioluminescence optical imaging, fluorescence optical imaging, micro computerized axial tomography (microCAT), ultrasound, and photoacoustics.

Awards and Honors: February 8, 2008

Natesh Parashurama, MD, PhD, postdoctoral scholar in the Multimodality Molecular Imaging Lab (MMIL), has received two awards: a Speaker and Travel Award for the Stem Cell Bioengineering Conference (American Institute of Chemical Engineers AICHE) and a 2008-2009 Dean's Fellowship for his proposal, "Molecular Imaging of the Cardiac Stem Cell Niche." Dr. Parashurama received his BS in chemical engineering from MIT; his medical degree from the State University of New York at Buffalo; his PhD in chemical engineering from Rutgers University, New Jersey; and a three-year graduate research fellowship at Harvard Medical School. Dr. Parashurama's research interests include applying quantitative molecular imaging tools to study cell proliferation and differentiation; cell function; the cellular micro-environment; cell trafficking and homing; the immune response; and cell therapy-mediated gene therapy.

Dr. Lawrence "Rusty" Hofmann Featured in AuntMinnie.com

By Julie Ruiz, PhD

Rusty Hofmann, MD, chief of interventional radiology, was recently featured in an AuntMinnie.com article by Edward Susman, "Imaging Set to Play Pivotal Role for Delivering Molecular Therapeutics." The article is based on Dr. Hofmann's presentation at the 2008 International Symposium on Endovascular Therapy (ISET) meeting in which he highlighted the importance of imaging in molecular therapeutics: "In human trials, there is no way to monitor the appropriate site to inject the drugs, to monitor delivery of the drugs, to monitor how the drugs traffic in the body, and no way to monitor how those drugs engraft." The injection of molecular agents in combination with imaging guidance can help resolve these problems by improving drug delivery. For the full text of "Imaging Set to Play Pivotal Role for Delivering Molecular Therapeutics," please access http://www.auntminnie.com/print/print.asp?sec=sup&sub=adv&pag=dis&ItemId=79852&d=1.

ISET celebrated its 20th anniversary at the 2008 conference in Hollywood, Florida. Attended by leaders in interventional cardiology, interventional radiology, and vascular specialties, this conference provides the most current noninvasive techniques for the diagnosis and treatment of vascular diseases through live case demonstrations. Conference presentations included ground-breaking research on topics such as gender differences in the endovascular repair of abdominal aortic aneurysms; outpatient uterine fibroid embolizations; the benefits of treating pregnant women who have DVT; and the use of anti-platelet therapy to reduce the risk of heart attack and stroke in PAD patients.

(Image courtesy of Mark Riesenberger)

Visiting Faculty: January 31, 2008

Hadassa Degani, PhD, is a recent visitor to our Department and on sabbatical from the Weizmann Institute of Science in Israel. Professor Degani has also spent a sabbatical year at Yale University and at the Pasteur Institute, as well as summers at the University of Oxford; University of the UK; Fox Chase Cancer Center in Philadelphia; and the University of Pennsylvania, where she also serves as an adjunct professor. She is known internationally for her work in MR imaging of breast cancer and, more recently, for her work on prostate cancer. She received a BSc in chemistry from the Hebrew University of Jerusalem in 1966, an MSc in physical chemistry from the Weizmann Institute of Science in 1969, and a PhD in chemistry from the State University of New York at Stony Brook in 1974. Her postdoctoral research was carried out both at Stony Brook and at the University of Tel-Aviv. In 1976, she joined the staff of the Weizmann Institute; she currently serves as a full professor in the Department of Biological Regulation and the Willner Family Center for Vascular Biology. Professor Degani is the incumbent of the Fred and Andrea Fallek Professorial Chair for Breast Cancer Research.

Professor Degani's research focuses on the development of magnetic resonance imaging and spectroscopy in biomedical research and the integration of these state-of-the-art methodologies with modern molecular biology. Specifically, her research centers on the hormonal regulation of breast cancer, as well as the role of blood vessels in the progression and metastasis of this malignancy. She and her colleagues use magnetic resonance to detect and diagnose breast and prostate cancer and to monitor the effectiveness of cancer therapy. For more information on her research and publications, please access http://www.weizmann.ac.il/Biological_Regulation/degani/. Professor Hadassa Degani and her husband, Dr. Gabriel D. Degani, have two daughters and a son; they also enjoy being grandparents to three grandchildren.

New Faculty Hires and Promotions: January 23, 2008

Zhen Cheng, PhD, became an assistant professor (research) of radiology and member of the Molecular Imaging Program at Stanford (MIPS) in September of 2007. He was an undergraduate at Sichuan University, where he received his Bachelor of Science degree in chemistry. Dr. Cheng also holds an MS from the National Research Center of Isotope Engineering and Technology & China Institute of Atomic Energy and a PhD from the Department of Chemistry at the University of Missouri-Columbia. From 2001 to 2003, he was a postdoctoral fellow in the Department of Radiology at Harvard Medical School. His awards include a Young Investigator Travel Scholarship to attend the 2005 Academy of Molecular Imaging Annual Conference and a 1997-1998 graduate fellowship at the University of Missouri-Columbia. Dr. Cheng is currently a member of the Cancer Molecular Imaging Chemistry Laboratory (CMICL) of MIPS where he is developing novel molecular imaging probes and non-invasive techniques for the early detection of cancer and its metastasis. He is also researching the molecular, metabolic, and physiological characteristics of cancers and their responses to therapy by identifying novel cancer biomarkers with significant clinical relevance; by devising new chemistry for the preparation of probes; and by validating new strategies for probes by using high-throughput screening.

(Image courtesy of Mark Riesenberger)

New Faculty Hires and Promotions: January 23, 2008

Aya Kamaya, MD, was appointed as an assistant professor in the abdominal imaging section of the Radiology Department on October 1, 2007. Since the completion of her fellowship in body imaging at Stanford in 2005, she has been a clinical instructor and clinical assistant professor in the abdominal imaging section at Stanford. During this time, she was given two teaching awards for her outstanding contributions to resident education, compassionate patient care, and research. She is currently the assistant fellowship director of the Stanford Body Imaging Fellowship. Prior to coming to Stanford for her fellowship, she completed her residency in diagnostic radiology at the University of Michigan, Ann Arbor, where she was awarded the Executive Council Award from the American Roentgen Ray Society for her work on "Color Doppler Twinkling Artifact" and the Laurence A. Mack Research Award from the Society of Radiologists in Ultrasound for her work on "Linear Streak Artifact." She completed medical school at the University of Utah in her hometown of Salt Lake City. As an undergraduate, she double majored in engineering sciences and Asian Studies, securing her two bachelor's degrees at Dartmouth College in Hanover, New Hampshire. Her research interests include investigating new ultrasound technologies such as photoacoustic ultrasound, in conjunction with the Electrical Engineering Department at Stanford; liver imaging; and women's imaging. Outside of work, her favorite activities include skiing and snowboarding through powder (her favorite ski resort is Snowbird, UT), as well as running at the Stanford Dish, surfing, and traveling.

(Image courtesy of Mark Riesenberger)

Announcements IV: January 23, 2008

Special Seminar Series on Radiological Informatics: As part of a special series on radiological informatics, we are offering seminars on Jan. 23rd, 24th, 28th, and 31st. Please click on the "Continue Reading This Entry" link below to find the title of each talk as well as the presenter's abstract and biography. For more information, please contact Dr. Sandy Napel.

1) Wednesday, January 23rd, at noon; Alway M104
Julia Patriarche, PhD
Mayo Clinic

Title:
"Detection of Change in Serial Magnetic Resonance Studies of Brain Tumor Patients"

Abstract:
The comparison of serial magnetic resonance imaging studies is a common task in clinical radiology. It is, however, widely considered not to be very reproducible. There are a variety of reasons for this, including the confounding of disease-related changes with acquisition-related changes and issues related to information presentation. We have constructed a computational system that performs the comparison of serial magnetic resonance imaging studies and presents changes in the form of a color-coded change map, superimposed on the anatomical images. The system additionally formats the output as a quantitative summary. We used this quantitative summary to conduct a study with 88 brain tumor serial comparisons. Our results were suggestive that it may be possible to use the change detector to identify cancer changes months earlier than is possible using manual inspection, alone.

We have recently implemented an integrated system for the change detector, which includes a graphical user interface (GUI). The GUI not only displays the color-coded change map, but also allows the user to turn it on and off. The GUI provides linked cursors, and it additionally provides "flicker" functionality to allow the user to rapidly alternate between the serial acquisitions. We are preparing to deploy the GUI change detector clinically, which will greatly increase the size and variety of possible future research studies and which will allow the direct clinical application of this technology.

The change detector is an example of a layered artificial intelligence (AI) architecture in which each layer builds upon the layer below, with each layer accomplishing progressively more sophisticated analyses. Specifically, the change detector is built on a lesion-finder application. The lesion finder is built on an automated sample point's algorithm. The automated sample point's algorithm is built on a significant region detection algorithm. Each of these algorithms has merit in its own right, and each can be used in a modular fashion in a variety of contexts. As a unified application, they together automatically address a complex clinical task. Early detection of changes may facilitate improved care through more rapid intervention following recurrence. It may also facilitate screening and personalized therapy. We additionally see the change detector as providing a solution to the problem of novel therapy comparison, by providing fully automatic, reproducible, and quantitative measures of change. We envision the change detector as a model of layered artificial intelligence, not only freeing the radiologist from the drudgery of information overload, but providing a model whereby greater information will enable many sophisticated automatic analyses by the computer, with the computer bringing to the attention of the clinician only what is relevant.

Biography:
Julia Patriarche is an informatics fellow in the Radiology Informatics Lab at the Mayo Clinic College of Medicine. She has completed an undergraduate degree in electrical engineering/computer engineering option at Queen's University in Kingston, Canada; a PhD in medical science/medical imaging; and a neurology fellowship at the Mayo Clinic College of Medicine.

2) Thursday, January 24th, at noon; Alway M112
Ross Mitchell, PhD
University of Calgary

Title:
"Virtual Biopsies: Non-Invasive Molecular Diagnosis"

Abstract:
Our expanding knowledge of the genetic basis and molecular mechanisms of cancer is beginning to revolutionize the practice of clinical oncology. Increasingly, molecular biomarkers of prognosis and treatment response are being used to classify tumors and direct treatment decisions. Advanced medical imaging platforms such as MRI, PET, and CT provide incredibly detailed images of tumors that reflect their structure, biochemistry, physiology, and perhaps genetics.

Studies by the Imaging Informatics Lab at the University of Calgary, and others, show that information about a tumor's molecular phenotype can be obtained by using novel algorithms and computational tools to more fully analyze tumor images. Such "virtual biopsies," performed by applying these image-processing techniques to routine diagnostic images (e.g. MRI, PET, or CT), could be a rapid and powerful means of assaying important cancer biomarkers. If successfully validated, and proven to have suitable sensitivity and specificity, the use of non-invasive, imaging-based molecular diagnostic tests would offer significant advantages over conventional surgical biopsies. For example, this could be important in the context of large heterogeneous tumors, multiple metastases, surgically inaccessible tumors, and settings where disease progression needs to be monitored frequently over time. Virtual biopsy research lies at the intersection of molecular imaging, medical imaging physics, and biocomputation, and is highly complementary to these areas. This presentation will cover key enabling technologies behind virtual biopsies and discuss some recent successes in this research.

Biography:
Dr. Ross Mitchell is an associate professor of the Departments of Radiology and Clinical Neurosciences and an adjunct professor of the Department of Computer Science at the University of Calgary. He is also the founding and chief scientist of Calgary Scientific Incorporated, a Multiple Sclerosis Society of Canada; a Donald Paty Scholar; and an Alberta Heritage Foundation for Medical Research Senior Scholar. Dr. Mitchell has received numerous awards for his research including the Berlex Canada MS Research Award; several Dean's Awards of Excellence from the University of Western Ontario; Best Paper Awards from the Canadian Association of Radiologists and the International Organization for Medical Physics; and two Awards of Merit from the Radiological Society of North America. Dr. Mitchell has a proven research track-record comprising 11 patents, 73 invited presentations, 63 peer-reviewed articles, and 150 published abstracts.

Dr. Mitchell supervises a research team investigating space/frequency analysis, medical image processing, as well as segmentation and visualization technologies. For more information, please see, http://www.ImagingInformatics.ca.

3) Monday, January 28th, at noon; Alway M104
Jianming Liang, PhD
Siemens Medical Solutions USA Inc., Malvern, PA

Title:
"Dynamic Chest Image Analysis, United Snakes, and
Computer-Aided Detection"

Abstract:
Modern medical imaging systems generate enormous datasets with ever higher coverage and resolution, but it is the clinically relevant information in these images that is paramount. I shall present several novel computational approaches for gleaning such information from chest X-ray images to reveal pulmonary functional abnormalities, for segmenting and characterizing organ motions, and for detecting the most lethal diseases from CT images, including pulmonary embolism and colonic polyps. The former approach has yielded model-based analysis and visualization methods for revealing focal and general abnormalities of lung ventilation and perfusion based on a sequence of digital chest fluoroscopy frames collected with the dynamic pulmonary imaging (DPI) technique.

In particular, I shall present a novel multiresolutional method with an explicit ventilation/perfusion analysis model, as well as "United Snakes," an interactive deformable model framework for lung registration and motion analysis, cardiac shape and motion analysis, and other applications. Finally, I will introduce a fast yet effective concentration-oriented tobogganing technique for efficient local artery/vein separation and multiple instance classification for the automated detection of pulmonary embolism from CT pulmonary angiography (CTPA), and a virtual colonoscopy technique that simplifies the complex 3D-polyp detection problem into a 2D-disk identification problem, significantly improving sensitivity while reducing computation time.

Biography:
Dr. Jianming Liang is a staff scientist at Siemens Medical Solutions USA, Inc., where he has been engaged in research and development activities in the domain of computer-aided diagnosis in medical imaging since December 2002. He holds a PhD degree (2001) in computer science and carried out his thesis work at the Turku Centre for Computer Science in Finland and in the Visual Modeling Group at the University of Toronto in Canada. From 2001-02, he was a Natural Sciences and Engineering Research Council (NSERC) of Canada Industrial Research Fellow. His research on dynamic chest image analysis received a University Faculty Research Award from the University of Turku. His other prizes include a Siemens Recognition Award and a Best Paper Award at the 2007 International Congress of Computer Assisted Radiology and Surgery in Berlin, Germany.

4) Thursday, January 31st, at noon; Clark Center Auditorium
Daniel Rubin, MS, MD
Stanford University

Title:
"Imaging Informatics: From Bench to Bedside and Beyond"

Abstract:
Vast amounts of knowledge lie within the grasp of radiology researchers and practitioners to help them to understand disease and to practice effectively, but much current biomedical knowledge is not being accessed and utilized. The explosion in images and non-imaging data is challenging the ability of radiology researchers to identify and to pursue promising new investigational directions. The latest results that researchers produce are not always informing radiologists in their day-to-day work, as there are few tools to help them to identify, retrieve, and use pertinent clinical and research knowledge at the point of care. Consequently, there is variability among radiologists in their clinical effectiveness, and opportunities for translating new discoveries into practice are being lost. The methods and tools of biomedical informatics are enabling biologists to cope with similar problems arising from the information explosion in biology, and they are adopting informatics techniques to function effectively in the e-Science era.

In this presentation, I will discuss ongoing work to develop and apply biomedical informatics techniques to meet the information challenges in radiology. Specifically, knowledge representation, semantic annotation, statistical natural language processing, data integration/warehousing, computer reasoning, and decision support are key directions in informatics needed to create intelligent applications for radiology. Future advances in radiology will lie at the intersection of imaging science and biomedical informatics. The new computer applications that emerge will change clinical imaging workstations into knowledge portals and enable radiologists to keep pace with new discoveries, to exploit new radiology knowledge, and to practice more consistently and effectively.

Biography:
Daniel Rubin is a research scientist in the Center for Biomedical Informatics Research and clinical assistant professor of radiology at Stanford University. He is director of scientific development for the National Center for Biomedical Ontology, a National Center for Biomedical Computing of the NIH Roadmap. He is chair of the RadLex Steering Committee of RSNA, chair of the Informatics Committee of the American College of Radiology Imaging Network (ACRIN), and co-chair of the Medical Imaging Systems Working Group of the American Medical Informatics Association. In addition to informatics, his background includes clinical and investigational radiology, as a radiologist and researcher. His academic focus is the intersection of biomedical informatics and imaging science, developing computational methods and applications to access and integrate diverse clinical and imaging data, to extract information and meaning from images, to enable data mining and discovery of image biomarkers, and to translate these methods into practice by creating computer applications that will improve diagnostic accuracy and clinical effectiveness.

New Faculty Hires and Promotions: January 23, 2008

Lewis Shin, MD, will be starting as an assistant professor of diagnostic radiology in February 2008. He has been a clinical instructor in our Department since August of 2007 after completing a body imaging fellowship from 2005 to 2007 through our Advanced Techniques for Cancer Imaging Program, which is funded by the National Cancer Institute. Prior to coming to Stanford, he attended Brown University where he received his BS in neuroscience in 1996 and his medical degree in 2000. Dr. Shin completed his internship and residency in diagnostic radiology at Winthrop University Hospital in Mineola, New York. His research interests include real time MRI airway imaging and body imaging, specifically diffusion-weighted imaging and virtual colonoscopy with CT and MR. Born and raised in New York, his hobbies
include ice hockey and golf.

(Image courtesy of Mark Riesenberger)

Announcements III: January 22, 2008

Special Seminar Series on Radiological Informatics: As part of a special series on radiological informatics, we are offering seminars on Jan. 23rd, 24th, 28th, and 31st. Please click on the "Continue Reading This Entry" link below to find the title of each talk as well as the presenter's abstract and biography. In addition to the seminars listed below, there will be a few more talks, which are being scheduled now and will be posted shortly. Please contact Dr. Sandy Napel for more information.

