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J UNE 2003 V OLUME 13, N UMBER 6 RSNA Visiting Professor Program Thrills Teachers as Well as Students Also Inside: New MQSA May Include Additional Requirements Radiology Residents Shy Away from Mammography UFE Safely and Effectively Treats Fibroids HIPAA Privacy Rule Requires New Documents from Researchers Strong Start for RSNA’s New Virtual Journal Club RSNA 2003 Course Enrollment Begins June 23 www.rsna.org/register

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  • JU N E 2003 VO LU M E 13, NUMBER 6

    RSNA Visiting Professor ProgramThrills Teachers as Well as Students

    Also Inside: New MQSA May Include Additional Requirements Radiology Residents Shy Away from Mammography UFE Safely and Effectively Treats Fibroids HIPAA Privacy Rule Requires New Documents from Researchers Strong Start for RSNAs New Virtual Journal Club

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  • RSNA NewsJune 2003 Volume 13, Number 6

    Published monthly by the Radiological Societyof North America, Inc., at 820 Jorie Blvd., Oak Brook, IL 60523-2251. Printed in the USA.

    Periodicals postage pending mailing withpostage in Oak Brook, IL 60523, and addition-al mailing offices. POSTMASTER: Send address correction changes to: RSNA News, 820 JorieBlvd., Oak Brook, IL 60523-2251.

    Nonmember subscription rate is $20 per year;$10 of active members dues is allocated to asubscription of RSNA News.

    Contents of RSNA News copyrighted 2003 bythe Radiological Society of North America, Inc.

    RSNA Membership: (877) 776-2636

    E X E C U T I V E E D I T O RJoseph Taylor

    M A N A G I N G E D I T O RNatalie Olinger Boden

    C O N T R I B U T I N G E D I T O RRobert E. Campbell, M.D.

    E D I T O R I A L B O A R DSusan D. Wall, M.D.

    Chair

    Lawrence W. Bassett, M.D.Richard H. Cohan, M.D.Nancy A. Ellerbroek, M.D.David S. Hartman, M.D.Bruce L. McClennan, M.D.William T.C. Yuh, M.D., M.S.E.E.Robert R. Hattery, M.D.

    Board LiaisonHedvig Hricak, M.D., Ph.D.

    Board Liaison-designate

    C O N T R I B U T I N G W R I T E R SStephen BarlasDennis ConnaughtonBruce K. DixonAmy Jenkins, M.S.C.Rita LietzMarilyn Idelman SoglinKen Schulze

    G R A P H I C D E S I G N E RAdam Indyk

    A D V I S O R SDave Fellers, C.A.E.

    Executive Director

    Roberta E. Arnold, M.A., M.H.P.E.Assistant Executive DirectorPublications and Communications

    2 0 0 3 R S N A B O A R D O F D I R E C T O R SDavid H. Hussey, M.D.

    Chairman

    Robert R. Hattery, M.D.Liaison for Publications andCommunications

    R. Gilbert Jost, M.D.Liaison for Annual Meeting and Technology

    Theresa C. McLoud, M.D.Liaison for Education

    Gary J. Becker, M.D.Liaison for Science

    Hedvig Hricak, M.D., Ph.D.Liaison-designate for Publications andCommunications

    Peggy J. Fritzsche, M.D.President

    Brian C. Lentle, M.D.President-elect

    Letters to the EditorE-mail: [email protected]: (630) 571-7837RSNA News820 Jorie Blvd.Oak Brook, IL 60523

    SubscriptionsPhone: (630) 571-7873 E-mail: [email protected]

    Reprints and PermissionsPhone: (630) 571-7829Fax: (630) 590-7724E-mail: [email protected]

    AdvertisingPhone: (630) 571-7819E-mail: [email protected]/advertising/ratecardrsnanews.html

    JU N E 2003

    1 People in the News2 Announcements

    Feature Articles 5 New MQSA May Include Additional

    Requirements 7 Radiology Residents Shy Away from

    Mammography9 UFE Safely and Effectively Treats Fibroids

    11 HIPAA Privacy Rule Requires New Documentsfrom Researchers

    13 Strong Start for RSNAs New Virtual JournalClub

    14 RSNA Visiting Professor Program Thrills Teachersas Well as Students

    Funding Radiologys Future22 Vanguard Profile: Philips Medical Systems23 Program and Grant Announcements25 R&E Foundation Donors

    21 RSNA: Working for You23 Radiology in Public Focus26 Meeting Watch27 Exhibitor News29 www.rsna.org

  • 1R S N A N E W SR S N A N E W S . O R G

    PEOPLEINTHENEWS

    Charles S. Resnik,M.D.

    A. Everette James Jr.,M.D., Sc.M., J.D.

    Stanley Baum, M.D.

    AUR/APDR Issue AwardsThe Association of University Radiologists honored two outstanding ra-diologists at its annual meeting in April. They are Stanley Baum, M.D.,editor-in-chief of Academic Radiology, and A. Everette James Jr.,M.D., Sc.M., J.D., from Chapel Hill, N.C.

    At the same meeting, Charles S. Resnik, M.D., from the Universityof Maryland Medical Center in Baltimore, received an AchievementAward from the Association of Program Directors in Radiology.

    CAR Awardees AnnouncedThe Canadian Association of Radiologists(CAR) has announced its 2003 award winners.In October, a CAR gold medal will be bestowedupon 1991 RSNA President Carl J. Zylak,M.D., from Henry Ford Hospital in Detroit.

    The CAR 2003 Young Radiologist Awardwill go to Derek Muradali, M.D., of MountSinai Hospital in Toronto.

    Pettigrew, Dean Named AIMBEFellowsThe American Institute for Medical and Bio-logical Engineering (AIMBE) has inductedtwo top NIBIB officials into its prestigiousCollege of Fellows.

    NIBIB Director Roderic I. Pettigrew,M.D., Ph.D., was honored for significantcontributions to research in MR imaging. Dr.Pettigrew is known for his pioneering work atEmory University using MR for 4-D imagingof the heart and work on quantitative assess-ment of blood flow and hemodynamics.

    NIBIB Deputy Director Donna J. Dean,Ph.D., was honored for directing the initialestablishment of the new institute and for im-portant contributions to the field. She was in-strumental in the formation and developmentof the organizational, administrative, scientif-ic and fiscal activities for NIBIB.

    McNeil, Pelc Join NIBIB Advisory BoardTwo new members have been appointed to the National Advisory Councilfor Biomedical Imaging and Bioengineering, the principal advisory bodyof the National Institute of Biomedical Imaging and Bioengineering(NIBIB). They are Barbara J. McNeil, M.D., Ph.D., and Norbert J.Pelc, Sc.D.

    Dr. McNeil is the Ridley Watts Professor and founding head of theDepartment of Healthcare Policy at Harvard Medical School. She is also a professor of radiology at Harvard Medical School and Brigham andWomens Hospital.

    Dr. Pelc is the associate chair for research and a professor in the Radi-ology Department at Stanford University School of Medicine.

    Barbara J. McNeil,M.D., Ph.D.

    Norbert J. Pelc, Sc.D.

    Roderic I. Pettigrew,M.D., Ph.D.

    Donna J. Dean, Ph.D. Carl J. Zylak, M.D.

  • 2 R S N A N E W S J U N E 2 0 0 3

    PEOPLEINTHENEWS

    Medicare Expands Coveragefor PET Scans, MR AngiographyThe Centers for Medicare and MedicaidServices (CMS) says it will expand cover-age of positron emission tomography(PET) to improve the care of Medicarebeneficiaries with thyroid cancer and thosewith potential cardiac diseases.

    CMS also says it is designing ademonstration to evaluate the potentialrole of PET for patients with suspected de-mentia, as well as a multi-disciplinary ex-pert meeting to fully explore the value ofPET for Alzheimer disease (AD). Formore information on the use of PET in theearly detection of AD, see the April issueof RSNA News.

    CMS has also announced that it in-tends to expand diagnostic options for cer-tain Medicare beneficiaries by making MRangiography available to patients with ab-dominal and pelvic vascular disease undercertain clinical circumstances.

    Record Number of Abstracts The RSNA Scientific Program Committee met June 6at RSNA Headquarters in Oak Brook, Ill., to work onthe scientific sessions for RSNA 2003. A record 7,700abstracts were received for consideration. Thats about300 more than those submitted for RSNA 2002.

    Letters will be sent in mid-June to notify individu-als about the status of their submitted abstracts for edu-cation exhibits. Letters will be mailed in mid-July forscientific papers and poster presentations.

    RSNAs program to make teenagersaware of careers in radiology wasnamed to the 2003 Associations Ad-vance America Honor Roll.

    Exploring Your Future in Radi-ology invites Chicago Public HighSchool students to spend a day at theRSNA Scientific Assembly and thencomplete a 100-question test aboutradiology. The winners of the 2002-2003 competition will be announced

    this summer. They will be presentedwith scholarship money during a cer-emony at RSNA 2003.

    Contributions such as yours arevital and add real value to society,says Michael S. Olson, C.A.E., presi-dent and C.E.O. of the American Society of Association Executiveswhich administers the awards. I commend the work you are doingand encourage you to continue.

    RSNA Public Outreach Program Added to AAA Honor Roll

    ANNOUNCEMENTS

    Send your submissions for People in the News [email protected], (630) 571-7837 fax, or RSNA News, 820

    Jorie Blvd., Oak Brook, IL 60523. Please include your full name and telephone number.You may also include a non-returnable color photo, 3x5 or larger, or electronic photo inhigh-resolution (300 dpi or higher) TIFF or JPEG format (not embedded in a docu-ment). RSNA News maintains the right to accept information for print based on mem-bership status, newsworthiness and available print space.

    Fearn to Lead ASRT in 2004-2005Dawn M. Fearn, M.A., R.T.(R)(T)(QM),CMD, is the new president-elect of the Ameri-can Society of Radiologic Technologists (AS-RT). She takes office this month.

