Dr. Beth G. McFarland, MD, FSABI

SSM St. Joseph/Radiology Imaging Consultants
St. Charles, Missouri

Dear SABI Members,

It is a great privilege that I humbly address you as the next President of the Society of Advanced Body Imaging for 2021.  As these unprecedented times continue to evolve, I am inspired by and greatly thank the remarkable talent and energy of the SABI Board of Directors, SABI Administrative staff, and all of you as fellows and members of SABI.  Together we can be rejuvenated and focused to pursue excellence in education, research, and clinical service to our patients in body imaging. These efforts are fueled by the heart of SABI’s mission to foster life-long, deep relationships among members that help define meaning and quality in our careers and to those we mentor. 

Over the past several years, SABI’s strategic planning has effectively changed and invigorated our mission in several significant ways. Some highlights which we now hope to expand include:

  • Future desired state and expansion- First and foremost, our future desired state “to innovate and translate cutting edge technology in body imaging” takes us beyond the pillars of CT and MR.  As we featured in our SABI 2020 program, innovative talks in ultrasound, CT and MR PET, quantitative imaging, and artificial intelligence were introduced in stimulating ways.  In addition to the Annual Program, this year we hope to begin our efforts in the recently formed Technology Assessment Committee to bring together expertise for applications of advanced body imaging technologies, particularly as related to AI.
  • Journal of Computed Assisted Tomography (JCAT)-  Now the official journal of SABI, JCAT gives us an exciting platform to publish and expand our reach as a society. After the early efforts of Prior SABI President Dr. Erik Paulson and most recently Dr. Scott Reeder, we are proud to officially announce that Dr. Eric Tamm will be the new Editor-in-Chief of JCAT. Dr. Tamm diligently served as Deputy Editor of JCAT in 2020.  We greatly thank Dr. Allen Elster, not only for his 25 dedicated years as Editor-in-Chief for JCAT, but also for enabling a smooth transition.

  • Annual Meeting 2021- We learned much and continue to expand the society’s digital learning outputs from our first ONLINE program in 2020.  As the pandemic continues to escalate and while we hope for an effective vaccine distribution in 2021, Dr. Joel Platt, Program Chair for 2021 will also have to be nimble in order for our society to respond to the shifting demands of the time. What is certain is that SABI once again will be able to come together and produce a tremendous program to educate and engage the thoughtful participants and audience of SABI.

  • Diversity Committee-  In response to the national and international upheaval over social injustice, we are committed to forming and put into action a Diversity committee this year.  We hope to provide opportunities for under-served minorities, potentially from high school to medical school levels of education, to attend and/or participate in our meeting and explore opportunities in mentorship.  We hope to jump-start our efforts from those already engaged, including Dr. Ella Kazerooni, Dr. Efren Flores, and Dr. Erika Newman whose impactful presentations enhanced the 2020 SABI program.  May we, as a society and as individuals, continue to embrace the need for change and work towards effective solutions.

  • Mentorship Program- One of the sustaining aspects of SABI’s foundation is the emphasis on mentoring, where interactive and refreshing exchanges between junior and senior faculty evolve over time. After the tremendous success of Dr. Rofsky’s first year-long mentorship program that produced six SABI graduates in 2019, we are excited to explore the expansion of these transformative efforts.

  • Year-round offerings- The rebranded SABI has begun to answer the call to expand beyond an annual course.  Drs. Aarti Sekhar and Nelly Tam will continue the SABI supported weekly case conference Cases for Aces, which has attracted a broad and loyal following of viewers every Tuesday from 2:00 - 3:00 pm EST.  After several successful webinars in 2020, Dr. Tara Catanzano, Chair of the Education Committee, will continue to host topical webinars targeted at all career levelsThe successful Fellows Happy Hour this past September, led by Dr. Desiree Morgan, SABI Board member, showed us how enjoyable it is to connect with each other, even if only digitally.  We hope to continue ONLINE gatherings throughout the year among fellows, faculty and early career/ members in training, and other groups, so please stay tuned for future fun!
  • Quantum Noise- Emblematic to SABI’s heart and soul in the middle of 2020’s chaos, we saw the break out debut performance of Quantum Noise,  led by the father-son duet of Dr. Neil Rofsky, leader of the band, and his son Bennett Rofsky, producer.  Although this band may be going on the road soon, we do look forward to another stellar performance in 2021 to give us a jolt of optimism and joy.