1) Wednesday, January 23rd, at noon; Alway M104
Julia Patriarche, PhD
Mayo Clinic

Title:
"Detection of Change in Serial Magnetic Resonance Studies of Brain Tumor Patients"

Abstract:
The comparison of serial magnetic resonance imaging studies is a common task in clinical radiology. It is, however, widely considered not to be very reproducible. There are a variety of reasons for this, including the confounding of disease-related changes with acquisition-related changes and issues related to information presentation. We have constructed a computational system that performs the comparison of serial magnetic resonance imaging studies and presents changes in the form of a color-coded change map, superimposed on the anatomical images. The system additionally formats the output as a quantitative summary. We used this quantitative summary to conduct a study with 88 brain tumor serial comparisons. Our results were suggestive that it may be possible to use the change detector to identify cancer changes months earlier than is possible using manual inspection, alone.

We have recently implemented an integrated system for the change detector, which includes a graphical user interface (GUI). The GUI not only displays the color-coded change map, but also allows the user to turn it on and off. The GUI provides linked cursors, and it additionally provides "flicker" functionality to allow the user to rapidly alternate between the serial acquisitions. We are preparing to deploy the GUI change detector clinically, which will greatly increase the size and variety of possible future research studies and which will allow the direct clinical application of this technology.

The change detector is an example of a layered artificial intelligence (AI) architecture in which each layer builds upon the layer below, with each layer accomplishing progressively more sophisticated analyses. Specifically, the change detector is built on a lesion-finder application. The lesion finder is built on an automated sample point's algorithm. The automated sample point's algorithm is built on a significant region detection algorithm. Each of these algorithms has merit in its own right, and each can be used in a modular fashion in a variety of contexts. As a unified application, they together automatically address a complex clinical task. Early detection of changes may facilitate improved care through more rapid intervention following recurrence. It may also facilitate screening and personalized therapy. We additionally see the change detector as providing a solution to the problem of novel therapy comparison, by providing fully automatic, reproducible, and quantitative measures of change. We envision the change detector as a model of layered artificial intelligence, not only freeing the radiologist from the drudgery of information overload, but providing a model whereby greater information will enable many sophisticated automatic analyses by the computer, with the computer bringing to the attention of the clinician only what is relevant.

Biography:
Julia Patriarche is an informatics fellow in the Radiology Informatics Lab at the Mayo Clinic College of Medicine. She has completed an undergraduate degree in electrical engineering/computer engineering option at Queen's University in Kingston, Canada; a PhD in medical science/medical imaging; and a neurology fellowship at the Mayo Clinic College of Medicine.

2) Thursday, January 24th, at noon; Alway M112
Ross Mitchell, PhD
University of Calgary

Title:
"Virtual Biopsies: Non-Invasive Molecular Diagnosis"

Abstract:
Our expanding knowledge of the genetic basis and molecular mechanisms of cancer is beginning to revolutionize the practice of clinical oncology. Increasingly, molecular biomarkers of prognosis and treatment response are being used to classify tumors and direct treatment decisions. Advanced medical imaging platforms such as MRI, PET, and CT provide incredibly detailed images of tumors that reflect their structure, biochemistry, physiology, and perhaps genetics.

Studies by the Imaging Informatics Lab at the University of Calgary, and others, show that information about a tumor's molecular phenotype can be obtained by using novel algorithms and computational tools to more fully analyze tumor images. Such "virtual biopsies," performed by applying these image-processing techniques to routine diagnostic images (e.g. MRI, PET, or CT), could be a rapid and powerful means of assaying important cancer biomarkers. If successfully validated, and proven to have suitable sensitivity and specificity, the use of non-invasive, imaging-based molecular diagnostic tests would offer significant advantages over conventional surgical biopsies. For example, this could be important in the context of large heterogeneous tumors, multiple metastases, surgically inaccessible tumors, and settings where disease progression needs to be monitored frequently over time. Virtual biopsy research lies at the intersection of molecular imaging, medical imaging physics, and biocomputation, and is highly complementary to these areas. This presentation will cover key enabling technologies behind virtual biopsies and discuss some recent successes in this research.

Biography: Dr. Ross Mitchell is an associate professor of the Departments of Radiology and Clinical Neurosciences and an adjunct professor of the Department of Computer Science at the University of Calgary. He is also the founding and chief scientist of Calgary Scientific Incorporated, a Multiple Sclerosis Society of Canada; a Donald Paty Scholar; and an Alberta Heritage Foundation for Medical Research Senior Scholar. Dr. Mitchell has received numerous awards for his research including the Berlex Canada MS Research Award; several Dean's Awards of Excellence from the University of Western Ontario; Best Paper Awards from the Canadian Association of Radiologists and the International Organization for Medical Physics; and two Awards of Merit from the Radiological Society of North America. Dr. Mitchell has a proven research track-record comprising 11 patents, 73 invited presentations, 63 peer-reviewed articles, and 150 published abstracts.

Dr. Mitchell supervises a research team investigating space/frequency analysis, medical image processing, as well as segmentation and visualization technologies. For more information, please see, http://www.ImagingInformatics.ca.

3) Monday, January 28th, at noon; Alway M104
Jianming Liang, PhD
Siemens Medical Solutions USA Inc., Malvern, PA

Title:
"Dynamic Chest Image Analysis, United Snakes, and
Computer-Aided Detection"

Abstract:
Modern medical imaging systems generate enormous datasets with ever higher coverage and resolution, but it is the clinically relevant information in these images that is paramount. I shall present several novel computational approaches for gleaning such information from chest X-ray images to reveal pulmonary functional abnormalities, for segmenting and characterizing organ motions, and for detecting the most lethal diseases from CT images, including pulmonary embolism and colonic polyps. The former approach has yielded model-based analysis and visualization methods for revealing focal and general abnormalities of lung ventilation and perfusion based on a sequence of digital chest fluoroscopy frames collected with the dynamic pulmonary imaging (DPI) technique.

In particular, I shall present a novel multiresolutional method with an explicit ventilation/perfusion analysis model, as well as "United Snakes," an interactive deformable model framework for lung registration and motion analysis, cardiac shape and motion analysis, and other applications. Finally, I will introduce a fast yet effective concentration-oriented tobogganing technique for efficient local artery/vein separation and multiple instance classification for the automated detection of pulmonary embolism from CT pulmonary angiography (CTPA), and a virtual colonoscopy technique that simplifies the complex 3D-polyp detection problem into a 2D-disk identification problem, significantly improving sensitivity while reducing computation time.

Biography:
Dr. Jianming Liang is a staff scientist at Siemens Medical Solutions USA, Inc., where he has been engaged in research and development activities in the domain of computer-aided diagnosis in medical imaging since December 2002. He holds a PhD degree (2001) in computer science and carried out his thesis work at the Turku Centre for Computer Science in Finland and in the Visual Modeling Group at the University of Toronto in Canada. From 2001-02, he was a Natural Sciences and Engineering Research Council (NSERC) of Canada Industrial Research Fellow. His research on dynamic chest image analysis received a University Faculty Research Award from the University of Turku. His other prizes include a Siemens Recognition Award and a Best Paper Award at the 2007 International Congress of Computer Assisted Radiology and Surgery in Berlin, Germany.

4) Thursday, January 31st, at noon; location TBA
Daniel Rubin, MS, MD
Stanford University

Visiting Faculty: January 18, 2008

Myeong Sub Lee, MD, PhD, and Sun Mi Kim, MD, have been visiting professors of radiology since March of 2007; they will be visiting our Department for one year. Dr. Lee received his PhD from the Department of Anatomy at Korea University of Seoul, Korea, and his MD from Yonsei University, where he is an associate professor in the Department of Radiology at Yonsei Wonju Medical School. His specialty is interventional neuroradiology, and he works with Dr. Marks in the division of interventional neuroradiology at Stanford. After completing her residency and a fellowship at the Asan Medical Center in Seoul, Dr Kim became an assistant professor of Seoul National University Bundang Hospital where she specializes in breast imaging, particularly mammography and ultrasound. Working as a visiting professor at Stanford, Dr. Kim has had the opportunity to interpret breast MRI cases and conduct research with Dr. Bruce Daniel. When they are not working, Drs. Lee and Kim enjoy spending time with their little boy, Jaewon.

Announcements II: January 15, 2008

Special Seminar Series on Radiological Informatics: As part of a special series on radiological informatics, we are offering seminars on Jan. 23rd, 24th, 28th, and 31st. Please watch future announcements for each seminar's title and abstract. In addition to the seminars listed below, there will be a few more talks, which are being scheduled now and will be posted shortly. Please contact Dr. Sandy Napel for more information.

1) Wednesday, January 23rd, at noon; location TBA
Julia Patriarche, PhD
Mayo Clinic

Title:
"Detection of Change in Serial Magnetic Resonance Studies of Brain Tumor Patients"

Abstract:
The comparison of serial magnetic resonance imaging studies is a common task in clinical radiology. It is, however, widely considered not to be very reproducible. There are a variety of reasons for this, including the confounding of disease-related changes with acquisition-related changes and issues related to information presentation. We have constructed a computational system that performs the comparison of serial magnetic resonance imaging studies and presents changes in the form of a color-coded change map, superimposed on the anatomical images. The system additionally formats the output as a quantitative summary. We used this quantitative summary to conduct a study with 88 brain tumor serial comparisons. Our results were suggestive that it may be possible to use the change detector to identify cancer changes months earlier than is possible using manual inspection, alone.

We have recently implemented an integrated system for the change detector, which includes a graphical user interface (GUI). The GUI not only displays the color-coded change map, but also allows the user to turn it on and off. The GUI provides linked cursors, and it additionally provides "flicker" functionality to allow the user to rapidly alternate between the serial acquisitions. We are preparing to deploy the GUI change detector clinically, which will greatly increase the size and variety of possible future research studies and which will allow the direct clinical application of this technology.

The change detector is an example of a layered artificial intelligence (AI) architecture in which each layer builds upon the layer below, with each layer accomplishing progressively more sophisticated analyses. Specifically, the change detector is built on a lesion-finder application. The lesion finder is built on an automated sample point's algorithm. The automated sample point's algorithm is built on a significant region detection algorithm. Each of these algorithms has merit in its own right, and each can be used in a modular fashion in a variety of contexts. As a unified application, they together automatically address a complex clinical task. Early detection of changes may facilitate improved care through more rapid intervention following recurrence. It may also facilitate screening and personalized therapy. We additionally see the change detector as providing a solution to the problem of novel therapy comparison, by providing fully automatic, reproducible, and quantitative measures of change. We envision the change detector as a model of layered artificial intelligence, not only freeing the radiologist from the drudgery of information overload, but providing a model whereby greater information will enable many sophisticated automatic analyses by the computer, with the computer bringing to the attention of the clinician only what is relevant.

Biography:
Julia Patriarche is an informatics fellow in the Radiology Informatics Lab at the Mayo Clinic College of Medicine. She has completed an undergraduate degree in electrical engineering/computer engineering option at Queen's University in Kingston, Canada; a PhD in medical science/medical imaging; and a neurology fellowship at the Mayo Clinic College of Medicine.

2) Thursday, January 24th, at noon; location TBA
Ross Mitchell, PhD
University of Calgary

Title:
"Virtual Biopsies: Non-Invasive Molecular Diagnosis"

Abstract:
Our expanding knowledge of the genetic basis and molecular mechanisms of cancer is beginning to revolutionize the practice of clinical oncology. Increasingly, molecular biomarkers of prognosis and treatment response are being used to classify tumors and direct treatment decisions. Advanced medical imaging platforms such as MRI, PET, and CT provide incredibly detailed images of tumors that reflect their structure, biochemistry, physiology, and perhaps genetics.

Studies by the Imaging Informatics Lab at the University of Calgary, and others, show that information about a tumor's molecular phenotype can be obtained by using novel algorithms and computational tools to more fully analyze tumor images. Such "virtual biopsies," performed by applying these image-processing techniques to routine diagnostic images (e.g. MRI, PET, or CT), could be a rapid and powerful means of assaying important cancer biomarkers. If successfully validated, and proven to have suitable sensitivity and specificity, the use of non-invasive, imaging-based molecular diagnostic tests would offer significant advantages over conventional surgical biopsies. For example, this could be important in the context of large heterogeneous tumors, multiple metastases, surgically inaccessible tumors, and settings where disease progression needs to be monitored frequently over time. Virtual biopsy research lies at the intersection of molecular imaging, medical imaging physics, and biocomputation, and is highly complementary to these areas. This presentation will cover key enabling technologies behind virtual biopsies and discuss some recent successes in this research.

Biography: Dr. Ross Mitchell is an associate professor of the Departments of Radiology and Clinical Neurosciences and an adjunct professor of the Department of Computer Science at the University of Calgary. He is also the founding and chief scientist of Calgary Scientific Incorporated, a Multiple Sclerosis Society of Canada; a Donald Paty Scholar; and an Alberta Heritage Foundation for Medical Research Senior Scholar. Dr. Mitchell has received numerous awards for his research including the Berlex Canada MS Research Award; several Dean's Awards of Excellence from the University of Western Ontario; Best Paper Awards from the Canadian Association of Radiologists and the International Organization for Medical Physics; and two Awards of Merit from the Radiological Society of North America. Dr. Mitchell has a proven research track-record comprising 11 patents, 73 invited presentations, 63 peer-reviewed articles, and 150 published abstracts.

Dr. Mitchell supervises a research team investigating space/frequency analysis, medical image processing, as well as segmentation and visualization technologies. For more information, please see, http://www.ImagingInformatics.ca.

3) Monday, January 28th, at noon; location TBA
Jianming Liang, PhD
Siemens Medical Solutions

4) Thursday, January 31st, at noon; location TBA
Daniel Rubin, MS, MD
Stanford University

New Faculty Hires and Promotions: January 10, 2008

John MacKenzie, MD, MS, became an acting assistant professor of pediatric radiology and chief of pediatric musculoskeletal imaging at Lucile Packard Children's Hospital (LPCH) in September of 2007. At LPCH, he is helping to expand the options for imaging and image-guided interventions for children, and he is excited to be back on the Farm. After completing his Bachelor of Science degree at Stanford with honors in computer science and the biological sciences, Dr. MacKenzie left Stanford for medical school at the Albert Einstein College of Medicine in the Bronx, which was initially a culture shock for him. However, Dr. MacKenzie enjoyed the East Coast enough to complete his residency at Brigham and Women's Hospital and two fellowships: a musculoskeletal and body MRI fellowship at the Hospital of the University of Pennsylvania and a pediatric radiology fellowship at Children's Hospital of Philadelphia. His research interests include molecular imaging applications for bone and joint disorders, and he is currently developing a research program in hyperpolarized carbon-13 imaging with members of Stanford Radiology (Drs. Dan Spielman, Shreyas Vasanawala, and Dirk Mayer) and General Electric (Ralph Hurd and Yi-Fen Yen). When he's not working, you may see him riding his green bike around campus reliving his undergraduate days as well as commuting to and from Caltrain. Dr. MacKenzie lives in San Francisco and enjoys hiking and carpentry; both his father and grandfather were carpenters. A native of Colorado, Dr. MacKenzie is currently teaching his seven-year-old daughter how to ice skate.

Announcements I: January 10, 2008

Special Seminar Series on Radiological Informatics: As part of a special series on radiological informatics, we are offering seminars on Jan. 14th, 23rd, and 28th. Each seminar is at 12 noon in Alway M104 unless otherwise indicated. Please watch future announcements for each seminar's title and abstract. In addition to the three seminars listed below, there will be at least two more talks, which are being scheduled now and will be posted shortly. Please contact Dr. Sandy Napel for more information.

1) Monday, Jan 14th:
James Z. Wang, PhD
Carnegie Mellon University and Pennsylvania State University

Title:
"A Data-Driven Approach Toward Knowledge Discovery and Improving Healthcare"

Abstract:
Radiology and biomedical informatics are revolutionizing healthcare. It has been predicted that a shortage of trained radiologists will continue in the next three decades. Effective computerized tools will therefore be in great demand. Radiology departments today generate an incredibly massive amount of digital medical images and metadata. Conventional PACS search methods allow physicians to locate images using metadata stored in relational databases. Much more can be done to leverage this wealth of data. Using massively parallel computers, we can mine millions of electronic medical records and millions of high-resolution, high-dimensional, multi-spectrum medical images to draw conclusions statistically based on past cases. We need to invent computational methods to harness the breathtaking quantity of digital information effectively and to generate biomedical knowledge at a pace we could not have imagined. In the last decade, my research group attempted to reduce the significant gap between low-level features extracted from images and high-level semantic concepts. Machine learning, statistical modeling, and mathematical tools have been utilized. I will introduce some of our past research results of relevance to the radiology community. Specifically, the talk will cover the SIMPLIcity visual similarity search, the 3-D hidden Markov models for analyzing volume images, the Automatic Linguistic Indexing of Pictures system, and the ontology-based annotation and retrieval of histological images and quantitative phenotypes. In the coming years, I plan to collaborate with radiologists, physicians, and biologists in order to develop indexing, retrieval, and mining algorithms and systems for large amounts of radiological images and patient-specific data.

Biography:
James Z. Wang is currently a visiting professor at the Robotics Institute of Carnegie Mellon University. He is also a tenured faculty member at Pennsylvania State University. He received a summa cum laude bachelor's degree in mathematics and computer science from the University of Minnesota. From Stanford University, Dr. Wang has received an MS in mathematics, an MS in computer science, and a PhD degree in medical information sciences. He has been a recipient of a National Science Foundation (NSF) Career award and the endowed PNC Technologies Career Development Professorship. Research interests of his group include automatic image tagging, semantics-sensitive image retrieval, image security, biomedical informatics, computational aesthetics, story picturing, art image retrieval, and computer vision. The group has published two monographs and more than 20 journal articles. Science media including Discovery News, Scientific American, National Public Radio, and MIT Technology Review, as well as wired news agencies, have reported his research.

