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Scott Reeder, MD, PhD, FSABI

Professor and Vice Chair of Research
Chief of MRI, Department of Research
University of Wisconsin, Madison

Dear Friends and Colleagues,

I hope this finds you well in what has been an astoundingly disruptive year.  The challenges of 2020 have been multi-faceted and significant, and have impacted each of us as individuals, our families, our communities, our country, and our world. Please accept my sincere thanks for all that you do, as you strive to deliver outstanding clinical care, education, and research squarely in the midst of this history-making pandemic, time of deep societal introspection and upheaval in response to social injustice, and economic uncertainty.  I appreciate and recognize the struggles and efforts of leaders to enact positive change in respectful, meaningful, and lasting ways in the face of such complex and painful social issues. Despite these challenges, I hope you share my optimism for the future.

During these times, SABI has pivoted to rethink and rework how we conduct society business. The Board of Directors and our rich network of talented members and committees has been hard at work since we last saw you in Denver.

We have continued our efforts to transform the SCBT-MR into the Society for Advanced Body Imaging. This includes an overhaul and rejuvenation of the entire governance structure of the society. A few examples of initiatives in 2019-2020 include:

  • a formal structure for “Technology Assessment Committees”. Lead by Dr. Bhavik Patel, the TAPs will be a collection of expert committees aimed providing guidance for the appropriate application of advanced imaging technologies in clinical care.
  • formation of the New Member and Early Career Committee.
  • continuation of the Mentoring Program led by Drs. Neil Rofksy and Carolyn Wang.
  • rejuvenation of the Education, Communications, and Membership Committees.
  • partnership with Aarti Sekhar and Nelly Tan to support their weekly “Cases with Aces” on-line weekly case conference.
  • detailed set of standard operating procedures and updates to the bylaws to codify the current evolution of our society for future generations of SABI members.
  • adoption of a statement of professionalism to ensure continued engagement and opportunities for all members and fellows to feel welcome as they contribute to SABI’s mission, goals, and activities.
  • modernization of our website. Check it out! 

In addition, we have finally brought home the Journal of Computer Assisted Tomography (JCAT) as the official journal of the SABI. Many thanks to Erik Paulson for launching this multi-year initiative, and to the numerous members of the society who have contributed to this achievement. We view this partnership as a golden opportunity to translate the innovations and cutting-edge work of our members into high impact publications that benefit the broader imaging community. Many thanks to Dr. Eric Tamm, who has contributed to JCAT with unbridled energy during the past year in his role as Associate Editor. After many years at the helm, Dr. Allen Elster, will be stepping down as Editor-in-Chief of JCAT. Wolters-Kluwer, in partnership with the SABI Board of Directors, conducted an international search this year to identify a new leader to succeed Dr. Elster. The search was recently completed, and we expect to make an announcement of the new Editor-in-Chief soon.

The challenges of the pandemic were met head on by our incredible Annual Meeting Program Committee, led by Dr. Beth McFarland. With great energy and determination, Dr. McFarland led the committee through a high-stakes transition from an in-person format to a rich digital program, in true SABI fashion. Cutting-edge plenaries, the Presidential Lecture, workshops, networking opportunities and much more, will all be available on a digital platform like you’ve never experienced before. Be sure to check out the program, and we can’t wait to see you online October 10th through 13th!

I’d also like to take this opportunity to thank all of the SABI members who have contributed to the society during the past year. Importantly, these efforts have brought a palpable invigoration of inclusion and collegiality to our society. Our membership continues to add dynamic and talented junior faculty from around the country with an increasingly diverse membership, and an emphasis on mentorship. It is wonderful to witness the networking, mentorship, and friendships that are being built between our senior and junior members.

I would also like to thank the SABI staff who have gone above and beyond to overcome the unprecedented challenges of 2020. Executive Director Michele Wittling, and her outstanding team including Jennifer Leeper, Jennifer Sheehan, and Stephanie Hige have done so much of the heavy lifting behind the scenes. Be sure to send them a note of thanks when you have a chance.

