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Cleveland Clinic Radiology Alumni Connection

Radiology Alumni Connection Q3/Q4 2012 Edition

Imaging Institute Updates Imaging Institute Expansion Continues Construction for Phase II (expansion of CT facilities to Gb3) began in March. Staff has been relocated to L-10 from the Interventional, Quality, Research, and Physics departments. Expansion of cardiac MRI facilities in J1 continues to move forward, with MRI delivery taking place in March and applications in April. The research mammography unit in A2 was delivered in March, and finishing upgrades to A2 have been completed. Construction for the Mellen Center 7T MRI has begun, with equipment delivery scheduled for January 2013. Phase III (Angio facilities expansion) is currently in design, with construction targeted to begin in March 2013. Funding for PET/MR (mMR) in Qb has been approved; the unit should be operational in March following renovation of a shelled MR pod in the new MRI facility. Agfa PACS Migration Being Implemented All locations have completed the implementation of the Agfa PACS except for eRadiology, where planning continues. Migration of legacy images from Siemens PACS to Agfa continues. Imaging Institute Informatics and Agfa are reviewing options for ongoing image storage along with CCF ITD evaluating “Cloud” (off-site storage) options. The

implementation of the Enterprise Image Viewer for CCHS enterprise is complete, with Weston’s implementation being done in July. The Syngo Workflow version 32 Upgrade is targeted for Q4 2012. Commissure upgrade to Powerscribe 360 is targeted for Q1 2013. Hardware has been installed, with configurations and testing getting started. North Hawaii Community Hospital integration with CCHS Commissure went live on Sept. 4. North Coast Cancer Care interpretations went live with Syngo Workflow and Agfa PACS on Oct. 1.

Imaging Institute Announcements Residency in Diagnostic Imaging Medical Physics Announced Under the leadership of Paul Johnson, MS, DABR, the section of Medical Physics is implementing a two-year residency in Diagnostic Imaging Medical Physics. One of only eight such residencies in medical physics nationwide, this program will be a hospital-based paid residency similar to other medical residencies at the Cleveland Clinic. Qualified candidates should have a master’s or doctoral degree in medical physics to train in the residency. The Cleveland Clinic’s board-certified medical physics staff, headed by William J. Davros, PhD, will train the resident to function as an

Visit us online at clevelandclinic.org/radiologyalumni. Submit your announcements or photos to radiologyalumni@ccf.org.

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Cleveland Clinic Radiology Alumni Connection

independent practitioner of medical physics. Upon graduation, the resident should be able to pass the American Board of Radiology examination in Diagnostic Imaging Medical Physics. The program anticipates having its first resident on board in the first half of 2013. For more information, please call Dr. Davros at 216.738.5553. Imaging Institute Receives Siemens Healthcare Research Grant Earlier this year, the Imaging Institute received a $1.6-million grant from Siemens Healthcare to perform research over four years on CT dose and dose-reduction methods. The study will include an evaluation of the image quality and diagnostic efficacy of new “iterative” image reconstruction techniques applied to low-dose CT scans by comparing them with conventional image construction techniques. Additional specifics will include an evaluation of scanning techniques to reduce dose in patients with Crohn’s, liver and kidney disease, an evaluation of the limitations of dose reduction on diagnostic image quality in phantoms and an assessment of the cumulative dose received and estimated cancer risks in patients who receive multiple scans over the duration of the diagnosis and treatment of their disease. The principal investigator is Brian Herts, MD. Effective February 1, Daniel Lockwood, MD (DR’08, NR’09), a neuroradiologist at Main Campus, was appointed Diagnostic Radiology Program Director, succeeding interim director David Einstein, MD. Scott Flamm, MD, was asked to serve as a member of the Medicare Evidence Development & Coverage Advisory Committee (MEDCAC), beginning June 1.