  • Wellness and Engagement- Stimulated by the successful plenary in 2020 during a tumultuous year, we look forward to developing a Wellness Initiative as another important avenue to bring members together to stimulate and inspire new energies. 

Finally, we soon face the end of the surreal year of 2020- a year, which brought us the compounding challenges of a tragic pandemic and death toll, economic hardships and uncertainties, systemic racism and uprisings, political polarization and mistrust, and continued natural disasters.  To quote the energetic editor of Applied Radiology, Dr. Erin Simon Swartz, “Even hindsight doesn’t want to be 20/20 anymore”.  The end of such a tumultuous year allows us to reflect on all that we are to be grateful for, especially groups of people like SABI who share common values and vision. May we at SABI now refuel our energies to run the marathon of challenges that lie ahead.   We hope that the strength of our fellowship gives us the focus and resolve to make sustaining and positive changes in 2021 and beyond.



A remarkably energized ONLINE program for SABI 2020 took place from Oct 10-13, 2020.  We exceeded our expectations for our first online program, with over 700 registered attendees and 112 faculty who together created a stimulating atmosphere of engagement.  Tremendous thanks goes out to the teamwork of committed efforts from an inspired faculty, with guidance from the SABI Board of Directors, combined with creativity and drive from the Program Committee (* see below) and endurance and dedication from the SABI Administrative staff.    Thanks to SABI Executive Director, Michele Wittling, an outreach to 19 academic programs was made, with over 430 residents and fellows in training introduced to SABI’s course.

The disappointment of not meeting in person in New Orleans was quickly replaced with enthusiasm provided by an innovative platform of Let’s Get Digital (thanks to Jennifer Leeper’s diligent search), aided with the IT support and training by Tallen Productions.  There was a palpable energy in the live text chats between the audience and faculty throughout the course content.  As many felt, this type of engagement during a lecture was better than in person,  posing an interesting challenge as we plan for the future.   A very special and unique component of the meeting was the live hosting in the Lobby.  Multiple university programs took part in hosting to promote or reflect upon the meeting content or to give updates in their region.  We greatly thank Dr. Brian Herts, SABI Board member, Jennifer Leeper, SABI Administration, and Paul Slawinski, IT support, along with all of the university programs who gave their time and energy as hosts.

The pre-conference symposium of “Artificial Intelligence- Essentials for the Clinician”, organized by Dr. Bhavik Patel and co-chair Dr. Andrew Smith, was a fantastic kick-off for the SABI program.  An all-star cast took us through a topical review, including a historical perspective of AI development, nuts, and bolts of deep learning, leading clinical applications, challenges in healthcare, and future directions.   To top off the day, Dr. Ivan Pedrosa, SABI Board member, helped to organize a stimulating live panel discussion between industry and academic thought leaders to discuss challenges and opportunities in AI.

Sunday featured the prized jewel of SABI, the scientific sessions for research.  Two one hour sessions were held for the oral presentations, with live video chats between the moderators and research presenters.  Three Pearls, two More Science sessions, and the Poster Presentations were also held Sunday through Tuesday, to encompass a total of 30 oral and 30 electronic poster presentations.  Monday evening the Research Award Ceremony was held moderated by Research Chair Dr. Olga Brook and committee member Dr. Ghaneh Fananapazir.  Great thanks to the diligent efforts of the research committee and Stephanie Hige, SABI administration.  We congratulate the Award Winners and all who presented abstracts to make this an outstanding year of research presented at SABI. Dr. Eric Tamm, acting as Deputy Editor of JCAT, also gave a heartfelt thank you to Dr. Alan Elster, as past Editor-in-Chief for 25 years who was instrumental in helping develop the new relationship of SABI with JCAT.

It was with tremendous pride that SABI premiered the first-ever band performance of Quantum Noise to kick off the Scientific Awards ceremony.  Led by Dr. Neil Rofsky, past President of SABI and current chairman at UT Southwestern, along with diligent editing efforts by his son Bennett Rofsky, this all SABI 10 member band danced, sang, and played to the Blues Brother Song,” Hold on I am coming”.  Truly symbolic to the heart, creativity, and fellowship of SABI, this performance will be an iconic moment of this 2020 meeting.  Watch Now!

