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Neuroradiology Events

2005

• Dr. Westesson presents QA in Neuroradiology

On December 14, 2005, Dr. Westesson gave a presentation on QA in Neuroradiology. He discussed self-criticism, self-analysis and quality of preliminary reports. The presentation started an intense discussion of our education system, our way of training residents and the way we do daily QA in Neuroradiology.

• Fourth Chapter of Neuroimaging Anatomy now online

"What Residents Need to Know About the Temporal Bone ," by Dr. Loris Cedeno, the fourth chapter in the Neuroradiology Normal Anatomy Series is now online.

• Maxillofacial Imaging Book released at RSNA

The Maxillofacial Imaging book by Drs. Larheim and Westesson was release at the 2005 RSNA in Chicago. This is the first substantial book on maxillofacial imaging since the early 1990's and covers the jaw and adjacent structures. By the second day the publisher, Springer, had sold all the books they had brought to the exhibit and could only take orders for more.

• Dr. Hiwatashi publishes the first article comparing vertebroplasty with kyphoplasty

Vertebroplasty and kyphoplasty are similar techniques used to treat painful compression fractures of the spine. There is much debate on which technique to use and Dr. Akio Hiwatashi et al. has now published the first article that actually compares the two techniques (Radiology. 2005 Dec;237(3):1115-9) with respect to the ability of restoring vertebral body height. Kyphoplasty was a little better, but the difference was so small that the authors question if it had any clinical significance.
Figure 2. Images of the L3 vertebral body from an 87-year-old woman. The vertebra was treated with kyphoplasty. The posterior elements of the vertebral body have been resected. A = anterior, C = central, P = posterior. (a-c) Sagittal reconstructed CT scans obtained in the middle portion of the vertebral body. (a) CT scan obtained before fracture, (b) CT scan obtained after fracture shows a decrease in vertebral body height. (c) CT scan obtained after kyphoplasty shows a 4-mm increase in vertebral height in the anterior and central portions. The height increase was less than 1 mm in the posterior portion of the vertebral body. The wedge angle decreased from 8° to 2°. (d-f) Schematics used to measure vertebral body height overlaid over the sagittal CT scans in a-c. (d) Before fracture, the vertebral body was 26 mm in anterior, 23 mm in central, and 28 mm in posterior portions. The wedge angle was 5°. (e) After fracture, the vertebral body was 18 mm in anterior, 13 mm in central, and 23 mm in posterior portions. The wedge angle was 8°. (f) After kyphoplasty, the vertebral body was 22 mm in anterior, 17 mm in central, and 24 mm in posterior portions. The wedge angle was 2°.
	Figure 3. Sagittal reconstructed CT images of the L4 vertebral body from an 87-year-old woman. The vertebra was treated with vertebroplasty. The posterior elements of the vertebral body have been resected. A = anterior, P = posterior. (a) Scan obtained in the middle portion of the vertebral body before fracture. (b) Scan obtained in the middle portion of the vertebral body after fracture shows a decrease in the vertebral body height. (c) Scan obtained in the middle portion of the vertebral body after vertebroplasty shows a 1-mm increase in the vertebral body height in anterior and central portions. No significant height increase is noted in the posterior portion. The change in wedge angle was less than 1°. There is leakage of the cement superiorly (arrow).

• Dr. Liu interviewed on "RSNA On-The-Air"

Dr. Xiang Liu, a visiting researcher in neuroradiology, was invited to present on “RSNA On-The-Air” at the recent Radiological Society of North America meeting. Dr Liu talked about advanced MR imaging, including perfusion and diffusion, tractography and sophisticated spine imaging.

• Third Chapter of Neuroimaging Anatomy now online

• Neuroradiology Goes Digital

In September 2005, Neuroradiology went completely digital and had 8 PACS stations installed. Each station is equipped with four high-resolution diagnostic monitors, one navigational monitor and a separate internet connected computer with its own monitor. Thus, each station has six monitors. The next step would be to be totally film and paperless, and dispense with the paper requisitions that we currently use to initiate dictations.

• Second Chapter of Neuroimaging Anatomy now online

• PET/CT Center fully operational

The University of Rochester PET/CT Center at Rochester Science Park is now fully operation. PET and CT scans are done on the most contemporary scanners on the market. Patients can be scheduled Monday through Friday with generally a very short waiting time.