    Fearn says shell focus on workforce re-cruitment and retention issues during her presi-dential year (June 2004 to June 2005). She alsohopes to expand ASRTs role as an advocatefor radiologic science issues in the legislativearena.

    Fearn is the director of the Samaritan Regional Cancer Center in Corvallis, Ore.

    Philips Promotes Price, StrengthensManagement TeamJack Price, president and C.E.O. for Sales &Service at Philips Medical Systems, NorthAmerica, has been promoted to executive vice-

    president of PhilipsMedical Systems.

    Also at Philips, twonew top executives havebeen added to the Med-ical Systems division.Randy E. Dobbs, for-mer president andC.E.O. of GE CapitalInformation TechnologySolutions for NorthAmerica, is the new

    C.E.O. for North Americas Sales & Service Re-gion. Barbara D. Franciose, former presidentand general manager for worldwide NuclearMedicine at Siemens Medical Solutions, is thenew global C.E.O. for the ultrasound businessline.

    Jack Price

    Dawn M. Fearn, M.A.,R.T.(R)(T)(QM), CMD

  • 3R S N A N E W SR S N A N E W S . O R G

    ANNOUNCEMENTS

    GOLD MEDALISTS

    HONORARY MEMBERS

    EUGENE P. PENDERGRASS NEW HORIZONS LECTURE

    The NIH Vision

    Detailed information about each of these honorees and presenters will be available in future editions of RSNA News.

    ANNUAL ORATION IN DIAGNOSTIC RADIOLOGY

    Internal Derange-ments of Joints:Anatomic-patho-physiologic ImagingCorrelation

    Distinguished Honorees and LecturersThe RSNA Board of Directors has announced this years list ofdistinguished honorees and lecturers to whom the Society willpay tribute at the 89th Scientific Assembly and Annual Meeting.They are:

    Stanley Baum, M.D.Philadelphia

    William G. BradleyJr., M.D., Ph.D.San Diego

    David B. Fraser, M.D.Musquodoboit Harbor,Nova Scotia

    Donald L. Resnick, M.D.San Diego

    Nicholas C. Gourtsoy-iannis, M.D.Heraklion, Crete, Greece

    Lilian F.L.Y. Leong, M.D.Hong Kong, China

    Elias A. Zerhouni, M.D.Bethesda, Md.

    Alois Rttimann, M.D.Zurich, Switzerland

    Jacob Valk, M.D., Ph.D.Wilnis, Netherlands

    ANNUAL ORATION IN RADIATION ONCOLOGY

    The Invaluable Roleof PET in RadiationOncology

    Lester J. Peters, M.D.Melbourne, Australia

  • 4 R S N A N E W S J U N E 2 0 0 3

    AMA Reviews Report on Com-mercialized Medical ScreeningWhen the American Medical Associationholds its annual policy making meeting thismonth in Chicago, the AMA House of Dele-gates is scheduled to review a report on com-mercialized medical screening.

    The report, from theAMA Council onScientific Affairs(CSA), briefly re-views the use ofelectron beam CTfor determiningcoronary artery calci-fication, spiral CT forlung cancer screening and CT colonographyfor colon cancer screening in the context ofgenerally accepted criteria that comprise avalid screening test. The use of total bodyscans for screening purposes was not specifi-cally evaluated.

    RSNA was able to comment on the sci-entific review included in a draft copy of thereport. These comments will be consideredby the CSA as it finalizes its report for con-sideration by the House of Delegates.

    More information will be available in afuture edition of RSNA News.

    Shaping Our FutureThe RSNA Associated Sciences Consortium is sponsoring three sym-posia during RSNA 2003. The theme for this years program will be Associated Sciences: Shaping our FutureForces at Work.

    The symposia will be held from 10:30 a.m. until 12:00 p.m. Each isapproved for 1.5 hours of CME credit.

    MONDAY, DECEMBER 1 Consumer-Driven Healthcare: Strategies for the Retail Medicine Era ofRadiology, presented by Russell C. Coile Jr.

    TUESDAY, DECEMBER 2Show me the Money: Government Reimbursement Policy, presentedby Bibb Allen Jr., M.D., and Are You Getting Paid for What You Do?Key Indicators to Audit, presented by James P. Trotter Jr.

    WEDNESDAY, DECEMBER 3 The Cost of Doing Business, presented by Monte G. Clinton and BobbiMiller, R.T.(R)(M)

    The Associated Sciences program also includes a series of eight refresher courses:

    How to Effectively Manage the Capital Asset Cycle: From AcquisitionPlanning to Replacement Strategies

    Continuity of Care Advanced Radiographic Practice Maximizing Your Practice Potential with Nurse Practitioners and

    Physician Assistants Workforce Crisis: Strategies for Management The Digital Department: Its Architecture and Design HIPAA: The Operational Impact in Radiology Digital Technology for Diagnostic Imaging (PACS, Digital Radiogra-

    phy and Computed Radiography)

    The Associated Sciences Consortium consists of American Health-care Radiology Administrators (AHRA), American Institute of Archi-tectsAcademy of Architecture for Health (AIAAAH), American Ra-diological Nurses Association (ARNA), American Society of Radiolog-ic Technologists (ASRT), Association of Educators in RadiologicalSciences, Inc. (AERS), Association of Vascular and Interventional Radi-ographers (AVIR), Canadian Association of Medical Radiation Technol-ogists (CAMRT), Radiology Business Management Association (RB-MA), Section for Magnetic Resonance Technologists (SMRT-ISMRM),Society for Radiation Oncology Administrators (SROA) and Society ofNuclear MedicineTechnologists Section (SNMTS)

    ANNOUNCEMENTS

    Letters to the EditorRSNA News welcomes Letters to the Editor.Let us know whats on your mind. Sendyour Letter to the Editor by mail to RSNANews, 820 Jorie Blvd., Oak Brook, IL 60523,by fax to (630) 571-7837, or by e-mail [email protected] Please include your fullname and telephone number. Letters may beedited for purposes of clarity and space.

  • 5R S N A N E W SR S N A N E W S . O R G

    Growing public concern over theperceived inaccuracies in mam-mogram interpretation may leadto new, congressionally imposed re-quirements for radiologists. Congress ispreparing to reauthorize the Mammog-raphy Quality Standards Act (MQSA).

    At a hearing in April before theSenate Health, Education, Labor andPensions Committee, MQSA author andcommittee member, Senator BarbaraMikulski (D-Md.), said, While federalstandards have improved the overallquality of breast x-rays incorrectreadings remain a strong concern.

    The acting committee chair, SenatorJohn Ensign (R-Nev.), sponsor of theHealth Act of 2003, said, The MQSAwas originally passed in 1992 to ensurethat all women have access to qualitymammography for the detection ofbreast cancer in its earliest, most treat-able stages. The issue of interpretiveself-assessment has been raised as apossible improvement to MQSA for thefuture. While an interpretive skills as-sessment is generally recognized as agood idea, there are questions as towhether an interpretive skills test willresult in improving a radiologists skillsin interpreting mammograms.

    Groups such as the Susan G. KomenBreast Cancer Foundation are advocat-ing interpretative skills assessment aspart of the MQSA-required CME, aswell as hospitals tracking additionalmammography quality parameters. Onebreast cancer survivor told the SenateCommittee that many within the sur-vivor community do not believe the cur-rent requirements are rigorous enough.

    Currently, interpreting physiciansmust read at least 480 mammogramseach year. In addition, educational re-quirements demand that every three

    years interpreting physicians must ob-tain 15 hours of category 1 CME cred-its specific to mammography.

    Professional radiology groups ac-knowledge that, in theory, it makes senseto improve the accuracy of mammograminterpretation but there is a delicate bal-ance to considerthe accessibility ofmammography versus making regulatoryrequirements so stringent that fewer radi-ologists specialize in mammography.

    D. David Dershaw, M.D., professorof radiology at Cornell University Med-ical College and director of breast im-aging at Memorial Sloan-KetteringCancer Center in New York, noted atthe hearings: The possible advantageof mandated self-evaluation, an addi-tional regulation that would need to befulfilled and documented by mammog-raphy facilities, should be weighedagainst the detrimental impact of in-creased regulation of mammography fa-cilities and radiologists interpretingmammograms. Steps that might furtherdiscourage radiologists from incorporat-

    ing mammography into their careersmay accelerate the developing crisis inavailability of mammography services.

    Articles published by The New YorkTimes in June 2002 spurred talk of fed-erally mandating the ACRs Mammog-raphy Interpretive Skills Assessment(MISA) program. The MISA test wasmade available in 1999 as an interac-tive computer-based CD-ROM. It offers radiologists an opportunity toparticipate in mammography self-assessment.

    Dr. Dershaw tells RSNA News thatthis type of program might be of valuebut should be optional, GenerousCME credits should be given for takingthe exam so that radiologists would beencouraged to participate.

    But he cautions that the resultsshould be nondiscoverable in court andby the public: While self-assessmenttesting may be of value, it should alsobe recognized that there are no data toindicate that such tests provide feed-

    New MQSA May IncludeAdditional Requirements

    Leonard Berlin, M.D.Chairman, Department of RadiologyRush North Shore Medical Center

    D. David Dershaw, M.D.Director of Breast Imaging, MemorialSloan-Kettering Cancer Center

    Continued on next page

    FEATURE:LEGISLATION

  • 6 R S N A N E W S J U N E 2 0 0 3

    back that accurately determines compe-tence. There is also no science to indi-cate that such tests result in improve-ment in the quality of medical care.

    In addition, Dr. Dershaw recom-mends that the entire package ofMQSA regulations be reviewed to de-termine what can be discarded, After10 years of federal regulation, none ofthe regulatory requirements have beendeleted. They have only been added to,making them progressively onerous.

    Leonard Berlin, M.D., chairman ofthe Department of Radiology at RushNorth Shore Medical Center and pro-fessor of radiology at Rush MedicalCollege in Chicago, also spoke beforethe committee: It is true that there ismuch variance among radiologists inrendering mammographic interpreta-tions and that some radiologists per-form poorly in this regard. Because ofsuch concerns, the need has been gen-erated to objectively assess and monitorthe performance of radiologists wheninterpreting mammograms, so as to as-sure the public that all mammogramsperformed in everypart of the nationreceive competent,relatively uniformradiological evalua-tion.

