UVA Radiology and Medical Imaging 2023 Impact Report

IMPACT REPORT 2023 Celebrating 100 Years of Imaging Advancement and Excellence

Radiology and Medical Imaging

Welcome

The Department of Radiology and Medical Imaging has become integral and essential to the provision of groundbreaking advanced medical care for the patients served by UVA Health. When the department was established more than a century ago, it was little more than a single X-ray machine in a hospital basement. Today, the department has transformed to become the nexus of patient care and now includes hundreds of faculty, trainees, and staff using state-of-the- art technology.

This report offers a look back at how far we have come and how we have focused on making the lives of patients better.

In doing so, the department has expanded and evolved our clinical, educational, service, and research missions – all of which are detailed in these pages. As we continue to establish novel initiatives and programs, we are very proud to be able to celebrate and recognize the many people who have helped to make the department what it is today.

In addition to appreciating our past, this document also serves to inspire us for the future. We must acknowledge that our work is never finished and if we are not moving forward, we are moving backwards. Imaging sciences and image-guided therapies continue to innovate and change, creating greater opportunities to make a difference and positively impact the well-being of our patients.

As I step down from my tenure as chair, please allow me to express my gratitude to everyone in the department for your dedication and commitment to service and making a difference for our patients and each other. As we welcome Dr. Colin Derdeyn into the chair position starting January 2, 2024, let’s embrace what lies before us in the upcoming century.

Best wishes, Alan H. Matsumoto, MD, MA Theodore E. Keats Endowed Professor

2 2 Chair, UVA Department of Radiology and Medical Imaging

Table of Contents Our History

4

Department Overview

8

Our Leadership

18

Awards and Recognition

20

Clinical Care

24

Education

54

Research

82

Alumni Society

98

Philanthropy

100

Our Team

108

Future Vision

110 3

Department

History 1910 1919 Robert G. Wiatt, MD, is appointed adjunct professor of roentgenology and serves as the first department chair.

1925 The department accepts its first physician for training, which consists primarily of on-the-job learning with a single instructor.

1936 Three residents graduate from the UVA Radiology Residency Program — a three-year program at the time.

1964 Theodore E. Keats, MD, is appointed as the fourth department chair.

4

Images from top to bottom: 1. Staff member at X-ray machine 2. Elizabeth Nalley with Ron Boswell 3. Vincent W. Archer, MD 4. Theodore Keats, MD

The first X-ray unit purchased for $1,000 is placed in the basement of the old UVA Hospital run by interns, where it would remain for the next 50 years.

1924 Vincent Archer, MD, is appointed as the second department chair.

1935 A formal radiological technologist training course is founded by Dr. Archer. Elizabeth Nalley, the first student to graduate from the program, will go on to serve as chief technologist and department manager at UVA until her retirement in 1981.

1961 George Cooper Jr., MD, is appointed as the third department chair.

Since the radiology residency’s inception, 59 residents have entered the program.

1966

1969 With the separation of diagnostic radiology and radiation therapy training, William Constable, MD, is named director of radiation therapy.

1977 The first CT scanner is installed at the University Hospital.

1988 A 4.7T MRI unit is purchased as part of a package deal with Siemens for two clinical MRIs.

1992 Bruce Hillman, MD, is appointed as the fifth department chair.

A dedicated angiography room and neuroradiographic suite are opened.

1973 Charles J. Tegtmeyer, MD, establishes UVA’s post-graduate program to train radiology technologists in angiography and special procedures.

1983 Prior to FDA approval, the first MRI unit is installed at Stacey Hall — the first human MRI unit in Virginia.

1990 Small animal imaging research is established as a UVA School of Medicine core lab, under the direction of Stuart Berr, PhD.

1999 The department performs 270,000 exams.

2000 The department introduces a PACS system to replace film-based imaging and provide for instant transmission of images in a digital format.

Images from top to bottom: 1. Wayne S. Cail, MD, with staff 2. Film Room staff with hard copy film 3. Bruce J. Hillman, MD 4. Klaus D. Hagspiel, MD reading on rollerscope 5. William Brant, MD

2002 The University’s first outpatient imaging center opens through UVA Imaging, a joint venture between the department, the UVA Medical Center, and Outpatient Imaging Associates.

The Center for In Vivo Hyperpolarized Gas MRI is created.

William Brant, MD, is appointed interim department chair.

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2003 UVA acquires its first mobile mammography van.

2007 A ClinScan 7T small animal MRI unit is installed.

2011 The Division of Nuclear Medicine and Molecular Imaging moves its services into UVA’s newly opened Emily Couric Clinical Cancer Center and initiates its outpatient Positron Emission Tomography program.

2013 The 4th UVA Outpatient Imaging Center opens at Zion Crossroads.

2015 The ACGME-approved Integrated IR Residency is implemented and accepts its first trainee, who will complete the program in 2021.

Two 129Xe hyperpolarizers are acquired from Polarean Inc.

6

Images from top to bottom: 1. Mobile mammography van 2. Michael D. Dake, MD 3. Alan H. Matsumoto, MD 4. Snyder Research Building 5. Sara S. McCann, MD, in the Battle Building

2005 Michael Dake, MD, is appointed as the sixth chair of the department.

2008 The department’s Research Division moves into 17,000 square foot space in the Snyder Translational Research Building at Fontaine Research Park.

Alan Matsumoto, MD, is appointed interim department chair and as the seventh chair in 2009.

2012 Through an academic/industrial partnership formed with PETNET, the department purchases a cyclotron with a $2 million NIH grant with Dr. Berr as PI.

2014

The Battle Building, UVA’s outpatient children’s center, opens with the inclusion of pediatric imaging services.

Images from top to bottom: 1. Jamieson M. Bourque, MD, at the Emily Couric Cancer Center 2. Opening of the Breast Care Center 3. Radiology at the Orthopedic Center 4. Colin P. Derdeyn, MD 5. Radiology staff celebrate after UVA basketball’s 2019 NCAA championship

2018 A cGMP radiochemistry lab is developed and implemented at the Snyder Research Building to allow for the creation of novel, first-inhuman radiopharmaceuticals.

2017 A dedicated human research PET/ CT scanner is installed at the Snyder Research Building.

The Educational Resource Center opens and includes an on-campus outpatient imaging facility with MR, CT, US, and plain film services A small animal Bruker Albira Si PET/SPECT/CT scanner is purchased through a $1.2 million NIH grant with Dr. Berr as PI.

2020

2021 A Bruker 9.4T MRI unit is installed at the Snyder Research Building.

2024

UVA’s multidisciplinary Breast Care Center opens at Pantops, east of the UVA Medical Center.

2022 The outpatient UVA Orthopedic Center on Ivy Road opens, offering integrated diagnostic and imageguided MSK services.

Colin P. Derdeyn, MD, is appointed as the eighth department chair, with a start date of January 2, 2024.

7

Department

Overview

PATIENT CARE

EDUCATION

Our Commitment

RESEARCH

8

SERVICE

OUR COMMITMENT

PATIENT CARE

Providing both the highest quality sub-specialty medical imaging services and best value in our region and nationally, comparable to or better than any other medical imaging healthcare organization

RESEARCH

Innovating and translating new discoveries into the clinical arena to advance the field and scope of imaging sciences and image-guided therapies to improve the lives of our patients

EDUCATION

Educating the next generation of providers and scientists about the diagnostic imaging sciences and image-guided therapies, and integrating traditional methods with novel media to provide the next generation of professionals with a broad and practical foundation of knowledge and experiences upon which to base their careers

SERVICE

Striving to advance radiology and medical imaging on a global scale far beyond the University of Virginia and the Commonwealth of Virginia; serving as national advocates, educators, and leaders within the field to impact the medical community as a whole

9

OUR PEOPLE The Department of Radiology and Medical Imaging is the collaborative effort of over 600 staff members.

11 62

RESEARCH FACULTY

ADMINISTRATIVE STAFF

71

78

TRAINEES

50,000

CLINICAL AND ACADEMIC RADIOLOGISTS

monthly visitors

OVER

600

STAFF MEMBERS

428

TECHNICAL STAFF

10

Department of Radiology and Medical Imaging volunteers at the 2023 United Way Day of Caring

OUR CARE

9

Our department has divisions that provide sub-specialty radiological care throughout Central Virginia.

Divisions Abdominal Imaging

Breast Imaging

Diagnostic and Interventional Neuroradiology

Musculoskeletal Imaging

Noninvastive Cardiovascular Imaging

Nuclear Medicine and Molecular Imaging

Pediatric Imaging

Thoracic Imaging

Vascular and Interventional Radiology

OUR RESEARCH Based at the Fontaine Research Park, the department’s research program consists of 17,000 square feet of space, with advanced preclinical and clinical MRI, PET imaging technology, and a cyclotron. The department also oversees the operations of the Focused Ultrasound Center, the world’s first such Center of Excellence dedicated to the advancement of this technology for the non-invasive treatment of various disease states.

17,000 sq. ft. of RESEARCH SPACE 11

EDUCATION

d

Ranke

0 TOP 2

We are committed to nurturing future leaders in the field of radiology through our intensive education programs.

2023 Alumni Lecture

UVA Diagnostic Radiology Residency ranked 19th among Residency Programs in the U.S. for clinical training according to DOXIMITY’S 2023-2024 Residency Program Navigator.

