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BREAKOUT DESCRIPTIONS AND OBJECTIVES
KEYNOTE: Artificial Intelligence in Diagnostic Imaging: Hype,
Reality, and Future Directions (NI)
Eliot Siegel, MD - Professor and Vice Chair Research Informatics, University of Maryland School of Medicine, Department of Diagnostic Radiology, Baltimore, Maryland; Chief of Radiology and Nuclear Medicine, Veterans Affairs Maryland Healthcare System, Baltimore, Maryland; Professor of Bioengineering, University of Maryland, College Park, Maryland; Professor of Computer Science, University Maryland Baltimore County, Baltimore, Maryland.
description: “Artificial Intelligence” (AI) has made tremendous advances recently and is poised to substantially change the practice of radiology. This revolution, even more than the transition from film based to digital radiology, has been accompanied by a unique combination of excitement, anxiety, and hype. The theme of this presentation is to explain what AI actually represents, to separate the hype from the reality, and to speculate specifically about how it will impact the practice of digital imaging.
OBJECTIVES
1. Discuss the impact of "AI" on the near and mid-term future of radiology.
2. Describe machine learning and its applications in diagnostic radiology.
3. List challenges/obstacles to the adoption of AI in diagnostic imaging.
BREAKOUT SESSION A
DIGITAL/RADIATION
SAFETY-FLUORO: Imaging Obesity: A Technologist’s Perspective
Kristin Beinschroth, BSRS, ARRT(R), CRT - Adjunct Faculty, Radiologic Technology, Chaffey College, Rancho Cucamonga Campus.
description: With obesity statistics in America on the steady rise, diseases linked to obesity increase exponentially. As imaging technologists, we understand the limitations of radiographic and fluoroscopic equipment and evolve our techniques for the best diagnostic quality images while minimizing radiation dose to patients and exposure to staff utilizing principles of ALARA. This presentation will also cover exams most commonly ordered on obese patients, symptoms associated with these diseases and accommodating these patients in radiology while providing compassionate care.
OBJECTIVES
1. Identify diseases related to obesity.
2. Examine commonly ordered imaging studies on obese patients.
3. Recognize limitations of radiographic and fluoroscopic imaging equipment.
4. Describe applications of ALARA during radiographic and fluoroscopic exams.
RADIOLOGY: The Dos, Don’ts and The Whys in Orthopedic Imaging
Elias Silva, RT – Radiologic Technologist, Diagnostic Imaging, Southern California Permanente Medical Group, Panorama City
description: In a fast-paced orthopedic imaging department, it is easy to move so quickly that we don’t take time to pay attention to the details. We will review correct positioning criteria and the reasons why the details matter in assisting with patient diagnosis.
OBJECTIVES
1. Identify correct positioning of routine views.
2. Critique positioning that should be improved.
3. Explain why it is important to provide the best positioning possible to assist the doctor in diagnosis.
MAMMOGRAPHY & ULTRASOUND: “D” Altered Breast
Payal Jain, MD - Radiologist/Breast Imager, Southern California Permanente Medical Group, West Los Angeles.
description: The presentation will cover the three most common breast altering procedures, corresponding imaging techniques and different imaging positions post-surgery. Specifically, it will help attendees be familiar with the spectrum of appearances of the altered breasts and understand the differences after each procedure.
OBJECTIVES
1. Identify the different types and procedures leading to the altered breasts.2. Describe the complexities of a surgical procedure involving the breasts.
3. Differentiate imaging modalities and positions that are compatible to breast altering procedures performed.
NUCLEAR MEDICINE: The Basics of Cardiac Rb PET/CT (.5R/.5I)
Mark C. Hyun, CNMT, NCT, RS, RT (N,R,CT), FASNC - Nuclear Medicine, Cardiac CT, Pre-Clinical Imaging & Cardiac Imaging Research Specialist, Department of Imaging & Biomedical Imaging Research Institute, Cedars-Sinai Medical Center, Los Angeles, California.
description: This presentation will give an in depth look into why using PET with Rubidium (Rb) could be the optimal myocardiac perfusion imaging (MPI) choice for patients with or suspected to have coronary artery disease (CAD). It will compare the different cardiac PET radiopharmaceuticals available as well as the radiopharmaceuticals used in SPECT imaging. Tracer extraction and flow quantification will be distinguished to identify the benefits of each. The importance of quality control of the Rb generator and PET/CT scanner will be explained. Typical indications and imaging protocols for cardiac PET MPI will be described along with how to recognize and troubleshoot potential imaging artifacts to ensure the highest image quality possible.