    Dr. Berlinagreed that self-as-sessment resultsshould not be avail-able to the public.He provided a com-prehensive reviewof how the publicsunreasonable expec-tation of the infallibility of mammogra-phy has led to untold lawsuits and hugejudgments against radiologists. Helinked those lawsuits to the price ofmalpractice insurance and a decreasingnumber of radiologists specializing inmammography. The purpose of myemphasizing the adverse impact of mal-practice on radiologists who do mam-mography is what may happen if the

    results of any self-as-sessment process un-dertaken by radiolo-gists are made publicor are discoverable inlegal proceedings, heexplained. The mal-practice litigationproblem will be exac-erbated and, as a re-sult, many more radi-ologists will simplyrefuse to undergo self-assessment exercisesand participate in per-formance improvement activities.

    At the Senate hearings, Democratsand Republicans seemed to agree that itmade sense to renew the law for twoyears during which time the GeneralAccounting Office could do a majorstudy on the pertinence of some of thecurrent regulations to the practice ofmammography in the 21st century andutility of mandating an ACR-type selfassessment. They agreed that allMQSA requirements should be re-viewed and that compliance with regu-

    lations should be an easiertask than it is presently.

    I know that radiologistsreading mammograms facemany challengeslow re-imbursement for mammog-raphy, difficulty readingmammograms and highmedical malpractice rates,Sen. Mikulski said. I wantto find the right balance toimprove the skills of physi-cians reading mammogramsto make sure womens livesare saved through the accu-

    rate reading of mammograms, but nottake steps that drive radiologists awayfrom mammography.

    Sen. Ensign concurred: The bot-tom line is that at a time when the med-ical liability crisis is hitting the industryharder than ever, the last thing the Fed-eral government should be doing is cre-ating more avenues for abusive law-suits. That is why Congress must bal-

    ance the need to find ways to improvethe quality and delivery of womenshealth, while at the same time preserv-ing a positive and equitable medical en-vironment for well-intentioned profes-sionals to practice.

    ReimbursementThe issue of grossly undercompensat-ed mammography services alsosparked some passionate testimony. Iencouraged them to raise reimburse-ment for mammography and to make itcomparable to reimbursement for simi-lar time and effect in reading CTs,says Dr. Dershaw.

    Two days after the hearing, SenatorsTom Harkin (D-Iowa) and OlympiaSnowe (R-Maine), along with 13 addi-tional cosponsors, introduced the AssureAccess to Mammography Act of 2003legislation identical to a measure intro-duced in the House in February.

    The new bill, like its predecessor,seeks to increase patient access to mam-mography by increasing Medicares lowreimbursement. This low reimbursementhas led to the closures of more than 700mammography facilities over the pasttwo years, according to ACR.

    More Radiology Residency Slots In addition to the increase in reim-bursement, the bill also provides for ad-ditional radiology residency slots.Specifically, the bill allows radiologyresidency programs to add one residenteach year for five years.

    Steps that might further

    discourage radiologists

    from incorporating

    mammography into their

    careers may accelerate

    the developing crisis in

    availability of mammog-

    raphy services.D. David Dershaw, M.D.

    Senator John Ensign (R-Nev.)

    Senator Barbara Mikulski(D-Md.)

    Continued from previous page

  • 7R S N A N E W SR S N A N E W S . O R G

    Radiology Residents ShyAway from Mammography

    The current shortage of mammogra-phers will likely get worse beforeit gets better.Lawrence W. Bassett, M.D., the Iris

    Cantor Professor of Breast Imaging atthe David Geffen School of Medicineat UCLA, and colleagues surveyedthird- and fourth-year radiology resi-dents, who had completed breast imag-ing rotations, at 211 accredited radiolo-gy residencies in the United States andCanada.

    Sixty-four percent of residentswould not consider a fellowship inbreast imaging if offered and 63 per-cent would not want to spend one-fourth or more of their time in clinicalpractice on interpretation of mammo-grams, says Dr. Bassett. The study appears in the June issue of Radiology.

    The most common reasons included: not interesting enough fear of lawsuits too much stressIt was somewhat surprising to find

    that 87 percent of residents rated inter-pretation of mammograms as beingmore stressful than other types of imag-ing, says Dr. Bassett. Thats higherthan I would have thought. The findingthat surprised us the most was the con-cern about liability. Apparently resi-dents are very attuned to medical-legalissues.

    As for the excitement of new tech-nology, Dr. Bassett admits that special-ties like neuroradiology involve com-plicated procedures where radiologistsget to use CT, MR and interventionalangiography. Breast imaging reliesheavily on conventional radiography,although there are interventional proce-dures and increasing use of digital tech-nology and sophisticated high-resolu-tion ultrasound equipment, he says.

    Coauthor Barbara S. Monsees,M.D., professor and chief of breast imaging at the Mallinckrodt Institute ofRadiology in St. Louis, says that in bothacademic and private settings, the out-look for access to quality breast imaging

    is dismal: Because of the Baby Boomerpopulation, an additional one millionwomen annually enter the pool of thoseneeding screening mammograms. In ad-dition, because breast cancer is morecommon in older women, we are seeinga rising number of breast cancers as theolder population increases.

    The National Center for Health Sta-tistics reports that the female popula-tion aged 40 to 84 years will increasefrom 64.6 million to 77.4 million in thenext two decades.

    Dr. Monsees, who is immediatepast-president of the American Societyof Breast Imaging, says clinics andhospitals are reluctant to expand theirmammography departments: If theyhave to make choices about wheretheyre going to put their resources,theyre going to put them into more lucrative servicesservices that paytheir own way. Because mammographyis a money loser, they dont want to invest in it.

    In addition, technical reimburse-ment for mammography services islower for hospitals than it is for outpa-tient facilities. This has had a major impact on teaching institutions because,for the most part, they are hospital-affiliated practices, according to Dr.Monsees.

    Lawrence W. Bassett, M.D.Iris Cantor Professor of Breast Imag-ing, David Geffen School of Medicine

    Barbara S. Monsees, M.D.Chief of Breast Imaging, Mallinckrodt Institute of Radiology

    The profession needs the help of

    others to drastically alter the re-

    imbursement scheme to compen-

    sate for actual costs [and]

    there needs to be some relief

    from medical-legal liability. Barbara S. Monsees, M.D.

    Continued on next page

    FEATURE:WORKFORCE

  • 8 R S N A N E W S J U N E 2 0 0 3

    There are disincen-tives to being in breast im-aging, says Dr. Monsees.People are concernedabout lawsuits, about thelack of reimbursement,about stress and burnout.Its perceived as a second-class specialty, which isalready affecting theworkforce. We see a de-cline in interest in breastimaging fellowships. Wehear from people in prac-tice that cant find radiolo-gists willing to read mam-mograms for the same rea-sons residents expressedin this survey.

    Dr. Bassett says the lack of interestin mammography cannot be blamed ontraining: This survey and previous sur-veys found that training has continu-ously improved both in the amount oftime residents spend on breast imagingand in their participation. Radiologyresidents are much more involved in in-terpretation, doing procedures, usingultrasound and so forth, than they werebefore 1990 when breast imaging wasincluded on the American Board of Ra-diology exam.

    He notes that of the 211 programsinvolved in the current study, 96 per-cent had a separate breast imaging sec-tion, compared with 81 percent in1992. The amount of time devoted tobreast imaging in the curriculum alsoincreased93 percent of programsnow require at least eight weeks. Resi-dents also reported that 41 percent ofthe directors or section heads workedexclusively in breast imaging and 75percent spent at least half their timeworking in mammography.

    During their rotations, the residentsindicated that they interpreted from 40to 575 mammograms per week with supervision, with a mean of 162 perweek.

    Still, the good news on the trainingfront has not translated to good news in

    clinical centers suffering from risingdeficits in breast imaging specialists.The researchers found that fellowshipsin breast imaging were offered at 53 institutions, but only 46 had filled theirpositions.

    Dr. Monsees says making breastimaging an attractive specialty toyoung radiologists will require intelli-gent policy decisions at the nationallevel: The profession needs the help ofothers to drastically alter the reimburse-ment scheme to compensate for actualcosts, and thats going to depend firston Medicare and Medicaid, and per-haps Congressional action. There alsoneeds to be some relief from medical-legal liability. There is movement inthat direction on Capitol Hill, but it isnt specific to breast imaging, and itmay not be enough help.

    Reading Volume and AccuracyA radiologists current reading volumedoes not statistically correlate with accuracy, according to a study in theFebruary 19 issue of the Journal of theNational Cancer Institute.

    Lead author, Craig C. Beam, Ph.D.,director of the Biostatistics Core at theH. Lee Moffitt Cancer Center and Research Institute of the University ofSouth Florida in Tampa, says, Themain implication of the study is that

    volume on its own is not a sufficientguarantor of expertise in mammogra-phy interpretation.

    The Beam study indicates that acomplex, multifactorial process is in-volved and needs to be better under-stood. For example, the researchersfound that recently trained radiologistsinterpreted mammograms more accu-rately than those trained earlier. Facili-ty-level factors that were statistically,significantly and independently associ-ated with better precision included thenumber of diagnostic breast imagingexaminations and image-guided breastinterventional procedures performed,being classified as a comprehensivebreast diagnostic and/or screening cen-ter or freestanding mammography cen-ter, and being a facility that practicesdouble reading.

    While the article acknowledgesthat volume might be a determinant ofexpertise and quality of care, Dr. Beamsays, We dont think that healthcarepolicy should base qualifying radiolo-gists solely on reading volume. I thinkwe need to investigate the set of fac-tors that go into making an expert anexpert.