• Dr. Kakimoto presents educational poster on dental implant imaging

	Dr. Naoya Kakimoto presented an educational poster on dental implant imaging at the 39th Annual Meeting of the American Society of Head and Neck Radiology in San Francisco, CA in September 2005. High-quality images with great detail let conference participants learn how to image for dental implants. Dr. Westesson who is a co-author of the presentation discussed the content (see photo above).

• Dr. Ohgiya presents his research on imaging of vascular malformations

Dr. Yoshimitsu Ohgiya presented his research on imaging of vascular malformations at the 39th Annual Meeting of the American Society of Head and Neck Radiology in San Francisco, CA in September 2005. His thesis is that high and low flow vascular malformations can be characterized non-invasively on cross-sectional imaging studies.

• Cindy Zink, Neuroradiology PA elected President of RRPAA

Cindy A. Zink, RPA-C

Cindy Zink, Neuroradiology PA, was elected president of the Rochester Regional Physician Assistant Association. The RRPAA is New York State's largest, oldest and most well established regional Physician Assistant Association. In 2005/2006 the RRPAA will celebrate it's 10-year anniversary. Since then the organization has been supported by PAs in the community with the latest membership growing to 169 active members. Each year the RRPAA Board of Directors offers two scholarships to PA students currently attending the Physician Assistant Program at Rochester Institute of Technology (RIT). Scholarships for $750.00 each are awarded to one 3rd year and one 4th year PA student.

• Imaging Anatomy in Neuroradiology

• Dr. Tore Larheim returns to Norway

Visiting Professor Dr. Tore Larheim traveled back to Oslo Norway on September 11, 2005, after having spent one intensive year at the University of Rochester. Dr Larheim completed a large book project entitled " Maxillofacial Imaging" that will be published by Springer in November of this year. This 450 page book will contain over 1400 illustrations on maxillofacial imaging. Dr. Larheim also worked on a research project classifying TMJ internal derangement into distinct categories.

• Dr. Doerthe Ziegelitz Arrives

Dr. Doerthe Ziegelitz from the University of Gothenburg, Sweden has arrive and will stay with us as a visiting researcher for one year. Dr. Ziegelitz will be concentrating her research work on MR perfusion studies under the guidance of Dr. Sven Ekholm.

• Clinical Neuroscience Conference in New Radiology Conference Room

• Viewbox era ends

PACS comes to Neuroradiology. In the next few weeks, Neuroradiology will go all digital as the last portion of our department that will stop using film and will interpret all images on monitors. Here we see Drs. Jared Christensen and Ravinder Sidhu in front of alternators (viewboxes) that have serve the department for probably 25+ years and will soon be retiring.

• Dr. Jeevak Almast goes back to Mauritius.

	Dr. Jeevak Almast served as a fellow in the Division of Diagnostic & Interventional Neuroradiology for two years and went back to Mauritius in July of 2005. During his stay at the University of Rochester, Dr. Almast was recognized for his outstanding teaching ability and received the residents' recognition award for best teacher.
	Dr. Almast giving a conference
The island of Mauritius is located in the Indian Ocean near Southern Africa, east of Madagascar.

• Drs. Westesson and Larheim publish landmark chapter on TMJ Imaging.

Drs. Per-Lennart Westesson and Tore Larheim publish landmark chapter on TMJ imaging. This is a major chapter in the 3rd edition of the text book "Temporomandibular Disorders: Evidence-based Approach to Diagnosis and Treatment" edited by Daniel M. Laskin, DDS, MS, DSc.

• Maxillofacial Imaging Book Ready for RSNA

• Neuroradiology 2005 Summer Party

The Neuroradiology summer party was held July 4, 2005 at the Rochester Canoe Club. All the neuroradiologists, fellows, residents, PAs, techs, secretaries and others related to us had a good time on the waterfront - sailing, playing and being together. Dr. Yuji Numaguchi from Japan and Dr. Tore Larheim from Norway were special guests. It was an international event with representatives from US, Taiwan, China, Sweden, and India.

• Neuroradiology Fills All 3 Fellowship Match Spots for 2006

Neuroradiology at the University of Rochester matched 3 fellow candidates for a starting date of July 1, 2006. Thereby we were one of the relatively few programs that totally filled in this year’s match. There were 71 active neuroradiology programs in the country of which 32 filled (45%) and 39 (55%) remained unfilled at the end of the match. 68% of the positions (118 positions were filled) were as 32% (56 spots) were left open.      Magnetic Resonance Imaging and Musculoskeletal radiology did best in this year’s match with 79% and 85% filled positions respectively. Interventional radiology did not do so well with 38% filled but was in good company with breast imaging (43% filled).      We are welcoming the 2006 neuroradiology fellows.