PROGRAMS Diagnostic Radiology Residency

Interventional Radiology Integrated Residency

Interventional Radiology Independent Residency

7 Fellowships (3 ACGME-Accredited)

Medical Student Elective Courses

IR Technologist Educational Program

1212

Graph: Number of residents in each program in 2023 34 Diagnostic Radiology Residents 10 Interventional Radiology Intergrated Residents 3 Interventional Radiology Independent Residents 25 Fellows/Instructors 6 Interventional Radiology Technologist Students

LOCATIONS We are proud to provide imaging services for Charlottesville locations and

9

5 Community locations.

CHARLOTTESVILLE LOCATIONS

University Hospital

UVA Cancer Center

UVA Orthopedic Center

UVA Educational Resource Center

UVA Imaging 415 Fontaine

UVA Breast Care Center

UVA Imaging 545 Fontaine

UVA Imaging Northridge

UVA Imaging Zion Crossroads

COMMUNITY LOCATIONS Haymarket Hospital Prince William Hospital Culpeper Imaging Center (outpatient) St. Mary’s Hospital in Richmond (Neurocritical Care Unit and Comprehensive Stroke Center)

Culpeper Hospital

13

EQUIPMENT

X-ray: Four plain film X-ray rooms, plus two in th

UVA Main Campus - University Hospital CT: Five CT scanners, with two primarily dedicated to Emergency Department; three dualsource CT scanners; one unique “CT-on-Rails” system based in interventional radiology for 3D imaging during interventional procedures Fluoroscopy: Three all-purpose fluoroscopy suites MRI: Two 3.0T MRI scanners, including one cardiovascular MR system; one 1.5T MRI scanner; one mobile 1.5T MRI scanner; one 1.5T MRI scanner dedicated for image-guided surgeries Ultrasound: Five diagnostic ultrasound suites and five ultrasound-guided procedure rooms X-ray: Four plain film X-ray rooms, plus two in the Emergency Department SPECT: one SPECT and one SPECT camera OR Imaging Support

UVA Main Campus - Emily Couric Clinical Cancer Center CT: One CT scanner Mammography: One 3D mammography unit Nuclear/SPECT Imaging: Two SPECT/CT cameras PET/CT: One PET/CT camera

14

he Emergency Department

UVA Main Campus - Education Resource Center CT: One dual-source CT scanner MRI: One 3.0T MRI scanner Ultrasound: Two ultrasound suites X-ray: Two plain film X-ray rooms

UVA Main Campus - Battle Building / Children’s Hospital / Outpatient Surgery Center DEXA: One DEXA unit Fluoroscopy: One all-purpose fluoroscopy suite Ultrasound: Two ultrasound suites X-ray: Two plain film X-ray rooms OR Imaging Support for Outpatient Surgery Center (OPSC)

UVA Breast Care Center, Peter Jefferson Place DEXA: One DEXA unit Mammography: Five 3D mammography units, with two rooms dedicated to contrast enhanced mammography Ultrasound: Five ultrasound suites ( one ultrasound is designated and optimized for US guided biopsy One mammography procedure room for biopsies 15

EQUIPMENT CONTINUED UVAI – 415 Fontaine Research Building, Charlottesville CT: Two CT scanners DEXA: One DEXA unit MRI: One large-bore 3.0T MRI scanner; two large-bore 1.5T MRI scanners Ultrasound: Two ultrasound suites X-ray: One plain film X-ray room X-ray: three rooms and one EOS (inside the Spine Center)

500 Fontaine Research Building, Charlottesville Fluoroscopy: Three units (inside the Urology Clinic)

545 Fontaine Research Building, Charlottesville C-Arms: Three OEC (inside the Pain Management Center) C-Arms: One OEC (inside the Physical Medicine & Rehabilitation Center)

UVAI – 2965 Ivy Road, Northridge Office Complex, Charlottesville CT: One CT scanner Fluoroscopy: One all-purpose fluoroscopy suite MRI: One large-bore 3.0T MRI scanner; one large-bore 1.5T MRI scanner Ultrasound: Two ultrasound suites X-ray: One plain film X-ray room

UVAI – Ivy Mountain Orthopedics Center, 2280 Ivy Road, Charlottesville CT: One extremity/weight bearing cone-beam CT scanner Fluoroscopy: Two all-purpose fluoroscopy suites MRI: One large-bore 3.0T MRI scanner; one large-bore 1.5T MRI scanner Ultrasound: One ultrasound suite X-ray: Nine plain X-ray rooms and one EOS

16

UVAI – 1015 Spring Creek Parkway, Zion Crossroads CT: One CT scanner DEXA: One DEXA unit Mammography: One 3D mammography unit MRI: One large-bore 1.5T MRI scanner Ultrasound: Two ultrasound suites X-ray: Two plain film X-ray rooms

Culpeper Outpatient Imaging CT: One CT scanner DEXA: One DEXA unit Mammography: One 3D mammography unit MRI: One 3.0T MRI scanner Ultrasound: Two ultrasound suites X-ray: One plain film X-ray room

UVA Imaging also offers remote MRI scanning at an offsite location in the Fontaine Research Park complex. A remote MRI technologist works in tandem with MRI tech aides at the imaging center, allowing for more efficiency in a “virtual” arrangement.

17

Our

Leadership Alan H. Matsumoto, MD, MA

Chair and Theodore E. Keats Professor of Radiology and Medical Imaging

Juliana Bueno, MD

Vice Chair of Education

Dan M. Wassilchalk, MHSA, RHIA, CPHQ, LHCRM

Arun Krishnaraj, MD, MPH

Vice Chair of Quality and Safety

Medical Center Administrator

Chief Operating Officer

Christopher “Cree” M. Gaskin, MD

Vice Chair of Informatics and Operations

18

James R. Carnes, MBA, MSN, RN

James R. Stone, MD, PhD Vice Chair of Research

Ziv J. Haskal, MD

Vice Chair of Professional Development

Adam B. Winick, MD

Vice Chair of Community Operations

Alan H. Matsumoto, MD, receives the 2019 SIR Gold Medal Photo credit: Society of Interventional Radiology

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Awards and

Recognition GOLD MEDAL AWARDS

YEAR

AWARDING ORGANIZATION

2023 2022

Society of Interventional Radiology

2022

International Society for Magnetic Resonance in Medicine

Association of Vascular and Interventional Radiographers

RECIPIENT

Ziv J. Haskal, MD

John P. Mugler III, PhD

2019 2012

Society of Interventional Radiology

2017

Association of Vascular and Interventional Radiographers

2017 2011 2005

American College of Radiology

20

Association of Vascular and Interventional Radiographers

Society of Uroradiology Radiological Society of North America Association of University Radiologists

Alan H. Matsumoto, MD

John S. Angle, MD

Bruce J. Hillman, MD

Ziv J. Haskal, MD, receives the 2023 SIR Gold Medal Award Photo credit: Society of Interventional Radiology

YEAR

AWARD

2016

Southeastern Neuroradiological Society

1999 1995

RECIPIENT

Mary E. Jensen, MD

American Society of Emergency Radiology American College of Radiology

1998

American College of Radiology

1961

American College of Radiology

Theodore E. Keats, MD

Karl K. Wallace, Jr., MD

Vincent W. Archer, MD

21

PRESIDENTS OF NATIONAL AND INTERNATIONAL ORGANIZATIONS TERM

ORGANIZATION

2015-2016

Society of Gastrointestinal Intervention

2015

Society for Cardiovascular Magnetic Resonance

2014-2015

Society of Interventional Radiology

2012-2014

Society of Academic Bone Radiologists

2007-2008

Society of NeuroInterventional Surgery

2005-2006

Association of Program Directors in Radiology

1997-1998 1994 1994-1995 22

PRESIDENT

Ziv J. Haskal, MD

Christopher M. Kramer, MD

Alan H. Matsumoto, MD

Mark W. Anderson, MD

Mary E. Jensen, MD

Spencer B. Gay, MD

Association of University Radiologists Society of Uroradiology

Bruce J. Hillman, MD

American College of Radiology (President) American College of Radiology Board of Chancellors (Chair)

Karl K. Wallace, Jr., MD

DEPUTY EDITOR OR EDITOR-IN-CHIEF ROLES TERM

PUBLICATION

2016PRESENT

Deputy Editor, Radiology: Imaging Cancer

2014-2023

Deputy Editor, Journal of the American College of Radiology Cardiovascular Imaging

2017-2019 2016PRESENT 2011-2020 2008-2010 2010-2015 1993-2001 1989-2001 1981-2001

Executive Editor, Journals of the American College of Cardiology

EDITOR

Luke R. Wilkins, MD

Christopher M. Kramer, MD

Editor-in-Chief, International Journal of Gastrointestinal Intervention Editor-in-Chief, Journal of Vascular and Interventional Radiology

Ziv J. Haskal, MD

Deputy Editor-in-Chief, CardioVascular and Interventional Radiology Deputy Editor, Magnetic Resonance in Medicine

John P. Mugler III, PhD

Editor-in-Chief, Emergency Radiology Editor-in-Chief, Applied Radiology Editor-in-Chief, Current Problems in Diagnostic Radiology

2003-2018

Founding Editor-in-Chief, Journal of the American College of Radiology

1989-1997

Founding Editor-in-Chief, Academic Radiology (formerly Investigative Radiology)

Theodore E. Keats, MD

Bruce J. Hillman, MD 23

Clinical

Care

We aim to provide the highest quality sub-specialty 232D4B diagnostic and image-guided procedural services in our region and nationally.

24

Table of Contents Divisions Abdominal Imaging

Breast Imaging

Diagnostic and Interventional Neuroradiology Musculoskeletal Imaging Noninvasive Cardiovascular Imaging Nuclear Medicine and Molecular Imaging Pediatric Imaging Thoracic Imaging Vascular and Interventional Radiology Clinical Staff Team Spotlights Patient Centered Care PACS Reporting / IT Informatics Performance Exam Volume

Quality Initiatives

26-27 28-29 30-31 32-33 34-35 36-37 38-39 40-41 42-43 44 45 48 50 51 52 25

ABDOMINAL IMAGING

FACULTY

Arun Krishnaraj MD, MPH Professor Divsion Chief Vice Chair of Quality and Safety

Gia A. DeAngelis, MD Associate Professor

Rebecca D. Dameron, MD Associate Professor

Rachita Khot, MD Associate Professor

Drew L. Lambert, MD Associate Professor

Ayman Mithqal, MD Associate Professor

Mahmoud Alarini, MD Assistant Professor

A.J. Pesch, MD Assistant Professor

Andres S. Flotten, MD Per-Diem

Daniel M. Sutton, MD Per-Diem

The Division of Body Imaging’s Abdominal Section specializes in abdominal and pelvic diseases and disorders. The section offers studies and procedures including those of the abdomen, pelvis, biliary system, and gastrointestinal and genitourinary tracts.

Through joining the Thoracic Section in the Division of Body Imaging, our access to combined resources allows for streamlined scheduling and a dedicated procedure service.

26

SERVICES Computed tomography Magnetic resonance imaging Drainage procedures Imaged-guided needle biopsies GI fluoroscopy Abdominal ultrasound

AN OPTIMIZED DIVISION Beginning in 2013, the Body Division used “lean thinking” to transform and better serve its patients. After a period of selfevaluation, the division reorganized its systems to become more efficient by standardizing processes and maximizing the talent of its staff. The result: reducing average wait time for cross-sectional procedures, increasing volume by 60%, and increasing employee satisfaction. In the fall of 2023, the Body Procedure Service transitioned to focusing exclusively on outpatient procedures allowing our service to improve access further by expanding the number of available appointments, including same-day add-ons.