OBJECTIVES
1. Indicate the differences in cardiac PET radiopharmaceuticals.
2. Compare the differences between PET and SPECT radiopharmaceuticals.
3. Distinguish the relationship of the tracer extraction vs the flow quantification.
4. Summarize the importance of Rb generator QCs.
5. Name the alerts and expiration limits of the Rb generator.
6. List the parameters of PET/CT scanners.
7. Identify the indications for cardiac PET MPI.
8. Define the imaging protocols of cardiac PET MPI.
9. Recognize and troubleshoot of the imaging artifacts from cardiac PET MPI.
BREAKOUT SESSION B
DIGITAL/RADIOLOGY: Radiology and Communication
Jana Arellano-Villaroel, MBA, R.T.(R)(T), Operations Manager/Clinic Manager, US Oncology, Riverside, Ca.; Contract Instructor, Flex Ed, Chino, Ca.
DESCRIPTION: This presentation will discuss the importance of communication in the medical imaging department and how it can impact the patient’s experience and the accuracy of the radiologist’s diagnostic report. Numerous points of communication in the day to day workflow of an imaging technologist will be explored. In addition, how using the Picture Archiving and Communication System (PACS) along with Electronic Medical Record (EMR) system can be utilized by the imaging technologist to improve diagnostic outcomes and patient satisfaction.
OBJECTIVES
1. Evaluate the importance of communication’s impact on achieving quality diagnostic images
and an accurate diagnosis.
2. Identify the interaction points of communication in the medical imaging workflow.
3. Utilize the PACS system and EMR system to bridge the communication gap.
RADIOLOGY: Radiology Image Analysis
Elliot S. Azizollahi, MD, Radiologist, Assistant Chief - Imaging Department, Southern California Permanente Medical Group, West Los Angeles.
description: Radiology Image Analysis is a presentation focused mainly on radiographic anatomy and common disease entities. It is an introduction to the overview of the breadth of diagnostic imaging. Its purpose is not to train attendees to become skilled interpreters of diagnostic imaging but to understand basic insight on what to see and recognize in radiographic images in order to contribute to the care of the patient at large.
OBJECTIVES
1. Analyze technical quality of different images using simple parameters.
2. Identify basic views of different anatomical parts of the body.
3. Recognize radiographic patterns of disease and other abnormalities and describe them using appropriate terminology.
4. Recognize the vital role of imaging in establishing the correct diagnosis and treatment of the injured/ill patient.
5. Describe both typical and atypical patterns of radiographic presentation.
MAMMOGRAPHY: Optimal Techniques in Mammographic Imaging
Bahar Moussavian, MD - Radiologist, Southern California Permanente Medical Group, Los Angeles Medical Center (Body and Women’s Imager).
description: This presentation will provide information on optimal techniques of screening mammographic imaging per ACR guidelines along with consequences that suboptimal mammographic images can pose on the institutions and the patients.
OBJECTIVES
1. Demonstrate appropriate breast positioning per ACR guidelines.
2. Discuss the impact that improper positioning has on patients.
3. Identify the impact improper positioning has on the institution.
ULTRASOUND: Sonography in Interventional Radiology
Andrew Song, MD - Interventional Radiologist, Diagnostic Imaging, Southern California Permanente Medical Group, Riverside
description: With the advancements to sonographic equipment and processing power available, the uses for ultrasound has dramatically increased especially in the Interventional Radiology (IR) suite. This presentation will review the history and common uses of IR, list the common disease entities and pathophysiology in IR, and describe the practical role of sonography in a busy IR practice.
OBJECTIVES
1. Review the history and common uses of Interventional Radiology (IR).
2. List common disease entities and pathophysiology in Interventional Radiology.
3. Describe the practical role of sonography in a busy IR practice.
NUCLEAR MEDICINE: Management of Well-Differentiated Thyroid Cancer with Emphasis on 2015 ATA Guidelines (T)
O’Neil Lee, MD - Radiologist, Nuclear Medicine, Southern California Permanente Medical Group, Orange County.
description: Nuclear Medicine has a unique role in managing patients with well-differentiated thyroid cancer. By understanding the biology of thyroid cancer, we can learn to optimize the diagnosis, treatment, and disease status monitoring.