Finally, I would also like to thank my colleagues on the Board of Directors, all of whom have contributed in extraordinary ways to usher in the evolution of our society, in a year we will never forget. My heartfelt thanks to Drs. Susan Ascher, Beth McFarland, Joel Platt, Brian Herts, Ivan Pedrosa, Desiree Morgan, and Aarti Sekhar. SABI is lucky to have you at the helm.

When the Board met in 2019 for the Strategic Planning retreat aimed at articulating the evolution of our society, we identified our desired future state, as:

“SABI is the go-to society for innovation and translation of cutting-edge technology into the practice of body imaging, in an engaging and inclusive environment that fosters the development of members through mentorship and education”.

I am so pleased to witness how our members have embraced this vision. When we articulated it in 2019, never could we have imagined the importance of this evolution as it relates to the events of 2020.

In my personal view, the evolution of SABI parallels the need to address social change in our broader society. It is important that we reflect on how SABI can respond to the systemic racial and social injustice of our larger communities. I would posit that, as a professional society, we hold a great responsibility to model in both words and actions the changes that we strive to see reflected around us. Specifically,

What we say is important. For this reason, the SABI Board of Directors has developed a statement of professionalism, posted on our website, articulating our commitment to equity, diversity and inclusion.

What we do is important. Talk is important, but actions are essential. The board has created two non-voting two-year Board positions including a Member at Large (Aarti Sekhar) and a Fellow at Large (to be named), as well as the position of Diversity Officer (to be named) to lead a nascent Diversity Committee, charged with developing and identifying concrete steps that SABI can take to address inequities and build opportunities for all in our field of advanced body imaging. We are actively pursuing options that include scholarships for high school students to attend the annual meeting and to provide opportunities for under-represented minorities in training to present during the Scientific Session at the SABI annual meeting, diversity awards, and other initiatives aimed at long term transformational change. While our members have embraced the importance of inclusion and diversity, we have much more work to do. Please join this conversation.

I want to end with a note of optimism. While 2020 will be remembered as a year of tragedy, division, social unrest, disease, and death, I also view it an opportunity for a rebirth of our appreciation for each other as human beings and to be openly grateful for the many gifts we have as individuals. Please take the time to reflect on what is truly important in your lives and how we can leverage this moment in history to effect broad positive change. I know we can do this together. We are an inclusive society of innovators who can transform the world into a better place.

I look forward to seeing you soon at the Annual Meeting. Be good to others, be well, and be safe.

With gratitude,

Scott B. Reeder, MD, PhD

President, SABI

 

 

 

 

 

 

 

 

We are excited to launch our action-packed ONLINE Annual Meeting coming up on October 10-13.

Our decision to use the platform Let’s Get Digital (LGD) will enhance our ability to connect and engage among the faculty and the participants.  There will be a lobby with live hosting during the transition times between plenaries, led by teams of SABI members across different universities.  The audience will be able to LIVE text chat with the lobby hosts, along with the plenary speakers during their talks and in the Q&A to follow. Participants will also be able to connect individually with each other. So we do hope this type of engagement will help to bring us together in meaningful ways, as speakers welcome us on Zoom from their homes and offices.

We start on Saturday, October 10 with the AI preconference symposium led by Dr. Bhavik Patel and Dr. Andrew Smith.  A dynamic range of talks from the history of AI and “Nuts and Bolts” to current clinical applications and future horizons.  The workshop is topped-off with a LIVE interactive panel discussion on “Challenges and Opportunities for Implementation of AI Solutions into Clinical Practice”, led by industry and academic thought leaders.

Sunday will highlight our esteemed Annual Scientific sessions featuring young and mid-career investigators.  The workshops on this day will focus on a range of career development topics and areas of topical scientific interests for young investigators. Research Awards will be celebrated at end of the day on Monday with a special LIVE ceremony.