Stephen Hatem, MD, right, received the Teacher of the Year Award at the Radiology Residency Class of 2012 Graduation Dinner on June 5. Recognized as a staunch supporter of radiology education and the residency program, Dr. Hatem was given a rousing round of applause when Mark Tushan, MD, left, announced the award. Carolyn VanDyke, MD (DR’80), Steps Down as Director of Radiology Medical Student Program After 13 years of dedicated service as Director of the Radiology Medical Student Program, Carolyn VanDyke, MD (DR’80), is handing off the program reins. As the program director, she Dr. Einstein recognizes Dr. VanDyke for her 13 taught and graded years of service as Director of the Radiology medical students, Medical Student Program at the 2012 Residency Class Graduation Dinner on June 5. decided what they would do, interfaced with medical schools and wrote students’ performance evaluations. “It’s a lot of work!” she said, “but students can be fun.” Although she will still be teaching medical students about three hours a week, she is looking forward to being “able to do more teaching with my own residents.” She also continues to serve as Associate Director of the Radiology Residency Program and on the Department of Radiology Education and the Resident Selection committees.

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Cleveland Clinic Radiology Alumni Connection

Dr. VanDyke completed her radiology residency at Cleveland Clinic in 1980. She joined Cleveland Clinic Radiology Department in 1991 after working as a staff radiologist at the Veterans Administration Medical Center of Cleveland (1980–1986) and University Hospitals of Cleveland (1986–1990). Myra Feldman, MD, succeeds Dr. VanDyke as Director of the Radiology Medical Student Program. Mike Forney, MD (DR’11, MR’12), is taking on the responsibilities of Associate Director of the Radiology Medical Student program. Meet George Belhobek, MD (DR’73), Radiologist Extraordinaire − Retired! After 36 years as a staff radiologist, section head and department chairman of Clinic Radiology, George Belhobek, MD (DR’73), now spends his time playing golf, cross-country skiing and traveling with his wife, Jeanie. Dr. Belhobek trained at Cleveland Clinic, completing a residency in diagnostic radiology in 1973. He then served two years in the U.S. Navy as a staff radiologist to fulfill his military obligation before joining Cleveland Clinic staff in diagnostic radiology in 1975. He held a joint appointment in the Department of Orthopaedic Surgery from July 1980 until his retirement at the end of 2011. One of the high points of his career was starting the Section of Bone and Joint Radiology in 1978. At the time he was the only member of the section; today there are 13 members.

Another achievement was chairing the Department of Diagnostic Radiology (Clinic) for 18 years, from July 1983 to 2002. Reflecting on his career, he said: “It was very satisfying to do both clinical practice and administration. It was a great ride, but all good things have to come to an end.” What are some of the major changes in his 36 years at Cleveland Clinic? “The size of the institution changed dramatically,” he said. “We had 200 to 250 total staff physicians in 1975. Today there are approximately 3,000 in the system.” He added: “It was very much a tertiary-care medical practice in 1975. Outside physicians referred difficult cases to us, and we had time to work through them. Now, with work coming from satellite hospitals, family health centers and Main Campus, and with everything being immediately transferable, many days are over-extended because so much material comes in.” What does he miss most? “The people that I worked with – the radiologists, the residents and fellows, and the other employees in the Imaging Institute. I made a lot of good friendships over the years. I miss that interaction!” Always interested in physical fitness, Dr. Belhobek now has time for a vigorous cardiac workout routine five to six days a week that includes an hour on an elliptical machine and a back- and extremitystrengthening program. His fitness routine also includes golf and cross-country skiing. He and his wife play golf together “locally, around the country and around the world.” In the winter they cross-country ski “locally when conditions allow it.” They also have a favorite place in Canada on Lake Superior where they often go – Stokely Creek Lodge, which “has a 135-km crosscountry ski trail system with generally three to four feet of snow on the ground.” The Belhobeks are traveling for three weeks in September to Greece, cruising on the Black Sea

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Cleveland Clinic Radiology Alumni Connection

and stopping in Istanbul, “something we couldn’t do when I was working full-time.”