    An accompanying editorial byJoann G. Elmore, M.D., from the University of Washington School of

    Graph 1 shows reasons selected by 132 resi-dents who would not consider a fellowship inbreast imaging if offered. Residents could selectas many reasons as they thought applied tothem. The y axis indicates the number of timesthe reason was selected by residents who wouldnot consider a fellowship in breast imaging.(Radiology 2003; 227:862-869) RSNA. Reprinted with permission.

    Graph 2 shows reasons selected by 133 residentswho would not like to spend a substantial portionof time (25%) in interpretation of mammogramsin their future practices. Residents could select asmany reasons as they thought applied to them.The y axis indicates the number of times a reasonwas selected by residents who would not like tospend a substantial portion of time (25%) in in-terpretation of mammograms.

    Continued from previous page

    Continued on page 12

  • 9R S N A N E W SR S N A N E W S . O R G

    Uterine fibroid embolization (UFE)may soon be the first line of treat-ment for fibroid tumors, which af-fect as many as 77 percent of womenaccording to government statistics.

    There are two trends that will in-tersect and make uterine fibroid em-bolization the preferred initial step infibroid treatment, says Mahmood K.Razavi, M.D., associate professor of ra-diology at the Stanford UniversitySchool of Medicine in California.Number one, patients are becomingmore and more informed about the pro-cedure to the point of directly referringthemselves for embolization. Numbertwo, gynecologists are beginning torecognize the efficacy of UFE and havestarted to refer patients for this proce-dure.

    UFE uses angiographic methodssimilar to those used in renal angiogra-phy or angiography of the extremities.A catheter is placed in each of the twouterine arteries andsmall embolizationparticles are injectedto block the arterialbranches that supplyblood to the fibroids.The fibroid tissue dies,the masses shrink, themyometrium is unaf-fected and, in mostcases, symptoms arerelieved.

    UFE offers a minimally invasive al-ternative to hysterectomy, which re-moves the uterus, and myomectomy,which surgically removes the fibroidsbut leaves the uterus in place.

    New research presented at theAmerican Roentgen Ray Society annu-al meeting in May found that UFE iseffective and may not cause infertility

    or premature menopause as previouslysuspected. A similar finding was report-ed at the Society of Interventional Ra-diology (SIR) meeting in March.

    In the June 2003 issue of the Amer-ican Journal of Roentgenology, Dr.Razavi published a paper comparingembolization with myomectomy. Weconcluded that anybody with sympto-matic fibroids should first be evaluatedfor embolization, he says. If for somereason the patient is not a candidate,then other procedures such as surgeryshould be considered.

    Dr. Razavi and colleagues com-pared 114 patients who underwent ei-ther UFE or myomectomy. We foundthat in terms of efficacy, the womenwho had bleeding were far better offwith embolization than with surgery,he says. There was a trend toward bet-ter pain and pressure outcome with em-bolization, but our numbers were notlarge enough to verify statistical signif-

    icance. Because my-omectomy removesthe mass, the surgicalpatients had betteroutcomes for reliefof bladder pressure.

    The recovery forUFE patients waseasier than for themyomectomy pa-tients. UFE was per-

    formed on an outpatient basis and pa-tients were back to normal activity byday 8. Myomectomy patients had athree-day hospital stay and took 36days to return to normal activity. Theuse of pain medication was also loweramong UFE patients. Estimated bloodloss was significantly higher for my-omectomy patients than for UFE pa-tients.

    Although it was not statisticallysignificant, the rate of reinterventionwith embolization was lower than rein-tervention with myomectomy, addsDr. Razavi.

    Since the mid-1990s UFE has be-come more common. Interventional ra-diologists have been performing uterineartery embolization for more than 20years; however, it was mainly used tostop postpartum hemorrhaging andbleeding associated with certain cancertreatments.

    Most women who have fibroids re-main asymptomatic. Only 10 percent to20 percent of fibroids require treat-ment, according to SIR. Medicationssuch as ibuprofen, hormone treatmentsand oral contraceptives are typicallyprescribed. When uterine fibroids donot respond to medication, surgical re-moval is often recommended.

    Drawbacks to UFE include smallrisks of amenorrhea, early menopause,pelvic inflammation and delayed

    Continued on next page

    UFE Safely and EffectivelyTreats Fibroids

    FEATURE:MEDICINEINPRACTICE

    Mahmood K. Razavi, M.D.Associate Professor of RadiologyStanford University School of Medicine

    We need to focus our efforts

    on educating the gynecology

    community about uterine

    fibroid embolization and its

    benefits to their patients. Mahmood K. Razavi, M.D.

  • 10 R S N A N E W S J U N E 2 0 0 3

    uterine cancer diagnosis, which is ex-tremely rare. The mortality risk is verylow, according to Dr. Razavi.

    Currently, Dr. Razavis researchgroup is studying the pelvic arteries tocharacterize fibroid blood supply. Theyare evaluating the correlation betweensize of the fibroid and outcome and be-tween MR characteristics and outcome.They are also looking at different meth-ods of minimally invasive fibroid treat-ment, such as ablation.

    Although the radiology communi-ty knows that embolization works,there has been a problem communicat-ing this knowledge to the gynecologycommunity, which sees these patientsfirst. At this point, most of our patientscome directly to us, he says. Workingwith gynecologists may be better forthe patient because some of them haveadditional gynecological problems that

    need to be attended to and we are notgynecologists. We need to focus our ef-forts on educating the gynecology com-munity about uterine fibroid emboliza-tion and its benefits to their patients.

    Patient Information about UFERSNA and the American College ofRadiology have a joint patient informa-tion Web site that provides easy-to-un-derstand information about radiologyprocedures and treatments. Patientswho search for information about UFEon RadiologyInfo (www.Radiology-Info.org), will find answers to the following questions: What is Uterine Fibroid Emboliza-

    tion? What are some common uses of theprocedure?

    How should I prepare for the proce-dure?

    What does the equipment look like?

    How does the procedure work? Howis the procedure performed?

    What will I experience during theprocedure?

    Who interprets the results and how doI get them?

    What are the benefits vs. risks? What are the limitations of Uterine

    Fibroid Embolization?RadiologyInfo also provides infor-

    mation on other womens imaging pro-cedures such as mammography, obstet-ric ultrasound, ultrasound-guidedbreast biopsy and x-ray guided breastbiopsy.

    Continued from previous page

    Type Ia anastomosis in a 45-year-old woman(a) Preembolization anteroposterior abdominal aortogram shows opacification of the right ovarian artery (arrowhead). Large uter-ine arteries are also visible bilaterally in the pelvis. (b) Selective right uterine angiogram in anteroposterior projection shows typi-cal myomatous blush. Note the absence of contrast material reflux into the tubo-ovarian segment. (c) Selective anteroposteriorovarian angiogram after uterine artery embolization. Reflux into the lower segment of uterine artery is visible, with truncation ofbranches supplying the fibroids (solid arrows). A faint ovarian blush (open arrow) also is evident. Ovarian artery flow is no longera source of blood supply to the fibroids. (Radiology 2002; 224:707-712) RSNA. Reprinted with permission.

    A B C

  • 11R S N A N E W SR S N A N E W S . O R G

    FEATURE:HIPAA

    HIPAA Privacy Rule Requires New Documents from Researchers

    Ever since privacy rules under theHealth Insurance Portability andAccountability Act (HIPAA) wentinto effect on April 14, all medical researchers, including radiology re-searchers, must heed new restraintsthat protect patients private health information.

    HIPAA defines research as a sys-tematic investigation, including re-search development, testing and evalu-ation, designed to develop or contributeto generalizable knowledge.

    HIPAA privacy rules for researchcover all human beings, living or dead,regardless of whether or not the re-search is supported by the federal gov-ernment.

    As most physicians know,every practice and healthcareorganization that act as a directtreating provider must nowprovide patients with a noticeoutlining the privacy practicesof their healthcare organizationand the patients privacy rights,and the organization must try toobtain written acknowledge-ment from patients that they re-ceived the notice.

    An indirect treatingprovider, such as a diagnosticradiologist who provides treat-ment based on another physicians or-der, also must prepare a notice and giveit to patients if they request it. Howev-er, the privacy rules do not mandatethat the indirect provider has to obtaina patients acknowledgement of the notice or post it in their office suite.

    Researchers in particular are re-quired to obtain a number of new docu-ments in order to conduct research inthe HIPAA era, including a researchauthorization form, a waiver of au-

    thorization, a review preparatory toresearch and a data use agreement.

    Under HIPAAs privacy rule, an in-stitutional review board (IRB) is re-sponsible for reviewing and approvingthe documents. At healthcare organiza-tions where no IRB exists, a privacyboard, as defined in the rule, has thesame responsibility. The privacy reviewis separate and distinct from a humansubjects review.

    Research Authorization FormHealthcare entities must obtain a pa-tients written permission before usinghis or her protected health information(PHI) for most clinical research. This

    requirement applies to new patients en-rolled in studies after April 14, 2003.Patients enrolled prior to April 14 donot have to sign a new authorization.

    The good news for researchers isthat the amended Privacy Rule allows asingle authorization form for all usesand disclosures of PHI that combinesinformed consent to participate in a re-search study and the HIPAA-requiredpatient authorization for research-relat-ed PHI use or disclosure.

    The research authorization formmust spell out the health informationthe researcher intends to use, includingmedical history, lab results, imagingstudies and physical findings. It alsomust name the people and organiza-tions that may use, share or disclose theinformation and the purpose of the dis-closure, along with an expiration datefor the use of the information.

    The form must notify the patientthat they have the right to refuse to signthe research authorization form and ad-vise them they may revoke the authori-zation after they have signed it. Addi-tionally, the form must notify the pa-tient of how they may revoke and the

    exceptions to that right, or referto the researchers notice of pri-vacy practices for that informa-tion.

    Under HIPAA, a patientmust withdraw in writing to re-voke subsequent use or disclo-sure of PHI. However, if datahave already been submitted tothe sponsor of the study, the re-searcher does not have to re-voke that data.