Our UVA radiologists offer outstanding expertise, collegiality and multidisciplinary care that is essential for me and our physicians, fellows and providers in the Division of Gastroenterology and Hepatology. The chest and abdominal radiology teams have been great partners in terms of clinical care, and we interact frequently for individual patient care and as part of GI, hepato-pancreato-biliary and colorectal tumor boards.

Our GI fluoroscopy team is the best in the region, offering specialty procedures that cannot be obtained elsewhere. There are innumerable cases where our radiology team offers critical information that alters and improves the clinical care and endoscopic procedures that we provide our patients.

-Andrew Y. Wang, MD Division Chief of Gastroenterology and Hepatology University of Virginia

27

BREAST IMAGING

FACULTY

Timothy B. Rooney, MD Associate Professor Division Chief

Jonathan Nguyen, MD Associate Professor

Carrie M. Rochman, MD Associate Professor Associate Program Director Cardiovascular Disease Fellowship

Matthew R. Caley, MD Assistant Professor

Ramapriya Ganti, MD, PhD Assistant Professor

Jessie Jahjah, MD Assistant Professor

The UVA Division of Breast Imaging understands the importance of providing a comfortable, compassionate atmosphere for our patients. That’s why our highly skilled experts work hard to provide only the best, patient-centered approach to care every step of the way.

With an untiring passion for breast health, the division is dedicated to providing the most advanced diagnostics, early detection, and treatment options for breast diseases. With the support of our entire team, our patients can rest assured that they are receiving the highest standards of care.

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SERVICES Galactography Image-guided interventional procedures

EXPANDING CARE The division performs approximately 16,000 mammograms, 2,900 breast ultrasounds, 800 breast MRIs, and 1,200 interventional breast

Digital mammography services

procedures per year. And while our main

Contrast enhanced mammography

facilities are located in Charlottesville, our breast

Magnetic resonance imaging

radiologists contribute at outlying community

Breast ultrasound

locations; we read all breast imaging at the

Screening and diagnostic mammography Tomosynthesis

Culpeper Outpatient Imaging Center and also scans done by the University of Virginia’s mobile mammography coach, which performs screening mammograms at different worksites to serve a broad, diverse patient population.

The ability for our surgeons to review imaging side-by-side with the breast imagers for all newly diagnosed patients, on the same day of the patient’s visit, has an enormous impact on those diagnosed with breast cancer. This approach allows the cancer treatment team to make decisions regarding surgery, systemic therapy, and radiation in a collaborative fashion. Patients benefit greatly from this approach.

-David R. Brenin, MD M.C. Wilhelm Professor in Diseases of the Breast, Department of Surgery Co-Director, UVA Focused Ultrasound Cancer Immunotherapy Center

IMPROVING QUALITY Our Breast Care Center is the only facility in Virginia combining surgery and breast imaging.

Unlike many other facilities, radiologists in our Breast Care Center work exclusively with breast imaging—rendering superlative quality of care.

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DIAGNOSTIC AND INTERVENTIONAL NEURORADIOLOGY FACULTY

Sugoto Mukherjee, MD Professor Division Chief

Avery J. Evans, MD Professor Chief of INR

T. Jason Druzgal, MD, PhD Professor Cardiovascular Disease Fellowship

Julie A. Matsumoto, MD Professor

David A. Joyner, MD Associate Professor

Joseph H. Donahue, MD Associate Professor

Thomas Eluvathingal Muttikkal, MD Associate Professor

Sohil H. Patel, MD Associate Professor

Tanvir Rizvi, MBBS, MD Associate Professor

Shamsher S. Dalal, MD Associate Professor NIS at St. Mary’s Hospital

Matthew J. Austin, MD Assistant Professor NIS at St. Mary’s Hospital

V. Tommy Doss, DO Assistant Professor NIS at St. Mary’s Hospital

David A. Ornan, MD Assistant Professor

David C. Abdullah, MD Per-Diem

Mary “Lee” Jensen, MD Professor Emeritus

The Division of Diagnostic and Interventional Neuroradiology consists of experienced and nationallyrenowned faculty who specialize in interpreting imaging studies of the brain, spine, and head and neck as well as in neurointerventions. Our faculty are all sub-speciality trained and offer emergency, inpatient, and outpatient services that are unmatched in the area.

In addition to routine neuroimaging diagnostic services, the division provides the whole gamut of spine procedures as well as head, neck, and skull base biopsies. The neuro-interventional group works as a team with other departments in providing minimally invasive treatment of cerebral aneurysms and 30 other cerebral vascular malformations, stenting of carotid arteries, vertebroplasty, and image-guided procedures.

SERVICES

PIONEERING FOCUSED ULTRASOUND

Routine cross-sectional brain, head, and neck tumor imaging

The University of Virginia has led the charge in

Diagnostic and therapeutic interventions for spine, head, neck, face, and skull base

In conjunction with neurosurgical physicians, the

Advanced perfusion and pre-surgical mapping techniques

methodologies to expand the application to other

Acute stroke intervention, endovascular management of aneurysms and malformations

applying focused ultrasound for essential tremor. division has developed imaging protocols and movement disorders such as Parkinsonism. We are also exploring expanding the use of UVA’s

Dual-energy CT, functional MRI, diffusion tensor imaging and tractography, spectroscopy, dynamic vascular and vessel wall imaging

Focused Ultrasound Center (FUS) for treatment

Vertebroplasty and kyphoplasty spine procedures

treatment methods as well as brain tumors.

of other neurologic conditions, including epileptic seizures that cannot be controlled through other

VIRGINIA’S FIRST PORTABLE MRI We are fortunate to have an exceptional partnership with Neuroradiology at UVA. As a cerebrovascular and endovascular neurosurgeon, I work closely with our team of dedicated neuroradiologists to help manage individuals with some of the most complicated neurovascular pathology. They are a critical piece of the healthcare team and are instrumental to my practice and to our Joint Commission-certified Comprehensive Stroke Center.

-Min Park, MD Professor Director, UVA Cerebrovascular and Endovascular Neurosurgery

The division operationalized the first portable MRI system of its kind in the Commonwealth of Virginia to significantly enhance the diagnosis, treatment, and progression of patients who benefit from bedside MRI - such as critically-ill intensive care unit (ICU), Emergency Department (ED), and isolation patients. The division is also exploring other novel uses including applications in patients with implants, where MR use would 31 otherwise be restricted or contraindicated.

MUSCULOSKELETAL IMAGING

FACULTY

32

Christopher “Cree” Gaskin, MD Professor Division Chief Vice Chair of Informatics and Operations

Mark W. Anderson, MD Professor

Kirkland W. Davis, MD Professor

Nicholas C. Nacey, MD Associate Professor Fellowship Director

Jennifer L. Pierce, MD Associate Professor Associate Division Chief

Maxie E. Kresse, MD Assistant Professor

Michael T. Perry, MD Assistant Professor

Sonia I. Crimaldi, MD Per-Diem

Using the latest in imaging technology, the Division of Musculoskeletal (MSK) Imaging and Intervention performs a full range of image interpretation and image-guided interventional procedures related to bones, joints and soft tissues of the spine, pelvis and extremities. We collaborate with numerous departments within the UVA Health System such as Orthopedic Surgery, Sports Medicine, Physical Medicine and Rehabilitation, Rheumatology, Radiation Oncology, Medical Oncology, Pathology, Neurosurgery, and others. In addition to diagnostic services, the division also specializes in minimally invasive biopsies and pain management therapies that can often be an effective alternative to surgery.

As a foot and ankle surgeon, I care for a wide variety of patients.

Whether they have severe arthritic conditions or play collegiate or professional sports, I am often asked to review advanced imaging studies for these challenging patients. As the interpretation of these images often helps guide their management, I am so grateful for the expertise of the UVA MSK radiologists who have helped me over the 13 years I have been in practice. They have also helped our patients with advanced techniques including dynamic ultrasound imaging, platelet-rich plasma injections, and

(TENEXTM) procedures for tendon and plantar fascia problems.

With the help of my MSK partners, I am able to confidently deliver the best orthopedic care to my patients.

-Joseph S. Park, MD Associate Professor Division Head, Foot and Ankle Service Department of Orthopaedic Surgery

SERVICES Diagnostic radiography (i.e. X-ray), CT, Ultrasound, MRI, DEXA MR and CT arthrography Image-guided biopsies of bone, bone marrow, and soft tissue lesions Pain management injections of the lumbar spine, pelvis, and extremities Treatment of tendinopathy Botox injections for treatment of Raynaud’s syndrome

PAIN MANAGEMENT AND CONSULTATION SERVICE Consultative pain management services are provided for complex cases to determine the imaging strategy best suited for each individual situation.

In addition to image interpretation,

MSK radiologists provide pain management services to patients receiving care through the UVA Spine and other clinics. For diagnosing and treating pain originating in the spine, we administer image-guided lumbosacral nerve blocks, epidurals, and facet joint injections. We also perform therapeutic injections of joints of the extremities.

RAYNAUD’S TREATMENT

TENDINOPATHY TREATMENT

Ultrasound-guided Botox injections can help

Ultrasound-guided

improve the circulation to fingers and toes to fight

tenotomy (TENEXTM) procedures may treat

the symptoms of severe Raynaud’s syndrome.

tendon degeneration and pain without open

percutaneous

needle

surgery.

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NON-INVASIVE CARDIOVASCULAR IMAGING

FACULTY

Klaus D. Hagspiel, MD Professor Division Chief

Jamieson Bourque, MD Professor Cardiology and Radiology

Christopher M. Kramer, MD Amit V. Patel, MD Professor Professor Chief of Cardiology Cardiology and Radiology

Patricia Rodriguez-Lozano, MD Assistant Professor of Medicine Associate Program Director Cardiovascular Disease

Patrick T. Norton, MD Associate Professor

The Division of Non-invasive Cardiovascular Imaging provides comprehensive state-of-the art imaging of the heart and the blood vessels. We use the most advanced imaging technologies in the region which allow our physicians to provide noninvasive and accurate diagnoses of diseases affecting the cardiovascular system. We work closely with our colleagues in Adult and Pediatric Cardiology and Cardiac Surgery, Vascular Surgery, Vascular Medicine and other medical and surgical specialties and sub-specialties to deliver the best possible imaging services and overall care.