In the Media “The General Radiologist in the 21st Century”: Summary and Comments Gregory Borkowski, MD (DR’79), Chairman of Cleveland Clinic Imaging Institute, recommended that Cleveland Clinic staff radiologists read the recent JACR article, “The General Radiologist in the 21st Century,” by Lawrence Liebscher, MD, et al.1 The article is summarized below, along with comments from Daniel Lockwood, MD (DR’08, NR’09), Cleveland Clinic Radiology Residency Program Director. The authors cite “the digitalization of radiologic images and the development of teleradiology, picture archiving and communication systems” as “driving fundamental shifts in radiology practice as it is known today.” The authors anticipate that molecular imaging will be “the next major contribution from the imaging field” as well as increasing capabilities “in imageguided therapeutics.” They predict “continued consolidation of radiology practices into larger, more robust practices capable of providing subspecialty expertise across a larger geographical area.” Changes in payment models will also impact organizational structures and the practice of radiology. With these forces driving the practice of radiology, “radiology and the medical community at large would be best served by maintaining a strong and well-trained cadre of general multispecialty radiologists who also develop additional focused expertise in a number of subspecialty areas. These multispecialty generalists, or MSRs, would ideally be supported by formally trained subspecialist radiologists, or single-specialty radiologists (SSRs), covering all of the areas of radiology.”

The authors assert that the core training in the first three years of radiology residency should provide the broad education needed for MSRs. The current design of the fourth year of residency allows residents to focus on two, three or four areas of subspecialty interest. “Coupled with the recent postponement of the final certification examination to 15 months after the completion of residency training, some residents may wish to spend most of that time in an academic environment.” Residents might want to pursue fellowship programs that are “dedicated to multispecialty training.” Asked to comment on the JACR article, Dr. Lockwood said, “We have been planning major curriculum changes in our program that are designed to provide more flexibility to fourth-year residents who have completed the core ABR exam process.” He added: “When the changes are in effect next year, each fourth-year resident will be able to designate two areas of concentration. The new ABR exam format will require examinees to choose three subspecialty areas for testing on the certifying exam 15 months after residency.2 Having two areas of concentration in the final year of residency will help prepare our residents for the exam of the future.” The current Cleveland Clinic Radiology Residency features 13 four-week blocks, with residents participating in 52 total modules during the 48-month program. The program currently trains eight residents per year, totaling 32 radiology residents. “The first three years of residency will be essentially spent in exam preparation,” Dr. Lockwood said. “In the fourth year the resident can concentrate on areas of special interest or in which he or she wishes to practice.”

Visit us online at clevelandclinic.org/radiologyalumni. Submit your announcements or photos to radiologyalumni@ccf.org.

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Cleveland Clinic Radiology Alumni Connection

The Cleveland Clinic program is built around the nine areas of specialization designated by ACGME: Neuroradiology Musculoskeletal Abdominal Imaging Breast Imaging Pediatric Ultrasound Cardiac Interventional Radiology Nuclear Radiology “It is always difficult to change a rotation from one program year to another,” he said, mainly due to logistical reasons. “We have reorganized our rotation schedule substantially to provide more flexibility for the residents during their last year of training, and hope that this will better prepare our trainees for the new board exam format and for future practice as radiologists. “The one thing that will not change is the importance of learning time that a resident has at a work station with one-on-one teaching from a supervising staff radiologist. That always has been, and always will be, the core foundation for our fouryear residency program.” _______________________ Lawrence Liebscher, MD, Cynthia Sherry, MD, Jonathan Breslau, MD, Gerald Dodd, MD, Howard Fleishon, MD, Paul Larson, MD, Carolyn Melzer, MD, and Richard Strax, MD, J Am Coll Radiol, Vol. 9: Issue 8, Aug. 2012, pp. 554–559.

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Philip O. Alderson, MD, and Gary J. Becker, MD, “The New Requirements and Testing for American Board of Radiology Certification in Diagnostic Radiology,” Radiology, Vol. 248: Number 3, Sept. 2008, pp. 707–709.