    Waiver of AuthorizationIf researchers need to use PHIfor some purpose other than

    treatment, payment, operations or a re-search protocol, they can apply for awaiver of authorization under these cir-cumstances: The research could not practically be

    conducted without a waiver and with-out access to and use of PHI.

    The use or disclosure of the PHI pres-ents no more than a minimal risk tothe patients privacy. Researchersmust show how they will protect the

    Continued on next page

    Researchers can avoid preparing all of the

    privacy documents and use PHI without a

    patients authorization by de-identifying or

    stripping the information of any specific

    identifiers. However, if the researchers need

    to use some of the patients health information

    they must file a data use agreement that

    spells out the limited identifiable data they need

    for research purposes.

  • 12 R S N A N E W S J U N E 2 0 0 3

    patients identifying information,present a plan to destroy the identi-fiers, and give written assurances thatthe protected health information willnot be reused.

    Reviews Preparatory to ResearchIf researchers need to assess the feasi-bility of conducting their research priorto beginning the study, they may sub-mit a document called a reviewpreparatory to research to the IRB/pri-vacy board. This preparatory reviewdocument permits PHI use and disclo-sure without requiring authorization ordocumenting the alteration or waiver ofauthorization if researchers only recordde-identified PHI and do not removePHI from the organization reviewing it.Practically, the document also shouldinclude the researchs title and the listof PHI the researchers intend to use.

    Data Use AgreementUnder HIPAA, researchers can avoidpreparing all of the privacy documentsand use PHI without a patients authori-zation by de-identifying or stripping theinformation of any specific identifiers.The HIPAA privacy rule lists 18 offi-cial identifiers of PHI, including the pa-tients name, address, telephone num-ber, employers name, social securitynumber and health insurance plan bene-ficiary number.

    However, if the researchers need to

    use some of the patients health infor-mation with only the obvious identi-fiers stripped from the dataset, theymust file a data use agreement thatspells out the limited identifiable data

    they need for research purposes.The overall purpose of the HIPAA

    privacy rule is to protect the rights ofindividuals to control disclosure of andaccess to their medical records. Civil

    penalties for not complyingwith the privacy rule include a$100 fine for each violation perindividual patient. So if the research involves 100 patients,the fine could be a hefty$10,000.

    Continued from previous page

    Continued from page 8

    More HIPAA Information Center for Medicare and Medicaid Services

    www.cms.hhs.gov/hipaa/hipaa2/default.asp American College of Radiology

    www.acr.org/dyna/?doc=departments/econ/hipaa/ American Medical Association

    www.ama-assn.org/ama/pub/category/4234.html

    HIPAA Privacy Rule Educational Materials for Researchers

    Several agencies of theU.S. Department of Healthand Human Services, in-cluding the National Insti-tutes of Health and theCenters for Disease Controland Prevention, have de-veloped HIPAA PrivacyRule educational materialsfor researchers and the re-search community.

    The materials are avail-able at privacyrule-andresearch.nih.gov.

    Medicine in Seattle, and colleaguesnotes, We still suspect that readinghigh volumes of films annually in con-junction with auditing and continuingeducation programs is the best ap-proach to obtain and maintain radiolo-gist expertise and thereby increase theaccuracy of mammography.

    Value of MammographyThe largest study to date on the bene-fits of mammography finds a signifi-cant drop in breast cancer deathsamong women who undergo screeningmammography.

    In the April 26 issue of The Lancet,Laszlo Tabar, M.D., director of the Department of Mammography at FalunCentral Hospital in Sweden, and col-

    leagues compared breast cancer deathsamong women before screening was in-troduced (1958-1977) with breast can-cer deaths among women after the in-troduction of screening (1978-1997).They found a significant 44 percentreduction in breast cancer mortality inwomen aged 40-69 years who were ex-posed to screening.

    Radiology Residents Shy Away from Mammography

  • 13R S N A N E W SR S N A N E W S . O R G

    Many radiologists are taking ad-vantage of RSNAs new inter-active Web site designed tohelp them learn more about specific ar-ticles in RadioGraphics, the Societysbi-monthly, peer-reviewed educationjournal.

    RadioGraphics editor William W.Olmsted, M.D., says he created theRSNA Virtual Journal Club (vjc.rsna.org) after finding that about 50 percentof residents queried in a recent RSNApublications survey do not participatein a formal journal club, I realizedRadioGraphics articles might be usedas the nucleus for starting this type ofprogram.

    Dr. Olmsted, who is also RSNAsEducation Editor, says he hopes theVirtual Journal Club will become animportant tool for residents and otherRSNA members who would like toknow more about the issues addressedin featured articles.

    How Does It Work?One article from the current issue ofRadioGraphics is featured on the Virtu-al Journal Club site.Readers can review thearticle as a PDF or onRadioGraphics Onlineand then can post theircomments and questionsto the authors. The au-thors will respond onlinewithin a few days of thepostings. After an initialthree-week period, thediscussion will remain open, but the author of the article will no longer respond.

    All content is monitored for appro-priateness and usage by RSNA staff.

    The first article, US of Gastroin-

    testinal Tract Abnormalities with CTCorrelation, was posted in January.The author of the article, Martin E.OMalley, M.D., is an assistant profes-sor at the University of Toronto. Dr.OMalley also works in the AbdominalImaging Division at the UniversityHospital Network and Mount SinaiHospital in Toronto.

    There were 2,300 hits to Dr. OMalleys online article and 2,000 hitson the discussion board. Dr. Olmstedcalls the response terrific.

    Dr. OMalley says the Virtual Jour-nal Club is a unique way of communi-

    cating with other radiologists: Thestrength of the program is that any radi-ologist with access to the Internet any-where in the world can ask the authors aquestion. The format is less formal andlabor intensive than writing a letter tothe editor, for example. I think this willallow more radiologists to participate inthis type of educational exercise.

    Dr. OMalley says he had no diffi-culties navigating the site, Once yougo through the initial steps, it is rela-tively easy to use. The only minordrawback is that the authors must be

    Strong Start for RSNAs New Virtual Journal Club

    William W. Olmsted, M.D.RSNA Education EditorRadioGraphics Editor

    Martin E. OMalley, M.D.Abdominal Imaging DivisionUniversity Hospital Network

    The strength of the program is that any radiol-

    ogist with access to the Internet anywhere in

    the world can ask the authors a question.

    I think this will allow more radiologists to

    participate in this type of educational exercise. Martin E. OMalley, M.D.

    Continued on page 16

    FEATURE:RESIDENTISSUES

  • 14 R S N A N E W S J U N E 2 0 0 3

    FEATURE:EDUCATION

    Two radiologists participating in theRSNA International Visiting Pro-fessor Program say their April vis-it to Guatemala was an incredibly re-warding adventure. In a telephone callfrom Antigua, Guatemala, James J.Abrahams, M.D., couldnt contain hisexcitement: This has been a phenome-nal experience. This terrific program isa plus to the RSNA.

    Dr. Abrahams is a nationally recog-nized neuroradiologist and head andneck radiologist at the Yale UniversitySchool of Medicine in New Haven,Conn. He is the chief of ear, nose andthroat radiology, a professor of diag-nostic radiology and surgery and direc-tor of medical studies for Yales Radi-ology Department. He traveled toGuatemala with Marc J. Gollub, M.D.,who is a specialist in gastrointestinal(GI) radiology and body CT at Memor-ial Sloan-Kettering in New York City.Dr. Gollub is chief of the CT section, isdirector of GI fluoroscopy and teachesresidents to perform state-of-the-artbarium studies.

    Like Dr. Abrahams, Dr. Gollub saysthe journey has had a significant impacton him: This has been a learning ex-perience as to how subspecialized mywork is in cancer radiology. At Sloan-Kettering, my primary focus is on radi-ology of the intestinal tract in cancerpatients. There is no such thing as a ra-diology specialist here in Guatemala.Radiologists here must be generalistsbecause there are so few of them.

    The entire nation of Guatemala, acountry the size of Tennessee, has 20CT scanners and four or five MR imag-ing units.

    In the United States, patients areaccustomed to the relative ease of ac-cess to medical care. In Guatemala

    City, patients line up at 5 a.m. for achance to get a radiographic study. Dr.Gollub says these are patients with seri-ous injuries and advanced forms ofcancer standing for hours in the warmhallways of Roosevelt Hospital. Gov-ernment financial assistance for pa-tients in Guatemala is limited.

    As part of the visit, Dr. Gollub hadthe opportunity to review unusual pa-tient studies that, until now, he has onlyseen in textbooks, such as patients suf-

    fering from parasites. The level of disease is far more

    advanced in Guatemala, especially inthe rural areas, than what we typicallysee in the United States, says Dr.Abrahams.

    The physicians say there are somedifferences in medical training for radi-ologists in Guatemala. There, studentsspend eight years in a combined col-lege/medical school/internship curricu-lum instead of the nine total years need

    RSNA Visiting Professor ProgramThrills Teachers as Well as Students

    Drs. Abrahams and Gollub (seatedleft to right) review a CT scan of thebrain at Democracy Hospital inGuatemala. Standing behind themare Dr. Eric Maldonado (left), chief of radiology, and Dr. Carlos Santizo.

    In Guatemala City, children prepare for the Holy Week proces-sional by making alfromascolorfulsawdust carpets.Photos courtesy of Dr. Abrahams

  • 15R S N A N E W SR S N A N E W S . O R G

    for this in the United States. InGuatemala, the chief radiology residentremains in the hospital where he or shehas trained. The rest of the fourth-yearresidents must continue training thatyear in rural hospitals. Most will even-tually go into private practice. Just likein the United States, there is a severeshortage of radiologists in Guatemala.

    Drs. Abrahams and Gollub begantheir journey in the capital, GuatemalaCity. They gave a series of talks at theNational Congress of Radiology ofGuatemala to very receptive audiencesof residents and radiology attendingphysicians.

    There is a great eagerness on thepart of the doctors and residents tolearn. Most radiologists in Guatemalarely on reading medical materials be-cause they dont have access to a lot oflectures, Dr. Gollub says.