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SERVICES Cardiac Computed Tomography

NATIONALLY AND INTERNATIONALLY RECOGNIZED EXPERTS

Cardiac Magnetic Resonance Imaging

The division’s advanced cardiovascular imaging

Computed Tomography Angiography Magnetic Resonance Angiography

services are available to our patients 24 hours a day, every day of the year. Our attending physicians are nationally and internationally recognized cardiovascular imaging experts and are comprised of faculty of the Department of

“NICV stands as an unparalleled beacon in the UVA healthcare system. Their dedication and commitment are a testament to the heights that collaborative medicine can reach. Every vascular medicine clinic session becomes a learning experience when we convene with our esteemed colleagues from Vascular Radiology, drawing from their profound insights. Their dedication to dynamic imaging delivers clarity, ensuring our patients receive the best possible care. Such is their impact that we advocate for all patient imaging to be done only at UVA, guaranteeing the epitome of quality and interpretation.

Radiology and the Division of Cardiovascular Medicine in the Department of Medicine at the University of Virginia.

Instrumental in pioneering clinical programs, their protocols are the bedrock of our exceptional patient care. But the story of our partnership continues beyond patient care. We’ve jointly ventured into academic realms, resulting in notable publications.

-Aditya M. Sharma, MBBS Associate Professor of Medicine, To UVA NICV, our heartfelt gratitude. Their contributions Cardiovascular Medicine are immeasurable, and our partnership is invaluable.”

University of Virginia

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NUCLEAR MEDICINE AND MOLECULAR IMAGING

FACULTY

Jiefu Zheng, MD Assistant Professor Interim Division Chief

Jamieson Bourque, MD Professor Cardiology and Radiology

Luke Lancaster, MD Associate Professor

Prem P. Batchala, MD Assistant Professor

Ethan S. Bergvall, MD Per-Diem

Jennifer S. Jurgens, MD Per-Diem

The field of nuclear medicine is constantly at the forefront of advanced targeted radionuclide treatments for cancer and numerous other diseases, and is transforming the future of patient care.

The Division of Nuclear Medicine and Molecular Imaging at the University of Virginia has always provided cutting edge patient care utilizing modern clinical medicine and technological progress.

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SERVICES PET/CT

Oncologic Neurologic Cardiac

Therapy Clinic Theranostics SPECT/CT Bone Endocrine Infection Lung Lymphoscintigraphy mapping Renal

NOVEL CARE The division offers an array of modern theranostic treatments that diagnose and address diseases.

In addition to procedures for bone pain, thyroid disorders, and liver cancer, UVA is one of the first hospitals in the region to offer theranostics to treat neuroendocrine tumors and prostate cancer.

NEW EQUIPMENT Siemens Symbia Pro.specta SPECT/CT Siemens Vision 600 PET/CT

The future of Urologic Oncology is tied closely to molecular imaging and theranostics. Our vital partnership with Nuclear Medicine is what keeps UVA at the cutting edge for diagnosis and innovative treatments for cancer patients.

-Kirsten Greene, MD, MAS Chair, UVA Department of Urology University of Virginia

Siemens Vision 600 PET/CT

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PEDIATRIC IMAGING

FACULTY

Reza J. Daugherty, MD Associate Professor Divsion Chief

Luke Lancaster, MD Associate Professor

Ju Hee Ahn MD Assistant Professor

Marcus I. Hook, MD Assistant Professor

Nicholas W. DiGeorge, DO Per-Diem

Frank W. Volberg, MD Per-Diem

An integral part of the UVA Children’s Hospital, the Division of Pediatric Imaging works closely with specialists in pediatric medicine and pediatric surgery to deliver exceptional imaging services and care to young patients in a family-friendly setting.

Unlike many other healthcare providers, our pediatric physician radiologists are trained specifically in the sub-specialty of pediatric imaging, and focus solely on providing imaging services for children and teens.

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SERVICES

RADIATION REDUCTION

Contrast-enhanced ultrasound and voiding urosonography

The division has taken significant steps to

Pyloric ultrasound

date, we’ve used our radiation-less contrast

Gastrostomy and gastrojejunostomy tube placement

reduce radiation doses to their patients. To ultrasound program to replace over 800 scans that would otherwise use fluoroscopy. Likewise, our functional magnetic resonance urography

Pediatric nuclear medicine

program serves as an alternative to MAG3 nuclear

Hip ultrasound

medicine studies. Additionally, ultrasound and

MRI and MR spectroscopy of pediatric brain disorders MRI tailored to congenital disorders and cancer predisposition syndromes Functional Magnetic Resonance Urography Spinal ultrasound

MRI have nearly completely replaced the use of CT in the evaluation of appendicitis in children.

COLLABORATIVE CARE The

Pediatric

Imaging

Division

frequently

brings departments together, through nearly 60 multidisciplinary conferences every month.

From UVA’s Neonatal and Pediatric Intensive Care Units to our Vascular Anomalies Clinic, the real-time discussion allows members across the health system to pool expertise on complex cases and optimize patient care.

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THORACIC IMAGING

FACULTY

Michael B. Sneider, MD Associate Professor Divsion Chief

Juliana M. Bueno, MD Associate Professor

Patrick T. Norton, MD Associate Professor

Juan M. Olazagasti, MD Associate Professor

Alan M. Ropp, MD, MS Associate Professor

The Division of Body Imaging’s Thoracic Section focuses on the diagnosis of non-cardiac chest diseases and disorders. Through a broad range of imaging modalities, the section performs and interprets imaging and image-guided procedures of the lungs, mediastinum, and chest wall.

Joining the Thoracic and Abdominal Sections together to form the Division of Body Imaging provides access to combined resources, allowing for streamlined scheduling and a dedicated thoracoabdominal procedure service.

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SERVICES Chest radiography Computed tomography Magnetic resonance imaging Lung cancer screening Oncologic imaging Imaging of interstitial lung disease Image-guided biopsies Therapeutic procedures

LUNG CANCER SCREENING With UVA offering one of the largest lung cancer programs in the region, the division has worked to improve effectiveness and reduce risk of lung cancer screenings. Over time, the Thoracic Section has used low-dose CT procedures to lower average radiation exposure by 80% while

The UVA Thoracic Radiology team is an outstanding group of physicians who have been instrumental in the comprehensive care of patients with interstitial lung disease (ILD). ILD is a heterogeneous group of diseases that are progressive, devastating, and often fatal. As such, accurate and early diagnosis is critical and requires a multidisciplinary approach that relies heavily on thoracic radiology findings.

Our ILD group collaborates closely with every member of the thoracic radiology team, and we are extremely grateful for their exceptional care, expertise, thoughtfulness, and collegiality.

-Tessy K. Paul, MD Associate Professor Medical Director of Interstitial Lung Disease Program Division of Pulmonary and Critical Care Medicine University of Virginia

still optimizing image quality. UVA has been designated by the Lung Cancer Alliance as a Screening Center of Excellence. The American College of Radiology has also accredited four UVA screening locations for safety measures and programs to stop smoking.

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VASCULAR AND INTERVENTIONAL RADIOLOGY

FACULTY

John (Fritz) Angle, MD Professor Divsion Chief Director of Procedural Services

Ziv J. Haskal, MD Professor

Alan H. Matsumoto, MD Professor Department Chair

James R. Stone, MD, PhD Professor

Luke R. Wilkins, MD Associate Professor

Chandler H. Fountain, MD

Sukhdeep (Sukhi) K. Grewal, MD Assistant Professor

John T. Matson, MD Assistant Professor

Daniel P. Sheeran, MD Assistant Professor Tech School Director

Amy C. Taylor, MD Assistant Professor

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The Division of Vascular and Interventional Radiology uses state-of-the-art imaging to perform a wide variety of minimally-invasive procedures. Interventional radiologists are dedicated to the diagnosis and treatment along with providing longitudinal care for patients with disorders of the chest, abdomen, pelvis, and extremities including: removal of blood clots in the lungs; locoregional therapy for liver, lung, and kidney cancer; relief of biliary and renal obstruction; reduction of pain and heavy menstrual bleeding associated with uterine fibroids; recanalization of narrowed and occluded arteries and veins; treatment of vascular malformations; maintenance of flow in dialysis fistulas; and occlusion of bleeding vessels. Interventional Radiologists can often offer a directed therapy where medical management is inadequate and provide a minimally-invasive alternative to surgery that may eliminate the need for hospitalization and shorten recovery.

SERVICES

BUILDING UP RESOURCES In 2020, Interventional Radiology moved into

Diagnostic arteriography and embolization for bleeding Renal and mesenteric artery angioplasty and stenting

a new space in the South Tower, next to the operating room, with state-of-the-art equipment that includes eight procedure rooms with CT available in two angiography suites and cone-

Peripheral artery intervention for atherosclerosis causing leg pain or ischemia

beam CT available in five more suites.

Biliary decompression for jaundice or infection

US for all the latest in intra-procedural diagnostic

Thrombectomy and thrombolysis for symptomatic pulmonary emboli and deep venous thrombosis Treatment of vascular malformations Venous access procedures such as port placement Embolization therapies for liver cancer

This

division also has access to IVUS, ICE, and CEimaging.

Meanwhile, this division is actively engaged in basic and translational research as well as clinical trial research—all designed to advance innovations in minimally invasive, image-guided therapies and further scientific knowledge in the field.

Procedures to maintain flow in dialysis fistulas Management of portal hypertension caused by chronic liver disease

Varicose vein treatment

When caring for patients with liver disease a team approach is essential. Interventional radiology lies at the cornerstone of therapy for portal hypertension and liver cancer. At UVA, we are fortunate to have an internationally recognized group of leading experts in the management of portal hypertension and malignancy. The support and guidance provided by these leaders in the field allows UVA to save many lives of patients with complex liver disease.

Vertebroplasty for painful vertebral fractures

-Nicolas Intagliata, MD, MS

Uterine fibroid embolization Prostate artery embolization for reducing symptoms of an enlarged prostaste

MD-INMD Gastroenterology

Associate Professor of Medicine University of Virginia

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CLINICAL STAFF

IR Team 2023

QUALITY STAFF LEADING QUALITY CARE The department’s work would not be possible without our skilled clinical staff. Technologists, nurses, advanced practice providers, and many others play a vital role in delivering excellent clinical care to our patients.

Our specialized team members work to ensure an effective and safe environment for both patients and staff, while also collaborating with radiologists and referring providers to address and optimize patient care during their imaging procedures. No matter the modality, the skill and care these team members provide is unmatched.