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Left to right, top row: Gregg Sydow, MD; Vlad Statsevych, MD; Alison Greiwe, MD; Matt Rainey, MD; Mark Tushan, MD. Bottom row: Kim Monteith, MD; Dan Roesel, DO; Nana Sintim-Damoa, MD

Of the eight, six are choosing to continue their education with fellowships at Cleveland Clinic: Alison Greiwe – Abdominal Imaging, Kim Monteith – Breast Imaging, Dan Roesel – Abdominal Imaging, Vlad Statsevych – Neuroradiology, Gregg Sydow – Cardiac Imaging, and Mark Tushan – Abdominal Imaging. Heart-heavy good-byes were shared with the two seniors leaving for other institutions: Matt Rainey – Interventional Radiology at University of Washington (Seattle), and Nana SintimDamoa – Pediatric Imaging at Children’s National Medical Center (Washington, DC). Imaging Institute Chairman Gregory Borkowski, MD, congratulates graduating residents

Imaging Institute Events 2012 Residents Graduation Dinner June 5 The Radiology Residency Class of 2012 celebrated their graduation at the Blue Point Grille on June 5. The festive evening was attended by almost 70 residents, staff and guests who enjoyed the chance to congratulate the eight senior residents on their 100-percent Board pass rate and to wish them well.

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Baljendra Kapoor (IR) and Chris Coppa (Abdominal)

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Cleveland Clinic Radiology Alumni Connection

Andrew Tievsky (Neuro) and James Massey, 3rd-year resident

Natalie Donnini, Justin Greiwe, Amy Tyson, Nana Sintim-Damoa, Keith Wolfe

1st-year residents Joseph Chang, Akash Garg, Justin LeBlanc, Michael Wang

Vlad Statsevych, Viktoryia Statsevych, Mark Tushan, Maria Antonelli

Mandy Roesel, Bindu Mikkilineni, Sarah Stock, Nidhi Sharma

Gregg Sydow, Nicole Sydow, Kim Monteith, Jeff Monteith

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Cleveland Clinic Radiology Alumni Connection

Welcome new residents, fellows and families to the Imaging Institute!

New Residents and Fellows Welcomed July 28 First-year residents and new fellows were welcomed to the Cleveland Clinic family at the home of Drs. Todd Stultz and Allison Vidimos on July 28.

Enjoying refreshments at the home of Drs. Vidimos and Stultz

Mingling on the patio during the Welcome Party

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Cleveland Clinic Radiology Alumni Connection

Drs. Allison Vidimos and Mark Baker

Vlad Statsevych, Dan Lockwood, Todd Emch, Todd Stultz

Kavita Bhatt (R1), Joshua Wilt, Sophia Tritle, Ben Tritle (R1), Fangbai Wu (R1), Priya Sundaram (R1), Alex Wu (R1)

Maria Antonelli, Mark Tushan, Allison Vidimos, Todd Stultz

Dipika Patel, Mark Tushan, Sylvia Zavatchen, Joan Marie Farris, Chuck O’Malley, David Einstein

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Cleveland Clinic Radiology Alumni Connection

Upcoming Alumni Events

Around CHHS

Fall Party and Pumpkin Hunt Oct. 6 The Neurological and Imaging Institute’s fall party and pumpkin hunt will be held on Saturday, Oct. 6, starting at 3 p.m. at the farm of Michael Modic, MD (GL-1‘76, DR’78, NR’79), in Seville. Spouses and children are welcome. Children who want to pick their own pumpkins from the pumpkin patch should wear long pants and bring gloves.

U.S. News & World Report Ranks Cleveland Clinic No. 4 in “Best Hospitals 2012 - 13” This year’s rankings mark the 18th consecutive year that Cleveland Clinic’s cardiology and heart surgery care has ranked as the best in the country. Since 1994, no hospital in the nation has ranked higher than Cleveland Clinic in cardiac care.