    Having lived in Guadalajara, Mexi-co, for three years, Dr. Abrahams wasable to conduct his lectures in Spanish.Its been a while since I taught inSpanish, so I was surprised by beingable to speak in Spanish for such a longtime. It was fun for me, he adds.

    Dr. Gollub, who speaks French,says he was able to pick up the Spanishvery quickly. He says he was verygrateful for two excellent translators,Rosa and Sue. I think they were sur-prised by the length of the lectures.They got to learn some new medicalterms too, he says.

    On their second day in Guatemala,Drs. Abrahams and Gollub toured Roo-sevelt Hospital. We projected casestudies from our laptops to 15 resi-dents. The residents were so eager forknowledge. Despite the warmth of theroom, no one fell asleep during the pre-sentations, Dr. Abrahams says.

    They shared several meals with theresidents giving them an opportunity totalk about medicine, work and theirfamilies.

    We had incredible hosts, who havemade this experience easy and wonder-ful, says Dr. Abrahams. Francisco A.Arredondo, M.D., incoming president

    of the Guatemala Congress of Radiolo-gy and a member of the RSNA Com-mittee on International Relations andEducation (CIRE) who is based inGuatemala, and Reuben Alvarez, M.D.,outgoing president of the GuatemalaCongress of Radiology, picked them upeach day and showed them around.Dr. Arredondo invited us to his homeduring Easter week.This has been such anice experience for us,Dr. Abrahams adds.

    The formal partic-ipation of Drs. Abra-hams and Gollub wasvery well received andtheir presentations were excellent, bothas audiovisual material and overall intheir content, says Dr. Arredondo. Allthe residents and radiologists that par-ticipated in the activities were veryhappy and enthusiastic about the visitand also to learn about the internationalprograms of RSNA. I think the experi-ence also was rewarding for the visitingprofessors.

    Drs. Abrahams and Gollub took abreak from teaching during Easterweek to tour the ancient ruins at Tikal.They also spent time in Antigua, theformer capital of Guatemala and its

    second oldest city. Antigua is famousfor Semana Santa, or the Holy Week.Thousands of people, including Drs.Abrahams and Gollub, watched as resi-dents carried heavy religious statuesand altars made with flowers andwalked through the streets of Antiguaover elaborately constructed alfromas(colored sawdust carpets also made

    with flowers). They wrapped up

    their trip teaching in ahospital in Quetzalte-nango, Guatemala.

    Dr. Gollub says heapplied for the VisitingProfessor Program with

    the encouragement of his chairman,Hedvig Hricak, M.D., Ph.D., who is thenewest member of the RSNA Board ofDirectors. Dr. Gollub says this programis a great fit for those who enjoy teach-ing and travel. He would recommend aworking knowledge of the language ofthe country whenever possible. Dr.Abrahams applied for the program afterreading an article about the Internation-al Visiting Professor Program in RSNANews.

    Interestingly, Drs. Abrahams andGollub did not know each other before

    Dr. Gollub reviews a GI case with radiologists and residents at Democracy Hospital.

    Continued on next page

    In Guatemala City,

    patients line up at 5 a.m.

    for a chance to get a

    radiographic study.

  • 16 R S N A N E W S J U N E 2 0 0 3

    they were accepted. They met for thefirst time at RSNA 2002 and spoke onthe telephone many times before theytraveled to Guatemala. I couldnt havepicked a better teammate. We weresupportive of each other and truly aug-mented each other during our presenta-tions, Dr. Abrahams says.

    As part of the Visiting ProfessorProgram, CIRE provided a $1,500budget for educational materials fromthe RSNA Education Resources Cata-log to be donated to the host institu-

    tions. Dr. Abrahams says the residentsenthusiastically reviewed the catalogfor educational materials to be sent tothem at a later date.

    From our side it was a most suc-cessful visit that left a lot of newknowledge and overall a great appreci-ation for RSNA, says Dr. Arredondo.The visiting professors now havemany new friends in Guatemala whoare very grateful for their teaching andopen attitude.

    Two other teams of visiting profes-sors will travel to South Africa and

    Kenya in August and El Salvador inNovember.

    2004 International Visiting Professors RSNA is currently accepting applica-tions for 2004 Visiting Professors. Pos-sible destinations include Argentina,Romania and Mexico.

    More information about the Visit-ing Professors Program, as well as ap-plication forms, can be found atwww.rsna.org/international/CIRE/ivppor by calling (800) 381-6660 x7741.

    Dr. Abrahams gives a copy ofthe RSNA Education CenterCatalog to Dr. Maria Fonsecade Chacon, chief of radiologyat Roosevelt Hospital, andchief radiology resident PabloHernandez. As part of theVisiting Professor Program,RSNA will provide $1,500worth of educational materi-als to the host institution.

    Continued from previous page

    available and willing to check the ques-tions on a regular basis for three weeks.Dr. OMalley says he would participatein the Virtual Journal Club in the future.

    Potential for the FutureDr. Olmsted says he hopes the VirtualJournal Club becomes popular. Hewould also like to include more arti-cles from RadioGraphics and other ed-ucational products and exercises in thefuture.

    Dr. OMalley says he sees greatpotential for the site too: I think thiswill be an excellent learning tool forradiology trainees. The format is lessintimidating than writing a letter to ajournal or asking a question at a con-ference in front of a large audience. Iwould encourage trainees to make thissite a regular part of their educationalexperience.

    In the March-April issue, the fea-tured article was Clinical Role of FDGPET in Evaluation of Cancer Patients

    by Lale Kostakoglu, M.D., and col-leagues.

    The feature article from the May-June issue of RadioGraphics is Pedi-atric Cervical Spine: Normal Anatomy,Variants, and Trauma, by ElizabethLustrin, M.D., and colleagues.

    Access to the site and to the onlineRSNA journals is free for RSNA mem-bers. If you havent activated your sub-scription yet, go to radiographics.rsna-jnls.org/subscriptions/.

    Continued from page 13

    Strong Start for RSNAs New Virtual Journal Club

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    C D - R O MGamuts in Radiology Version 4.0By Maurice M. Reeder, M.D., with MRIGamuts by William G. Bradley Jr. andUltrasound Gamuts by Christopher R.Merritt

    The innovative and versatileGamuts In Radiology 4.0 contains theentire Gamuts in Radiology 4th Edi-tion textbook, plus more than 5,000radiographic images. Gamuts 4.0covers every modality of radiologic im-aging, including ultrasound, CT, MRI,mammography, angiography and plainfilms.

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    RSNA Member Price: $247.00

    C D - R O MEssentials of RadiologyBy Judith Korek Amorosa, M.D.

    The Essentials of Radiology is de-signed to teach the basics of currentradiology practice. It is useful for

    medical students (starting at any lev-el), residents of all specialties, clinicalcolleagues, physician assistants,nurse practitioners, nurses, technolo-gists, hospital administrators, man-aged care administrators, lawyers andlay support groups. This CD-ROMcontains over 330 interactive casesusing the well-established teachingmethods of Dr. Lucy Squire. In all,there are over 900 questions includ-ed in the course and over 2,300 im-ages (including x-ray, CT, HRCT, MRI,nuclear imaging, static ultrasound, re-al-time ultrasound and real-time fluo-roscopy). This is truly a comprehen-sive overview of the essentials of radi-ology and represents over 50 hours ofradiology instruction for the beginningstudent.RSNA Member Price: $125.00

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  • Continued from previous page

    N E W S L E T T E RThe RBMA Bulletin

    Your premier resource when itcomes to radiology education. TheRBMA Bulletin includes featured sto-ries written by industry professionalsas well as pertinent articles on prac-tice management, compliance issuesand legislation, HIPAA and ACR up-dates. You will also find up-to-date in-formation on RBMA educational semi-nars, conferences, networking oppor-tunities and products. Published sixtimes per year.RSNA Member Price: $90.00

    B O O KThe HIPAA Workbook for Privacyand Security

    The HIPAA Workbook for Privacy andSecurity: A Radiology Guide to Imple-mentation of the Health InsurancePortability and Accountability Act is aradiology-specific guide to implement-ing the HIPAA Privacy and SecurityStandards that includes sample poli-cies and procedures, consent and au-thorization forms, sample business associate and chain of trust agree-ments, planning and implementationguidelines, and much more.RSNA Member Price: $995.00

    T O O L K I TRBMA ComplianceImplementation Toolkit

    The RBMA Compliance Implementa-tion Toolkit was designed for andwritten by RBMA members ClaudiaMurray and Hilary Huebsch Cohen,J.D. Designed as a turnkey Toolkit so-lution for radiology and radiation on-cology practices to customize a com-pliance plan for their practice. RSNA Member Price: $895.00

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    B O O KWorkbook on Dosimetry andTreatment Planning for RadiationOncology ResidentsR.K. Wu, et. al.