2) Wednesday, January 23rd:
Julia Patriarche, PhD
Mayo Clinic

3) Monday, January 28th:
Jianming Liang, PhD
Siemens Medical Solutions

2007 MIPS Retreat

On October 24th, the Molecular Imaging Program at Stanford (MIPS) held a two-day retreat by the beach at Asilomar in Pacific Grove, California. Dr. Sam Gambhir, professor of radiology and bioengineering, director of the Molecular Imaging Program at Stanford, and chief of the Nuclear Medicine Division, gave the opening remarks, which were followed by lunch and one-minute talks moderated by Michael Moseley, PhD. Professor of Chemistry Carolyn Bertozzi from the University of California, Berkeley, delivered the keynote address entitled "Shedding Light on Glycans." The retreat also included discussion groups, a game show, and a faculty volleyball game.

Dr. Gambhir delivers the opening talk.

Tsinghua University's "Oversea Expert," Dr. Gary Glover

By Julie Ruiz, PhD

As he jogged along the banks of the Wanquan River sharing the path with a swarm of bicyclists, Dr. Gary Glover wound through the campus of Tsinghua University in the northwestern suburbs of Beijing. Selected by Tsinghua University as their "Oversea Expert," Dr. Glover came to the University to share his scientific expertise and knowledge with their faculty and students as they initiate their own MRI program. He brought graduate student Catie Chang with him for part of the trip.

Sponsored jointly by the National Office of Foreign Experts and the Department of Education, Tsinghua's "Oversea Expert Program" is designed to bring "recipients of important international awards . . ., professors of world-renowned universities, and other established experts who have a great reputation in their corresponding international research community" to help train students and faculty in MR research and program design as well as to offer specialty courses and to provide guidance and consulting for research projects. Tsinghua University has over 20,000 students (including 12,000 undergraduates, 6,200 master's degree candidates and 2,800 doctoral candidates) and approximately 8 colleges, 43 departments, 44 research institutes, 9 engineering research centers, and 163 laboratories. The University also offers 37 bachelor's degree programs, 107 master's degree programs, and 64 PhD programs.

Karen Ying, PhD, associate professor in the Department of Engineering Physics and the Medical Physics and Engineering Institute, extended the invitation honoring Dr. Glover as Tsinghua University's Oversea Expert, who is to return annually for one month each year for a total of three years to provide scientific expertise and continuing guidance for Tsinghua's MRI program. Dr. Ying teaches a graduate course on the principles of magnetic resonance imaging. She and her three undergraduate and three graduate students comprise the whole MR imaging program for the University. They have no scanners; all MR and CT research is done at local hospitals. The University is constructing a medical school.

Dr. Ying has been a professor at Tsinghua for two years; prior to that, she taught and researched in the United States for ten years. Her father has taught in Tsinghua's Department of Engineering Physics for over 57 years. In talking with him, Dr. Glover learned that during the Cultural Revolution under Chairman Mao's reign, Dr. Ying's father was forced to quit the University and work on the farms for one and a half years. Although a professor emeritus, he still has five graduate students with whom he works.

During his visit from November 15th to December 5th, Dr. Glover gave 9 two-hour class lectures, and Ms. Chang gave 2. His lectures covered such topics as pulse sequence design and fast imaging techniques; the principles of diffusion/perfusion MRI and flow imaging; and functional MRI. He described the building in which he lectured as "gigantic with hundreds of classrooms that were busy from 0 o'clock in the morning until N o'clock at night." "Even as I walked around at 9 PM," Dr. Glover remarked, "there were students in the classrooms studying. There was a constant bustle of people around me, and bikes where everywhere at all hours; there were few cars on campus and no students' cars."

In addition to his lectures, Dr. Glover held two public evening colloquia and three meetings with University officials including the university president, provost, Vice President Ke-Jun Kang, Medical School Dean Zhao, and the Department of Engineering Physics Head Tang Chuanxiang. One topic he and the University faculty and administration discussed was the possibility of a foreign exchange program for graduate-level research/education between Tsinghua and Stanford to foster strong collaboration between our two institutions. He also spoke at a meeting with General Electric regarding research collaboration between GE, Stanford, and Tsinghua.

Established in 1911, Tsinghua University was built on the site of "Qing Hua Yuan," a former royal garden of the Qing Dynasty. Dr. Glover stayed at the guest house, which was across from a small island known as Jinchun Garden, where the eighth emperor of the Qing Dynasty, Xian Feng, had lived. From 8 AM until about 10 AM, Dr. Glover was greeted by the sights and sounds of people dancing to traditional Chinese music in the -20 degrees Fahrenheit weather in Han Pavilion of Jinchun Garden, which is surrounded by a lake with scenic bridges.

Han Pavilion

Also undaunted by the cold weather were the "pillbox" guards who stood watch over the campus from 6 AM until around 11 PM.

During his visit, he was amazed by the excellent customer service he received, "I went into the equivalent of a 'Best Buy,' and there were 27 clerks in the camera department waiting to help me. In the local pharmacy, there were 11 clerks--one every foot and a half of counter space. When my card key didn't work in my hotel door, two people and part of a third person came to remedy it after an extensive discussion. The service was wonderful!" While the customer service was excellent, the air quality was not: "I saw four power plants on campus burning coal; I never saw the sun; it was always filtered through the haze, and there were no stars at night. It was hard to breathe as I jogged on campus."

In his free time, Dr. Glover did some sightseeing in Beijing, a city of over 15 million people. He toured the Great Wall of China; the Forbidden City and its "Hall of Medium Harmony" (something has been lost in the translation); Tian Anmen Square; the Lao She Tea House; Fragrance Hill; the Sleeping Budha; the Botanical Garden; the Thirteen Ming Tombs; and the Chairman Mao Solemn Memorial. The streets were packed with bicyclists as most goods were transported by bicycle cart. While in Beijing, he also had the opportunity to visit a CT manufacturing site.

His visit to Tsinghua University was only part of his three and a half week "lecture circuit." Prior to coming to Beijing, Dr. Glover had flown to the University of Maryland where he gave two lectures: one on real-time fMRI and another on alternative fMRI methods. On his way home from Beijing, he flew to the University of Vancouver, B.C., to give another lecture because Judy Illes, PhD, the Canada research chair in neuroethics at the University of Vancouver and former director of grants in our Department, had invited Dr. Glover to give a lecture for their colloquium series.

Awards and Honors: December 17, 2007

2007 IEEE (Institute of Electrical and Electronics Engineers) Medical Imaging Travel Grant Winners Frances Lau, MS, Peter Olcott, and Guillem Pratx, MS, were awarded travel grants to present their novel and original work at the 2007 IEEE NSS-MIC (Nuclear Science Symposium and Medical Imaging) Conference in Honolulu, Hawaii.

Frances Lau, MS, graduate student in the Molecular Imaging Instrumentation Laboratory (MIIL), gave an oral presentation at the 2007 IEEE NSS-MIC Conference on the different methods for simplifying the circuits in the data acquisition system she and her colleagues are developing for a 1mm3 resolution breast-dedicated PET system. Ms. Lau's research interests include circuits and devices for biomedical applications; she is currently working on the design and development of hardware for a breast cancer imaging PET system.

Peter Olcott, graduate student in the Bioengineering Department and member of the Molecular Imaging Instrumentation Laboratory, gave a talk at the 2007 IEEE NSS-MIC Conference entitled Data Acquisition System Design for a 1 mm3 Resolution PSAPD-Based PET System that describes the data acquisition architecture he and his colleagues are developing for a new PET mammography system. Because of his strong presentation skills and the rating of his presentation abstract as the fourth highest, Mr. Olcott was one of two runners up for the two Best Student Paper Awards, which recognize contributions to the fields of nuclear and plasma sciences. Mr. Olcott graduated with a BS in computer science from the University of California, San Diego, in 2003. This fall 2007, he expects to receive his MS from Stanford in bioengineering and, subsequently, to begin the PhD bioengineering program. His current research interests include the development of an intra-operative hand-held gamma ray camera (nuclear imager) for the surgical staging of cancer; data acquisition systems for application specific (PET mammography) PET systems; and a new PET detector design for high-field simultaneous PET/MRI imaging. Mr. Olcott adds the following: "I have a 3-year-old son, and I spend all of my free time being a new parent. I love to play tennis, softball, and basketball, and members of Lucas/Radiology are quite welcome to send me unannounced requests to play these sports."

Guillem Pratx, MS, doctoral candidate in electrical engineering and member of the Molecular Imaging Instrumentation Laboratory, was also awarded a 2007 IEEE Medical Imaging Travel Grant to present his work at the 2007 IEEE NSS-MIC Conference in Honolulu, Hawaii. Mr. Pratx completed his undergraduate work in engineering at the Ecole Centrale in Paris, France. In the Molecular Imaging Program at Stanford (MIPS), he is completing his dissertation research, which centers on the development of practical algorithms that exploit graphics processing units (GPU) for fast medical image reconstruction in ultra-high resolution PET systems under development at Stanford. In support of his work, he has received several awards, including the NVIDIA Fellowship, the Society of Nuclear Medicine Bradley-Alavi Student Fellowship, and the Stanford Bio-X Graduate Student Fellowship.

A picture from the IEEE Luau, from left to right: Peter Olcott's son; Peter Olcott; Arne Vandenbroucke, PhD; Frances Lau, MS; James Matteson, PhD (Univ. of California, San Diego); Craig Levin, PhD; Guillem Pratx, MS; David Starfield, PhD candidate (Univ. of Witwatersrand, Johannesburg); Yi Gu; and Paul Reynolds.

Awards and Honors: December 10, 2007

Arne Vandenbroucke, PhD, postdoctoral scholar in the Molecular Imaging Instrumentation Laboratory (MIIL), was awarded an IEEE (Institute of Electrical and Electronics Engineers) Scholarship to attend a short course at the 2007 IEEE NSS-MIC (Nuclear Science Symposium and Medical Imaging) Conference. Dr. Vandenbroucke earned his PhD in experimental particle physics from Gent University in Belgium. Before coming to Stanford, he worked on the HERMES experiment, researching the spin structure of the nucleon at the DESY (Deutsches Elektronen Synchrotron or the "German Electron Synchrotron") in Hamburg, Germany. As part of Dr. Levin's group at Stanford, his research interests include medical imaging, especially PET. Dr. Vandenbroucke is currently involved in the research and development of a dedicated high-resolution breast cancer imaging PET system. When he is not in the lab, he likes spending his time outdoors sailing, hiking, and traveling.

Awards and Honors: December 4, 2007

Gang Niu, PhD, postdoctoral scholar in the Molecular Imaging Probe Laboratory (MIPL), has been awarded the Department of Defense (DOD) Prostate Cancer Training Award through the DOD's Prostate Cancer Research Program (PCRP). PCRP Training Awards are designed to fund innovative, high-impact research by scientists whose achievements reflect their potential for successful training and who are committed to a career in prostate cancer research. Dr. Niu received the award for his original research in Hsp90 targeted imaging and therapy. He has been working at MIPL under the supervision of Dr. Xiaoyuan Chen since 2006 after receiving his PhD in free radical radiation biology at the University of Iowa, Iowa City, in 2005. His PhD research focused on molecular imaging and tumor gene therapy mediated by the human sodium iodide symporter (hNIS), investigating the role of hNIS as a reporter gene monitoring gene transfer and expression. His current research interests include the investigation of tumor initiation and the progress and response to various therapies with non-invasive molecular imaging strategies including optical and radiological modalities.

Awards and Honors: December 3, 2007

Juergen K. Willmann, MD, research fellow in the Molecular Imaging Program at Stanford (MIPS), has received the 2007 RSNA Trainee Research Fellow Award for his research project, "Molecular Imaging of Therapeutic Angiogenesis in Murine Hindlimb Ischemia Using PET and 64Cu-labeled Vascular Endothelial Growth Factor121." This Award was created in 1994 by the RSNA Program Committee to recognize the contribution of investigators to the RSNA Scientific Assembly and Annual Meeting. Dr. Willmann has been a research fellow in MIPS since 2006, and he is concurrently an assistant professor of diagnostic radiology at the Institute of Diagnostic Radiology, University Hospital Zurich, Switzerland. He received his MD from the Albert-Ludwigs-University Freiburg, Germany, and was the chief resident of diagnostic radiology at the University Hospital Zurich, Switzerland. In 2005, Dr. Willmann received the "venia legendi" from the University of Zurich, Switzerland. His research interests include multi-modality molecular imaging of angiogenesis and stem cell therapy and the development of new imaging probes for the early detection of cancer.

Donna Cronister Wins the 2007 Marshall D. O'Neill Award!

(Image courtesy of Sharon Pollio)

By Julie Ruiz, PhD

Our own Donna Cronister was named this year's winner of the Marshall D. O'Neill Award for her exceptional and enduring support of Stanford University's research enterprise. Now in its 17th year, this prestigious and university-wide award is bestowed annually by the Office of the Vice Provost and Dean of Research in honor of Marshall D. O'Neill, associate director of the W.W. Hansen Laboratories from 1952 until 1990. Donna is the 27th recipient of this award.

"I was quite surprised when I took the call from Ann Arvin, vice provost and dean of research. I probably sounded like a complete idiot because I honestly did not know what to say," Donna remarked. "I am very honored just to be nominated, and I am very proud to be the 2007 recipient of the Marshall D. O'Neill Award."

While most 2007 award candidates were nominated by one or two faculty members, Donna was nominated by eight. Gary Glover, PhD, director of the Radiological Sciences Laboratory (RSL), described Donna's award as an "outstanding, University-wide endorsement of what we have all known for a very long time--that Donna is simply above exceptional in every way!"

Working with 12 faculty and over 80 graduate students, postdoctoral scholars, research assistants, and research associates, Donna manages each facet of the lab's research, which includes coordinating funding for researchers, organizing courses and conferences, and planning the budget. She is also involved in the day-to-day operations at the Lucas Center and oversees the payroll; reimbursement; accounting; personnel policies and procedures; building maintenance; supply ordering; and service policies.

These are just a few of the many tasks for which Donna has been responsible since she came to Stanford in 1990 after working in the corporate world:

"My husband and I moved to California from Montana in 1980 after the birth of our twin daughters. I was a stay at home mom until the girls were about two and a half years old. When my husband came home and found me lying on the back of the couch so they couldn't get to me, we decided it was time for me to go back to work! I worked for three years for a chemical company and then moved on to Xerox where I worked for about eight years. During this time, we added another daughter to the family. Xerox had a massive reduction in force, and I took about six months off before applying at Stanford.

The rest, as they say, is history. I have been with the Radiological Sciences Laboratory since February 1990. We have seen our lab grow from Gary, Norbert, and me to about 90 folks now! I oversee the lab, and I am also the administrative director for the Lucas Service Center." When she's not at work, Donna loves to garden and to spoil her grandson and granddaughter. "Life couldn't be better for me," she added.

Dr. Gary Glover extended an invitation to attend Donna's November 12th reception to "every one of the hundreds of students, faculty, and everyone else who knows or has been touched in ways large or small by Donna over the years." At her reception at the Faculty Club, Associate Dean of Research John Brauman presented the Marshall D. O'Neill Award to Donna on behalf of the vice provost and dean of research, Ann Arvin. To see pictures from Donna's reception taken by Sharon Pollio, please access http:// http://share.shutterfly.com/action/welcome?sid=0AaNG7ZqzbN2Low. To read more about her award, please see http://news-service.stanford.edu/news/2007/november7/marsh-110707.html and http://daily.stanford.edu/article/2007/11/13/radiologyLabManagerWinsCampusAward.

Lifetime Achievement Award: Dr. Henry H. Jones

(Image courtesy of Mark Riesenberger)

By Julie Ruiz, PhD

"My greatest achievement is that I survived," Dr. Jones said to me after I spoke with him about our "Lifetime Achievement Award." In his 68 years of serving Stanford Radiology, Dr. Henry H. Jones, professor emeritus, has done much more than survive. He has left a long legacy of achievements and a lasting impression on those who have had the opportunity to interact with him.

Born on June 9, 1917, in Altoona, Pennsylvania, he was the second son of Henry O. and Euphemia Heilman Jones. His older brother, Howard, died in infancy. His father was a urologist, and his mother was the superintendent of music for the Altoona school system and, later, was a writer of style reviews and producer of fashion shows for the William F. Gable Department Store. "She was so successful," Dr. Jones told me, "that department stores as far away as Pittsburgh wanted to hire her to produce their style reviews."

After graduating from Haverford College in 1939 with a BA in chemistry, Dr. Jones attended the graduate chemistry program at Harvard. "I spent a year pretending to be a chemist at Harvard and learned that I wasn't really going to be the kind of chemist I wanted to be because I didn't fully comprehend the application of partial differential equations." In 1940, he applied and was accepted to medical school at Yale. In medical school, he was reminded that medicine requires a life time of learning, which is something he had observed throughout his childhood because both his father and grandfather were physicians. "In your first- and second-years of medical school, you realize that what you are learning today you will use for the rest of your life," Dr. Jones remarked. Because of his interest in chemistry and mathematics, Dr. Jones felt a natural affinity for radiology.

At the end of 1941, he was inducted into the army to serve in World War II, but he was assigned back to finish his medical studies. After completing a rotating internship in 1943 at Metropolitan Hospital in New York City and a residency in radiology at Yale in 1946, he served in the army as an instructor at the Army School of Roentgenology at Fort Sam Houston in San Antonio, Texas, where he trained physicians to be radiologists or "90-day wonders," as they were commonly called. "That was a great experience," he told me. "I had just finished my residency in radiology and now I was teaching what I had learned. If you want to learn something, teach it!" After three cycles of training, he was assigned as head of radiology in Bad Constadt, Germany, which was the orthopedic center for the army of occupation.