OBJECTIVES
1. Discuss the biology of thyroid cancer.
2. Explain the role of I-131 therapy in managing thyroid cancer.
3. Describe how to optimize I-131 therapy.
BREAKOUT SESSION C
DIGITAL/RADIATION SAFETY-FLUORO: Mutually Exclusive or More of the Same?
Robert McDermott, MS, DABR, CRT, CNMT – Adjunct Professor, Radiologic Technology Program, Cypress College, California.
description: Attendees will review radiation and fluoroscopy safety terms, guidelines, and organizations to include best practice for reducing dose for patients with obesity.
OBJECTIVES
1. Review radiation safety terms.
2. Understand licensing regulations from past to present.
3. Differentiate between radiologic regulating branches.
4. Apply radiation safety to imaging obese patients.
RADIOLOGY: It’s the Parts that Matter: Gender Diversity in Diagnostic Imaging
Virginia Sanders, RT - Staff technologist, Southern California Permanente Medical Group, San Diego.
description: Our concept of gender has originally been binary (male/female) however the gender landscape is shifting, and healthcare workers should have some awareness of this change. There are many different genders that people now identify as. Within this Gender Diverse Community (GDC) are transgender individuals who pose a particular challenge for us in Diagnostic Imaging (DI) due to their gender identity and gender expression not being the same as their sex assigned at birth. We may not know where the reproductive organs are located on transgender patients and therefore, expose a patient to unnecessary ionizing radiation. New communication tools are suggested to work with the GDC in a respectful and professional manner. Additionally, we suggest a new intake form for DI that every patient must complete prior to an X-ray exam.
OBJECTIVES
1. Explain the Gender Spectrum.
2. Define gender identity, gender expression and other gender terms.
3. Identify factors that contribute to the disparity in healthcare between transgender individuals and the rest of the population.
4. Apply strategies to improve communication between rad techs and the gender diverse community, particularly transgender patients.
DIGITAL/MAMMOGRAPHY: Mammography Quality Control: A Refresher
Matt Wait, MS, DABR, Medical Radiation Physicist, Medical Imaging Technology and Informatics, Southern California Permanente Medical Group, Woodland Hills.
description: The presentation will provide mammography technologists and physicists with a review of digital mammography technology, radiation safety, quality control activities performed, and review responsibilities assigned by regulatory and accreditation bodies.
OBJECTIVES
1. Review digital mammography technology.
2. Identify basic radiation safety and personnel dosimetry principles.
3. Describe responsibilities assigned by MQSA, ACR, and the State of California.
4. Explain mammography technologist’s QC responsibilities and procedures.
5. Describe the physicist’s QC responsibilities and procedures.
6. Examine misconceptions about mammography technology, radiation safety, and QC.
ULTRASOUND: Interesting Pelvic Ultrasound Cases
Ingrid Burger MD - Radiologist, Southern California Permanente Medical Group, West Los Angeles, (Section Chief, Ultrasound)
description: Upon completion of the presentation, attendees will be introduced to the use and purpose of cine clips as surrogates during pelvic sonography for imaging etiologies leading to diagnoses. In addition, an introduction and discussion on color and spectral Doppler will be entertained alongside a conglomerate of interesting case studies in which diagnostic ultrasonography is performed for evaluating pelvic pain revealing gynecologic etiologies. At the conclusion of the presentation, attendees will demonstrate knowledge in identifying paramount clinical evidence during diagnostic ultrasonography to communicate with the radiologist to aid in generating accurate diagnosis during challenging studies.
OBJECTIVES
1. Describe during pelvic sonography when cine clips are helpful/necessary in making a diagnosis.
2. Explain when imaging pelvic structures, how color and spectral Doppler are helpful/necessary in making a diagnosis.
3. Identify the key pieces of information to communicate to the Radiologist to aid an accurate diagnosis in regard to pelvic sonographic imaging.
NUCLEAR MEDICINE: Theranostics in Nuclear Medicine Practice (T)
R. Jay Idea, MD. - Lead Nuclear Medicine Physician, Southern California Permanente Medical Group, Woodland Hills
description: The theranostic approach in nuclear medicine is an established tool for molecular targeting that combines diagnostic imaging and therapy. Advantages of this approach include visualization and detection of potential targets that predict if a patient will respond to therapy for estimating potential response, and eventual toxicity.