    Provides a guide for second andthird-year residents in radiation oncol-ogy for their one-month physics anddosimetry training. 32 pp.RSNA Member Price $6.00

    R S N A P u b l i s h e r P a r t n e r s

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    C D - R O MInteractive Head & NeckBarry Berkovitz, Claudia Kirsch, Bernard J.Moxham, Ghassan Alusi, Tony Cheeseman

    Detailed and labeled 3D model ofthe head and neck that can be rotat-ed and layers of anatomy added orstripped away. 3D model is supple-mented by text, MRI, clinical slides,video clips and 3D animations.RSNA Member Price: $250.00

    C D - R O MInteractive SpineHilali Noordeen, Hazem Elsebaie, AlanCrockard, Robert B. Winter, John Lonstein,Ben Taylor, Roger Soames, Peter Renton,Stewart Tucker, Lester Wilson, Joseph J.Crisco

    Detailed and labeled 3D model ofthe entire spine that can be rotatedand layers of anatomy added orstripped away. 3D model is supple-mented by text, MRI, clinical slides,video clips and 3D animations.RSNA Member Price: $250.00

    C D - R O MInteractive ShoulderStephen Copeland, Louis U. Bigliani, RogerEmery, Andrew Amis, Andrew Chippindale,David W. Stoller

    Detailed and labeled 3D model ofthe shoulder, forearm and elbow thatcan be rotated and layers of anatomyadded or stripped away. 3D model issupplemented by text, MRI, clinicalslides, video clips and 3D animations.RSNA Member Price: $250.00

    C D - R O MInteractive HipAndrew Chippindale, Fares Haddad, JorgeGallante, Marchi Maheson, Sarah Muirhead-Allwood, Edmund Chao, David W. Stoller

    Detailed and labeled 3D model ofthe hip joint and upper leg that canbe rotated and layers of anatomyadded or stripped away. 3D model issupplemented by text, MRI, clinicalslides, video clips and 3D animations.RSNA Member Price: $250.00

    C D - R O MInteractive KneePaul Aichroth, Vishy Mahadevan, Justin M.Harris, David W. Stoller

    Detailed and labeled 3D model ofthe knee that can be rotated and lay-ers of anatomy added or strippedaway. 3D model is supplemented bytext, MRI, clinical slides, video clipsand 3D animations. RSNA Member Price: $250.00

    C D - R O MInteractive Foot & AnkleVishy Mahadevan, Robert Anderson, LloydWilliams, Penny Renwick, David W. Stoller

    3D model of the foot and ankle thatcan be rotated and layers of anatomyadded or stripped away. 3D model issupplemented by text, MRI, clinicalslides, video clips and 3D animations.RSNA Member Price: $250.00

    C D - R O MInteractive HandD.A. McGrouther, Judy C. Colditz, Justin M.Harris, David W. Stoller

    3D model of the hand, wrist, fore-arm and elbow that can be rotatedand layers of anatomy added or

    stripped away. 3D model is supple-mented by text, MRI, clinical slides,video clips and 3D animations.RSNA Member Price: $250.00

    C D - R O MSports Injuries: The KneePaul Aichroth, Roger Wolman, TracyMaunder, Andrew Amis, Anthony Bull

    3D model of the knee that can berotated and layers of anatomy addedor stripped away. 3D model is supple-mented by sports injuries, rehabilita-tion and biomechanics text, clinicalslides, video clips and 3D animations.RSNA Member Price: $250.00

    C D - R O MOrthopaedics In Action: PrimaryHip ArthroplastyT.W.R. Briggs, M.Ch. (Orth) FRCS,Consultant Orthopaed, S.R. Cannon, J. Skinner

    3D model of the hip that can be ro-tated and layers of anatomy added orstripped away. It covers all aspects re-quired for primary Total Hip Arthroplas-ty, from patients first visit to outpa-tients clinic through pre-operativeplanning phase and the surgical pro-cedure itself, utilizing both lateral andposterior approaches. Descriptive textis supplemented by live surgery videoclips and 3D animations.RSNA Member Price: $250.00

    C D - R O MInteractive Spine ChiropracticEditionAlexandra Webb, Guy Gosselin, JonathanCook, Dana J. Lawrence, Roger Soames

    Detailed and labeled 3D model ofthe entire spine that can be rotatedand layers of anatomy added orstripped away. 3D model is supple-mented by chiropractic examination,conditions and treatment sections in-cluding text, clinical slides, video clipsof tests and treatment.RSNA Member Price: $250.00

    B O O KBone Dysplasias, 2e(0195214749)Jurgen Spranger

    The long-awaited new edition of this1974 classic is now available! Perfectto aid in the evaluation of patientswith skeletel dysplasias. 600 pp. RSNA Member Price: $175.00

    B O O KInterventional RadiologyJames Byrne

    This new book describes a range ofimaging techniques used in the regionof the head, neck, and spine. 368 pp. RSNA Member Price: $225.00

    B O O KRadiation PathologyLuis Felipe Fajardo

    Up-to-date coverage of the effectsof ionizing radiation on human tissues.472 pp. RSNA Member Price: $175.00

    B O O KImaging in RheumatologyDavid Isenberg & Peter Renton

    This book provides a unique reviewof all modalities in imaging that canassist the clinician in diagnosingrheumatological diseases. 560 pp. RSNA Member Price: $152.50

    B O O KPrinciples and Practice ofBrachytherapyC.A. Joslin, A. Flynn and E.J. Hall

    This highly effective treatment isgiven complete coverage in this book.464 pp. RSNA Member Price: $149.50

    B O O KPractical Radiation Protection inHealthcareColin J. Martin and David G. Sutton

    Includes general radiation princi-ples, coverage of both ionizing andnon-ionizing radiations, and guidanceon which methods to follow. 384 pp.RSNA Member Price: $69.95

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  • B O O KMRI of the Foot & Ankle: Pearls,Pitfalls & PathologyR.J. Rolfes, M.D., S.J. Pomeranz, M.D., andT.W. Kim, M.D.

    This 200+ page textbook is brokendown into chapters on ligaments, ten-dons, fractures, arthropathy, coali-tions, oesteochondral defects, os-teonecrosis, impingement, tarsal tun-nel and neural entrapment, achilles,masses, infections, plantar fasciitisand parts & accessories. Fully indexedfor ease of use, the hard cover volumeis built to assist readily in daily prac-tice and study of this complex and of-ten difficult area. 200+ pp. RSNA Member Price: $112.50

    B O O KMRI Total Body Atlas Vols. 1-3 SetStephen J. Pomeranz, M.D.

    Complete set of the definitive, com-

    prehensive anatomic reference not on-ly commonly referenced structuresthroughout the body, but also spaces,areas between joints and less fre-quently imaged anatomic locations.768 pp. RSNA Member Price: $630.00

    B O O KMRI Total Body Atlas Vol I NeuroStephen J. Pomeranz, M.D.

    Definitive, comprehensive anatomicreference detailing not only commonlyreferenced structures in the brain andspine, but also the larynx, neckspaces, and cranial nerves. 229 pp.RSNA Member Price: $225.00

    B O O KMRI Total Body Atlas Vol II OrthoStephen J., Pomeranz, M.D.

    Definitive, comprehensive anatomicreference detailing not only commonlyreferenced structures in the muscu-loskeletal axis, but also areas between

    the joints in the extremities. 326 pp.RSNA Member Price: $225.00

    B O O KMRI Total Body Atlas Vol III BodyStephen J. Pomeranz, M.D.

    Definitive, comprehensive anatomicreference detailing not only commonlyreferenced structures in the chest, ab-domen and pelvis, but also thebrachial plexus, uterus and testes. 213pp.RSNA Member Price: $225.00

    B O O KGamuts & Pearls Ortho MRIStephen J. Pomeranz, M.D.; contributingauthors: Timothy J. Jenkins, N. Judge KingIII, Mark J. Paluszny and R. Eric Shields

    Subdivided into shoulder, elbow,hand & wrist, hip & thigh, knee, foot &ankle, musculoskeletal system andprotocols & predicaments chapters,there is a wealth of information herefor the busy imager at an extremelyaffordable price. 396 pp.RSNA Member Price: $85.50

    B O O KGamuts & Pearls Neuro MRIStephen J. Pomeranz, M.D., and Peter J.Smith

    Subdivided into brain, spine, head &neck and protocols & predicaments

    chapters, there is a wealth of informa-tion here for the busy imager at an ex-tremely affordable price. 398 pp.RSNA Member Price: $85.50

    D V DCardiac MRI Conference Series:Cardiovascular MRI TechniquesWojciech Mazur, M.D.

    Dr. Mazur addresses such topics asthe anatomy of an MRI scanner, howto image the heart, cardiac analysisand spin tagging. The viewer is treatedto coverage of stress modalities, rest-stress MR perfusion and spiral CTcoronary angiography. Dr. Mazur alsodiscusses the sizing spinal CT coronaryangiography.RSNA Member Price: $135.00

    C D - R O M , V H SConference Series 23 Lecture SetStephen J. Pomeranz, M.D. and JohnReeder, M.D.

    This video recorded lecture seriesinvites you into our state-of-the-artstheatre for lectures regarding muscu-loskeletal anatomy and pathology,subdivided into knee, foot & ankle,hip, shoulder, elbow, and hand & wrist.RSNA Member Price: $2,430.00

    B O O KPACS: A Guide to the DigitalRevolutionKeith J. Dreyer, Amit Mehta and JamesHunter Thrall

    With contributions from leaders inthe field of PACS, this user-friendlyguide addresses the introductory con-cepts, computing fundamentals, ad-vanced imaging technologies and fu-ture opportunities. This text is gearedtoward radiologists, technologists, ad-ministrators and IT professionals wish-ing to gain a broader understanding ofthis emerging field. 408 pp., 122 illus.RSNA Member Price: $85.50

    B O O KThe Internet for RadiologyPracticeAmit Mehta

    The Internet and related technolo-gies have had a significant impact onthe field of radiology, enabling the ac-ceptance, installation and proliferationof adjunct technologies such as pic-ture archiving and communication sys-tems (PACS), teleradiology, voicerecognition (VR) and electronic med-ical records (EMR). This book containsauthoritative coverage of the generalapplication of the Internet in medicine,radiology Web sites, teleradiology,EMR and patient care. 208 pp., 40 illus.RSNA Member Price: $31.50

    B O O K & C D - R O MAJCC Cancer Staging ManualFrederick L. Greene, David L. Page, Irvin D.Fleming, April Fritz, Charles M. Balch,Daniel G. Haller, Monica Morrow

    The AJCC Cancer Staging Manual,prepared by the American Joint Com-mittee on Cancer, is used by physi-cians and health care professionalsthroughout the world to facilitate theuniform description of neoplastic dis-eases. The staging information in theAJCC is uniform with the UICC andmust be used for all tumors staged asof January 1, 2003. The Manual in-cludes 45 staging forms on CD-ROMfor individual or institutional use. 480 pp., 95 illus.RSNA Member Price: $53.95

    B O O KAJCC Cancer Staging HandbookFrom the AJCC Cancer Staging Manualprepared by the American Joint Com-mittee on Cancer, the Cancer StagingHandbook contains the complete textof the manual, except for the stagingforms and CD-ROM, conveniently sizedto fit the pocket of a lab coat for com-plete portability. 408 pp., 37 illus.RSNA Member Price: $35.95