After his discharge from the army in 1948, he went to speak with the chair of the Radiology Department at Yale, Henry Kaplan, MD, who had taught him during residency and who had recently been hired to head the Stanford Radiology Department. Dr. Jones' reputation preceded him, and it was the impression he had left on Dr. Henry Kaplan that led to his hire at Stanford. "After I was discharged from the army, I was looking for a position as an academic radiologist so I went to talk to Henry Kaplan. I asked him, 'Do you know of any available academic jobs in radiology?' He answered, 'Why? You already have one at Stanford.' It's the only job application I've ever done in my life! It was very inexpensive; I didn't fill out any forms or anything." So, Dr. Jones came to Stanford at the end of June 1948. Because Dr. Kaplan did not leave Yale for Stanford until September, Dr. Jones ran the Department until his arrival. As the only senior, full-time faculty member, he worked 7 days a week for 14 to 16 hours a day, and he taught all the radiology courses until Kaplan arrived in September of 1948.

After 68 years in our Department, he has left an enduring legacy and the results of his life time of learning are reflected in the plaques that line the walls of his office, such as the Robert Reid Newell Memorial Award and the Broad Street Pump Award. Conferred by Physicians for Social Responsibility (PSR), the Broad Street Pump Award is bestowed upon physicians who apply their medical knowledge in socially responsible ways. Dr. Jones was a founding member of PSR and a leader in the movement to eliminate nuclear war and weapons of mass destruction. "I was very surprised and extremely pleased. I'm delighted to have this award," he commented. Dr. Jones was also the first chief of the radiology service at the Palo Alto Veterans Administration Hospital, and he earned the moniker "Bones Jones" in recognition of his subspecialty regarding the skeletal system. His research focused on the mechanisms governing the growth and modeling of the skeletal system.

Dr. Jones has accumulated a great number of roentgenograms throughout his career, and he has donated them to our departmental resident and medical student teaching library: "I used to teach the bone and joint part of the radiology clerkship, and I have bequeathed the set of films I accumulated through my teaching to the library for use by the medical students and residents. I think it's useful, and it's organized so that people can teach themselves. People do very well teaching themselves by the time they get to medical school. If you can't teach yourself by then you're in deep trouble." The Stanford University Medical Media and Information Technologies (SUMMIT) is compiling his extensive collection of radiographs. For more information on this project, please see http://summit.stanford.edu/pdfs/mediaserver_ts.pdf and http://summit.stanford.edu/pdfs/meadiaserver_tearsheet.pdf. His collection is also featured in Dr. Amy Ladd's Paget's Disease E-Book, which can be viewed at http://paget.stanford.edu/, and he has given several detailed and informative online lectures on bone disease, including one on osteomyelitis (http://osteomyelitis.stanford.edu/pages/hjones.html) and one on osteosarcoma (http://osteosarcoma.stanford.edu/pages/EbookInfo.html).

After retiring on December 31, 2006, he worked part-time until January of 2007. I asked him how he spends his time, and he told me, "I'm reorganizing my film collection, and I'm cleaning my desk, which could take a while. I make a little progress on it, and I come back to find it's grown back again; I don't understand how it piles up, but it does." He also enjoys spending time with his grandchildren, Emmerson (age 11) and Elliott (age 6).

To read more about what our Department was like when Dr. Jones began at Stanford, please see his first-author publication, "A History of the Department of Radiology at Stanford University" published in the American Journal of Roentgenology 1995 Mar;164(3):753-60 (http://www.ajronline.org/cgi/reprint/164/3/753).

"HAPPY DAY!"

Radiology Interest Group at Stanford (RIGS) Initiates Website

By Teresa Newton

The Radiology Interest Group at Stanford (RIGS), along with the Radiology Department and Residency Program, is proud to announce the launch of the RIGS website: http://rigs.stanford.edu.

According to the RIGS website, the Radiology Interest Group at Stanford "is a group of Stanford medical students organized to foster interest in the field of radiology and provide advice to those who wish to pursue radiology as a career. RIGS holds events to provide medical students a better idea of what radiology is and what the various imaging specialties are, to guide those applying to residencies in this field, and to encourage women and minorities to consider a career in radiology; these events also allow medical students the opportunity to meet radiology physicians and residents. In addition, RIGS is a resource for those interested in research opportunities in the field of radiology."

For more information, please contact one of the group's officers: Rebecca Rakow-Penner (rakow@stanford.edu), Bhargav Raman (ramanb@stanford.edu), or Cece Chen (qcece@stanford.edu).

2007 RSL Post-Retreat Update

By Julie Ruiz, PhD
(thanks also to Donna Cronister and David Paik, PhD, for their contributions to this article)

The RSL had another productive and fun retreat at Asilomar this past September (for the pre-retreat blog article, please see http://radiology.stanford.edu/blog/archives/2007/09/2007_rsl_retrea.html). Among the highlights were the group introductions. Like last year, the group introductions were informative as well as entertaining. This year, each RSL group was asked to create an advertising campaign--a TV, radio, web, or print ad--to explain what the group does and why it is important. You can view the introductory presentations from the groups of Drs. Norbert Pelc and Dan Spielman at http://www.stanford.edu/~smazin/pelcgroupintro2007/inversitis.wmv and http://www.stanford.edu/~pritib/MRSvsMRI.wmv, respectively.

Our guest speakers included 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, and Dr. Kelly Skeff, professor of medicine (general internal medicine). Dr. Lay delivered our key note address on geophysical imaging. He discussed how scientists infer the structure of the earth's core by looking at the seismic data collected worldwide; he also addressed the challenges involved in the visualization of their data. Dr. Skeff's presentation on good teaching practices produced a very interactive discussion about teaching, which was applicable to all kinds of pedagogy.

Other highlights included RSL Family Feud; karaoke night; a photo contest; an RSL sweatshirt for retreat participants; and a productive town hall meeting.

Norbert

Wendy

Donna Cronister summarized the items raised during the RSL town hall meeting as follows:

"1. Key operator for printers, copiers/fax machine: Designate a person on each floor to maintain the printers/copiers. This does not mean simply replacing empty toner cartridges but keeping an eye on the equipment to insure that the proper supplies are on hand and that the equipment is operating properly (i.e., high copy quality, not jamming, etc.).

2nd floor: 4 printers/1 copier/1 fax (Marlys is the key operator).

1st floor: 4 printers (1.5T and 3D Lab--soon to be 5 printers when the second 3T comes online; 1 copier (1.5T). Keesha is responsible for the 3D Lab printers. Anne, Sandra, and Romi are responsible for the printers located in magnet suites.

Basement: 3 printers (including the 3T magnet suite)/1 copier/1 fax. Sharon will be the key person for the copiers at this level. Marlys will keep an eye on the copier.

Sublevel: 2 printers (including the 7T magnet suite)/1 copier (Lanzie's office)/1 fax. Lanzie will be responsible for the copier, fax, and printer in PS055. Anne, Sandra, and Romi will be the contacts for the 7T magnet.

2. Stocking kitchens: Designate a person on each floor to keep the kitchen stocked with plates, napkins, cups*, utensils, and coffee/tea supplies. Marlys has an order for regular delivery of coffee, creamers, etc. If we run low on supplies, please contact her. Marlys will maintain the kitchen on the second floor. Sharon is our basement stocker, and Lanzie is our sublevel stocker!

*The subject of paper cups stirred a rousing conversation about conservation. We would like to change our attitudes about using paper cups. Everybody must have a mug at home they can donate (e.g., 'World's Best Mom'; 'I Heart You'; etc.); you know the mugs I am talking about. If you do not have a cup or cannot afford a cup, then a cup will be provided to you free of charge. Of course, a real cup requires real washing, but we are adults, and nobody would have to be reminded to wash their cup and put it away!

3. Recycling: We have recycling bins/barrels located in strategic areas throughout the center. Please use them. At the entrance of each galley located on the Medical School Lab Surge (MSLS) side of the building are large recycling barrels for cans/bottles and mixed paper. If you do happen to see an overflowing recycling bin in our area, please do not hesitate to empty them into these barrels. The barrels are on wheels and, therefore, are mobile, and they can be moved to your area if you have a large scale paper clean up. The reason I do not have them located on our side of the building is because of the following: 1) SPACE and 2) Since the second floor is carpeted, I would rather that the dirty recycling barrels, which are emptied weekly by the Peninsula Sanitary Service, Inc. (PSSI), are not wheeled across the carpeting, especially in the muddy, rainy season. A small electronic waste receptacle is located near the basement elevator. If you need to recycle CDs, cell phones, pagers, small drives, zip drives, and memory sticks, this is the place to do it. These receptacles are emptied biweekly. Also, please recycle batteries in the small canister on the second floor. There are also battery recycling containers located at the MSLS galleys next to the large recycling barrels.

4. PCards and Reimbursements: I have asked Luis if he and I could present, at an RSL group meeting, a quick overview of what can and cannot be purchased with the PCard. Also, we will provide a travel 'cheat sheet' for you in order to reduce the amount of time for your reimbursement. This will explain what we can pay in advance, what documentation you will need when you have returned from the trip and request reimbursement, and WHY we need this documentation.

5. John has hung up two of the large pictures that were littering the hall.

6. John is looking into the best way to make the water cooler taller (6" or so) to accommodate some of our taller friends.

7. Somebody requested that Magnetic Resonance in Medicine (MRM) and Journal of Magnetic Resonance Imaging (JMRI) be added to the library. There is almost an entire MRI set down there already, including the really old ones when it was not a full-sized journal. Norbert offered to lend his bound set to the library as long as they do not walk off."

Awards and Honors: October 23, 2007

Garry E. Gold, MD, associate professor of radiology, was recently awarded the President's Medal for Outstanding Research in Bone and Joint Disease at the 2007 meeting of the International Skeletal Society. The President's Medal is given to members of the International Skeletal Society in honor of their outstanding scientific achievements on an international level. Recipients also receive a monetary award to support their research efforts.

Announcements I: October 2007

The Radiology Interest Group Presents "Careers in Radiology: Panel and Meet and Greet": Tuesday, October 30, 2007, at 6:15 PM. The Radiology Interest Group and the Department of Radiology will be holding the second annual "Careers in Radiology: Panel and Meet and Greet." The purpose of the event is to introduce medical students to what life is like as a radiologist. Members of the Radiology faculty, along with fellows and residents, will be there to answer medical students' questions such as Why become a radiologist? What is the balance like between home, life, and work? What are the subspecialties in radiology? What does an interventional radiologist do versus a diagnostic radiologist? The event will be held at Nexus Cafe at the Clark Center on October 30 at 6:15 PM (a light dinner will be served). Please email Rebecca Rakow-Penner (rakow@stanford.edu) to RSVP or to ask any questions about the Radiology Interest Group.

New Faculty Hires and Promotions: October 8, 2007

Patrick Barnes, MD, became a professor of radiology on September 1, 2007. Dr. Barnes received his medical degree from the University of Oklahoma College of Medicine, Oklahoma City, Oklahoma, where he was also a resident. After completing his residency, he became a fellow in pediatric neuroradiology and cardiovascular radiology at Children's Hospital and Harvard Medical School, in Boston, Massachusetts. Before coming to Stanford in 2000, he was an associate professor of radiology at Harvard Medical School and director of neuroradiology and MRI at the Boston Children's Hospital. At Stanford, he has been the section chief of pediatric neuroradiology and the medical director, MRI/CT, at Lucile Salter Packard Children's Hospital since 2002. He was chosen as the Senior Faculty of the Year for 2002-2003, 2004-2005, and 2005-2006 for his outstanding contributions to resident education, compassionate patient care, and research. Dr. Barnes has provided outstanding clinical, educational, and administrative leadership for the Neuroradiology and Pediatric Radiology Programs in the Department of Radiology, and he continues to help build the Developmental Neuroscience Program in the Department and at Lucile Packard Children's Hospital.

(Image courtesy of Mark Riesenberger)

New Staff Hires and Promotions: October 3, 2007

Pam Hertz, RVT, joined our Department on August 6, 2007, as the new research veterinary nurse. She earned her certificate and diploma as a licensed registered veterinary technician in June of 1999 from Foothill College. Prior to coming to Stanford, she had been working in small animal veterinary practices since 1996. Her immediate supervisor will be Wendy Baumgardner, RVT, LATg, who will train her in the various areas of animal research and policy. Ms. Hertz says that she looks "forward to working with and learning from Wendy; she has been a great teacher." In her time off, she enjoys snow skiing, day hikes, golfing (she still needs lots of practice), and spending time with family and friends. Although she does not have any pets of her own now, she enjoys spending time with her friends' pets.

Celebrating 15 Years of Service: Keshni Kumar

Keshni Kumar, CRT, has worked at Stanford University for 15 years. At seventeen years of age, she began volunteering at Stanford Hospital and Clinics (SHC), when Dr. Rubin was a resident, to get exposure to the hospital environment. She attended Foothill College and Santa Clara University, and she graduated as a radiologic technologist. She has been working for Stanford Hospital and Clinics since 1992. Soon after, she was the lead technologist at Cowell Student Health Center (currently the Vaden Health Clinic) for two years and then served as the senior CT technologist at SHC for seven years. During Technologist Week, she won the Employee of the Year Award, which was a trip to Hawaii. She is now one of the top producers of the 3D lab, where she has been a radiologist assistant for three years. Ms. Kumar takes pride in her work: "I am very proud of how I contribute to patient care, which is why I still work at the Hospital as a relief CT technologist twice a month. I love challenging and intriguing new technologies." Her hobbies include teaching, running, hiking, and cooking.

(Image courtesy of Mark Riesenberger)

Awards and Honors: October 1, 2007

Craig Levin, PhD, associate professor of radiology and leader of the Molecular Imaging Instrumentation Laboratory (MIIL), has been awarded a new R01, "Enhancing Molecular Cancer Imaging with Cadmium Zinc Telluride PET" from the National Cancer Institute. This projects consists of studying novel imaging sensors comprising a semiconducor material known as cadmium zinc telluride (CZT) and incorporating these sensors into an innovative configuration for an advanced positron emission tomography (PET) system designed for imaging small laboratory animal cancer models. The proposed system built with these CZT imaging sensors promises to enhance substantially the capabilities of PET to detect, visualize, and quantify low concentrations of molecular cancer probes reaching their target on or within cells of diseased tissues. If successful, this work will impact the development of new cancer imaging assays and help to guide the discovery of novel treatments for cancer. In the MIIL, Dr. Levin's research involves the development of novel instrumentation and software algorithms for in vivo imaging of subtle molecular processes associated with disease in the clinic as well as in small laboratory animal research. The goals of the projects are to enhance the photon sensitivity and spatial, spectral, and/or temporal resolutions in order to advance the ability to accurately detect and measure lower concentrations of molecular signal. The ultimate goal is to introduce these new imaging tools into studies of molecular mechanisms and treatments of disease within living subjects.

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.

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.

Identity of Former Exorcist Movie Star, Dr. X, Revealed

Thank you for your patience and your guesses regarding Dr. X's identity in our previous article, "Former Exorcist Movie Star, Dr. X, Tells All"
(http://radiology.stanford.edu/blog/archives/2007/05/former_exorcist.html).

Yes, it is our own Dr. Barton Lane, chief of neuroradiology at the Veterans Administration Hospital in Palo Alto, California, who played the anonymous role of Regan's radiologist in The Exorcist (1973). Please find more pictures from his movie debut below! You can also view a short clip from his angiography scene by clicking on the following link: http://radiology.stanford.edu/blog_exorcist/.

Dr. Barton Lane (l) with Dr. Norman Chase (r), the chief of New York University (NYU) Medical Center when Dr. Lane was a neuroradiology fellow

Dr. Barton Lane (l) with his twin brother, Clinton (r)

Inside Terrorism: the X-ray Project

By Teresa Newton

"The idea for 'Inside Terrorism' began to coalesce in my mind in 2002 as a personal response to terrorism and to my discomfort with the way terrorism has been justified in some circles. This is a documentary of survivors of terrorism," remarked Diane Covert, the artist who created "Inside Terrorism: the X-ray Project." Sponsored by the Radiology Interest Group at Stanford (RIGS) along with various co-sponsors, this exhibit will be showing at the Fairchild Auditorium from September 4-15.

The images of "Inside Terrorism: the X-ray Project" are striking and emotional but, at the same time, are devoid of graphic imagery such as that depicted in Francisco Goya's images of war or Mathew Brady's photographs of the Civil War. We are shown pieces of survivors in CT scans and X-rays with titles like "Smashed Arm," "Damaged Leg," and "Broken Foot." The medium of X-ray and CT, however, makes the horror seem a step removed from the truly gritty and bloody reality of war wounds.

The mundane is made bizarre with images such as "Hex Nut in Brain," "Nail in Arm," and "Watch in Neck." Terrorists often create bombs using common objects, such as hex bolts, nuts, nails, and watches, that were meant for peaceful, utilitarian purposes. These unusual images are the by-products of terrorism's war on civilians.

The images of "Inside Terrorism: the X-ray Project" are displayed on four-sided kiosks, illuminated from the inside, and as standard wall-hung pieces. The CT and X-ray images are of victims of terrorist attacks from the two largest hospitals in Jerusalem, but they could be from anywhere--London, Madrid, New York, Lebanon, etc.

The artist, Diane Covert, described her choice of this unusual medium as follows: "Photography is a way of making an image by drawing with the very light that the objects reflect, so when we look at photographs from the Civil War battlefield of Antietam, we see something very close to the horror of the scenes as they appeared to the photographer. We see records of actual events. Modern medicine draws not with the visible light spectrum used in photography, but with electromagnetic radiation--X-rays and CT scans--and with this we can see inside the human body."

The opening reception for the exhibit is on September 4 from 5:30 PM-7:30 PM. To view the exhibit online, please go to http://www.x-rayproject.org.