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• Dr. Numaguchi is Visiting Professor

Dr. Yuji Numaguchi is in Rochester as a visiting professor for three weeks this summer. Dr. Numaguchi will be working in the division during the end of June and beginning of July 2005. He will give multiple lectures and seminars to the residents and fellows during his stay with us. We are all looking forward to having Dr. Numaguchi back in the division.

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• University of Rochester opens Advance Imaging Center

University Imaging at Science Park held it's grand opening Thursday, June 2nd. The new center has a cyclotron and can produce and deliver short-lived isotopes directly to the PET scanner. Coinciding with the opening was the Stanley M. Rogoff Memorial Lecture giving by Dr. Steven M. Larson on "The Role of PET and PET/CT in Oncology."

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• Neuroradiology submits record number of presentations to RSNA

After an intensive few weeks, 21 abstracts (papers, posters and exhibits) were submitted by Neuroradiology for the 2005 RSNA. They span from interventional to diagnostic topics and we are very proud that everybody could come together and work so intensively to get this done.

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• Dr. Paramjeet Singh Visiting Professor

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• Maxillofacial Imaging Book Near Completion

The Maxillofacial Imaging book by Drs. Larheim and Westesson is coming along very well. After 8 months of very intense work, Dr. Larheim is now finishing the book on maxillofacial imaging. The table of content has been expanded and the number of images greatly exceeds what we had initially anticipated. It will be a landmark text defining the specialty and contains numerous high quality images using all contemporary imaging techniques.

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• Dr. Leena Ketonen Visiting Professor on May 13, 2005

Dr. Ketonen was the Chief of Neuroradiology (1991-94) and Chief of Pediatric Neuroimaging (2003-4) here at the University of Rochester. Dr. Ketonen has had a long-term interest in pediatric neuroradiology. She completed a monumental book when she was at the University of Rochester on pediatric neuroradiology entitled "Pediatric Brain and Spine: An Atlas of MRI and Spectroscopy". It is a great pleasure to have Leena here as a visiting professor.

• Five First Year Fellows in Neuroradiology

• Dr. Toshio Moritani publishes landmark article on diffusion MR imaging of brain injury

This major review article was published in the February 2005 issue of the American Journal of Neuroradiology* and is largely based on the material that Dr. Moritani collected during his stay at the University of Rochester. The object of this review was to illustrate and describe excitotoxic mechanisms in various acute neurologic conditions, such as infarction, hypoxic ischemic encephalopathy (HIE), the early phase of wallerian and transneuronal degeneration, shaken baby syndrome, status epilepticus, a corpus callosum lesion related to either seizures or antiepileptic drugs, diffuse axonal injury, toxic or metabolic leukoencephalopathy, the acute phase of multiple sclerosis, and Creutzfeldt-Jakob disease (CJD).    Excitotoxic brain injury is the final common pathway for various neuropathologic conditions and causes cytotoxic edema. Diffusion-weighted (DW) imaging is especially useful for the early detection of cytotoxic edema as an area of abnormal hyperintensity associated with a decreased apparent diffusion coefficient (ADC). *Moritani T, Smoker WR, Sato Y, Numaguchi Y, Westesson PL. Diffusion-weighted imaging of acute excitotoxic brain injury. AJNR Am J Neuroradiol. 2005 Feb;26(2):216-28. [Medline]

Hyperacute infarction 2 hours after onset

• PET-CT Center will open soon

University of Rochester Center for Advanced Imaging located in Rochester Science Park is nearing completion.

• Early cherry blossoms in Japan

Adjunct Professor Yuji Numaguchi reports early cherry blossoms in Japan

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• Don't miss the ER show on Thursday, February 17th, featuring a stroke victim and the Merci Retrieval System

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• Neuroradiology develops a new administrative office for secretaries, Regina and Belinda.

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• 100% passing rate for CAQ in Neuroradiology

All the neuroradiology fellows trained at the University of Rochester Neuroradiology Fellowship Program who have taken the Certificate of Added Qualifications (CAQ) in Neuroradiology from the American Board of Radiology have passed on the first attempt. We have had no conditions and no failures. This is a result that we are very proud of and we strive to continue at this level.

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• Dr. Lawrence N. Tanenbaum presented Radiology Grand Rounds, January 10, 2005, on "Advances in 3.0T Clinical MR"

Pictured from left to right: Mr. Kenneth J. Sikorski (Account Executive GE Healthcare), Dr. Henry Wang and Dr. Lawrence Tanenbaum.

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