During Monday’s Culture of Innovation plenary, we were privileged to have the renowned Dr. Elias Zerhouni give the insightful Presidential Lecture of “Precision Medicine and the Future of Imaging”.   Directly before this in the lobby, Dr. Scott Reeder, SABI President, interviewed his mentor, Dr. Zerhouni, for a remarkable 30-minute discussion about Dr. Zerhouni’s life and career.   Emblematic to the core values of mentorship and lifelong relationships in SABI, they reflected on career highlights and advice for pursuing one’s passion.  See Interview.

Over the course of SABI’s program, 12 plenary sessions and 17 workshops were presented, with thanks to Jennifer Sheehan, SABI administration for her dedicated efforts to coordinate the faculty efforts.   Outstanding content was presented across classic clinical and technology plenaries. Highlights include:

  •  Dr. Aarti Sekhar and her co-moderator Dr. Guarav Katri hosted the first-ever Tumor Board, leading a stimulating review with practical clinical pearls of hepatobiliary, colorectal, and sarcoma cases among a panel of surgeons, gastroenterologist, and radiologists.  

  • Dr. Ella Kazerooni helped create and participate in the topical plenary session, “Pandemic: Health Care Inequities and Opportunities”.  Impactful talks were also given by Dr. Efren Flores on reducing barriers in a lung cancer screening program for under-served patients at MGH and Dr. Erika Newman on the “Promise Program” which is helping to build a more diverse surgery department at the University of Michigan. As SABI starts their efforts with diversity, these ideas and contacts will help launch our efforts.

  • Innovations in CT plenary included a popular Dual Energy CT debate, moderated by Dr. Rendon Nelson, who led a four-panel to discuss if DECT had lived up to its potential.  Innovations in MR included the ever-popular short talks on abbreviated MR protocols across different organ systems.

  • The final plenary of Beyond Interpretation focused on Wellness and Engagement as a fitting finish for this 2020 program, thoughtfully moderated by Drs. Stephanie Weinstein and Claude Sirlin.  Planned before the pandemic,  but ever more important during the year of COVID 2020, these creative Ted like 5-minute talks included topics of wellness and engagement at work, resiliency, powers of sleep, mid-career development, gratitude and leadership opportunities.  

New appointments were announced at the Business meeting.  We congratulate Dr. Ihab Kamel, as the new Board member and Secretary of SABI and Dr. Nicole Hindman, as the new Fellow at Large.   We also warmly welcome as new Fellows of SABI, Dr. Mishal Mendiratta-Lala, Dr. Aarti Sekhar and Dr. Motoyo Yano.  We look forward to all of their continued dedication and efforts in the society.

Finally after this tumultuous year, let us close our efforts for 2020 and renew our energies by putting into practice the words of Jessica Robbins in her message on leadership, “pursue your passion with gusto”.  May we carry forward the buzz and energy we felt during this program as we go into 2021.

*SABI 2020 Program committee:  Ella Kazerooni, Aarti Sekhar, Avinash Kamdakone, Bhavik Patel, Ghaneh Fananapazir, Olga Brook, Chris Francois, Desiree Morgan, Scott Reeder, Joel Platt, Ihab Kamel and Brian Herts.


SABI is dedicated to fostering research in diverse subspecialties within body CT and MR through its research program. The Society's research program consists of The Scientific Research Abstracts which provide financial awards to winners.  Accepted abstracts are presented at the annual meeting to a national audience.  Presentations are eligible for awards recognizing excellence.