Awards and Honors: August 13, 2007

Pat Basu, MD, MBA, diagnostic radiology resident, has received two honors: the American Medical Association (AMA) Jordan Fieldman, MD, Resident and Fellow Section Award and election to the Graduate Medical Education Committee. The Jordan Fieldman, MD, Award is named after Dr. Jordan Fieldman, who was an active voice for physicians during his residency and who passed away prematurely in 2004. Each year, the Fieldman Award is bestowed upon one resident physician who has demonstrated efforts in health advocacy and in improving the medical environment for physicians and their patients. The award winner receives funding to attend the two national annual AMA meetings and to give a presentation on the importance of health advocacy and an update on his/her own efforts. Dr. Basu was also one of five residents to be elected by residents and fellows to the Graduate Medical Education Committee for a one-year term. Along with attending physician representatives from each department in the School of Medicine, the Committee reviews and votes on all aspects of residency education such as resident/fellow benefits, hours, and education.

Awards and Honors: August 2, 2007

Frances Lau, MS, graduate student in electrical engineering and member of the Molecular Imaging Instrumentation Laboratory as well as the VLSI Research Group at Stanford, has received the McCormick Travel Grant Award. These travel awards were established by Katharine McCormick, who bestowed $5 million to Stanford in support of women pursuing careers in academic medicine. Ms. Lau will use her award to attend the 2007 Nuclear Science Symposium and Medical Imaging Conference where she will present her work on designing and developing electronics for a 1 mm resolution breast dedicated PET imaging system. Her research interests also include circuits and devices for biomedical applications.

Awards and Honors: August 2, 2007

Peter Olcott (on left), graduate student in the Bioengineering Department and member of the Molecular Imaging Instrumentation Laboratory, and Guillem Pratx, MS, (on right) graduate student in electrical engineering and a member of the Molecular Imaging Instrumentation Laboratory, have both won Bio-X Travel Awards. Mr. Pratx received his award for his oral presentation entitled, "Acceleration of Fully 3-D List-Mode OSEM for High-Resolution PET Using Graphics Processing Units," which he gave at the 9th International Meeting on Fully Three-Dimensional Image Reconstruction in Radiology and Nuclear Medicine. Mr. Pratx has developed real-time software for an intra-operative gamma camera and is now focusing on practical image reconstruction algorithms for high-resolution, pre-clinical PET systems. Mr. Olcott was granted his award at the 2007 Society of Nuclear Medicine Conference for his presentation, "Evaluation of a New Readout ASIC for a 1 MM Resolution PET System Based upon Position Sensitive Avalanche Photodiodes." His research focus is on delivering clinical imaging instrumentation for the Department of Radiology and the Molecular Imaging Program. Initially, he developed an intra-operative, hand-held gamma ray camera (or nuclear imager) for the surgical staging of cancer. Currently, he is engineering two novel clinical PET systems. The first system is the data acquisition electronics for a dual panel PET mammography camera. The second is a new PET detector for a combined clinical PET/MR scanner.

Awards and Honors: August 2, 2007

Eun Kyoung Ryu, PhD, postdoctoral scholar in the Molecular Imaging Probe Laboratory, has been awarded a Dean's Fellowship. Since 1941, endowment funds from donors to Stanford medical research have enabled these awards. Dr. Ryu's research interests include the development of novel radiotracers for brain imaging.

Awards and Honors: July 27, 2007

Angela M. K. Foudray, MS, CPhil, graduate student in physics at Stanford and member of the Molecular Imaging Instrumentation Laboratory, has received funding to attend the 2007 International Workshop on Bayesian Inference and Maximum Entropy Methods for her research project, "Bayesian Estimator for Angle Recovery: Event Classification and Reconstruction in Positron Emission Tomography." Ms. Foudray is currently developing a PET system using novel position sensitive avalanche photodiodes for higher sensation sensitivity and resolution specifically to image breast cancer mechanisms in small animals.

Nobel Symposium, "Watching Life through Molecular Imaging," Co-Hosted by Drs. Gambhir and Ringertz

By Julie Ruiz, PhD

The first Nobel Symposium to focus exclusively on molecular imaging was held at the Karolinska Institute in Stockholm, Sweden, from May 6 to 9, 2007. The conference featured world-renowned experts who addressed the increasing importance of molecular imaging for visualizing the biological processes in living organisms at the cellular and molecular levels. Sanjiv Sam Gambhir, MD, PhD, a pioneer in the field of molecular imaging, was selected to coordinate and host "Watching Life through Molecular Imaging" along with Hans Ringertz, MD, PhD, visiting professor of radiology at Stanford and professor emeritus of radiology at the Karolinska Institute in Sweden. Dr. Ringertz has been a member of the Nobel Assembly for Medicine and Physiology since 1986, and he was chair of the Nobel Assembly in 2003.

Drs. Gambhir (left) and Schwaiger (right)

"Watching Life through Molecular Imaging" featured an impressive list of speakers including Elias Zerhouni, MD, director of the National Institutes of Health, who delivered the opening address on the role of imaging in transforming medicine. The keynote speaker was the original inventor of positron emission tomography (PET), Michael E. Phelps, PhD, professor and chair of molecular and medical pharmacology as well as director of the Crump Institute for Molecular Imaging at the University of California, Los Angeles. Dr. Phelps addressed molecular imaging with PET in molecular diagnostics and molecular therapies.

Dr. Zerhouni delivers the opening address.

Other distinguished speakers included one of the co-developers of the combined PET/CT scanner, David W. Townsend, PhD, professor of medicine and radiology as well as director of the Cancer Imaging and Tracer Development Research Program at the University of Tennessee in Knoxville. Along with Dr. Ronald Nutt, president of CPS Innovations, Dr. Townsend developed the combined PET/CT scanner, which was named by Time magazine as the medical invention of the year 2000. Also among the conference presenters were Stanford scientists Craig Levin, PhD, associate professor of radiology (nuclear medicine), and Christopher Contag, PhD, associate professor of pediatrics (neonatology), associate professor of microbiology & immunology, and associate professor of radiology.

Drs. Townsend, Levin, and Contag

In his closing remarks, Dr. Gambhir noted the rapid development and immense promise of molecular imaging to provide tools for the far earlier detection of cancer and the assessment of therapy response. Specifically, he praised the interesting results in hyperpolarized MRI; the improvements in imaging agents; the importance of nanotechnology; and the increase in signal amplification. His closing remarks also addressed a myriad of new breakthroughs made possible by molecular imaging such as an increased understanding of brain biology, particularly in the areas of addiction and Alzheimer's disease.

Simultaneously, Dr. Gambhir stressed that the field needs molecular imaging and "morphologic and anatomical imaging to advance" together. A main theme of his closing remarks and the conference was the importance of unifying across multiple modalities and disciplines to encourage drug development; consortium activities for sharing imaging biomarkers; and clinical translation. "We need to start unifying principles even in the complex environment of tumor biology," Dr. Gambhir asserted, "by looking at the relationships between components of a system."

Dr. Norbert Pelc's Research Featured in AuntMinnie.com

By Julie Ruiz, PhD

Our Department's innovative research on volumetric inverse geometry CT (IGCT), directed by Dr. Pelc, ScD, was recently featured in an AuntMinnie.com article, "Inverse-Geometry CT Project Promises Higher Image Quality, Fewer Artifacts," by Eric Barnes (http://www.auntminnie.com/index.asp?Sec=sup&Sub=cto&Pag=dis&ItemId=76261).

Current multi-detector-row CT systems are unable to acquire volumes thicker than 4 cm in a single rotation, which impedes the imaging of larger organs, such as the heart, in a single rotation. The extension of this technology to image thick volumes has fundamental limitations. By using an array of sources, Dr. Pelc's IGCT research allows thicker volumes to be imaged faster with higher resolution and no cone-beam artifacts, which promises to improve the imaging of larger organs and to benefit difficult applications such as cardiac CT angiography and perfusion studies. Dr. Pelc described his results as "promising": "It's a technology that can be scaled to an arbitrary slab thickness; does not have conebeam artifacts; can deliver isotropic and homogenous spatial resolution across a higher volume; and offers excellent dose efficiency, partly as a result of the virtual bow tie." For more detailed reading on Dr. Pelc's research, please see "Inverse-Geometry Volumetric CT System with Multiple Detector Arrays for Wide Field-of-View Imaging" in Medical Physics (June 2007;34(6):2133-2142)
(available online at http://scitation.aip.org/getpdf/servlet/GetPDFServlet?filetype=pdf&id=MPHYA6000034000006002133000001&idtype=cvips).

The AuntMinnie.com article featuring Dr. Pelc's IGCT research is based on his June 13, 2007 presentation, "Volumetric Inverse Geometry CT (IGCT) with a Large Field-of-View," from the 9th Annual International Symposium on Multidetector-Row CT (MDCT) held at the Hyatt Regency in San Francisco, CA. Dr. Pelc was one of more than 64 world-renowned speakers featured at the MDCT, which offered over 180 lectures on topics such as "Technology: Present and Future"; "Contrast Medium Delivery and Risk Management"; "Pediatrics"; and "Cardiac PET/CT and Non-Coronary Applications."

The conference also included a special seminar on cardiovascular imaging; a hands-on workstation training; extensive equipment exhibits; and the 5th annual workstation face-off. During the face-off, physician-operators navigated the same five clinical datasets using different workstations to compare the capabilities, image quality, and workflow strategies of the workstations.

Stanford Radiology and the Canary Foundation Create Center of Excellence for Cancer Early Detection

From left to right: Gary M. Glazer, MD, Professor and Chair of Radiology; Don Listwin, CEO of the Canary Foundation; Beverly S. Mitchell, MD, Stanford Cancer Center Deputy Director; Philip Pizzo, MD, Medical School Dean; and Sam Gambhir, MD, PhD, Professor of Radiology, Professor of Bioengineering, and Director of the Molecular Imaging Program at Stanford (MIPS).

By Julie Ruiz, PhD

The Stanford Department of Radiology and the Canary Foundation have united to support research in early cancer detection by slating a grand total of $11.5 million dollars for research in molecular diagnostics and by creating the Center of Excellence for Cancer Early Detection. The Canary Foundation, a nonprofit organization that funds research in early cancer detection, has donated $7.5 million to Stanford University to fund early cancer detection. Of this total, $1.5 million will go to the Stanford Cancer Center, which has recently received a National Cancer Institute designation. The Department of Radiology will match the remaining $6 million of the Canary Foundation pledge with $4 million, resulting in the allocation of $10 million to establish a Center of Excellence for Cancer Early Detection. Headed by Sanjiv Sam Gambhir, MD, PhD, professor of radiology as well as bioengineering and director of the Molecular Imaging Program at Stanford (MIPS), the Center will advance molecular diagnostics by emphasizing molecular imaging to detect cancer at its earliest and most treatable stage.

Our Chairman, Gary M. Glazer, praised the alliance between our Department and the Canary Foundation: "Stanford's Radiology Department has played a leading role in advancing the revolution in medical imaging, which has transformed patient care over the past several decades. The newly developing field of cellular and molecular imaging has immense promise for providing tools for the far earlier detection of cancer and the assessment of response to therapy than existing methods. We are delighted that the Canary Foundation has recognized this potential and the strengths of Stanford by generously contributing to create this Center of Excellence."

The money for the Center will be allocated by a board consisting of Dr. Gary M. Glazer; Dr. Sam Gambhir; Dr. Beverly Mitchell, deputy director of Stanford's Cancer Center; and Donald Listwin, founder and CEO of the Canary Foundation (http://www.canaryfoundation.org). Dr. Gambhir is one of the researchers who will receive funds from the Canary Foundation's pledge. His work focuses on merging advances in molecular biology with those in biomedical imaging to revolutionize the diagnosis and management of disease and enable fundamental studies of cancer biology in living subjects (http://cancer.stanford.edu/features/research_news/Canary-Gift.html).

By making a pledge, the Canary Foundation has recognized the potential of developing new tools for the early detection of cancer and acknowledged the strengths of our faculty to make this a reality. The broad initiatives of the Center of Excellence offer great synergies with existing efforts across our Department and the School of Medicine. This remarkable opportunity will enable our faculty to pursue promising lines of work in early cancer detection.

2007-2008 New Chief Residents

Congratulations to our two new chief residents for the 2007-2008 academic year, Karen Conner, MD, MBA, and Thomas Efird, MD! They assumed their chief duties on July 1, 2007.

Dr. Conner with her daughters, Layne (l) and Drew (r).

Chief Resident Karen Conner, MD, MBA, has a close connection to Stanford; she was born at Stanford Hospital and grew up in Los Altos and Sunnyvale with a brief stint in Boulder, Colorado. For her undergraduate degree, she returned to Boulder, Colorado, to attend the University of Colorado at Boulder, graduating in 1989. For several years after college, she worked in biotech research, primarily medical diagnostics, and was a project manager at a start-up company just before entering medical school at the University of California, Los Angeles (UCLA). While at UCLA, Dr. Conner did research in women's imaging, graduating from the joint MD/MBA program in 2004. She then completed her internship at LDS Hospital in Salt Lake City, where she and her family took advantage of the skiing opportunities. Dr. Conner is a full-time single parent of two great teenage daughters, Drew and Layne, and their activities have become her second job. Drew loves rowing crew, and Layne is into competitive soccer and is starting lacrosse. In her free time, Dr. Conner loves to surf, ski, travel, and do anything outdoors. She is looking forward to her year as chief, and she hopes to make a positive difference in the radiology residency program.

(Image courtesy of Mark Riesenberger)

Like Dr. Conner, Chief Resident Tom Efird, MD, is a Californian. He grew up in Fresno, California, and attended Stanford University, earning his BA in English literature. After college, Dr. Efird lived in Hermosa Beach, California, for two years and worked for Geffen Records for a short time before becoming the manager of a startup software company in Beverly Hills, California. He obtained his medical degree from Tulane University in New Orleans, Louisiana, where he also completed his internship in internal medicine. While at Tulane, he met his wife, Arianne Ferguson, MD, who was one of his medical school peers. They married a little over a year ago, and she is now an R2 at Stanford in psychiatry. Although they do not have children yet, they enjoy playing with their Jack Russell Terrier, Riley. When he is not working, Dr. Efird also golfs, travels, and skis, as well as plays guitar and reads novels. He is really enjoying his residency, and he is looking forward to a great year.

Awards and Honors: July 3, 2007

Frances Lau, MS, graduate student in electrical engineering and member of the Molecular Imaging Instrumentation Laboratory as well as the VLSI Research Group at Stanford, was awarded the Stanford Bio-X Program Graduate Student Fellowship to support her interdisciplinary research on the design and development of a 1 mm resolution breast dedicated PET imaging system. Ms. Lau is also a member of the "Women in Electrical Engineering" (WEE) mentoring program through which she mentors new graduate students regarding class selection, research groups, qualifying examinations, and adjusting to graduate student life.

New Faculty Hires and Promotions: July 3, 2007

Shreyas Vasanawala, MD, PhD, will join the pediatric radiology and Department of Radiology faculty effective July 1, 2007. Dr. Vasanawala received his MD degree and a PhD in biophysics from Stanford University, followed by residency training in radiology at Stanford University Medical Center and a pediatric radiology fellowship at the Lucile Packard Children's Hospital this past year. During his fellowship, Dr. Vasanawala received specialty training in pediatric musculoskeletal imaging at Cincinnati Children's Hospital Medical Center and pediatric cardiovascular imaging at Sick Kids in Toronto. He will be appointed as director of body magnetic resonance imaging and co-director of MRI at the Lucile Packard Children's Hospital.

Awards and Honors: June 28, 2007

(From left to right: Martin P. Sandler, MD, FACNP, (outgoing SNM President); Sven N. Reske, MD, (awardee); Andrew Quon, MD, (awardee); Tore Bach-Gansmo, MD, PhD, (awardee); and Heinrich R. Schelbert, MD, PhD, (editor-in-chief, The Journal of Nuclear Medicine)

Andrew Quon, MD, assistant professor of radiology and nuclear medicine; Sandy Napel, PhD, professor of radiology and co-director of the 3D Medical Imaging Laboratory; Chris Beaulieu, MD, PhD, professor of radiology; and Sanjiv Sam Gambhir, MD, PhD, professor of radiology and bioengineering; director of the Molecular Imaging Program at Stanford; and chief of the Nuclear Medicine Division, have been awarded the 2007 Society of Nuclear Medicine (SNM) Best Clinical Article for their paper entitled "'Flying Through' and 'Flying Around' a PET/CT Scan: Pilot Study and Development of 3D Integrated 18F-FDG PET/CT for Virtual Bronchoscopy and Colonoscopy" published in the July 2006 Journal of Nuclear Medicine. In their article, they present a new imaging and processing protocol that can visually remove the organs and highlight tumors and cancerous "hot spots" in 3D positron emission tomography (PET)/computed tomography (CT) images.

Awards and Honors: June 26, 2007

Melissa Enriquez, MD, was awarded the 2007 Norman Blank Award for the outstanding medical student in Radiology. The award was created in memory of longtime faculty member and Director of Admissions Norman Blank, MD. Faculty who worked with Enriquez were impressed by her "extraordinary organizational and communication skills, ambition, drive, and commitment to radiology" and "great leadership potential." Dr. Enriquez "single-handedly resurrected the moribund Radiology Interest Group at Stanford, served as its president, and organized several after hours events to familiarize medical students with the field of radiology." She also arranged for this group to receive funds from the Associated Students of Stanford University (ASSU). Dr. Enriquez will graduate from the 2007 class of the Stanford Medical School on June 16. She matched at Harbor-University of California at Los Angeles (UCLA) Medical Center for a transitional year internship, and UCLA for a residency in diagnostic radiology. As award winner, she will receive a popular radiology textbook and a cash prize.

Lifetime Achievement Award: Dr. William Northway, Jr

(Image courtesy of Mark Riesenberger)

By Julie Ruiz, PhD

During his first year as an assistant professor of Stanford Radiology in 1964, Dr. William Northway, Jr, was captivated by what appeared to be multiple cysts in the chest X-rays of premature infants in severe respiratory failure who had been treated with mechanical ventilation and high oxygen concentrations. With his curiosity piqued, he began his research. By 1967, Dr. Northway had made a startling discovery: the high levels of oxygen used to treat respiratory failure in newborn premature infants were causing a new chronic lung disease, which he called bronchopulmonary dysplasia (BPD). His pioneering work dramatically changed the treatment of respiratory failure in newborn premature infants.