    B O O KPractical FDG ImagingA Teaching FileDominique Delbeke, William H. Martin,James A. Patton, Martin P. Sandler

    This is a comprehensive referenceof cases with FDG images obtained ondedicated PET tomographs and hybridscintillation gamma cameras. Withover 300 FDG images, this book willserve as an excellent stand-aloneguide for nuclear medicine physicians,radiologists, oncologists and residentsin their practice of clinical PET. 440 pp. 320 illus.RSNA Member Price: $116.00

    B O O KPositron Emission TomographyBasic Science and ClinicalPracticePeter E. Valk, Dale L. Bailey, DavidTownsend, Michael N. Maisey

    This book covers the basic scientificprinciples and clinical applications ofPET in research and medical practiceand contains a final section discussingfuture directions of PET. It will be aninvaluable reference resource to ad-vanced research laboratories, clini-cians, graduates and advancedtrainees in general nuclear medicineand radiology practices requiring morein-depth knowledge of the principles ofPET. 904 pp., 546 illus.RSNA Member Price: $152.00

    B O O K3D Contrast MR AngiographyThird EditionMartin R. Prince, Thomas M. Grist, Jrg F.Debatin

    This new edition addresses all rele-vant technical aspects, provides imag-ing protocols and describes tailoredimaging strategies for different vascu-

    lar regions. Basic concepts: pulmonaryMRA, thoracic aorta, abdominal aorta,renal arteries, mesenteric arteries,portal vein, peripheral arteries, ex-tracranial carotid arteries and archvessels, 3D contrast MR venography.298 pp., 200 illus.RSNA Member Price: $28.50

    B O O KNormal and Abnormal SwallowingImaging in Diagnosis and TherapySecond EditionBronwyn Jones

    This beautifully illustrated volumepresents an updated approach to therole of imaging in the diagnosis andtreatment of the patient with dyspha-gia. Centered around the gold stan-dard imaging modality, i.e. videofluo-rography, the text also includes chap-ters on other modalities such asultrasound, computed tomography andmagnetic resonance imaging. 308 pp.,248 illus. RSNA Member Price: $143.00

    B O O KImaging-Guided InterventionalBreast TechniquesDavid Dershaw

    This how to text features the mostup-to-date information on biopsy tech-nology, including the advantages anddisadvantages of biopsy probes. It alsoaddresses issues of patient manage-ment, and discusses the results of thelatest studies on problems in thehistopathologic interpretation of tissueobtained during biopsies. 288 pp.,304 illus.RSNA Member Price: $125.00

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    Springer-Verlag, New York, Inc. 175 Fifth Ave.

    New York, NY 10010(800) SPRINGERwww.springer-ny.com

  • PLEASE NOTE: RSNA merely facilitates communication between its members and publishers participating in the program. RSNA has not reviewed and does not recommendor endorse the content of any materials offered for sale by those publishers. RSNA does not participate in any way in the sale of those materials by the publishers. There-fore, RSNA disclaims any responsibility for the content or use of any materials purchased through the Publisher Partners program.

    R S N A P u b l i s h e r P a r t n e r s

    C o n t i n u e d f r o m p r e v i o u s p a g e

    J O U R N A LInternational Medical Devices(IMD) International Medical Devices (IMD)furnishes Chinas healthcare field withvital information on the latest devel-opments in this vibrant industry. IMDis distributed to general and militaryhospitals across China. It is supportedby the Department of PharmaceuticalAdministration of State Economic andTrade Commission and the Bureau ofDrugs and Medical Instruments ofHealth Department of General Logis-tics Department of the PLA, etc. (12issues)RSNA Member Price: $58.80

    J O U R N A LConventional Clinical Equipment(CCE) Conventional Clinical Equipment(CCE), launched in 2002, provides vi-tal information on conventional med-ical equipment to serve the needs ofsmall- and medium-size hospitals inChina. With innovated friendly design,

    the magazine reports the latest devel-opment directions and technologicaladvancements of various medical de-vices. (6 issues)RSNA Member Price: $29.40

    J O U R N A LChina Now: Medical Products(CN:MP) China Now: Medical Products keepsforeign marketers abreast of Chinasmedical device industry develop-ments. It reports on the countrys lat-est policy and regulations, markettrends, technologies, products andother relevant information. (Spring &Autumn issues)RSNA Member Price: $14.00

    Technology Exchange Ltd.Suite 1102Fo Tan Industrial Center26-28 Au Pui Wan StreetFo Tan, Shatin, Hong KongOrder online at: app.tech-ex.com/share/RSNASubform2003E.pdf

    B O O KAtlas of Cross-Sectional andProjective MR Cholangio-Pancreatography A Teaching FileLieven van Hoe, Dirk Vanbeckevoort,Werner van Steenbergen

    Magnetic resonance cholangio-pan-creatography (MRCP) is a novel noninvasive technique for diagnosis of

    pancreatic-biliary disease. This bookhighlights the advantages, limitationsand indications of MRCP, includingspecific examples that showcase theutility of this technique in a large vari-ety of clinical conditions. 429 pp. 450 illus.RSNA Member Price: $89.00

    B O O KA Clinicians Guide to NuclearMedicineAndrew Taylor, M.D., David M. Schuster,M.D. and Naomi Alazraki, M.D.

    This book builds on and expandsthe basic concepts found in Funda-mentals of Nuclear Medicine. This in-troduction to the diagnostic and ther-apeutic uses of nuclear medicine pro-cedures is a must have for clinicians,residents, interns, medical studentsand referring physicians. It reviewsnuclear medicine procedures, avail-able alternatives, advantages and lim-itations of each, and provides patientinformation to aid in preparing pa-tients. Softcover, 410 pp., 2000RSNA member price: $40.50

    B O O KSelf-Study Program III: NuclearMedicine CardiologySeries Editor: Elias H. Botvinick

    Whether youre a nuclear medicineresident preparing for your board ex-ams or a veteran clinician, the Nu-clear Medicine Self-Study ProgramSeries in Nuclear Medicine Cardiologywill meet your self-assessment needs.Each book includes an extensive listof annotated references, questionsand answers with critiques, along withan authoritative syllabus review of thetopic.Topic 1: Physical and Technical Aspectsof Nuclear CardiologySoftcover, 95 pp., 1997RSNA member price: $31.50Topic 2: Pharmacologic StressSoftcover, 195 pp., 1998RSNA member price: $56.70Topic 3: Cardiac PET Imaging and Topic 4: Radionuclide Assessment ofCongenital Heart DiseaseSoftcover, 127 pp., 1998RSNA member price: $44.10Topic 5: Myocardial Perfusion Scintigra-phyTechnical AspectsSoftcover, 218 pp., 2001RSNA member price: $107.10Topic 6: Myocardial Perfusion Scintigra-phyClinical AspectsSoftcover, 396 pp., 2001RSNA member price: $163.80

    B O O KSelf-Study Program IV: OncologySeries Editor: Thomas P. Haynie, M.D.

    Management of cancer patientshas significantly grown with better di-agnostic techniques and chemothera-peutic agents. Learn about these ex-citing advances in nuclear oncologicimaging and therapy with SNMs Self-Study Program Series in Oncology.Each book includes an extensive listof annotated references, questionsand answers with critiques, along withan authoritative syllabus review of thetopic. This series is ideal either forresidents preparing for board exami-nations or for veteran clinicians seek-ing to enhance their knowledge.Topic 1: An Overview of Nuclear OncologySoftcover, 50 pp., 1997RSNA member price: $18.00Topic 2: Conventional Tumor ImagingSoftcover, 74 pp., 1997RSNA member price: $31.50Topic 3: Antibody Tumor ImagingSoftcover, 49 pp., 1998RSNA member price: $18.00Topic 4: PET Tumor ImagingSoftcover, 88 pp., 1999RSNA member price: $25.20Topic 5: Bone Cancer Therapy and Topic 6: RadioimmunotherapySoftcover, 83 pp., 2000RSNA member price: $18.00

    B O O KA Tabulated Summary of the FDGPET LiteratureSanjiv S. Gambhir, M.D., Ph.D., JohannesCzernin, M.D., Judy Schwimmer, M.B.A.,M.A., Daniel H.S. Silverman, M.D., Ph.D.,R. Edward Coleman, M.D., and Michael E.Phelps, Ph.D.

    This supplement to The Journal ofNuclear Medicine provides a compre-hensive literature review of the use ofFDG PET in oncology, cardiology andneurology. This supplement hasproven useful for healthcare providers,administrators and health economistswho wish to better understand therole of FDG PET in the medical man-agement of patients. Softcover, 93pp., 2001RSNA member price: $13.50

    B O O KSNM Procedure GuidelinesManualCommission on Health Care Policy andPractice Guidelines and CommunicationsCommittee

    The guidelines were developed inresponse to requests for standardizedprotocols for nuclear medicine proce-dures and will keep your departmentup to date on the latest technologiesand recently approved radiopharma-ceuticals used in nuclear medicine.Softcover, 180 pp.RSNA member price: $67.50

    B O O KGuide for Diagnostic NuclearMedicineJeffry Siegel, Ph.D.New SNM/ACNP Guidance on Revised10 CFR Part 35

    The newly published Guide for Di-agnostic Nuclear Medicine is a one-stop reference for nuclear medicineprofessionals who want to bring theirdepartments and institutions intocompliance with the recently revisedrequirements of 10 CFR Part 35.Working closely with representativesfrom the Nuclear Regulatory Commis-sion (NRC), Jeffry A. Siegel, Ph.D.,compiled this useful resource thatcovers all pertinent regulations, ad-dresses compliance concerns andstandards, and provides At a Glance

    and summary features. Siegel is chairof the Joint Government RelationsCommittee of the American Collegeof Nuclear Physicians and the Societyof Nuclear Medicine (SNM), whichrecognized the need