2020 Winners:

Hounsfield Award
Abou Elkassem
University of Alabama Hospitals
Comparative Effectiveness of AI-assisted vs. Standard of Care Methods in Advanced Cancer Longitudinal Response Evaluation in a Multi-Institutional Study
  ​Lauterbur Award
Jitka Starekova
University of Wisconsin Health
Nephrogenic Systemic Fibrosis in Patients with Impaired Renal Function exposed to Gadoxetic Acid
Resoundant Innovation Award
Sherif Elsherif
University of Florida
Automated Body Composition Analysis from Abdominal Computed Tomography Scans using Deep Learning Diagnostic performance of PET/MRI compared with PET/CT for gynecological malignancies
  Young Investigator Award
Elka Rubin
Stanford University School of Medicine
The Differing Effects of the Competitive Season and Off-Season on Knee Articular Cartilage in Collegiate Basketball Players using Quantitative MRI
Moncada Award
Arjun Desai
Stanford University School of Medicine
Automated Body Composition Analysis from Abdominal Computed Tomography Scans using Deep Learning

Three Pearls
Jigarkumar Rangunwala
University of Mississippi Medical Center
Problem-solving Role of MRI in Evaluation of Splenic Abnormalities

Hyunjoong Kim
New York-Presbyterian
Gynecologic Imaging With Serum Biomarker Correlates

Emily Rutan
Georgetown University
The Hepatic Arterial Buffer Response





Stephen Cai
University of Pittsburgh
Novel MR-based Deep Learning Algorithm for Assessment of Liver Fibrosis in Patients with
Non-Alcoholic Fatty Liver Disease

Huy Michael Do
National Institutes of Health
Deep Learning Detection and Classification of Interstitial Lung Disease Patterns

Neema Patel
Mayo Clinic FloridaMayo Clinic Florida
What you need to know about Liver Transplantation: The Good, The Bad, and The Ugly


More Science Sessions
Christin Park
University School of Medicine
Ultra-low-dose FDG PET/MR Enterography with Deep-Learning Image Reconstruction

Huy Michael Do
National Institutes of Health
Public availability of 3D print build files during a time of crisis for a patented radiology device that quantifies upright angles in portable chest x-rays


















Creating Lasting Improvements
With racism and health inequity in the national
spotlight, some are asking: How can we bring
about long-term change from crisis?



For many, COVID-19 has exposed deep cracks in the U.S. healthcare system — for others, these cracks have been evident all along, but the combination of the pandemic and the death of George Floyd provided the perfect storm to bring these weaknesses to the fore. “COVID-19 revealed the rampant effects of racism on medicine,” says Daniel B. Chonde, MD, PhD, resident physician and co-chair of the department of radiology, diversity, and inclusion’s committee on education at Massachusetts General Hospital (MGH). Rather than bury our heads, though, now is the time to harness that attention and energy — and turn it into progress, Chonde says. “This is one of those times where you could be doomscrolling or you could do something about it,” he says.

Elyse R. Park, PhD, clinical associate in psychology at MGH and director of behavioral research for the MGH Tobacco Research andTreatment Center, the Benson-Henry Institute for Mind Body Medicine, and the MGH Cancer Survivorship Program, agrees. “I think the advocacy around healthcare access for vulnerable populations has really raised people’s awareness,” she says. “Those together really influence people’s awareness of health disparities at all institutional levels.”

So now that we see it, what can we do? Part of the answer lies in outreach, according to Chonde and Park, to communities and to medical students. According to Park, as the country settles in for the next wave of the pandemic, a key area in which institutions can start beefing up their efforts to combat inequities in healthcare — community outreach. “A longstanding issue with clinical research is that racial and ethnic minority populations have historically low enrollment rates in clinical trials,” she says. “That creates a cascading effect — all of that research does not represent these groups in terms of conclusions, but also long-term access to care. We have
been trying to create policies to allow us to do more community-based outreach to vulnerable populations, which we had not been able to get any traction on before.”

But, she says, there is tension between privacy issues and community outreach, and the right balance needs to be struck. “This is very basic but sometimes people have to consent before we do outreach, but we want to do outreach prior to consent,” Park says. “For example, in our current study, Screen Assist, we send patients
information about a study that provides free tobacco treatment support for patients undergoing lung cancer screening (LCS). We have created a video that features a physician who emphasizes the importance of quitting smoking and getting LCS. Yet, we have to respect patients’ privacy and not reveal that they are eligible for LCS. Unless we’re allowed to move forward and do more direct outreach into these vulnerable populations, we can’t accomplish what our research is intended to.”

COVID-19 revealed the rampant effects of racism on medicine.