Monday at 1 pm EST, will premiere the Presidential Lecture of the renowned Dr. Elias Zerhouni, former head of NIH and Chair and Vice Dean at John’s Hopkins University, entitled “Precision Medicine and the Future of Imaging”. Dr. Zerhouni’s state of the art discussion with his trademark vision and passion will be appreciated by all. On Monday afternoon, for the first time ever, we will host a dynamic multi-disciplinary Tumor Board to discuss challenging hepatobiliary, colorectal, and sarcoma cases, moderated by Dr. Aarti Sekhar and Dr. Gaurav Khatri.

On our final day Tuesday, October 13, we feature the 1 pm plenary of “COVID Pandemic: Health Care Inequities and Opportunities”.  Dr. Ella Kazerooni will present how the pandemic has exposed health care inequities in the U.S.  This session will also highlight forward-thinking programs to overcome barriers in underserved populations with lung cancer screening, along with the success of the impactful “Promise” program at the University of Michigan to recruit and sustain more diverse faculty. 

Throughout the course, we will no doubt showcase our time tested plenaries across Cardiothoracic, Hepatobiliary, and Pancreas, Innovations in CT, Pelvic MR and Prostate, Innovations in MR and Fast MR protocols, GI Tract, Body composition, and Quality and Safety.  Topical workshops will also be nestled within the program. To end the meeting on Tuesday, we will host a special Beyond Interpretation plenary of “Wellness and Engagement”, with short, thoughtful talks to inspire our energies and health as we continue to face the challenges of 2020.

Finally, we could not have made this ON LINE course happen without the energetic and creative efforts of the Program Committee:  Joel Platt, Brian Herts, Desiree Morgan, Aarti Sekhar, Avinash Kambadakone, Ella Kazerooni, Chris Francois, Ihab Kamel, Olga Brook, Ghaneh Fananapazir, Scott Reeder and Bhavik Patel, the guidance and support of the SABI Board of Directors and most importantly the tireless efforts of our tremendous SABI Administrative Staff: Michele Wittling (Executive Director), Jennifer Leeper, Jennifer Sheehan and Stephanie Hige.

We look forward to you joining us for this year’s special program for SABI, online. 

May our reach be broadened to spread energy and fellowship of SABI to you all with great gusto and goodwill!

 

Beth McFarland, MD, FSABI

President-Elect

 

 

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Keeping the Conversation Going
A civil rights activist encourages continued
dialogue as radiology addresses its lack of
underrepresented minority physicians.

 

As the U.S. reckons with its racial inequality of the past and present, the ACR is exploring how it can leverage its own advocacy network to create a future of healthcare equity. The Bulletin talked with Henry W. Wiggins Jr., MD, a Black radiologist and civil rights activist, about his early experiences in the profession.

How did you get your start in radiology?

I remember being a high school senior in Clearfield, Pennsylvania, in 1951, when my entire class got to go to Washington, D.C., but I couldn’t go because restaurants and hotels in Washington D.C., at that time, refused to serve Black Americans. I was the only Black intern at University Hospital, Iowa City, from 1959–1960. I was an internal medicine resident from 1960–1961 and a radiology resident from 1961–1964. When I was at Michael Reese Hospital in Chicago from 1964–1966, I was the only Black radiologist on staff.

I was drafted into the U.S. Navy and relocated with my family to serve at the San Diego Naval hospital as Lieutenant Commander during the Vietnam War from 1966–1968. During the first few months, I made several calls to look at available housing — only to be told that nothing was available when I showed up in person. This obvious racism affected my ability to do my job and the well-being of my family.

Later, I was transferred to Bremerton Naval Hospital in Washington. When I arrived at the hospital for the first time, I was mistaken for Dr. Bryant, the other Black physician on staff, which was bittersweet. On the one hand, it was disheartening to be mistaken for another Black doctor. On the other hand, I was glad that for once I wasn’t going to be the only one on staff.

In your 1965 Postscript essay, “Freedom: Spirit of the Selma March,” you wrote about your participation in the march from Selma to Montgomery. How did this experience change you?