OBJECTIVES
- Provide a brief history of theranostics in nuclear medicine.
- Define theranostics as it applies to nuclear medicine.
- Describe and discuss the currently utilized theranostic imaging and therapy agents.
- Identify clinical cases that illustrate theranostic agents.
BREAKOUT SESSION D
RADIOLOGY: The
Importance of High-Quality Exams in Diagnostic Imaging
David Saperstein, DO - Radiologist, Southern California Permanente Medical Group, Fontana
description: Our duty as radiologic technologists is to produce high quality radiographic images to allow the radiologists to create an accurate diagnostic report which ensures the patient receives the appropriate care from their treating physician. This presentation will provide an explanation of how the technical factors we choose, contribute to the diagnostic quality of our images along with the effect those factors have on radiation dose.
OBJECTIVES
1. Explain mAs vs KVP regarding dose and image quality.
2. Be familiar with radiation safety – time and distance.
3. Identify the importance of obtaining good-quality images.
DIGITAL/RADIOLOGY: CT Assisted Virtual Treatment Planning in Orthognathic Surgery
David Bell, DDS, MD - Maxillofacial Surgeon, Head and Neck Surgery, Southern California Permanente Medical Group, Orange County.
description: Orthognathic surgery is performed on the face to correct developmental facial growth deformities resulting in a compromised bite, abnormal facial cosmetics and facial asymmetry, breathing disorders including obstructive sleep apnea, TMJ problems, speech problems, and problems related to social development and psychological well-being. The face is a complex three-dimensional structure and normalizing the structure of the face in the virtual realm with the aid of CT 3D reconstructed images to plan surgery has revolutionized the practice orthognathic surgery in the past 10 years.
OBJECTIVES
1. Explain orthognathic surgery.
2. Describe how facial CT scan data is utilized to plan and execute orthognathic surgery.
3. Assess how 3D printing of surgical guides has revolutionized orthognathic surgery.
DIGITAL/MAMMOGRAPHY: 3D Mammography at a Glance
Mara Ridane, R.T. (R)(M), ARRT - Assistant Director of Diagnostic Imaging Services, Southern California Permanente Medical Group, Los Angeles Medical Center.
description: In this presentation the attendees will be able to differentiate between 3D and 2D mammography units. In addition, attendees will recognize the importance of 3D mammography and 3D Stereotactic Biopsy units in the fight against malignancies.
OBJECTIVES
1. Distinguish between 3D and 2D mammography.
2. Recognize the importance of 3D mammography “Tomosynthesis” in diagnosing normal and abnormal pathology, therefore minimizing the number of patients re-calls.
3. Discuss the importance of 3D Stereotactic Biopsy units in the fight against cancer.
ULTRASOUND: Ultrasound of the Placenta
Cameron Manbeian, MD - Interventional Radiologist, Southern California Permanente Medical Group, South Bay.
description: The placenta is not to be confused with a city in Southern California’s Orange County suburbs but the vital organ responsible for supplying nutrients and oxygenated blood while removing waste products in a developing fetus. Abnormalities and/or pathologies of the placenta, if left undetected, can become life threatening to the fetus and the mother. Ultrasound of the placenta is a key tool in the prenatal screening to help ensure the baby and mother live a healthy gestational life together. Ultrasound, with its wide availability and lack of ionizing radiation is generally the first choice for placenta imaging. Delineation of normal anatomy vs normal anatomic variances vs pathologies on sonographic images will be presented and explained to help sonographers produce the highest quality images of the placenta possible and ensure that the radiologist makes the most accurate diagnostic interpretation.
OBJECTIVES
1. Identify normal sonographic presentation of placental anatomy.
2. Recognize normal anatomic variances of placenta seen on ultrasound images.
3. Describe common placental pathologies and their sonographic appearance.
NUCLEAR MEDICINE: Nuclear Medicine Artifacts (I)
Brian Helbig, MS, DABR, Medical Radiation Physicist, Medical Imaging Technology and Informatics, Southern California Permanente Medical Group, South Bay.
description: Artifacts can culminate in many shapes and forms within nuclear medicine. While some are due to inherent damage or issues with imaging devices, many can be addressed. As a result, the ability to differentiate artifacts in a clinical environment can be extremely useful. This talk will overview various artifacts within nuclear medicine spanning from planar to SPECT and PET imaging. It is the intention of this talk to prepare you to identify and avoid, or appropriately address, artifacts within your own clinical practice.