— Daniel B. Chonde, MD, PhD

Community outreach is especially important now, Park says, because with a second COVID-19 surge looming and no end in sight, there is growing concern amongst researchers that trends observed over the last few months will only worsen. “Folks in vulnerable populations were disproportionately affected, and unfortunately there’s a lot of concern about this trend continuing when there’s a vaccine,” she says. “There’s also a growing concern that existing disparities in cancer screening are going to widen — that URMs are going to be more hesitant and slower to return to preventive care because their communities have been disproportionately affected by COVID-19 and they want to limit their in-person exposure, which includes going to a hospital/clinic for screening. Racial and ethnic minorities already have later diagnoses traditionally, so then that just amplifies the cycle.”

Park notes that it’s important that radiologists advocate for remote treatment visits to the extent that they can, understanding the logistical challenges and particularly financial challenges of the populations that have been really hard-hit by COVID-19. “Try to think creatively about how you can reach out to patients in safe ways — promoting remote communication so that they don’t have to keep coming into the hospital,” Park says. Longer-term, really homing in on efforts to increase diversity in the field will be key, says Chonde. “Our job as radiologists is to be a place where any medical student feels safe. We should be soliciting diverse populations to choose radiology.” All in all, Chonde is optimistic. “With each of these crises, we’re able to make incremental steps,” he says. “My hope is that we’re able to capitalize on one of these events to ignite some lasting effects.” 

AuthorCary Coryell, publications specialist, ACR Press 


Seldom Seen
Transgender patients deserve radiology's commitment to screening outreach and access.


“Imaging needs of transgender patients have historically not been on the minds of radiologists and their staff,” says Justin T. Stowell, MD, senior consultant and assistant professor of radiology at Mayo Clinic in Florida, who also sits on the ACR Commission for Women and Diversity, where he leads a gender-focused workgroup. “Even pre-pandemic, these patients had limited access and often felt discouraged from coming in for healthcare services in general. Many just don’t trust physicians who often may be uneducated about transgender health issues.”

During a time of unprecedented attention to systemic social injustices and healthcare disparities — putting the inequitable treatment of marginalized populations center stage — radiology has an opportunity to serve the transgender community through staff training, collaboration with colleagues, and a heightened awareness of transgender patients’ needs and experiences.

By definition, transgender and gender-diverse individuals have a gender identity which does not align with the sex assigned to them at birth. Gender identities not congruent with sex assigned at birth are often included within the broader social classification of lesbian, gay, bisexual, transgender, and queer (LGBTQIA+) people, however, gender identity and sexual orientation are not the same.1

Count Everyone

Conversations around transgender care aren’t happening as often as they should, according to Linda Moy, MD, professor of radiology at NYU Langone Health and specialty chair for the ACR Appropriateness Criteria® (ACR AC) for Breast Imaging. The ACR AC are evidence-based guidelines to assist referring physicians and other providers in making the most appropriate imaging or treatment decision for a specific clinical condition — and an upcoming iteration will include transgender breast imaging guidelines for the first time.

Radiologists and referring clinicians may only see or be aware of a small number of transgender patients in their community, Moy says. But that does not negate the need to address transgender health issues. “The ‘this doesn’t apply to me’ way of thinking by clinicians presents a huge obstacle,” she says. “Transgender patients constantly face barriers to screening and other healthcare services because of stigma, discrimination, and patients’ fears of being balked at,” Moy adds. Ignorance and insensitivity around medically relevant services for these patients may start at the front desk, with an RT, or with a referring physician.

“There are incredible unconscious biases that exist in our society,” Moy says. “The goal in radiology — especially in screening — is always to make all patients comfortable and relaxed,” Moy stresses. “We are the portal that will potentially take the patient to other services.”

And this matters to patient outcomes. Gender-affirming therapy may influence an individual’s risk of developing sex-specific cancers such as breast and prostate cancer. In addition, transgender patients still require routine age-based screening based on applicable recommendations.


Start Early

The value of radiology in connecting transgender patients with other services in the healthcare value chain must be taught earlier in medical training, says Baer Karrington, a 2021 MD and MScPH candidate at NYU Langone and NYU Grossman School of Medicine, which is one of the only medical schools to include an objective structured clinical examination focusing on transgender patient care. Many transgender patients end up doing their own research to find out what services they will need. “That becomes more difficult when it comes to finding the appropriate preventive care or screening,” Karrington says. “Transgender men, for instance, have much lower rates of cervical cancer screening compared to cisgender women, despite continuing to need this screening if they have a cervix.”