Being around other people who were doing the same thing, for the same reasons I was, ignited a new chapter in my life. There weren’t only Black folks there — there were people of all races, from all over the country. I discovered that the reasons I was marching were relevant and important to a broad spectrum of people — not just to me and my community. That’s why I also participated in the Million Man March in Washington, D.C., in 1995.

How do racial disparities in healthcare continue to be a public health crisis for Black communities?

There is a shortage of Black physicians. For Black families, this may mean that they can’t see a physician they feel comfortable with or who understands their culture. But disparities in healthcare don’t just affect Black communities. They affect Native Americans, Latinxs/Hispanics, people from different socioeconomic groups — everyone who lacks representation in the profession.

Why do you think radiology lags behind other medical specialties in its percentage of Black physicians?

Medicine in general lacks representation of Black physicians, not just the field of radiology. And one can’t talk about this without considering the effects of the Flexner Report of 1910, a landmark study of medical education in the U.S. and Canada.

The medical school closures that occurred as a result of this report disproportionately affected schools at Historically Black Colleges and Universities (HBCUs). Of the seven medical schools at HBCUs, five were closed. Because of widespread admissions discrimination at the time, it was almost impossible for aspiring Black medical students to study anywhere else.

During the ‘50s and ‘60s, plenty of Black students applied at all medical schools, not just the ones at HBCUs. They just weren’t being accepted. It became commonly known in the community that we weren’t being accepted elsewhere. Looking back, I knew very few Black physicians who studied at other medical schools. The resulting shortage of Black physicians continues today and extends to radiology.

Medicine in general lacks representation of Black physicians, not just the field of radiology.

Although the overall number of Black male college graduates has increased, the number of Black male medical students has actually decreased since 1978. Why do you think this is?

I think there are a lot of factors involved in decreased enrollment. Cost is one of them. Lack of representation in medicine is another, because many college students won’t choose to study something in which they don’t see themselves represented.

The National Medical Association (NMA) was created in 1895 to serve Black physicians who were not permitted to join the AMA at that time. I used to do recruitment tours on behalf of the NMA to help spark interest in a medical career among students of color.

I also used to host the NMA section at RSNA, with Black radiologists, residents, and medical students in attendance. That proved to be a good venue for recruiting Black medical students into radiology.

Targeted radiology internships and mentorship programs are also a way to attract more URM physicians to radiology. It may be beneficial to expose students of color to careers in medicine at an even earlier age — in high school or middle school.

How might the radiology community address and eliminate implicit bias?

Implicit bias needs to be discussed more often — in our CME, at our conferences — to the point where everyone is aware of their own biases. We all have them.

Medical students need training, and early, about what implicit bias is, how to recognize and challenge their own biases, and how to ensure those biases don’t spill over into their practices. In patient care situations, this is critical, and sometimes it is literally a matter of life or death. While I don’t have concrete solutions for inclusion, what I do know is that we as a profession have to talk about it. Hopefully, conversation will lead to action that improves health equity and representation within our field, to the benefit of the patients we serve.

Author

Interview by Laura Sirtonski, freelance writer, ACR Press  

 


Learning from Crisis
Across the country, the pandemic hs thrown
inequities in the healthcare system into the
spotlight - and radiologists believe this visibility
might actually spur change.

 

In March, just as the pandemic was heating up on the East Coast, staff at Massachusetts General Hospital’s Chelsea Healthcare Center quickly realized its location — just four miles from Boston — had all the earmarks of a possible COVID-19 hot spot. Not only were COVID-19 patients showing up at the Center in greater numbers than MGH’s Boston campus, but they also had noticeably more severe disease, as shown on chest X-rays.

With a population of 40,000 packed into 2.2 square miles, Chelsea is the smallest and most densely populated city in Massachusetts. Most of the residents identify as Hispanic or Latinx and speak a language other than English at home. Median income is significantly lower than Boston; one in five residents live below the poverty line. Many residents are essential workers in restaurants, childcare facilities, sanitation departments, and manufacturing plants — who can’t work from home and often don’t get paid leave if they get sick.