Dr. Northway is a Stanford legacy, who was born and raised in Palo Alto. His father served as the chair of physical medicine and rehabilitation at Stanford, and his mother was a nurse at Stanford-Lane Hospital before her marriage. He attended Palo Alto High School and Stanford University for his undergraduate and medical degrees. At Stanford, he met Drs. Henry Jones and Henry Kaplan and decided to become a radiologist. After medical school, Dr. Northway headed to the East Coast to complete an internship in internal medicine at the New York Hospital (Cornell University). He returned to Stanford in 1958 to begin his residency in radiology and encountered Dr. Robert Evans, the first pediatric radiologist at Stanford, and Dr. Herb Abrams. Both were critical to his interest in becoming an academic pediatric radiologist.

After finishing his residency in 1961, he enlisted in the air force and was stationed at Keesler Air Force Base Hospital in Biloxi, Mississippi, as the assistant director of the Department of Radiology from 1961 to 1963: "I spent two years in the United States Air Force as a captain and as one of two radiologists at a 500-bed hospital." At Keesler, he met and married his wife, Linda. In 1963, Dr. Northway obtained a fellowship at the Hopital des Enfants-Maladies in Paris, France, with the assistance of Dr. Robert Evans and Professor Jacques Lefevre, the leading French pediatric radiologist at the Hopital des Enfants-Maladies. Through Dr. Kaplan, he also secured a James Picker Foundation Fellowship for support.

Working at the Hopital des Enfants-Maladies was an enlightening experience, according to Dr. Northway: "The hospital had about 500 beds at the time, and it was repudiated to be the largest and oldest children's hospital in the world. Many of my patients had been flown in from the French colonies in Africa, so I saw things that you wouldn't see in the United States, like scurvy, which is caused by vitamin C deficiency; rickets, which is caused by vitamin D deficiency; and tuberculosis (TB) of the spine and other areas. They also had a large ward of patients with congenital bone dysplasias that no one had categorized yet."

He returned to Stanford in 1964 as an instructor in radiology and held a faculty position at Stanford throughout the rest of his 34-year career. Over the years, Dr. Northway has seen a multitude of changes. When he began in the Stanford Department of Radiology, children were not separated from adult patients for radiologic purposes. Also, radiotherapy, nuclear medicine, and diagnostic radiology were still one department when he was the director of the Division of Diagnostic Radiology from 1976 to 1981.

Most memorable were the technological advances. In the 1970s, CT and ultrasound technologies were primitive, but developing, Dr. Northway recalled: "We were just starting to have ultrasound and CT at that time. Initially, Dr. Zatz, who was developing the ultrasound technique, immersed the body part to be examined in water, and he reached in the water bath with the ultrasound equipment to make the images."

Teaching has changed as well. When Dr. Northway presented at grand rounds early in his career, he and his colleagues always presented with X-rays, lab results, and the patient, who is rarely involved with grand rounds today because of privacy issues. These changes in teaching have made it exciting but challenging. "Someone said once that by the time you have been out of medical school for 10 years only 10% of what you learned will still be in effect. When I was in medical school, they hadn't discovered DNA! The fun of teaching is passing on new knowledge," Dr. Northway asserted. Even amidst all the revolutionary changes, Dr. Northway had time to complete his research, in part, because the chair, Henry Kaplan, had established a policy that allowed each new tenure track faculty member to spend two days a week on research and three days on clinical care.

This protected research time allowed Dr. Northway to make a discovery that would permanently alter the treatment of premature infants with respiratory failure or hyaline membrane disease/respiratory distress syndrome (RDS). When he arrived at Stanford in 1964, pediatricians were just beginning to use very high levels of oxygen to treat premature infants with RDS. When a colleague asked him to look at a series of chest X-rays from treated premature infants, Dr. Northway was puzzled by the appearance of cystic changes in the lungs. After ruling out staphylococcus pneumonia, he examined all the infant charts, nursing notes, and pathology and concluded that the lung changes were related to pulmonary oxygen toxicity.

Dr. Northway's findings were published in a seminal article entitled, "Pulmonary Disease Following Respirator Therapy of Hyaline Membrane Disease (Bronchopulmonary Dsyplasia)," in The New England Journal of Medicine (1967 Feb 16;276(7):357-68). His many research studies on BPD helped advance the therapy of premature infants with respiratory failure by promoting the lowering of therapeutic oxygen concentrations. This, along with lower ventilator pressures and other advances in neonatology, significantly decreased the mortality rate for premature infants with respiratory failure.

In 1998, Dr. Northway retired from a 34-year academic career. During the same year, he was selected as the "Pioneer Session Honoree" by the Society for Pediatric Radiology (SPR) for his important contributions to the development of pediatric radiology. In 2003, he was awarded the SPR Gold Medal. In honor of his distinguished career, Dr. Northway also received the 2005 J.E. Wallace Sterling Lifetime Alumni Achievement Award, which is bestowed annually by the Stanford Medical Alumni Association in recognition of "exceptional lifetime achievement" in medicine. He continues to serve our Department as an active emeritus professor of radiology and pediatrics.

American Association of Physicists in Medicine (AAPM) Praises Medical Physics at Stanford

By Julie Ruiz, PhD

During their visit to Stanford on January 19, 2007, members of the AAPM Science Council were extremely complimentary about medical physics at Stanford after touring the Departments of Radiology and Radiation Oncology. AAMP Science Council Chair, John Boone, PhD, described seeing "one impressive lab after another, from MRI to x-ray CT physics, radiation therapy to molecular imaging, image processing to small animal imaging." By the end of the tour, he concluded that "excellence in medical physics research was evident at a scale that is perhaps matched by only a handful of universities in North America."

More than 5,000 medical physicists belong to the AAPM, a scientific, educational, and professional organization that promotes the application of physics to medicine and biology. Composed of 19 members, the AAMP Science Council acts as a clearinghouse for scientific inquiries and makes scientific policy recommendations to the AAMP Board. The Science Council meets on a regular basis and, once a year this meeting is held at a member's institution so that the Council can learn about the science being done by AAPM members. For more information on the AAMP, please visit http://www.aapm.org/org/default.asp.

The chair of our Department, Gary M. Glazer, MD, would like to thank Norbert Pelc, ScD, who is also a member of the AAMP Science Council, and the rest of the Stanford faculty and staff who helped coordinate the Science Council's tour of Stanford facilities: Chris Contag, PhD; David Dick, PhD; Sam Gambhir, MD, PhD; Arun Ganguly, PhD; Gary Glover, PhD; Paul Keall, PhD; Craig Levin, PhD; Sandy Napel, PhD; and Lei Xing, PhD.

Quick Stats: 3D Imaging Laboratory Equipment at the Lucas and Clark Centers

Thanks to Laura Pierce, MPA, RT (CT), for compiling this list.

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.

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.

3D Laboratory Celebrates Ten Years of Service

By Laura J. Pierce, MPA, RT (CT)

3D lab group photo taken March 2007 (image courtesy of Mark Riesenberger). First row (L to R): Sandy Napel, PhD, 3D lab Co-Director; Laura Pierce, MPA, RT (CT); Geoffrey Rubin, MD, 3D lab Co-Director; Second row (L to R): Kala Raman, MS; Keshni Kumar, CRT; Linda Novello, RT (MRI); Third row (L to R): Noe Hinojosa, RT (CT); William Johnsen, RT (CV) (RCIS); Lakeesha Winston; and Marc Sofilos, RT.

In September 2006, the Stanford 3D Medical Imaging Laboratory celebrated a decade of service to the Stanford Medical community. When the 3D Medical Imaging Laboratory was established in 1996, we had 300 square feet of space in the basement of the Grant building, occupied by one 3D imaging technologist (Laura Logan), and seven engineering students, postdoctoral fellows, and clinical researchers. The average monthly 3D volume was 64 examinations. Today, we have 1300 square feet of space in our two labs and six 3D imaging technologists: Laura Pierce, 3D Lab Manager (formerly Laura Logan); Marc Sofilos; Linda Novello; Keshni Kumar; William Johnsen; and our newest technologist, Noe Hinojosa. We also employ a full-time administrative assistant, Lakeesha Winston, and a software engineer, Kala Raman. The lab retains an annual average of twelve engineering graduate students and postdoctoral fellows as well as two clinical MD researchers. Our average monthly 3D volume has increased more than ten fold to 750 examinations.

In 1996, Co-Directors Geoffrey Rubin, MD, and Sandy Napel, PhD, created the 3D laboratory with the mission of developing and applying innovative techniques for the efficient analysis and display of medical imaging data through interdisciplinary collaboration. Ten years later, this mission continues to drive our operations and infuses our clinical, educational, and research goals. Clinically, our objective is to deliver 3D imaging advances as rapidly as possible following validation by the Stanford and worldwide healthcare communities. The 3D laboratory operates simultaneously in two locations: the first floor of the Lucas Center in P170 and the third floor of the James H. Clark Center in room S344 (next door to Peet's Coffee). We have processed over 44,000 examinations since our inception in 1996 (see figure 1). The lab provides 3D services for nearly every clinical department at the Stanford Medical Center. Ninety percent of our referrals are from CT examinations; the remainder is from MRI studies. With rapid advances in CT and MRI scanning over the past ten years, our 3D examinations now provide a larger range of coverage with better temporal and spatial resolution (see images 1, 2, and 3).

Our educational aim is to disseminate knowledge and duplicate our 3D services at other institutions by providing training for local and international physicians and technologists in the latest developments in 3D imaging. The 3D lab is attended by a rotation of Stanford Radiology fellows, residents, and medical students who are acquiring skills in 3D interpretation, which will be useful in their future clinical practices. In response to the external demand for 3D imaging training, the 3D lab has sponsored an increasing number of domestic and international visiting radiologists and technologists who have sought training through our 3D clinical fellowship program. We average three to five visiting fellows per month from a combination of local, national, and international hospitals and medical centers.

To fulfill our research goals, we are developing new approaches to the exploration and analysis of diagnostic images that will create new and more cost-effective diagnostic approaches as well as new techniques for the design and planning of therapy. The students and fellows we educate also make important contributions to our research by developing new image processing techniques. Professor Sandy Napel is the advisor of several PhD candidates and, occasionally, postdoctoral fellows. Each does research on a challenging area of image processing, such as the computer-aided detection of cancerous polyps on CT colon studies.

As we enter our second decade, the 3D Medical Imaging Lab continues to function as an international leader in clinical care, teaching, and research in medical imaging analysis. The confluence of talented medical and engineering expertise in our Department as well as the most up-to-date equipment has been a consistent source of innovative developments in our diagnostic and treatment planning approaches.

Figure 1. Annual volume of exams processed by the 3D laboratory over the past ten years.

Image 1. Example of a full-range maximum intensity projection (MIP) from 1996. This 3D image was acquired on a GE Advantage Windows workstation.

Image 2. Example of a full-range aorto-iliac runoff CT angiogram (MIP) image from 2006. Notice the improved spatial resolution and increased anatomical coverage. This image was acquired on a GE Advantage Windows workstation.

Image 3. Volume Rendered 3D image of the heart, demonstrating improved temporal resolution.

The Center for Cancer Nanotechnology Excellence Focused on Therapy Response (CCNE-TR) and the National Cancer Institute (NCI) Annual Site Visit, March 30, 2007

By Julie Ruiz, PhD

Over 75 visitors from a variety of universities, foundations, and industries attended the CCNE-TR/NCI annual site visit organized by Sanjiv Sam Gambhir, MD, PhD, professor of radiology and bioengineering; director of the Molecular Imaging Program at Stanford; chief of the Nuclear Medicine Division; and principal investigator of the CCNE-TR. The annual CCNE-TR/NCI site visit provides an opportunity for the NCI to review and experience CCNE-TR research and enables the scientists involved in the multiple cores of the CCNE-TR to convene in one meeting and share their scientific progress.

(Image courtesy of Mark Riesenberger)

Dean Philip Pizzo, MD, and Beverly Mitchell, MD, director of the Cancer Center, were among the 20 speakers presenting in the Clark Center. The site visit also included presentations featuring such topics as the proteomic identification of markers of therapeutic response in prostate cancer; the biological modification of quantum dots for in vivo targeting; and mouse cancer models for integrated tissue/serum proteomics and molecular imaging.

Like scientists at the National Cancer Institute (NCI), researchers at the CCNE-TR are convinced that nanotechnology will make a significant impact on cancer diagnosis and management in potentially revolutionary ways. The goal of the CCNE-TR is to develop and validate nanotechnology so that it will be possible to predict which patients will likely respond to a specific anti-cancer therapy and to monitor their response to therapy. Because of our investments in faculty and infrastructure, Stanford Radiology was selected in 2006 as one of eight institutions in the nation to receive support from the National Institutes of Health (NIH) to develop the CCNE-TR. This Center includes scientists from Stanford and from six other sites across the country: the University of California at Los Angeles; the University of Texas at Austin; the Fred Hutchinson Cancer Research Center; Cedars Sinai; Intel; and the General Electric Global Research Center. The CCNE-TR has greatly expanded our Department's collaborative efforts, and we now work with an additional 35 faculty in more than 20 departments here at Stanford and across the country.

Awards and Honors: March-April 2007

Scott W. Atlas, MD, professor and chief of neuroradiology and senior fellow at the Hoover Institution, has been accorded a grant from the Presidential Fund for Innovation in International Studies to support his research project, "Health Care for One Billion: Experimenting with Incentives for the Supply of Health Care in Rural China." Along with Scott Rozelle, PhD, Helen F. Farnsworth senior fellow at the Freeman Spogli Institute for International Studies, Dr. Atlas is examining the effects of existing health policies and institutions in rural China. Their project also studies a practice common in China's healthcare system that allows physicians both to prescribe drugs and to receive a large profit from drug sales. Their research experiments with realigning the incentives surrounding this practice. Dr. Atlas has also recently received a Fulbright Scholar Award to collaborate with leaders in China on improving and restructuring the healthcare system in China, a system that has dramatically devolved over the course of the past decade despite significant economic development in other areas. This year, Presidential Fund grants at Stanford were awarded to faculty teams composed of faculty from different disciplines who do not usually work together. Their projects had to involve collaborative research and teaching and to address one of three primary areas: the societal and security implications caused by China's female deficit; incentives to provide healthcare services in rural China; and the impact of higher education's rapid expansion in developing countries. For more information, please see http://news-service.stanford.edu/news/2007/february28/presfund-022807.html.

Feng Cao, PhD, postdoctoral scholar in the Cardiovascular Molecular Imaging Lab, received the 2006 Best Basic Science Paper Award from the journal, Circulation, for her paper, "In Vivo Visualization of Embryonic Stem Cell Survival, Proliferation, and Migration after Cardiac Delivery." In this article, Dr. Cao and colleagues analyze the fate of murine embryonic stem (ES) cells carrying fluorescence, bioluminescence, and positron emission tomography reporter genes transplanted into the heart.

Chona Diosomito, radiology clerical supervisor, received the March Stanford Hospital and Clinics Radiology Wingspread Award from the former recipient. Ms. Diosomito has been working in the scheduling division of Stanford Radiology since January 23, 2006, after moving to California from New York. She has worked in the health-care industry since 1990 as a patient financial services cash control supervisor for St. Vincent's Catholic Medical Center, Comprehensive Cancer Center (Aptium Oncology), and Hospital for Special Surgery. Ms. Diosomito's experience as a supervisor has given her an appreciation of how important it is to provide excellent care for each patient. In recognition of her outstanding work, Ms. Diosomito was awarded the Wingspread Award, which 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. 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.

Garry E. Gold, MD, associate professor of radiology, has been awarded a 2007 Cum Laude Award for an outstanding paper by the Society of Computed Body Tomography and Magnetic Resonance (SCBT/MR). The title of the paper is "Isotropic MRI with 3D-FSE-XETA (Extended Echo Train Acquisition)" (Gold GE, Busse RF, Stevens KJ, Han E, Brau AC, Beatty PJ, Beaulieu CF).

Sam Mazin, MS, graduate student in the Electrical Engineering Department, has been awarded the Society of Photo-Optical Instrumentation Engineers (SPIE) Cum Laude Award for his poster, "A Fast 3D Reconstruction Algorithm for Inverse-Geometry CT Based on an Exact PET Rebinning Algorithm." Only one poster within the "Physics of Medical Imaging" conference can receive this award each year. Cum Laude Awards are bestowed upon scientists who attain a standard of excellence judged by the quality and quantity of their results.

Joseph McGinley, MD, PhD, second-year radiology resident, has been selected as one of six trainees nationwide in radiology and cardiology to participate in the "Siemens Outstanding Academic Research (SOAR) Award Program: Awards for Excellence in Cardiac CT," sponsored by the Society of Cardiac Computed Tomography (SCCT). Dr. McGinley was selected to participate in this program based on his interest in cardiac imaging, current CV, and previous areas of research, which include a PhD in cardiac physiology focused on valvular heart disease from Temple University in Philadelphia. Under this award program, Dr. McGinley has been selected to write and present a review of the CT imaging of valvular heart disease. His manuscript will be published in Applied Radiology, and he will compete with the six other candidates at the 2nd annual meeting of the SCCT in July of 2007 in Washington, D.C. One person will be awarded from each specialty and will receive a six-month funded fellowship in cardiac imaging research as well as funding to return for the annual meeting in 2008.