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TEAM SPOTLIGHTS CT Team 2020

PREPARED FOR ANYTHING The team of diagnostic radiology technologists has to thrive in a remarkably diverse set of circumstances, with relentless and varied volume.

The entire spectrum of care at UVA Health relies on these technologists: whether it’s imaging infants in the NICU or geriatric patients in the Transitional Care Hospital; providing routine scans of chests or broken bones to X-raying trauma cases in the Emergency Department; operating the C-Arm to provide real-time fluoroscopic imaging in the operating suites; or using a portable unit that travels to every room in the hospital.

“That’s the job,” says Diagnostic Radiology Supervisor Anthony Calise. “Whoever comes in, whatever comes up, we don’t say no. We don’t turn any imaging request down. If a patient is in the building and needs an X-ray, we have to figure it out. Every single day.”

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TEAM SPOTLIGHTS CONTINUED

UVA Radiology Diagnostic Radiology Technologists stand before the mural in the UVA Health main lobby

CONSTANT IMPROVEMENT Safety is the first priority for the MRI team at UVA Health, which is often called on to perform complex scans — whether those patients are seriously ill or incapacitated, require general anesthesia, or have implantable medical devices.

As a result, the MRI team is always looking for ways to improve their methods for safety protocols, but also image quality and patient care. Their focus isn’t on how well they did today; it’s on being better tomorrow.

“What we do is about experience, but it’s also about seeking knowledge,” says Thomas Huerta, lead MRI technologist and quality assurance lead for MRI. “A sequence didn’t work, so we have to call a patient back. We go back over it with the tech who did it, and we show them alternatives, what to look for, and how to fix it. We’re always trying to make things better.”

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IMPACTING PATIENT LIVES

The patient care team in the Division of Nuclear Medicine and Molecular Imaging is smaller than others, but they play an outsized role in the lives of their patients.

The technologists, nurses, access associates, and coordinators who work to schedule, image, and treat patients develop deep relationships with the people they serve. And they get to see the long-term impact of the care they provide.

“It’s not just a one-time visit—we get to see patients through highs and lows, developing relationships with them over the years,” says Nuclear Medicine Nurse Coordinator Jeri Pugh, RN. “We do everything we can for a patient. We work well together to take care of a patient as a whole. The friendly attitude here really makes it such a positive work environment to be in. And I think patients can feel that.”

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UVA Radiology team members make an impact on patient care every day

Patient Centered Care As part of providing quality clinical care, the department strives to provide patients with the proper understanding and autonomy for their health decisions. It’s sometimes easy for patients to feel disconnected from their radiologists; at UVA, we’ve taken steps to improve those lines of communication for a more personal, and more effective, approach.

REVAMPING REPORTING

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In 2018, the department instituted what was

Among others, these efforts led to the

then a novel approach for improving care:

“patient-friendly” lung cancer screening

a form at the end of radiological reports for

report, an infographic document catered

providers and patients to submit feedback.

towards accessibility. The report includes

The goal was to refine reports to what the

essential and easy-to-digest information

people reading them found most useful.

including

When roughly 75% of feedback came from

computed tomography, patient results and

patients

department

interpretation, and a list of next steps of care.

looked for ways for patients to be more

With other medical institutions following

knowledgeable about the care they were

suit on these initiatives to improve patient

receiving.

reports, our department is proud to impact

themselves,

the

adescription

of

low-dose

patient care — in Virginia and beyond.

AN INSIDE VIEW In 2017, the Department of Radiology and Medical Imaging created the blog Inside View, as a resource for patients to learn more about the field before they receive care. The site contains information directly approved

by UVA physicians about how procedures work and different options for care. Today, Inside View serves as an educational archive for approximately 50,000 global visitors every month. t

INSIDE VIEW

50,000 Radiology blog monthly visitors

ONLINE OUTREACH The department’s social media platforms offer a direct source of imaging news and education for our patients. We provide a regular stream of useful information: updates about the department, reminders to get screened for breast and lung cancer, and Inside View articles in order to cultivate an informed patient community. t reports, our department is proud to impact patient care — in Virginia and beyond.

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PACS REPORTING / IT INFORMATICS PACS/IT INTEGRATION STRUCTURED REPORTING In 2018, the department instituted what was Among others, these efforts led to the As part of the initiative to improve clinical images, figures, tables, and interactive then a novel approach for improving care: “patient-friendly” lung cancer screening care quality, the department has pioneered elements. a form at the end of radiological reports for report, an infographic document catered interactive multimedia reporting. UVA providers and patients to submit feedback. towards accessibility. The report includes Radiology is the first site in the country These components together enable a faster The goal was to refine reports to what the essential and easy-to-digest information to fully implement this next generation review of key findings within a detailed report, people reading them found most useful. including adescription of low-dose reporting technology to create sophisticated improving providers’ quality and efficiency of When roughly 75% of feedback came from computed tomography, patient results and yet clear reports for referring providers and care. Not only are the reports more powerful, patients themselves, the department interpretation, and a list of next steps of care. patients. but many of the new tools to create them looked for ways for patients to be more With other medical institutions following actually facilitate faster radiologist workflow knowledgeable about the care they were suit on these initiatives to improve patient Instead of using plain text only to construct while reducing error. receiving. reports, our department is proud to impact reports, UVA radiologists routinely create patient care — in Virginia and beyond. reports enriched with text formatting, key

SAMPLE REPORT 50

PERFORMANCE VOLUME EXAM 334,942

515,557

612,684

800K

600K

400K

200K

0 2015

2019

2023

wRVU’s in 2015, 2019, and 2023

FISCAL YEAR 2015 The department captures roughly 335,000 wRVU (work relative value units), which at the time are growing at a rate of roughly two to three percent.

FISCAL YEAR 2019 During the preceding year (FY2018), UVA Health signed a primary service agreement to serve the Culpeper, Prince William, and Haymarket Medical Centers through UVA Community Health.

The Department of Radiology and Medical Imaging’s Community Division was formed to meet the new demand. FY2019 is the first full fiscal year that includes the heavily increased volume; the department posts approximately 150,000 wRVUs from the Community Division.

FISCAL YEAR 2023 The department’s wRVU growth surges due to growth of UVA Health and UVA Community Health. Plans are underway to reorganize the department’s Community Division and integrate it into UVA Community Health; however, the department will still import approximately 45,000 wRVUs to meet demand through its continued partnership with UVA Community Health.

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QUALITY INITIATIVES Our Team

Arun Krishnaraj, MD, MPH Vice Chair of Quality & Safety

Mark D. Golub, MD, MPH Quality Officer

Kaitlin E. Dorrier, MHA Director of Quality

Wayne L. Dell, MD Resident Quality Officer

UVA Radiology Quality Program Our dedicated quality team focuses on quality efforts to facilitate con­tinuous improvements in safety, performance, and outcomes that are aligned with mandates of regulatory organizations.

Practicing safe, effective, value-added radiology is a common goal for our department as we con­tinually strive to perpetuate the highest quality of patient care and stay competitive in the rapidly changing healthcare environment.

Community Division Quality Program For the imaging reads at Culpeper, Haymarket and Prince William Hospitals (UVA Radiology’s Community Division), UVA quality officers collaborated with RAYUS/Foundation Radiology Group (FRG) to institute a robust quality improvement project using peer-reviewed data to understand root causes of radiologic misinterpretations. This effort has been amazing and has resulted in improved interpretation.atient care — in Virginia and beyond.

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Education

With education as a core mission of the Department of Radiology and Medical Imaging, we pride ourselves on passing knowledge down to the next generation of health professionals and fostering an environment where every individual learns from each other.

Our programs include a wide range of educational opportunities for all members of the academic community: including one-on-one teaching, comprehensive clinical experiences, case review conferences, research seminars, professional development lectures, and more.

We are committed to serving:

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Medical Students

Residents

Fellows

Faculty

Researchers

Technologists

2023 residents receive fleece jackets from The Keats Society

Table of Contents

Residencies Diagnostic Radiology Residency

Interventional Radiology Residencies

Tracks

Resident Wellness Program

56-59 60-63 64-65 66-67

Fellowships 68-71 Medical Student Education 72-75 Career and Professional Development 76 Interventional Radiology Tech Training Program 77 Diversity, Equity, and Inclusion 78-81

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RESIDENCIES Diagnostic Radiology Residency Our four-year ACGME-accredited Diagnostic Radiology Residency Program exposes trainees to all aspects of diagnostic and procedural radiology and medical imaging. Residents train in each of our eight sub-specialty areas to learn a disciplined approach to medical problem-solving and decisionmaking. Through exposure to a great volume and variety of case complexity, our workflow is set up to ensure residents develop a solid fund of knowledge, intellectual curiosity, independence, autonomy, responsibility, and resilience.

Leadership

Juliana Bueno, MD Program Director, DR Residency Vice Chair of Education

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Joseph H. Donahue, MD Associate Program Director, DR Residency

Carrie M. Rochman, MD Associate Program Director, DR Residency

LEADING FROM WITHIN It is part of our mission to train the next generation of leaders in radiology, who can provide excellent care to our patients as well as pursue regional or national leadership roles, according to their aspirations; to accomplish this, our program offers the following leadership opportunities during training:

Chief Residents

Resident QA Officer

academic

and

This position works with the vice chair

Residents

serve

of quality and the director of quality

the

assurance and compliance to craft the

department’s residents. Together they

resident quality and safety curriculum,

support their fellow trainees in many

with opportunities to conduct research

ways, including coordinating schedules,

and participate in national quality and

programming education initiatives, and

safety meetings.

The

peer-elected

administrative as

leaders

chief and

advocates

for

serving as liaisons to the department.

Resident IT Officer

DEI Resident Leader

Granted to a resident who demonstrates

Supported by the de Lange Diversity and

interest in the role of technology in

Inclusion Fund, a representative from

radiology,

with

each residency class leads and supports

the vice chair of clinical operations to

departmental and institutional efforts to

contribute towards the department’s

promote DEI values in the department.

this

position

works

IT-related projects, such as a central online education portal, PACS consulting matters, and report tracking tools.

d

Ranke

0 TOP 2

UVA Radiology Resident Program Graduation - Class of 2019

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DR RESIDENCY CONTINUED AFTER RESIDENCY Graduates from the program have enjoyed extraordinary success in obtaining post-residency training positions at leading academic medical centers, with nearly 95% choosing to remain at UVA for fellowship or instructor training. Our alumni can be found all over the nation in varied professional roles, from jobs in private practice to professorships and chairman at major academic centers.