Karrington is pursuing adolescent medicine with a focus on gender-affirming care and served as a patient representative in the creation of the new ACR AC on Transgender Breast Cancer Screening. “Transgender patients have already fought to get surgery, to get their hormones, and even to get people to use the name of their choosing. When they get to radiology, they may then be charged with determining, on their own, the types of studies they need and what their risk factors are. That is not fair,” Karrington says.

Humanize Access

“Unfortunately, a lot of what drives our decision-making in healthcare may be what insurance companies pay for,” Stowell says. “If you are a transgender woman, but your driver’s license or other legal documents list ‘male’ — services can be denied. The insurance company will likely say breast cancer screening is not recommended for men,” Stowell notes.

Beyond insurance coverage, screening and intake forms also matter. Take a patient-centric approach in revising your forms, Stowell suggests. “This is something patients will see during their first encounter with an imaging group. There should be spaces on forms for sex assigned at birth, gender identity, and appropriate pronouns,” he says.

Simple changes to screening forms could capture information about transgender patients that guides appropriate care recommendations, Stowell says. Because of their central place in patient care, radiologists have an important part in defining what is appropriate for transgender patients, says Frances Grimstad, MD, MS, an attending in the division of gynecology at Boston Children’s Hospital and a clinical instructor at Harvard Medical School.

“If I send a transgender woman who has had a vaginoplasty in for a pelvic US and the imaging practice misidentifies the patient, she may be screened incorrectly,” Grimstad says. “When the radiologist interprets the scan, he or she won’t understand that this patient should not have a uterus. It isn’t because it is surgically absent, rather that it was never there to begin with. Similarly, the radiologist may not realize that there should be a prostate.”

Having all the facts about a transgender patient means realizing that requiring patients to disclose irrelevant personal information could be unnecessarily problematic, Stowell says. Some patient forms call for an organ inventory (listing what organs you have), Stowell notes. “Why is that necessary? Maybe just a surgical history would be enough,” he says. “There are also questions like, ‘If you are a woman, could you be or become pregnant?’ Take out the word ‘woman,’” Stowell suggests. “The question is only there so the radiologist can explain the potential risks of radiation to a fetus, if necessary.”

Mindfulness and sensitivity in your radiology reports are equally important — as the words you choose may dictate a patient’s comfort level. “A report with unnecessary mentions of ovaries and a uterus can be uncomfortable to a transgender male,” he says. “Some of these patients don’t want to acknowledge these body parts, so unless there is an issue related to them, use pertinent negatives with a neutral statement such as ‘no pelvic mass.’”

Push Training 

Such considerations in transgender patient care will grow through more gender diversity training for radiologists and their support staff, Grimstad says. “For radiologists, if they don’t understand the kinds of surgeries or hormonal therapies common among transgender patients, they will be interpreting images with incomplete information,” she asserts.

“We depend on radiologists to stand up as leaders and ask what a referring physician needs to interpret information appropriately. Referrers have been trained with a very cisgender approach to imaging,” Grimstad says. “The reality is that medicine is moving towards a model where we understand that the sex binary and the gender binary have limited us,” says Grimstad.

Transgender awareness training should be mandatory for your entire radiology staff, Stowell believes. While radiologists must be informed, so should front office staff, coders, and RTs. For example, says Stowell, “Technologists shouldn’t be afraid to ask the patient if there are parts of an exam they aren’t comfortable with.”

Collaboration with referring clinicians might allow targeted delivery of anticipatory guidance prior to imaging so the patient is aware of what is required during an exam and why it may be necessary for diagnosis. “The patient might also be able to help with part of the exam so it doesn’t feel so invasive.”

Raising awareness can start with showing staff a video or providing them with transgender resources they can pass along to colleagues and patients, he says. “Simple things, like wearing rainbow or transgender rights ribbons, or displaying them in your facility’s waiting areas or check-in stations, show that your specialty supports the transgender community,” Stowell says.