2012 RSNA Cleveland Clinic Radiology Alumni Reception Nov. 25 Drs. Gregory Borkowski, Alice Rim and Pauline Kwok invite you to a reception in honor of our alumni and staff who will be attending the annual meeting of the Radiological Society of North America. All former and current interns, residents, fellows, staff, special friends and spouses/ companions are welcome. Sunday, Nov. 25, 6 to 8 p.m. Renaissance Chicago Downtown Hotel Gold Coast Room 1 West Wacker Dr., Chicago 60601 RSVP by Nov. 15. Email: alumni@ccf.org Online: clevelandclinic.org/alumni logging into Alumni Community Phone: Ellie Biehl at 216.445.6961

Save the Date Imaging Institute’s Holiday Party Dec. 15 The Imaging Institute’s Holiday Party will be on Saturday, Dec. 15, at the Cleveland Browns Stadium. Details to come.

Overall, Cleveland Clinic is ranked as the No. 1 hospital in Ohio and again placed among the nation’s best hospitals, ranking 4th in the country. In all, 14 Cleveland Clinic specialties placed in the Top 10 nationally, with No. 1 rankings in heart, nephrology and urology. The complete “Best Hospitals 2012–13” rankings for Cleveland Clinic are as follows: Cancer: 6 Cardiology/Heart Surgery: 1 Diabetes/Endocrinology: 2 Ear, Nose & Throat: 2 Gastroenterology: 2 Geriatrics: 4 Gynecology: 3 Nephrology: 1 Neurology/Neurosurgery: 5 Ophthalmology: 9 Orthopedics: 3 Pulmonology: 3 Rheumatology: 2 Urology: 1 Among Cleveland Clinic’s highly ranked programs, 12 placed in the Top 5 and seven − cardiology/ heart surgery; diabetes/endocrinology; ear, nose & throat; gastroenterology; nephrology; rheumatology; and urology − placed among the Top 2. U.S. News assessed nearly 5,000 hospitals, with fewer than 150 scoring high enough to be ranked in even one category. Rankings are based on death rates, procedure volume, advanced

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Cleveland Clinic Radiology Alumni Connection

technology, patient services, and the balance of nurses and patients, except in four specialties − ophthalmology, psychiatry, rehabilitation and rheumatology − in which hospitals were ranked on reputation alone. Cleveland Clinic Florida Approved for Transplant Programs at Weston Facility In August the Agency for Health Care Administration (AHCA) in Florida approved Cleveland Clinic Florida’s applications for heart, liver and kidney transplant services. Cleveland Clinic Florida saw the need to create transplant programs to treat a growing number of patients who now must seek transplant services outside of South Florida. Research showed that about 15 percent of patients have to travel out of the area for liver transplants, 23 percent for kidney transplants and 33 percent for heart transplants. Cleveland Clinic Florida has the clinical areas of expertise to support a comprehensive transplant program, employing more than 215 physicians in 35 medical specialties, including highly experienced transplant surgeons who will be able to provide patients with excellent pre- and posttransplant care. “Cleveland Clinic is a recognized pioneer in the field of organ transplantation,” said John Fung, MD, PhD, Chairman of the Digestive Disease Institute and Director of the Transplant Center at Cleveland Clinic Ohio. “Our patient outcomes and survival rates have been at or above national standards. We will work closely with our nationally recognized colleagues in Florida to implement this model of success for providing high-quality, value-based transplant services.”

Avon Health Center Opens Emergency Department Sept. 5 The Richard E. Jacobs Health Center in Avon opened a 24-hour Emergency Department on Sept. 5. Board-certified, emergency medicine physicians and nurses are available around-theclock to provide comprehensive state-of-the-art care to adults and children. Patients will have private treatment rooms and access to complete Cleveland Clinic lab and radiology services, primary and specialty care, and surgical services. Transport services by ambulance or helicopter are available if necessary for hospital admissions. Other services that are available at the 190,000-square-foot center include a fullscale imaging center, an infusion suite for chemotherapy and an on-site retail optometry and pharmacy. The facility also offers a large physical-therapy area with two pools for aquatic therapy.

Medical Editor – Pauline Kwok, MD (TRS’95, DR’00, ABI’01) Cleveland Clinic Alumni Specialty Director, Radiology kwokp@ccf.org

Visit us online at clevelandclinic.org/radiologyalumni. Submit your announcements or photos to radiologyalumni@ccf.org.


Fall 2012 Radiology Alumni Connection