Physicians and staff at Chelsea Healthcare Center knew the community well, says Patricia Daunais, (R) RTR, operations manager for the imaging department at the clinic, an affiliate of MGH. “But COVID-19 put it really front and center how the demographics here could actually make the community so much sicker compared to other communities,” says Daunais. “This community just was not a candidate to stay safe.”

Chelsea is not an outlier in this. Across the country, the COVID-19 pandemic has thrown inequities in our healthcare system into the spotlight. And that might actually be a good thing.

Bringing Health Disparities in the Spotlight

Just as the death of George Floyd brought systemic racism to the fore, COVID-19 has pushed health disparities into the spotlight. “We now see how we’ve been failing different populations in our community,” says Lucy B. Spalluto, MD, MPH, vice chair of health equity at Vanderbilt University Medical Center (VUMC) in Nashville, Tenn. According to Spalluto, the concurrence of these events has magnified the urgency. “All of a sudden, the whole world became much more aware of the need for change,” she says.

The best care in the world does little good for those who cannot access or afford that care, who do not have the resources to follow treatment recommendations, who do not speak English, or who do not feel welcomed by the healthcare system. COVID-19 points that out like nothing before, says Arun Krishnaraj, MD, MPH, director of body imaging for the University of Virginia Medical Center and chair of ACR’s Commission on Patient- and Family-Centered Care. From the moment stay-at-home orders were issued and non-essential businesses were shuttered, the country was divided — between those who were able to follow recommendations and those who could not.

While white collar workers adapted to working from home, essential workers still had to stock grocery stores or work in the food service industry — often arriving by public transport. Some patients without symptoms had the luxury of getting tested for COVID-19 just out of curiosity, while others experiencing symptoms avoided testing because they couldn’t afford to be sick. Those living in suburban houses with separate bedrooms voluntarily self-quarantined, while those in congregate housing and multi-generational households had no way to isolate themselves from sick family members.


“When the CDC finally released data on deaths by race, ethnicity, and other factors, it became very apparent that Blacks and those who were Latinx/Hispanic were having much higher death rates than other groups,” says Krishnaraj. “Native Americans were also seeing disproportionately high rates of infection in their communities.”

“Why does being Black or Latinx/Hispanic mean you have to die at a higher rate?” asks Krishnaraj. Answering that question may help identify the root causes of health disparities, start closing the gaps, and lead to a more equitable healthcare system, he says. “Perhaps good can come from a crisis like this,” Krishnaraj says. “It can shine a spotlight on the issue. The recognition may compel people to act and put into place systems that could minimize or eliminate health disparities. That’s the hope.”

Increasing Awareness to Drive Change

According to Spalluto, the pandemic has created a lot of necessary interest at the local, community, and national level in understanding what health disparities are and why they exist. “I hope that this very trying time will drive necessary change in our healthcare system,” she says.

In 2016, VUMC established the Office of Health Equity to coordinate and support equity efforts across the institution. “They really try to drive all the departments toward better care and encourage collaboration and cooperation to meet the needs of diverse populations and help build trust in communities,” Spalluto says. “A key piece of this is diversifying the healthcare workforce to better meet the needs of diverse populations.”

“Health equity needs to be integrated into the full triad of academic radiology departments: research, clinical work, and teaching,” she says. “There is systemic racism and bias within our healthcare system, and we need to recognize that if we want to move forward.” According to Spalluto, VUMC prioritizes research projects that involve underserved and underrepresented populations, all while encouraging patient-, family-, and community-centered care that ensures patients from widely diverse backgrounds feel safe in the radiology care environment.

Krishnaraj recognizes that building trust in the current health system is an uphill climb, especially in marginalized communities that have more than ample reasons to distrust the system. Although the progress towards a possible vaccine against COVID-19 gives him hope, he fears that those who need it most will not be willing to get it or to participate in the clinical trials. The Tuskegee experiments and exploitation of Henrietta Lacks eroded trust in the healthcare system, especially among Black patients, he points out. Wealth and education gaps don’t help either. “Members of marginalized populations may have perceptions like, ‘this isn’t the place for me’ or ‘this isn’t a situation that I feel comfortable with,’” he says. “And that’s where patient-centered care comes in.”