OBJECTIVES
1. Review of common artifacts in nuclear medicine.
2. Describe the nature and causes of common artifacts.
3. Discuss various artifacts within nuclear medicine scanning from planar to SPECT and PET imaging.
4. Identify ways to avoid common artifacts within a clinical setting.
BREAKOUT SESSION E
DIGITAL/RADIOLOGY: Temporal Bone
Anatomy and Pathology on CT
Sameer Ahmed, MD - Associate Physician/Surgeon, Otology/Neurotology, Head and Neck Surgery, Southern California Permanente Medical Group, Downey.
description: The bulk of this presentation will cover basic anatomy of the external, middle, and inner ear in addition to normal structures seen in the temporal bone on CT. The latter third of the presentation will discuss different pathologies of the temporal bone and their corresponding CT findings.
OBJECTIVES
1. Identify the external auditory canal, tympanic membrane, and middle ear structures.
2. Identify inner ear structures (cochlea, vestibule, and semicircular canals) and temporal bone structures (endolymphatic duct, subarcuate tract, and internal auditory canal).
3. Identify the facial nerve along its intra-temporal course.
4. Describe common temporal bone pathologies.
RADIOLOGY: Fundamentals of Chest Radiograph Interpretation
Jong H. Yun, MD - Radiologist, Southern California Permanente Medical Group, San Diego.
description: Although chest radiographs are relatively simple compared to other modalities, they contain a wealth of information about the condition of the patient. The anatomy of the chest as well as the nature of the pathology determine how abnormalities appear on chest radiographs. By reviewing multiple examples of common as well as rare but interesting abnormalities seen on chest radiographs, this presentation will explain the critical role that technologists and radiologists play in the evaluation and care of our patients.
OBJECTIVES
- Identify anatomy of the chest.
- Discuss the range of pathology involng the chest.
3. Evaluate how anatomy and pathology present themselves on chest radiographs.
4. Compare cases of common, rare and interesting abnormalities seen on chest radiographs.
DIGITAL/MAMMOGRAPHY: Advances in Breast Imaging
Jessica Clements, MS, DABR, FAAPM - Chief Physicist and Regional Radiation Safety Officer for Southern California Permanente Medical Group.
description: Attendees of this course will receive an overview of how new technology in breast imaging is assessed for clinical use. There will be special focus on several technologies that have advanced breast imaging in the past 10 years.
OBJECTIVES
1. Describe how advances in breast imaging have been designed for higher accuracy in screening.
2. Explain how new technology in breast imaging addresses special patient populations.
3. Discuss processes for assessing new technology and implementing it clinically.
ULTRASOUND: FETAL HEART ULTRASOUND
Cameron Manbeian, MD - Interventional Radiologist, Southern California Permanente Medical Group, South Bay.
description: Congenital heart disease (CHD) is a leading cause of infant mortality and structural cardiac anomalies are among the most frequently missed by prenatal ultrasonography. Prenatal detection of CHD can vary by differences in the sonographer’s experience, maternal obesity, transducer frequency, abdominal scars, gestational age, amniotic fluid volume and fetal position. This presentation will cover techniques that sonographers can utilize to provide optimal imaging of the fetal heart, and describe how anatomy, structural abnormalities, and pathology will present themselves on images.
OBJECTIVES
1. Identify techniques to provide optimal prenatal screenings of the fetal heart.
2. Evaluate how anatomy and pathology present themselves on fetal heart ultrasound.
3. Review abnormalities seen on fetal heart ultrasounds.
NUCLEAR MEDICINE: The Evolution of Sulfur Colloid (R)
Raynold J. Ho, MBA, CNMT, ARRT(N), NMTCB - Program Director/Clinical Coordinator, Nuclear Medicine Program, Loma Linda University, California; Staff Nuclear Medicine Technologist, Southern California Permanente Medical Group, Fontana.
description: This presentation will dissect all the facets associated with Tc99m Sulfur Colloid, a gamma emitting radiopharmaceutical that is being used for various purposes in the Nuclear Medicine department. The origins of Sulfur Colloid and its original uses along with its additional uses and where it is commonly used will be explored.
OBJECTIVES
1. Describe the origins of Sulfur Colloid.
2. Discuss the original uses of Sulfur Colloid.
3. List the Sulfur Colloid’s additional uses.
4. Identify where Sulfur Colloid is used today.