Invite Treatment

Until a national, collaborative push for the equitable care of transgender patients gets more traction, radiology groups must do what they can now to foster change. “As a breast imager, we find the detection of breast cancer to be important among all patients,” Moy says. Outreach efforts encouraging women to come in for screening mammography, however, can be very biased towards cisgender women, she notes.

“Transgender patients who come in have said that they are reluctant to come back — that they weren’t addressed appropriately and felt uncomfortable,” Moy says. “Some RTs, doctors, and even patients in the waiting rooms have biases towards transgender patients. We are dealing with an ongoing process of educating people.” Education and culture change can be slow, but unfortunately in the time it takes a practice to adapt, transgender patients are missing screening after screening.


Change Perceptions

A host of indicators may define your practice or radiology department as inclusive or exclusionary in the eyes of transgender patients, Stowell says. If a transgender patient has a negative experience at a facility, they may not come back for much-needed follow-up care. It may even discourage them from getting other healthcare services, like a Pap smear or flu shot, Moy says.

Even signage says a lot. “If a facility is called ‘Center for Women’s Imaging,’ for instance — even if you are offering US and other modalities — you’re basically telling transgender men they can’t come in to have their gynecological exams there,” Stowell says. “Similarly, you’re telling a cisgender male with a mammographic issue that he is sitting in a women’s center.”

While you may not need to change the name of your practice, you can make it clear that restrooms are gender-neutral, Stowell says. You can have transgender literature in your waiting rooms — ranging from magazines to pamphlets for transgender help centers. “No one is forced to pick it up and read it, but it lets transgender patients know they are welcome,” he says. Consider your changing area — do patients have privacy? Are your gowns pink, reinforcing the perception of a gendered space?

October is Breast Cancer Awareness Month and has always been associated with pink to show unity among supporters and survivors. “While pink [ribbons] can make cisgender women feel more comfortable or empowered, they may not speak to the smaller number of transgender patients who see that messaging in waiting rooms or through outreach campaigns,” Moy suggests. Rainbow and transgender rights ribbons alongside the pink may seem more inclusive.

Public displays of nondiscrimination policies, LGBTQIA+ affirmative reading materials, and awards of distinction (e.g., the Human Rights Campaign Healthcare Equality Index) can all be nonverbal indicators of a facility’s commitment to inclusivity, fostering open communication, and patient retention.1 These are silent indicators, Stowell says, and transgender patients in your community will look for these things when seeking services.

“Radiology practices are looking to get patients back on track post-COVID-19,” Stowell points out. “Making inclusion part of your brand can only help.” If you want your radiology group to be forward-facing — so, doing the right thing for all patients — an inclusive mindset is key. Radiology is as important for transgender patients as it is for any cisgender patient who needs imaging, Stowell says. “Always be sensitive to what your patient is facing — and to how you present yourself.”

For now, radiology personnel can help break down barriers to care by providing a welcoming clinical environment, practicing cultural humility, and staying up to speed with changing recommendations for transgender care.2

“In moving forward, what radiologists can do is collaborate with other clinicians who are providing care to transgender patients and find out where we can have the biggest influence,” Stowell says. “Imaging is used universally in healthcare, so it makes sense that radiologists be involved early in conversations around improving transgender care.”



1. Stowell JT, Grimstad FW, Kirkpatrick DL, Brown LR, Flores EJ. Serving the needs of transgender and gender-diverse persons in radiology. J Am Coll Radiol. 2019;16(4):533-535.

2. Sowinski JS and Gunderman RB. Transgender patients: what radiologists need to know. Am J Roentgenology. 2018;210(5):1106-1110.

AuthorChad Hudnall, senior writer, ACR Press  

2020 Board of Directors



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



Joel Platt, MD, FSABI
University of Michigan
Medical Center

Brian Herts, MD, FSABI
Cleveland Clinic


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


Desiree Morgan, MD, FSABI
University of Alabama
 at Birmingham

Ihab Kamel, PhD, MD, FSABI
Johns Hopkins Bayview
Medical Center

Nicole Hindman, MD, FSABI
New York University


Eric Tamm, MD, FSABI
MD Anderson Cancer Center



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


Aarti Sekhar, MD
Emory University



















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Priya Bhosale, MD

Administrative Editor
Jennifer Sheehan