Teresa Nelson, CRT, MRI supervisor, received the April Stanford Hospital and Clinics Radiology Wingspread Award from the former recipient. Raised in San Carlos, California, Ms. Nelson is a native of the peninsula. In 1994, she graduated with her AS degree from Canada College's Radiology Technology Program and worked at Seton Medical Center in Daly City and California Pacific Medical Center (CPMC) in San Francisco. Ms. Nelson started her Stanford career in January of 2000, when she began working in diagnostic radiology and mammography. During the fall of 2001, she completed MRI training and has been the MRI supervisor since 2003. As the MRI supervisor, Ms. Nelson has had the opportunity to train other technologists and engage in research. Last year, she spoke at the Fifth Annual Breast MRI Interpretation, Correlation, and Intervention Continuing Medical Education (CME) Conference in Las Vegas with Anne Marie Sawyer, RT (R) (MR), from the Lucas Center. In recognition of her outstanding work in MRI, Ms. Nelson was awarded the April Wingspread Award, which 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. 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.

Sandra Rodriguez, RT (R) (MR), MR research technologist, was awarded a Women's Opportunity Award from the Soroptimist Club. Many Women's Opportunity Award recipients have overcome enormous obstacles in their quest for a better life. The purpose of the awards is to improve the lives of women by giving them the resources that they need to improve their education, skills, and employment prospects. To be eligible for a Women's Opportunity Award, the applicant must provide the primary financial support for her family and must be enrolled in or have been accepted to a vocational/skills training program or an undergraduate degree program. Since its inception in 1972, the Women's Opportunity Awards Program has disbursed $15 million and has assisted more than 20,000 women. Ms. Rodriguez is currently enrolled in the Bachelor of Science in Health Administration (B.S.H.A) online program through the University of Phoenix. She anticipates receiving her degree in the 2008/2009 academic year and continuing her education by attaining a Master of Health Administration (MHA).

Ricky Tong, PhD, medical student in the Multimodality Molecular Imaging Lab, was awarded a 2007 Society of Nuclear Medicine Student Fellowship for his proposed project, which involves creating a transgenic mouse with the ubiquitous expression of a triple-fusion reporter protein. Any cells and tissues taken from this universal donor mouse can be traced using three of the most commonly available imaging techniques: bioluminescence, fluorescence, and PET. Dr. Tong's transgenic mouse promises to be an extremely valuable tool in many fields such as cancer and transplant biology.

David N. Tran, medical student at Stanford University, was awarded a "Society of Computed Body Tomography and Magnetic Resonance (SCBT/MR) in Training Award" at the 30th annual 2007 meeting of the Society of Computed Body Tomography and Magnetic Resonance (SCBT/MR). The award is granted to the young investigator who presents the best paper in CT or MR. Mr. Tran's winning paper is entitled, "Promises and Limitations of Dual-Energy CT in Lower Extremity CT Angiography" (Tran DN, Roos J, Straka M, Sandner D, Razavi H, Chang M, Pelc N, Napel S, Fleischmann D). He obtained his undergraduate degree from the University of California, Los Angeles, in electrical engineering and is currently a second-year medical student. Mr. Tran's research interests include improving the diagnostic evaluation and treatment planning for patients with peripheral arterial occlusive disease, and he is considering diagnostic and interventional radiology as a future clinical career.

Joseph Wu, MD, PhD, assistant professor of medicine (cardiology) and radiology, has received a California Institute for Regenerative Medicine (CIRM) SEED grant for his work on the in vivo imaging of hESC derivatives and tumorigenicity. Through his research, Dr. Wu is investigating human embryonic stem cell survival, proliferation, and differentiation in vivo to improve the safety of hESC delivery. Selected from among 231 applications, Dr. Wu is one of twelve Stanford principal investigators to be funded in this initial round by the CIRM, which has approved 72 grants totaling approximately $45 million over the next two years.

The Stanford Hospital and Clinics Digital Image Library

By Julie Ruiz, PhD

(Image courtesy of Mark Riesenberger.)
1st row: Carla (retiring as of 4/3/07), Tori (Victoria), Deborah
2nd row: Nancy, Ofelia, Lorna
3rd row: Louie, Jose, Kiki (LaKitra), Kim
4th row: Greg, Peter

The digital image specialists at the SHC Digital Image Library have a cumulative work experience of over 164 years. The specialists on staff and their years of service to our Department are as follows: Carla (over 33 years); Deborah, Digital Image Library Supervisor, (over 25 years); Greg (over 20 years); Jack (over 16 years); Jose (over 16 years); Peter (over 13 years); Ofelia (over 11 years); Lorna (over 6 years); Louie (over 6 years); Orwson (over 5 years); LaKitra "Kiki" (over 5 years); Nancy (over 5 years); and Kimberly "Kim" (over 3 years).

Our team provides a myriad of services for our Department as well as all other Hospital and clinical departments. These duties include processing requisition forms and sending patient tracking forms to the reading area for radiologists to dictate. Daily reports are utilized by the digital image library staff to insure all imaging exams have been dictated in a timely manner to meet departmental standards. The staff also import outside images from films or CDs into the Picture Archiving and Communications System (PACS) for comparison purposes. Patient radiology exams are prepared in the format of a CD for case managers and facilities external to Stanford when a patient has been discharged. The staff pulls and delivers exam studies for patient appointments at 10 different clinics. The number of clinic "pulls" has decreased from 20 clinics down to 10 clinics since the introduction of the PACS system.

In addition, the digital image specialists answer phones and manually compile exam folders on the PACS system for the musculoskeletal (MSK) section as well as the chest section. The transcription quality assurance (QA) duties are performed on a daily basis through the combined efforts of the outside transcription company, the radiologist, and the digital image library staff. At least four of the imaging studies that the staff processes on a daily basis are for law suits. They are divided into two categories: litigation cases, which implicate the Hospital as a defendant who is being sued by a patient, and subpoenas, which are used for evidence in a lawsuit and do not directly involve the Hospital as a defendant.

Most of the exam requests processed by the Digital Image Library staff are in digital format, but plain film copies are made upon request.

Life before Match Day: An Interview with Melissa Enriquez, MD, MPH, Former Stanford Medical Student

By Julie Ruiz, PhD

When she was five years old, Melissa Enriquez decided that if she could not be a cat, she wanted to be a physician. After attending Harvard University for her undergraduate education, she spent six years at Stanford University: four years as a medical student; one year researching issues related to women's health and infectious diseases; and one year completing the Master in Public Health (MPH) Program at the University of California, Berkeley. She has spent the past year applying to internship and radiology residency programs. For her internship, she applied to transitional programs, which offer a rotational mix of surgery, medicine, and emergency room (ER) medicine. Because her fiance, Leroy Sims, MD, was a Stanford medical student as well, Dr. Enriquez coupled matched so that she and her fiance could be geographically connected. She completed seven internship interviews.

During her residency interviews for radiology programs, she spoke to as few as three people and as many as six. Each interview was typically 15 to 25 minutes long. Her longest interview was 30 to 40 minutes long. Dr. Enriquez approached the residency interview process as an opportunity to meet somebody new and to share her story with someone else: "Who else is going to let you talk about yourself for 20 minutes? No one else is going to let you do that so it's great! Who else comes up to you and says 'tell me about your family'?"

Why did you decide to become a physician?
"In medicine, as difficult as this road is, you always know at the end of the day that you are making a contribution for the good. It doesn't have to be 'I saved someone's life,' or 'I invented some cure,' or something. It really just has to be that everyday you know that you are engaged in something that has some higher meaning."

How did you decide to become a radiologist?
"I went to my advisor, and he suggested coming up with six professional goals and six personal goals and scoring all the specialties across those goals, which I did, but I thought to myself, 'I want to go with gut feeling.' His point of view was that gut feeling can't be everything. You need to back it up with looking at your long-term plan and not just how you feel right now. If I went with gut feeling, I probably would have picked something I liked right now, and I may have been unhappy with it 15 years down the road. While I was doing this spreadsheet, I was also taking the diagnostic radiology elective, which is taught by Dr. Mindelzun. I liked it. I was reading the book for fun. It was suggested reading, but I don't think the rest of the class was necessarily doing all the reading, and I almost read the whole book just sitting in coffee shops. I thought,'I like this stuff,' and I went to my advisor halfway through the clerkship. He arranged for me to go to the interventional radiology (IR) suite the last two weeks every morning, which gave me the opportunity to participate a little more as a medical student and kind of address my concerns about radiology not having enough patient contact. After just those two weeks of meeting more people in the Department, I was really starting to think 'I can think of myself doing this. I like technology, having been a web developer in the past, and I like the people in the Department.' They were really laid back and supportive. I thought, 'Other people can't picture themselves sitting in a reading room for hours,' but I had no problem with doing that, having written code for hours on end and forgetting to eat and go to the bathroom."

Have you chosen a specialty?
"Picking a medical school was a lot easier than picking a specialty. A lot of people stress themselves out over where to go, etc. I think that at that age, knowing that you're going to go somewhere for four, five, or six years is an adventure. It's exciting and no matter where you go, you're going to get a great education. Picking a specialty is your life; it determines what your day-to-day life will be like forever, or for as long as you're working at least, so I think it is a lot harder."

"I am interested in academic medicine. I like teaching. I taught as a teaching assistant for nine quarters: all during medical school. During the preclinical years, it was fun. I think that's what keeps you young: hanging out with younger people [medical students] whom you teach a year after you took the course. I just made sure that I got to know the material a little bit better, and I liked the challenge. These are extremely intelligent, resourceful people. Trying to add value to their educational experience is challenging, and I think that's always going to be the case if you are in academic medicine, and you are learning how to teach adults while keeping up with new technology and new developments. You are always going to be stimulated, and I really like that."

What were your residency interviews like?
"I knew I wanted to do radiology--that process was easy. Then you have to choose which programs to send your applications to and for that I turned to faculty, like Dr. Jeffrey, and I asked for advice from Dr. Mindelzun. He met with us, took us to pizza, and talked about programs. He mainly gave us advice about the interview process: about being you, being natural, and having a conversation. The funniest thing he said to us was not to be like the KGB. He had an anecdote about an interviewee who came and just wouldn't give up information--one word answers. I will always remember that because it's hilarious; I can't imagine someone going into an interview and being completely closed."

What were your interview questions like?
"I've had some topics that focus on my family life or my history of immigration to the U.S. I've had other ones that focus on my MPH and what I want to do with it; others that talk about research; and others that talk about when I was a travel guide writer for a summer. I think that in radiology, the interview process is very conversational. There are no scary questions. Even the people who may be a little bit confrontational are never that confrontational."

What was the hardest interview question you were asked?
"'What was the hardest decision that you ever had to make?' Why is this so difficult a question when we've all had many difficult decisions to make? I think that most of us, once we've made the difficult decision, embrace it and don't look back on it like it was tough or something to regret. It was really hard for me to answer. So, I thought 'Have I really been making easy decisions all my life?' They never seem that difficult in retrospect in looking back over my life."

Do you have any advice for other medical students regarding the residency application process?
"Be aware of geographical biases for interviews. I was told that if I wanted to apply to New York and get an interview, I would have to have family in New York or do a rotation away in New York. No one believes that you will ever leave California. They have stories about people from California who sign up for interviews and then don't show up. The reputation is that you wouldn't leave--that everything is so beautiful and golden in California that you wouldn't dream about leaving. That was something I never would have anticipated."

"They want happy, constructive, and productive residents. The tough thing is that if you don't know about geographical bias as an applicant you might think you can just get an interview, and you might not do the things you need to do, such as go there for a rotation or write statements that are specific for that area."

"Why are the women applicants one [woman] to three [men]? Pediatrics and obstetrics/gynecology tend to have more women. On the interview trail, there were days when it was just me or 1 other woman and 10 men. Dr. Desser mentioned a study that claimed that women thought that radiology involved a lot of radiation, and therefore, didn't want to do it. It makes sense. Every time I tell a friend or family member, they think I will be taking X-rays. They don't say CT. They think just the name of the field implies radiation. I don't know why it [radiology] would be woman unfriendly. We are planning on doing a session on women in radiology and discussing this. I have another theory that it's based on the number of women in the physical sciences. It might be that. In radiology, you have to take physics, but that shouldn't preclude any of us. There are not that many doctors or medical students who like physics. I also wonder if they see the specialty as technology heavy. If people think it's only about radiation, there must be a lot of other misconceptions about radiology."

Match Day, March 15, 2007
When Melissa Enriquez was handed her envelope at the School of Medicine's annual Match Day ceremony on March 15, 2007, she thought, "Oh my god, my future is in this envelope!" (https://med-intranet.stanford.edu/education/spotlight/). She and her fiance, Leroy Sims, MD, were pleasantly surprised when they opened their match envelopes. Both of them will be headed to the University of California, Los Angeles (UCLA), which was their top choice as a couples match. Dr. Enriquez will be doing her transitional-year internship at Harbor-UCLA and residency at UCLA, while Dr. Sims will be completing his internship and residency in emergency medicine at Harbor-UCLA. Drs. Enriquez and Sims were 2 of 68 Stanford medical students who participated in the Match Day residency assignment process, along with 17,000 medical students across the United States. Stanford medical students matched 100%, and more than 85% matched with one of their top three choices. For more information on Match Day, please see "Hugs and High-Fives as Medical Students Meet Their 'Match'" by Tracie White (https://med-intranet.stanford.edu/education/spotlight/) and the Dean's Newsletter (March 26, 2007) (http://deansnewsletter.stanford.edu/).

Match Day, March 15, 2007

By Terry Desser, MD

The 2007 National Resident Matching Program results were announced on Thursday, March 15, 2007, and it was another banner year for Stanford Radiology. After a very successful recruiting season, we are welcoming nine new Stanford Radiology residents for 2008. Here are some brief descriptions of our new residents.

Stacey Crawford, MD, MBA, Dartmouth Medical School
Stacey Crawford is the daughter of a radiologist and will be the first woman to graduate from Dartmouth with a joint MD/MBA degree. While at Dartmouth, she conceived and developed their mini-MBA program for medical students. She also worked on a tele-ultrasound project and tested it in Central America.

Albert Hsiao, MD, PhD, University of California, San Diego, School of Medicine
Albert Hsiao studied biology and computer science at Caltech before entering the Medical Scientist Training Program at the University of California, San Diego. His PhD in bioengineering and his work in bioinformatics earned him several prizes, including a Radiological Society of North America (RSNA) trainee research prize. This year, as a visiting student on our cardiovascular imaging (CVI) rotation, he took to the computer graphics TeraRecon workstation like a fish to water. In his interview with me, he confessed that even as a child he would reprogram his video games to make them run faster. Albert hopes to contribute both to our image processing group in the 3D lab and the bioinformatics efforts of Dr. Gambhir's Molecular Imaging Program at Stanford (MIPS).

Michael Kim, MD, Joan & Sanford I. Weill Medical College of Cornell University
Michael Kim is originally from New Jersey and studied genetics and microbiology at Rutgers before entering Cornell Medical College. He is the founder of the Cornell Radiology interest group. Michael worked on the neuroradiology service with Dr. Atlas as a visiting medical student, and we are delighted he decided to come and join us for residency.

Deborah Lee, MD, David Geffen School of Medicine at the University of California, Los Angeles
Deborah Lee grew up in southern California and graduated as salutatorian of her undergraduate class at the University of Southern California, achieving the highest GPA of any woman student. At UCLA medical school, she did research on pancreatic cancer and traumatic brain injury, as well as work on protein folding. She is a big Martin Scorcese fan and is delighted to be moving to the Bay Area and closer to her sister who works at Guidant.

Jared Narvid, MD, University of California, San Francisco, School of Medicine
Jared Narvid was a Russian and Eastern European studies major at Yale before embarking on a neuroimaging fellowship in Washington DC in the year before medical school. As a medical student at the University of California, San Francisco, he has conducted neuroanatomic studies of face recognition in patients with neurodegenerative diseases.

Srihari Sampath, MD, PhD, Joan & Sanford I. Weill Medical College of Cornell University (on left) and Srinath Sampath, MD, PhD, Joan & Sanford I. Weill Medical College of Cornell University (on right)
Srinath and Srihari Sampath are twin brothers originally from southern California. Both have already attracted notice at the national level for their brilliant work in different fields of molecular genetics. At Stanford, they hope to contribute to the Molecular Imaging Program--as well as to our intramural basketball team.

Anobel Tamrazi, MD, PhD, University of Illinois College of Medicine at Urbana-Champaign
Anobel Tamrazi and his family were Christian refugees who fled Iran and eventually settled in the Bay Area. After attending San Jose State University, Anobel entered the Medical Scientist Training Program at the University of Illinois at Urbana-Champaign where he researched the fluorescent labeling of estrogen receptors. During medical school, he worked in Dr. Gambhir's lab as a visiting student, and he hopes to continue that work during residency.

Amy White, MD, Georgetown University School of Medicine
Amy White is a former competitive cyclist and Olympic hopeful who now applies her considerable energies to the radiology realm. As a medical student at Georgetown, she worked on several manuscripts and grants in interventional radiology and was a winner of the RSNA student research award.

Life after Match Day: An Interview with Pejman Ghanouni, MD, PhD, First-Year Stanford Radiology Resident

By Julie Ruiz, PhD

While in the MD/PhD program at Stanford University, Peji Ghanouni left Stanford to join several collaborative scientific efforts in Copenhagen, Baltimore, and Portland, and he spent two years at a start-up biotech company. Returning to Stanford to finish his last two years of medical school after completing his PhD and working in the biotechnology industry gave him an appreciation of the different opportunities within medicine; this perspective ultimately developed into an interest in the new advances within the field of radiology.

Dr. Ghanouni was accepted into the Radiology Residency Program at Stanford. He was particularly excited about the opportunity to apply his graduate research skills earned studying adrenergic receptors to molecular imaging. While earning his PhD in molecular and cellular physiology, Dr. Ghanouni studied how adrenergic receptors respond to hormone binding. To investigate how a hormone causes a biophysical change and what that conformational change means for protein activity, Dr. Ghanouni fluorescently labeled purified receptors, using similar approaches to molecular imaging methodologies. He hopes to apply what he has learned to this field.