Making Patient-Centered Care the Cure

Connecting with patients in ways that put them at ease and help them engage in their care is the key to building back trust and addressing health disparities laid bare by COVID-19, says Krishnaraj. “The primary way we can do this is to ensure that each patient receives the same amount of education, support, guidance, and empowerment throughout the care process,” he says.

For example, patients who speak English have opportunities to ask questions and become active and engaged partners in their care and in shared decision-making, resulting in better outcomes. Patients who speak a language other than English have a much harder time — even with an interpreter available by phone. “We’re not connecting with these patients because we don’t speak their native language, thus we’re not as familiar with what their needs are,” Krishnaraj says. As a result, they are less likely to follow up on care and more likely to miss appointments.

Reframing these situations from non-adherence and no-shows to “missed imaging care opportunities” (a term coined by Efrén J. Flores, MD, officer of radiology community health improvement and equity at MGH) can make all the difference, Krishnaraj says. Something as simple as a voucher for a shared ride service or help filling out a Patient Assistance Programs application can solve a problem like getting to an appointment or filling a prescription. “The first part is just asking the question about what patients need or what challenges they face,” he says. “Even if the radiology department doesn’t have the resources to address the problem, raising awareness of the issues patients face when trying to access care can lead to greater compassion and empathy and improve care for patients.”


Krishnaraj gives the example of colonoscopy. Black people are at higher risk for colon cancer and are also less likely to come in for screening. The preferred screening tool — colonoscopy — requires a full day off from work, which is difficult for many people. However, CT colonography offers an alternative that doesn’t require anesthesia and is less costly, both in terms of time and money. “How can we increase the awareness and access to CT colonography among Black people to improve health outcomes?” he asks. Questions like that can lead to new approaches and solutions that help close gaps in care.


Spalluto urges radiologists to meet their patients face-to-face so they can better understand their needs and build trust with them. While that may be harder than ever while wearing PPE, she says, it’s more important than ever. “We need to help patients feel safe in the healthcare environment, especially patients who were not feeling safe or welcome even before COVID-19.” Spalluto says the increased awareness and discussions about health disparities in her community and across the nation have given her new hope. “It will drive solutions to address those health disparities.”

ENDNOTES

 1. Flores E. How respiratory illness clinics brought COVID-19 testing to underserved communities. Massachusetts General Hospital. Published June 1, 2020. Accessed July 31, 2020.

Author

By Emily Paulsen,  Freelance Writer, ACR Press

 

 

2020 Board of Directors

 


PRESIDENT
Scott Reeder, MD, PhD, FSABI
University of Wisconsin - Madison


 

PRESIDENT-ELECT

Beth McFarland, MD, FSABI
SSM St. Joseph Health Center


 

VICE PRESIDENT

Joel Platt, MD, FSABI
University of Michigan
Medical Center

 

TREASURER

Brian Herts, MD, FSABI
Cleveland Clinic


 

CHIEF MEMBERSHIP OFFICER

Ivan Pedrosa, MD, PhD, FSABI
University of Texas SW
Medical Campus

SECRETARY

Desiree Morgan, MD, FSABI
University of Alabama
 at Birmingham

IMMEDIATE PAST PRESIDENT

Susan Ascher, MD, FSABI
Medstar Georgetown
University Hospital

MEMBER AT LARGE

Aarti Sekhar, MD
Emory University

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

To renew: click the button above and sign in to your SABI account. After signing in, hit “Pay Open Orders” to add your 2020 membership to your shopping cart. For help signing in, please email info@sabi.org

SABI is trying to increase the society's outreach and involve more members in society information. The communications committee hopes to use social media to create a space where members can stay up to date, and connect on society news. As well as learn from recent research and members can share and discuss relevant materials.  Follow us, and interact with the various posts. The more interaction on the social media pages, the broader the viewership.

 
    

 

 

 Chief Editor
Priya Bhosale, MD

Administrative Editor
Jennifer Sheehan