Carrie M. Rochman, MD Associate Professor Resident Class of 2007 Breast Imaging Fellow Class of 2012

95% STAY FOR FELLOWSHIP

The educational programs at UVA’s Department of Radiology and Medical Imaging are special. When I arrived here as a radiology resident I knew I was entering a program with top-level radiological training and facilities. But what really drives education here is the culture of respect and support that each trainee receives.

I’ll always be grateful for the enthusiasm, dedication, and kindness that my mentors displayed on a daily basis. I was supported for my individual strengths and encouraged to become the best version of myself. It’s why I stayed at UVA for fellowship, and why I’m proud and honored to continue that tradition as a faculty member in the UVA Radiology Breast Imaging Division.

-Carrie M. Rochman, MD Associate Professor Resident Class of 2007 Breast Imaging Fellow Class of 2012

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RESIDENCIES Interventional Radiology Residencies Our Interventional Radiology Residency Programs offer a broad and more indepth experience in the clinical diagnosis and care of patients with diseases commonly treated by an interventional radiologist. Furthermore, the residencies allow the trainees an opportunity to become more familiar with and participate in research to further the field of vascular and interventional radiology.

Leadership

Luke R. Wilkins, MD Director, IR-Integrated Residency Director, IR-Independent Residency

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Daniel P. Sheeran, MD Associate Director, IR-Integrated Residency

Amy C. Taylor, MD Associate Director, IR-Independent Residency

2023 graduating IR residents with Drs. Matsumoto, Wilkins,and Angle

The division offers two tracks for interventional radiology residents: a six year Integrated Residency Program for new residents and a one-two-year Independent Residency Program for those who have already completed a diagnostic radiology residency.

Integrated Residency Each

year

the

department

accepts

Independent Residency The

one-to-two-year

IR-Independent

three new residents into the six-year

residency is designed for up to two

IR Integrated Residency, which offers

physicians interested in interventional

a combined experience to supplement

radiology who have already completed

diagnostic radiology skills with specialized

a diagnostic residency program. The

training in the clinical diagnosis and care

curriculum

of patients commonly treated by an

education and competency experiences

interventional radiologist. The residency

in IR and related services in both inpatient

allows the trainees an opportunity to

and ambulatory environments, including

become more familiar with and participate

IR clinic, vascular surgery, surgical ICU,

in research to further the field of vascular

neurointerventional procedures, vascular

and interventional radiology.

medicine, and non-invasive cardiovascular

is

configured

to

provide

imaging.

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IR RESIDENCIES CONTINUED HISTORY OF THE IR RESIDENCY The IR residency at UVA was established in 2000 when we matched our first medical student into the pioneering Vascular and Interventional Radiology Pathway, a first-of-its-kind six year program providing residents all the tools to practice IR at the highest level in a wide variety of practice settings.

Chandler H. Fountain, MD IR Indepedent Resident Class of 2023

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Sukhdeep (Sukhi) K. Grewal, MD IR Integrated Resident Class of 2023

COLLABORATION

FACILITIES

Our close collaboration with the diagnostic

We have been very privileged to be able

radiology faculty allows us to provide an

to train our residents in outstanding

outstanding diagnostic program, tailored

facilities. In 2019 we moved into a new

to the needs of up-and-coming IRs. We

space next to the operating room with

are very fortunate to have the strong

state-of-the-art equipment that includes

support of the Surgery Department in

eight procedure rooms with CT available

providing our residents an internship

in two angiography suites and cone-beam

and intensive care and vascular surgery

CT available in five more suites. We also

rotations that form the foundation of our

have access to IVUS, ICE, and CE-US for

IR program.

all the latest in intra-procedural diagnostic imaging.

IR SYMPOSIUM Each fall, UVA Interventional Radiology holds a symposium that provides medical students with an overview of the imaging, anatomy, pathology and treatments pertinent to IR. The event is free and open to all medical students, especially those interested in IR. Participants have the chance to hear from some of today’s top interventional radiologists, network with current UVA IR residents, and take part in hands-on simulations.

2022 IR SYMPOSIUM 63

Tracks As part of our thorough residencies, we offer several tracks to serve our trainees’ different educational needs. These pathways offer residents the opportunity to explore their individual passions as they prepare to become the next generation of innovators and leaders in radiology.

NUCLEAR MEDICINE DUAL CERTIFICATE PATHWAY For trainees with an early interest in nuclear medicine, the Diagnostic Radiology/Nuclear Medicine Pathway is available to all diagnostic radiology residents beginning in their third year of residency. Through this track, residents spend a total of 16 months in nuclear medicinespecific training — as opposed to four months - in order to receive an ABR sub-specialty certificate.

Jiefu Zheng, MD Program Director, DR Residency/ Nuclear Medicine (DR/NM) Pathway

EARLY SPECIALIZATION IN INTERVENTIONAL RADIOLOGY TRACK Each year, up to two diagnostic radiology residents are admitted into the Early Specialization in Interventional Radiology Track, which offers an alternative pathway for those who indicate an early wish to pursue further training in interventional radiology. The program is designed to facilitate and maintain the pathway from diagnostic radiology to sub-specialty training in IR, fulfilling training requirements through the completion of 12 IR or IR-related rotations during the PGY 2-5 years,

Luke R. Wilkins, MD Program Director, ESIR Track

as well as exposure and documentation of at least 500 IR or IR-related procedures.

DIAGNOSTIC RADIOLOGY RESEARCH TRACK While many residents participate in research in various capacities during their training, this track offers one resident each year additional support to pursue and enhance their professional development in this area during their years of training. Through dedicated research time, mentoring opportunities, and funding for research and educational activities, the track provides a foundation for prospective clinicianscientists to successfully launch an academic medical career.

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The ultimate goal of this track is to develop leaders in clinical and translational research who will help advance the field on the national and international level.

T. Jason Druzgal, MD, PhD Program Director, DR Research Track

GLOBAL HEALTH LEADERSHIP TRACK Open to both diagnostic radiology and interventional radiology residents, the mission of this program is to provide an enduring educational exchange between the Department of Radiology and Medical Imaging at the University of Virginia and underserved international health care organizations. Through this partnership with the UVA Center for Global Health’s Global Health Leadership Track, our vision is to have an established and sustainable health care education elective for UVA radiology residents that positively impacts both our residents

Jennifer L. Pierce, MD, Program Director, GHLT Program

and underserved international communities.

Members perform rotations in their second and third years of residency in Uganda, with a new site in Tanzania to be added. During their time abroad, residents identify needs in their international community and work on a project to answer questions or improve care. The track includes a wide range of educational activities — from case-sharing with partner institutions to lectures on tropical medicine and global health.

This program is made possible through the Dr. Spencer B. Gay Global Health Leadership Track and International Resident Fund.

SUSTAINED CONNECTIONS In 2017, then-residents Connor Louden, MD, and Jonathan Chahin, MD, visited the Mbarara University of Science and Technology in Uganda in order to learn hands-on as part of the Global Health Leadership Track. While their trip was only four weeks, the relationship between Mbarara University and the University of Virginia endured, as Mbarara University residents dialed in to regular video lectures given by UVA residents. It’s just one of the ways the relationships with partner institutions last — through a mutual sharing of knowledge and trust.

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RESIDENT WELLNESS PROGRAM WELLNESS DAYS Our Resident Wellness Program offers regular field trips and activities for residents. These “Wellness Days” serve as an opportunity to explore the vast offerings of UVA and Charlottesville, while also building friendships community between classmates.

“I feel privileged to train at UVA in an environment that is collegial, respectful, and adaptive. The educational team, including program leadership, education coordinators, and residents, is responsive and always thinking of ways we can improve the already stellar educational experience here. This, paired with the advanced case mix and exposure to novel modalities, makes this department the ideal place to train while being supported throughout residency by phenomenal colleagues.”

Tom Battey, MD Diagnostic Radiology, Class of 2024 Chief Resident “What I love most about the department here is the quality education and the time that the attendings dedicate to teaching. I feel that I learn something new every time I sit with them for a read out, and that one on one dedicated education is invaluable.”

Olivia Richardson, MD

PGY-3 IR-Integrated Resident,

Class of 2027

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“I am a fourth year radiology resident and I have been extremely pleased with my radiology education.

At UVA there is simultaneously rigor in teaching, case volume and complexity, and gradual increase in autonomy while there is a focus and respect for the importance of having a healthy work-life balance.

All of the faculty are approachable and enjoy teaching and mentoring. It has been very easy to find faculty who are interested in developing academic projects and collaborations. I feel confident that wherever my career interests lead me, our faculty will help guide me in the best way to develop my interests and achieve my goals. I would absolutely recommend UVA for residency training.”

Dionysios Koroulakis, MD PGY-4 Diagnostic Radiology Resident Class of 2025

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FELLOWSHIPS The department offers fellowships for both ACGME and non-ACGME accredited sub-specialty training. The one-year programs enable our trainees to accumulate a broad base of medical knowledge, develop progressively independent interpretive and technical skills under supervision, and become proficient at accurate clinical decision-making and consulting. Teaching and research opportunities are tailored to the special interests and talents of each individual.

At the conclusion of the fellowship, graduates possess the skills for any number of paths: whether it’s building an academic career in radiology and medical imaging, advancing sub-specialty knowledge or skills as an advanced clinical fellow or instructor, or entering community practice.

Our Fellowships ACGME Accredited

NEURORADIOLOGY NUCLEAR RADIOLOGY PEDIATRIC IMAGING

Joseph H. Donahue, MD Program Director, Diagnostic Neuroradiology Fellowship

Jiefu Zheng, MD Program Director, Nuclear Radiology Fellowship

Reza J. Daugherty, MD Program Director, Pediatric Imaging Fellowship

*Started in 2020, our pediatric fellowship is the only one of its kind in Virginia.

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Non - ACGME Accredited

ABDOMINAL IMAGING

BREAST IMAGING

A.J. Pesch, MD Program Director, Abdominal Imaging Fellowship

Jonathan V. Nguyen, MD Program Director, Breast Imaging Fellowship

CARDIOTHORACIC IMAGING

MUSCULOSKELETAL IMAGING

Patrick T. Norton, MD Program Co-Director, Cardiothoracic Fellowship

Alan M. Ropp, MD, MS Program Co-Director, Cardiothoracic Fellowship

Nicholas C. Nacey, MD Program Director, Musculoskeletal Imaging Fellowship

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FELLOWSHIPS CONTINUED

Visting Programs

In addition to full fellowships, the department offers additional programs for outside radiologists to bolster their sub-specialty knowledge and experience through the department’s programs.