Why did you choose radiology?
"I stumbled upon radiology. As a medical student, I took an introductory radiology course taught by several of the faculty here, including Dr. Mindelzun, and I really enjoyed it. Through a rotation with Dr. Mindelzun that followed the class, I saw that as a radiologist, one has to know something about everything. Actually, a lot about everything. For each disease, a radiologist has to blend knowledge of clinical symptoms, pathology, treatment, prognosis, and, of course, what the disease looks like using various imaging modalities, all to arrive at a reasonable list of possible diagnoses."

"The breadth of the field appealed to me. Another thing I liked about radiology was that it's a field that tends both to reinvent and to expand itself. Some procedures originally done by radiologists are now performed by other specialists. Our field has moved on to invent new things, whether evolutionary new algorithms for imaging, or, as in molecular imaging, potentially revolutionary new technologies and applications. I found those possibilities appealing as well. Even during the course of my training, the field will develop new imaging approaches. I'm fortunate to be at one of the places where those technologies are being developed and tested."

"I saw how fundamental radiology is to clinical decision making. Now as a resident, I enjoy my involvement in evaluating a patient, merging what we provide by looking at images of a patient's pathology with the clinical information that physicians provide. We're a service to the rest of the hospital. I appreciate that aspect of it. I like interacting with my colleagues. I've been here long enough to I recognize a lot of faces when they come and talk to us about whatever is going on with their patient, and I enjoy working with them to figure out what might be wrong."

"The last thing that was missing for me was that, as a PhD, I wanted to pursue academic research. I wasn't sure how, with my molecular biology and biochemistry background, I would be able to pursue research and radiology. The people I knew who have done research in radiology have had a physics or engineering background. They performed fundamental research on engineering, computer science, and algorithm development. It wasn't until Dr. Gambhir came that I saw an opportunity to apply my own background to research in the molecular imaging program here. I think that opportunity clinched my decision to pursue a career in radiology."

What was the residency interview process like?
"Interviewing is tiring. You have to travel, and deal with jet lag, and hotels, and driving directions, make a showing at the pre-interview dinner, try to answer the interviewers' questions intelligently, and then do it all again the next day or week."

"By the time an applicant gains an interview, everyone's academic record is similar. At that point, it has more to do with how you present yourself personally. How do you communicate? Are you easy to get along with? Are the interviewers, your future colleagues, likely to want to spend the next four years in a dark room with you?"

"Usually, there are five half-hour interviews. As an applicant, I was trying to get a sense of the personality of the various programs. And of course, the interviewers were trying to get a sense of me. Later, the interviewers get together and discuss their impressions of the applicants. It's not scientific, but it seems to work. Each program tries to attract people with particular personalities, reflecting the personalities of the people who are already there."

Where did you do your internship?
"I did a transitional internship at Santa Clara Valley Medical Center, which is the local county hospital. As a transitional intern, I rotated through the specialties--surgery, obstetrics/gynecology, pediatrics, medicine, emergency medicine--for one or a few months each, as opposed to spending a full year as a surgery or medicine intern. Through this type of internship, I was re-exposed to the various fields of medicine, but now as an intern, I had more responsibility in managing my patients. I loved it. The Valley is a fun place. Like most county hospitals I've heard of, the interns play a very hands-on role in managing the patients. Plus, the pathology that we saw there was amazing. All too frequently, our patients presented late in the course of a disease, and we would see and learn to manage the consequences of that."

"During some of my internal medicine months, I also rotated through Stanford. Since I'd been here as a student, I was generally familiar with the organization here. Stanford tends to be much more specialized, with fellows in every subspecialty helping to manage the patients. On the other hand, there are complex patients that I helped care for here that aren't going to be seen at most hospitals."

What has your first year as a resident been like?
"In a word, humbling. After all of these years of study, I almost feel that all I learned was the equivalent of the alphabet, and now I actually have to learn to read and write. It can be a frustrating transition; as an intern, I could do a good job taking care of very sick people. Now as a first-year radiology resident, I don't know enough to do more than listen and read. Basically, I've spent the year trying to build a foundation of knowledge, in preparation for taking call. We are eased into call, with lots of supervision by more senior residents, fellows, and attendings. On the other hand, by the time you are a third-year radiology resident, you are ready to manage most situations yourself. So when somebody comes to the Emergency Department (ED) and you're looking at their films, trying to figure out what's wrong with them--a surgeon may walk in to talk about another patient, a pediatrician may walk in, an internist, all trying to figure out what's wrong with their patients--you have to know the pathology for all of those patients. It's exciting that I'll be able to do that soon, but it's daunting because I have a lot to learn before then. Our class is about to start call, and while there is an element of anxiety, from what everyone tells me, you tend to learn a lot on call, in part because of the level of responsibility. I'm looking forward to it."

Research Opportunities in Japan: The Japanese Society for the Promotion of Science (JSPS) Fellowships

By Julie Ruiz, PhD

Like our National Science Foundation (NSF), the JSPS is one of the largest funding agencies in Japan with an annual budget of $1.8 billion. Of this amount, approximately $1.5 million was awarded to 50,000 scientific projects in 2006. From the total JSPS budget, foreign researchers received $100 million through international science cooperation programs. These JSPS programs provide opportunities for foreign researchers to conduct collaborative research activities at Japanese universities and research institutions. There are five JSPS programs open to U.S. scientists: the JSPS Invitation Fellowships for Research in Japan (1. short term and 2. long term); the JSPS Postdoctoral Fellowship Programs for Foreign Researchers (3. short term and 4. standard); and the JSPS Summer Program. Almost all Japanese universities and institutions participate in these programs.

In 2005, 73 U.S. scientists (4.3% of the total 1,704 fellows) participated in JSPS international programs. Of the total 1,704 international scientists, 30.5% (519) were from the biological, agricultural, and medical sciences while 35.3% (601) were from the mathematical, physical, and engineering sciences.

For more information about JSPS opportunities, please contact the Director, Dr. Seishi Takeda, at the JSPS San Francisco Office (510) 665-1890, by email (webmaster@jspsusa-sf.org), or through the JSPS website (http://www.jspsusa-sf.org). A condensed overview of each fellowship follows.

A) JSPS Invitation Fellowships for Research in Japan (1. short term and 2. long term)

1. JSPS Invitation Fellowships for Research in Japan: short term (2007-2008) (14 days to 60 days)

STIPEND: $153 (daily allowance); $1,271 (domestic research travel allowance); round trip air ticket

QUALIFICATIONS: for senior scientists, university professors, and other persons with substantial professional experience

STATISTICS: approximately 235 awarded/year; for FY 2007: 34 (applied)/12 (selected)--medical sciences; 94 (applied)/33 (selected)--engineering sciences; and 92 (applied)/33 (selected)--math/physical sciences

APPLYING: Japanese researchers wishing to host a U.S. fellow apply to JSPS, OR U.S. researchers apply to the NIH; application period: Sept. 4-8, 2006 (first recruitment)/May 7-11, 2007 (second recruitment)

FOR MORE INFO.: http://www.jsps.go.jp/english/e-inv/main.htm

2. JSPS Invitation Fellowships for Research in Japan: long term (2007-2008) (61 days to 10 months)

STIPEND: $3,127 (monthly allowance); $847 (domestic research travel allowance); $339 (research expenses); round trip air ticket

QUALIFICATIONS: for postdoctoral researchers, assistant professors, professors, or research associates, or for those with equivalent experience; PhD holders must have held a doctoral degree for a period of six years or longer as of April 1, 2007; non-PhD holders must be a university professor, associate/assistant professor, research associate, OR other person without a doctoral degree, who holds an academic position at an equivalent level, but does not have a PhD (and will not receive one in FY2007)

STATISTICS: approximately 70 awarded/year; for FY 2007: 20 (applied)/6 (selected)--medical sciences; 58 (applied)/16 (selected)--engineering sciences; and 50 (applied)/14 (selected)--math/physical sciences

APPLYING: Japanese researchers wishing to host a U.S. fellow apply to JSPS, OR U.S. researchers apply to the NIH; application period was Sept. 4-8, 2006

FOR MORE INFO.: http://www.jsps.go.jp/english/e-inv/main.htm

B) JSPS Postdoctoral Fellowship Programs for Foreign Researchers (3. short term and 4. standard)

3. Short-Term JSPS Postdoctoral Fellowship Program (2007-2008) (16 days to 11 months)

STIPEND: Research grant: $686/month; $3,237 (monthly allowance for PhDs) and $2,966 (monthly allowance for non-PhDs); $496 (travel $); $1,695 (settling in); round trip air ticket

QUALIFICATIONS: for graduate students, postdoctoral researchers, and faculty; all applicants must hold a doctorate degree, which must have been received within six years prior to April 2, 2007, OR be enrolled in a doctoral course at a university outside of Japan and be scheduled to receive a Ph.D. within two years of the fellowship going into effect

STATISTICS: approximately 60 awarded/year; for FY 2006: 15 (applied)/ 8 (selected)--medical sciences; 46 (applied)/13 (selected)--engineering sciences; and 42 (applied)/14 (selected)--math/physical sciences; of U.S. applicants: 26 (applied)/10 (selected)

APPLYING: U.S. researchers apply through the JSPS San Francisco Office or the NIH: Nov. 2, 2006 (first recruitment); Jan. 4, 2007 (second recruitment); Mar. 2, 2007 (third recruitment); April 4, 2007 (fourth recruitment); July 4, 2007 (fifth recruitment); and Sept. 5, 2007 (sixth recruitment); OR, find a Japanese researcher to apply on your behalf: Nov. 27-Dec. 1, 2006 (first recruitment); Feb. 5-9, 2007 (second recruitment); April 2-6, 2007 (third recruitment); May 7-11, 2007 (fourth recruitment); Aug. 6-10, 2007 (fifth recruitment); Oct. 9-12, 2007 (sixth recruitment)

FOR MORE INFO.: http://www.jsps.go.jp/english/e-fellow/postdoctoral.html

4. Standard JSPS Postdoctoral Fellowship Program (2007-2008) (12 to 24 months)

STIPEND: Research grant: $12,712; $3,237 (monthly allowance); $496 (travel $); $2,695 (settling in); round trip air ticket

QUALIFICATIONS: for postdoctoral researchers and faculty; all applicants must hold a doctorate degree, which must have been received within six years prior to April 2, 2007

STATISTICS: approximately 400 awarded/year; FY2007: 173 (applied)/35 (selected)--medical sciences; 373 (applied)/76 (selected)--engineering sciences; and 117 (applied)/24 (selected)--math/physical sciences

APPLYING: U.S. researchers apply through the NIH or the Social Science Research Council (SSRC), OR have a Japanese host researcher apply on your behalf through JSPS; Sept. 4-8, 2006 (first recruitment)/May 7-11, 2007 (second recruitment)

FOR MORE INFO.: http://www.jsps.go.jp/english/e-fellow/postdoctoral.html

C) JSPS Summer Program (2007-2008) (2 months)

STIPEND: Travel grant and stipend: approx. $4,525

QUALIFICATIONS: for predoctoral and postdoctoral researchers

APPLYING: Contact Ms. Akiko Chiba, at the Tokyo Regional Office of the NSF: http://www.nsftokyo.org/spmenu.html; tel: +81 (0)3 3224 5502; fax: +81 (0)3 3224 5507; e-mail: achiba@nsf.gov

FOR MORE INFO.: http://www.jsps.go.jp/english/e-summer/index.html

Is Iodine Safer than Gadolinium in the Renal Impaired Patient?

By Bob Herfkens, MD

Why nephrogenic systemic fibrosis (NSF) occurs in some patients who receive gadolinium-based contrast agents for MR imaging is still a mystery. First recognized in 1997, NSF is a rare disease occurring in renal insufficiency that causes a thickening of the skin as well as the muscles and vital organs. In the summer of 2006, NSF was linked to the administration of a high dose of gadolinium in patients with renal failure. Recently, the FDA announced an advisory, cautioning the use of gadolinium chelates in patients with moderate renal failure (gfr<60) and recommending discontinuing the use of it in patients with severe renal failure (gfr<15), unless prompt dialysis is arranged.

So, is gadolinium safe to use for our MR imaging studies? Our current MRI screening form contains a question about the presence of kidney (renal) disease. If this is checked "yes," indicating that the patient does have a history of kidney disease, the technologist must notify the radiologist before the MRI scan is initiated. The radiologist must determine if the MRI scan should be performed and if performed, if the scan should be with or without contrast agents.

In all patients with any history of renal disease, the use of gadolinium compounds should be minimized. Specifically, the use of Omniscan must be avoided. Patients with normal renal function and/or patients with no known history of renal failure who are receiving gadolinium contrast agents should voluntarily hydrate themselves after their studies.

Clearly, a whole generation of radiologists has grown up relying on the use of gadolinium. However, it is widely overlooked that most diagnoses can be made with non-contrast exams. We are too reliant on contrast enhanced exams. Time to dust off those old protocols! Because NSF has only been associated with renal failure patients, the wholesale use of iodinated contrast enhanced CT in this group should be weighed against the risk of iodinated contrast induced nephropathy. More news on this topic is forthcoming.

For more information, please visit the following links:

www.fda.gov/cder/drug/infopage/gcca/default.htm

RSNA NEWS includes a comprehensive feature article on this topic at http://www.rsna.org/Publications/rsnanews/feb07/upload/RSNANews_Feb07
_Gadolinium.pdf.

ACR MR Safe Practice Guidelines for 2007 will soon be available online on the American College of Radiology website (www.acr.org).

"Nephrogenic Systemic Fibrosis: Risk Factors and Incidence Estimation," by Elizabeth A. Sadowski, MD, and colleagues will appear in the April print issue of Radiology and is now available online at http://radiology.rsnajnls.org/cgi/content/full/2431062144v1.

"Gadolinium-based MR Contrast Agents and Nephrogenic Systemic Fibrosis," by Phillip H. Kuo, MD, PhD, and colleagues is available in the March print issue of Radiology or online at http://radiology.rsnajnls.org/cgi/content/full/2423061640v1.

GFR estimation sites:
www.globalrph.com/cgi-bin/crcl.cgi

www.nephron.com

nephron.com/cgi-bin/CGSI.cgi (includes body mass in the calculation)

THE CODING CORNER: Where All of Your Coding Questions Are Answered

By Darryl Costales
(Image courtesy of Mark Riesenberger)

ULTRASOUND OF THE ABDOMEN
Question: What anatomical structures need to be imaged and mentioned in a dictated report when performing an ultrasound (US) of the abdomen complete, CPT 76700 (.81 WRVU's)?

Answer: According to the 2007 CPT-4 coding manual, a complete US of the abdomen includes the liver, spleen, gall bladder, common bile duct, pancreas, kidneys, the upper abdominal aorta, and inferior vena cava, including any demonstrated abdominal abnormality. All of these structures need to be imaged and dictated in the report in order to bill correctly.

If you image and dictate a single organ, quadrant, or follow-up exam, then the appropriate charge would be an ultrasound abdomen limited, CPT 76705 (.59 WRVU's).

Have you got a question for the Coding Corner on billing, procedure codes, modifiers, or other related issues? Is there a topic you would like to see in a future issue? Just looking for general information? Ask us and we will do our best to answer your questions clearly and accurately (darrylc@stanford.edu).

HIFU Symposium a Great Success

(Image courtesy of Mark Riesenberger)

By Susie Spielman

On Monday, February 5, Stanford hosted a Symposium on MR-guided High Intensity Focused Ultrasound (MR-guided HIFU). The symposium was developed to introduce the new technology to our faculty and students and to demonstrate both the clinical capabilities and research opportunities for focused ultrasound techniques. The interdisciplinary nature of this exciting new treatment modality proved to be a great draw throughout the Stanford School of Medicine (SOM).

Recently installed on the 3T MRI in the Lucas Center, MR-guided HIFU was developed by InSightec and is a promising technique for the next generation of non-invasive therapy systems. With this technology, ultrasound energy is focused at a point deep within the body. One very exciting use is the thermal ablation of targeted tissue. This can be done with minimal heat deposition at the skin surface and without skin puncture or incision. MRI temperature imaging provides real-time control of the treatment.

The symposium featured leading world experts who described their experiences, current projects, and vision for the future. The talks covered HIFU applications for uterine fibroids, the prostate, the neurological system, the liver, the spleen, general abdominal tumors, and the bone. A hands-on session focusing on uterine fibroids (currently the only FDA approved technique) followed the symposium. This technology offers great potential for replacing invasive procedures and providing therapeutic alternatives to millions of patients.

We were delighted to welcome over 100 faculty, students, and residents from throughout the SOM to our event. The audience included representation from the Departments of Urology, Obstetrics & Gynecology, Comparative Medicine, Radiation Oncology, Otolaryngology, Pathology, Orthopedics, Surgery, and, of course, Radiology. From outside the University we had attendees from Hewlett Packard (HP); General Electric (GE); the Lahey Clinic; the University of California, San Francisco; the University of Wisconsin, Madison; and the Focused Ultrasound Surgery Foundation.

Within our own faculty, Kim Butts Pauly, PhD, Graham Sommer, MD, Rusty Hofmann, MD, Bob Herfkens, MD, and Bruce Daniel, MD, have begun to develop research programs utilizing HIFU.

For more information, please visit the following links:
The original program: http://www.stanford.edu/dept/radiology/focusedultrasound/
Insightec: http://www.insightec.com/

Continuing Medical Education

By Susie Spielman

Stanford's Continuing Medical Education (CME) Program has grown into the leading radiology CME effort in the country. In FY 2006, we welcomed over 3,300 registrants to 14 courses from more than 24 countries. Our symposia are developed to educate radiologists, technologists, and scientists about impending transitions to new and emerging technologies. In 2006, we grew our program by introducing courses on PET/CT and molecular imaging, small animal imaging, and the treatment of venous disease. Our International Symposium on Multidetector Row CT (MDCT), now in its eighth year, is one of our most successful programs. We had a record-breaking year in 2006 with 950 attendees. The meeting has been groundbreaking as a new model for education in radiology, and its influence on the field is unmatched.

http://radiologycme.stanford.edu/dest