ANGIOGRAPHY AND INTERVENTIONAL RADIOLOGY OBSERVERSHIP This one-week program offers practicing radiologists an opportunity to observe a wide variety of IR procedures. Our division performs over 12,000 procedures including peripheral arterial interventions, TIPS/BRTO, venous angioplasty, and more. The observership includes daily educational sessions and working conferences to discuss case management.

BREAST IMAGING INTERNATIONAL VISITING SCHOLARS PROGRAM The scholars program aims to improve breast imaging knowledge and practice at foreign medical institutions. For this tuition-free initiative, visiting physicians enter a multi-month residency at the Breast Imaging Division of the UVA Breast Care Center. Clinical observation includes all aspects of breast imaging—screening and diagnostic mammography, tomosynthesis, contrast-enhanced mammography, breast ultrasound, breast MRI—as well as breast procedures—US-guided biopsy, stereotactic guided biopsy, MRI-guided biopsy, cyst aspiration, wire localization, radioactive seed localization, and galactography. procedures.

VISITING INTERVENTIONAL RADIOLOGY PROFESSORSHIPS Interventional Radiology at UVA has a long history of hosting visiting scholars for clinical observation, teaching, and research. These visiting professors are often from other countries and choose to spend their sabbatical with UVA IR. Their lengths of stay are a minimum of two months, though visit durations have lasted up to 18 months.

The professors get an

opportunity to see new procedures and contribute to our program through invited lectures and conducting research with our faculty.

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MEDICAL STUDENT EDUCATION

Medical Student Interest Group luncheon

The Department of Radiology and Medical Imaging offers medical students an innovative program designed to familiarize students with the interpretation of medical images as they observe while rotating through our diagnostic radiology areas.

Students at UVA’s School of Medicine gain the opportunity to add to their depth of knowledge regardless of planned specialty. As radiology spans across all medical fields of study, we aim to broaden students’ knowledge and help mold exceptional physicians of the future.

Michael B. Sneider, MD Medical Director, Medical Student Radiology Rotations

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Daniel C. Sheeran, MD Director, Radiology Interest Group

School of Medicine Electives The department offers 11 electives for fourth-year medical students at UVA. One of the most popular courses for the School of Medicine is the General Diagnostic Radiology elective, which is offered both as a four-week and a two-week program.

RADIOLOGY ELECTIVES General Diagnostic Radiology

Abdominal Imaging

Angiography and Interventional Radiology

Breast Imaging

Diagnostic Neuroradiology

Diagnostic Radiology Research

Musculoskeletal Imaging

Nuclear Imaging

Pediatric Imaging

Radiology and Pathology Correlation

Thoracic Imaging

The UVA School of Medicine’s Claude Moore Medical Education Building

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MEDICAL STUDENT EDUCATION CONTINUED

RADIOLOGY INTEREST GROUP The Radiology Interest Group exists to serve students at UVA’s School of Medicine as they explore the specialty and plan for the future. The group provides opportunities for shadowing, research, didactic sessions, and hands-on exposure to diagnostic imaging and is especially geared towards early career physicians in their first three years of medical training.The RIG also provides a supportive community for discussing elective course materials and advice during the radiology residency application process. Each team also includes a DEI student representative to promote the group and our specialty to medical students from underrepresented in medicine groups.

RESEARCH PROGRAM FUNDING The department provides support for the Medical Student Summer Research Program. This initiative aims to support projects that address local and regional healthcare disparities and that might help us improve and better our department and the services we provide to our community.

VISITING MEDICAL STUDENTS SCHOLARSHIP Each year, the Department of Radiology and Medical Imaging offers $1,500 in travel and housing scholarships for up to seven outside fourth year medical students who wish to do a visiting diagnostic or interventional radiology elective at the University of Virginia. These scholarships are available to students who are either first-generation medical school attendees and/or part of an underrepresented in medicine group, as well as those applicants with strong interest in working in topics of diversity, equity, and inclusion.

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CAREER AND PROFESSIONAL DEVELOPMENT Through robust programs, we aim to provide learning opportunities for our entire department, regardless of the stage of one’s career. Whether faculty, trainees, fellows, or other care providers, our Radiology Career and Professional Development Program offers lectures, presentations, seminars, mentoring, and resources designed to foster academic and professional growth.

EXPANDING MEDICAL KNOWLEDGE The Department of Radiology and Medical Imaging’s Keynote Lecture Series and Grand Rounds Series bring experts and thought leaders from across the globe to the UVA. The lectures and discussions are related to major topics in radiology and medicine — ranging from critical imaging topics, to AI in radiology, diversity in healthcare, and emerging practice models disrupting the field. This national series is open to the UVA community and viewers across the world.

LEARNING FROM COLLEAGUES Mechanics of Academics Mechanics of Academics is a series of seminars and presentations designed to help UVA Radiology faculty and trainees navigate through aspects of a radiology

Ziv J. Haskal, MD Professor Vice Chair of Professional Development

career and develop building blocks for academic and professional growth. These lectures are delivered by faculty members and experts across UVA Health.

The

presentations vary in scope: some are

Academic Writing Training

specifically focused on navigating aspects

The department provides both one-on-

of a career in radiology, while many others

one and small seminar writing groups

are applicable to physicians working in

to assist, edit, and train faculty in study

any department or discipline.

conception

as

well

as

preparation and reviewing.

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manuscript

IR TECH TRAINING PROGRAM

Established in 1973 by Dr. Charles J. Tegtmeyer, the post-graduate Interventional Radiology and Special Procedures Internship offered at the University of Virginia Medical Center provides a challenging and rewarding opportunity for dedicated radiology technologists interested in pursuing a career in the field of interventional radiology.

Dr. Tegtmeyer founded the internship in 1973 in anticipation of the evolution and expansion of interventional radiology. He believed that technologists proficient in all facets of patient care, equipment and instrumentation, and procedures would be an invaluable asset to the collaborative team required to provide excellent and innovative care to patients.

Daniel P. Sheeran, MD Medical Director, The Charles J. Tegtmeyer Program of Interventional Radiology and Special Procedures

Our program is founded upon the principle that dedicated core curriculum and clinical instruction are essential components in the transformation of a registered radiologic technologist into a skilled and knowledgeable vascular interventional technologist.

The paid internship provides funding for participants because we believe that the professional efforts and education of a board-certified radiologic technologist should be acknowledged, respected, and compensated.

Currently, the school trains up to seven interns per year.

Since its inception, the school has graduated over 200 technologists.

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DIVERSITY, EQUITY, AND INCLUSION

In keeping with the fundamental role that the concepts of diversity, equity, and inclusion play at both UVA Health and the UVA School of Medicine, the UVA Department of Radiology and Medical Imaging aims to be a leader in fostering an environment that embraces inclusivity, compassion, respect and a sense of belonging for all. Whether serving in a clinical, educational, administrative or research capacity, we believe that all members of our community are personally and professionally enriched by our commitment to equity.

Juliana Bueno, M.D. Director, Diversity and Inclusion

As healthcare providers, our fundamental goal is to continually work to better reflect and represent the population of the patients we serve. The curriculum in our radiology training programs fundamentally supports that clinical goal as we educate the radiologists and technologists of tomorrow.

We recognize that prioritizing equity, inclusivity, and justice in radiology education requires a multilevel approach. By focusing on the current model of academic progress, we have developed initiatives targeted to all levels of the educational pipeline. By incorporating these initiatives in our department’s educational programs, we aim to build capacity and create

Tavir Rizvi, MBBS, M.D. Justice, Equity, Diversity and Inclusion Strategist

leaders with unique skills who can act as multipliers of our efforts among students, residents and faculty, as well as in our community.

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LEARN MORE HERE

DE LANGE DIVERSITY AND INCLUSION FUND The de Lange Diversity and Inclusion Fund aims to encourage residents who have an interest in enhancing diversity and inclusion in the field of radiology to join the efforts of the department in this area during their residency training.

The fund supports the efforts of one residency class representative per year of training who helps lead and contribute to departmental and institutional efforts to promote a culture of respect in the workplace

environment

and

in

our

community. The resident representatives also

participate

recruitment

in

the

residency

process

by

attending

recruitment fairs, taking part in Q&A sessions, and serving on interview panels.

Eduard de Lange, MD

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DIVERSITY, EQUITY, AND INCLUSION CONTINUED

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NEAR-PEER WOMEN’S LEADERSHIP GROUP The department’s Near-Peer Women’s Leadership Group is a mentoring program led by female radiology residents who serve between 20 and 35 female medical students each year. The group gives female medical students a unique opportunity to shadow female residents and exchange ideas about our specialty, workflow, career paths and future plans. The “near-peer” model of our program provides a safe and low-stress space for students to gather information about radiology from residents who are closer to their experiences as students and can relate easily to their experience.

JEDI PROGRAM The JEDI (Justice, Equity, Diversity and Inclusion) Program is part of the UVA School of Medicine’s efforts to encourage work in diversity and inclusion across all departments at the school. Each department has appointed a new DEI leader to aid in recruiting and retaining highly qualified diverse students, trainees, faculty and staff; ensure mentorship is available at all levels; and help allocate financial and personnel resources to sustain diversity and inclusion initiatives.

MEDICAL STUDENT SUPPORT The department offers two initiatives to support diversity, equity, and inclusion for medical students.

We offer scholarships for visiting fourth year medical students interested in completing a radiology elective at UVA; these scholarships are designed for students who are either first-generation medical school attendees or part of an underrepresented group in medicine. Meanwhile, we also offer funding to UVA medical students for Summer Research Program projects related to healthcare disparities.

LADYOLOGIST INITIATIVE UVA Radiology proudly hosts a variety of Ladyologist events throughout the year for our female and gender non-binary trainees and faculty with support from The Keats Society. The goal of these initiatives is to create a respectful space that fosters the growth and representation of this underrepresented community within the department in hopes of welcoming more women to this field in the future.

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Research Leadership

James R. Stone, MD, PhD Vice Chair of Research

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G. Wilson Miller, PhD Division Chief

UVA’s Department of Radiology and Medical Imaging is dedicated to advancing the diagnosis and treatment of disease through the advancement of medical imaging research.

Our faculty are dedicated to work involving the development of new approaches to imaging, including the invention of new instrumentation, imaging procedures and protocols, image acquisition sequences, and image analysis techniques. Additionally, our faculty apply these novel techniques from the bench to bedside through basic, translational, and clinical research. Research occurring within the department moves across the pipeline of translation, allowing for early and more advanced testing in patients.

Table of Contents Medical Imaging Locations

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Focused Ultrasound Center 86 Imaging Resources 87 Research Cores 88-89 Our Research 90-99 83

MEDICAL IMAGING LOCATIONS Much of the department’s research occurs within 17,000 sq ft of laboratory and core space that is distributed across three floors of the Snyder Translational Research Building at the Fontaine Research Park. This includes wet and dry laboratory space, two whole body MRI scanners, a whole body PET-CT scanner, small animal imaging systems (a trimodal scanner and MRI), and a hyperpolarized gas laboratory. The Snyder Building also contains office and carrel space for faculty, postdocs, and graduate students involved in the program, as well as two conference rooms.

Snyder Translational Research Building

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Small Animal Trimodal Scanner

In addition to the Snyder Building, the department conducts research and maintains equipment at several other UVA locations, including the following: Main Hospital Radiology Department Focused Ultrasound Center Breast Care Center Elson Student Health Center

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FOCUSED ULTRASOUND CENTER The world’s

first

center of its kind The University of Virginia is proud to be designated as a Focused Ultrasound Center of Excellence by the Focused Ultrasound Foundation.

The UVA Focused Ultrasound Center was

treats uterine fibroids and bone metastases,

established in September 2009, designating

conducts cancer research, and is currently

it the first Center for Excellence by the

spearheading

Focused Ultrasound Foundation. The UVA

trials combining focused ultrasound and

FUS Center was established through a

immunotherapy.

public-private

partnership

between

world’s

first

clinical

the

Commonwealth of Virginia, UVA, Focused

The University of Virginia is proud to be

Ultrasound

Foundation,

and

designated as a Focused Ultrasound Center

GE, under

the clinical direction of Alan

of Excellence by the Focused Ultrasound

Insightec,

Matsumoto, MD (who assumed the role in 2018) and Richard Price, PhD.

Since

its inception, the UVA FUS Center has had a strong impact on brain research, having pioneered clinical trials for essential tremor and Parkinsonian tremor, as well as technical and preclinical studies for neurological disorders. The UVA team also

86

the

Foundation.

IMAGING RESOURCES The department is proud to offer a full range of the latest imaging technology and related services.

MRI Our dedicated research MRI Suite at the Snyder Building features a 3-Tesla scanner, a 1.5-Tesla scanner, a patient examination room, and an advanced computer lab for data post-processing. A dedicated group of accomplished scientists is on hand and eager to lend their extensive expertise to help other researchers further scientific knowledge in basic and clinical imaging research.

In addition, the department has access to 20 hours per week on any of the MRI scanners at the hospital for research purposes.

PET/CT

DEXA

The Snyder Building offers a PET/CT

Our program includes a DEXA scanner

Siemens Biograph mCT as a dedicated

housed at the Elson Student Health

research

human

Center, used exclusively for research

and animal studies. The machine is

at UVA. The most common use of a

located in close proximity to the UVA

DEXA scanner is to assess for the loss

Radiochemistry Core, which produces

of bone mineralization; however, this

investigational agents.

system also harnesses the unique

scanner

for

both

capabilities of DEXA to evaluate body tissue composition. This resource is made available through a collaborative partnership between Medical Imaging Core and the Department of Kinesiology.

87

RESEARCH CORES The department plays a key role in the University of Virginia’s research cores.

These cores are communal efforts to make research more efficient and costeffective by pooling research expertise and resources.

MEDICAL IMAGING RESEARCH CORE The Department of Radiology and Medical Imaging operates the Medical Imaging Research Core, which houses and operationalizes the two whole body MRI scanners, whole body PET-CT scanner, and the DEXA scanner. This core also employs two full time research technologists who operate and oversee the equipment. This facility, which is funded and operated by the department, operates as a true institutional core, supporting the conduct of research by investigators across at least four schools and many departments. Many high impact discoveries have been made by investigators using this facility.

James R. Stone, MD, PhD Professor and Core Director Vice Chair of Research

MOLECULAR IMAGING CORE The Molecular Imaging Core, housed within the Snyder Building, specializes in imaging small animals with MRI, CT, CT-SPECT, bioluminescence, fluorescence, and MicroPET scans, some of which can be combined in multimodality scans. It also has image analysis software and produces custom imaging agents. Meanwhile, the Core provides training, support, and results analysis for investigators.

Maurits Jansen, PhD Professor and Core Director

RADIOCHEMISTRY CORE Since 2017, the Radiochemistry Core has worked to provide investigators with high-quality novel and existing radiopharmaceuticals, including radiolabeled small molecules, peptides, proteins, and antibodies. These materials, when imaged with PET, offer preclinical and clinical research possibilities in the field of molecular imaging. The Core operates within the Snyder Building, adjacent to the Molecular Imaging Core facilities and UVA’s Cyclotron.

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Shivashankar Khanapur, PhD Assistant Professor and Core Director

Maxine Carlson and Jaime Mata, PhD, performing quality control on a bag of hyperpolarized Xenon-129 gas for clinical MRIs of the lungs

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OUR RESEARCH HYPERPOLARIZED GAS MRI RESEARCH The department’s two xenon polarizers.

UVA’s research on the development and application of magnetic resonance imaging using the “hyperpolarized” noble gases helium-3 and xenon-129 as inhaled contrast agents began in the mid-1990s, when a multidisciplinary, multi-institutional team, led in UVA Radiology by researchers James Brookeman, PhD, and John Mugler, PhD, and including radiologist Eduard de Lange, MD, and researcher Stuart Berr, PhD, acquired the first human images in the world using hyperpolarized xenon-129 (see figure above).

Since those early studies, the UVA team has made numerous pioneering contributions to acquisition technology and disease-based applications in pathologies such as asthma, COPD, and cystic fibrosis.

The team has produced six finalists, including four winners, in the prestigious Young Investigators’ Award competition at annual meetings of the International Society for Magnetic Resonance in Medicine for work on hyperpolarized-gas MRI. Over $20 million in funding from federal and private sources has supported this research. The current team is led by Jaime Mata, PhD, John Mugler, PhD, G. Wilson Miller, PhD, Alan Ropp, MD, and Y. Michael Shim, MD.

John P. Mugler III, PhD Professor 90

Jaime F. Mata, PhD Professor

G. Wilson Miller, PhD Associate Professor

Alan M. Ropp MD, MS Associate Professor

Brain PET Map

PARAMETRIC PET IMAGING, KINETIC MODELING, AND DEEP LEARNING IN RODENT AND HUMAN HEARTS AND BRAINS The laboratory led by Bijoy Kundu, PhD, develops advanced PET analytics and deep learning technologies for non-invasive evaluation of metabolism and blood flow, in order to predict disease progression and classification in rodent and human hearts and brains. Recent works from the laboratory developed these PET analytics in rodent hearts to test the hypothesis that impairments in myocardial metabolism precede structural and functional changes in hypertension induced left ventricular hypertrophy (LVH) and heart failure. Ultimately, therapeutic intervention targeting metabolic abnormalities improved cardiac metabolism and function and prevented

Bijoy K. Kundu, PhD Associate Professor

LVH in hypertensive rat hearts. Continued on page 92.

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PARAMETRIC PET IMAGING, KINETIC MODELING, AND DEEP LEARNING IN RODENT AND HUMAN HEARTS AND BRAINS CONTINUED

Cardiac-Rodent Trimodal The

discovery

of these

cardiac

metabolic

Further works developed a memory network for

changes, which precede the development of

predicting model blood input enabling efficient

hypertension-induced heart failure, has potential

parametric PET mapping of rat hearts for

to advance the development of unique diagnostic

predicting disease progression. Meanwhile, some

and novel therapeutic approaches targeting

of the laboratory’s newer works also developed

cardiac metabolic abnormalities to prevent and

end-to-end deep learning pipelines for parametric

ameliorate cardiac dysfunction and heart failure.

brain PET mapping in localization of focal epilepsy and brain tumor classification in humans.

ARCH TIPS STUDY Ziv J. Haskal, MD,

is

the global principal

investigator for the Becton, Dickinson, and Company-sponsored and FDA-approved clinical study of a new device and novel clinical strategy for using transjugular intrahepatic portosystemic shunts (TIPS) for treating complications of portal hypertension. The study will enroll 150 patients across the United States and European Union, culminating four years of animal studies, device design, and protocol development.

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Ziv J. Haskal, MD

TARGETED ALPHA PARTICLE CANCER THERAPY The group of Jiang He, PhD, is developing next-generation cancer treatments involving targeted alpha particle therapy (TAT). Unlike traditional treatments, alpha particles release a high amount of energy over a short distance, causing significant damage to cancerous cells while sparing surrounding healthy tissue. This precision therapy shows promising potential for treating various types of cancer, particularly those that are resistant to conventional treatments.

By exploiting the unique properties of alpha particles and highly specific targeting molecules to deliver the radiation directly to cancer cells, this innovative therapy holds great promise in revolutionizing cancer treatment at the molecular level and improving patient outcomes.

Jiang He, PhD Associate Professor

TARGETED ALPHA PARTICLE CANCER THERAPY (TAT) Normal cells

Alpha particle

Radionuclide

Cancer cells

Alpha-particle-emitting radionuclides

Alpha-particle emitting radionuclide linked

Selectively accumulate into linked cancer

Kill cancer cells locally in cancer lesions by

to antibodies or other molecules that

lesions throughout human body after

high energy alpha particles throughout the

specifically target cancer.

intravenous infusion

body while sparing normal cells/tissues

From Business Wire

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PRECLINICAL CANCER RESEARCH The preclinical image-guided cancer therapy lab of Luke Wilkins, MD, evaluates novel antimetabolic treatment for primary and secondary liver cancer in a large animal model. The group has shown the superiority of this treatment when compared to standard clinical care; the results are promising for allowing a safer and more effective treatment for patients with primary and secondary liver cancer. Further, the lab has investigated the impact of embolic drug delivery on the tumor microenvironment utilizing an innovative technique known as matrix assisted laser

deposition

ionization

(MALDI).

This

approach has yielded impactful discoveries on the efficacy of catheter-directed cancer therapy and methods to improve and optimize drug

Luke R. Wilkins, MD Associate Professor

delivery.

Figure: MALDI map of drug deposition in a woodchuck liver tumor. Note the heterogeneous deposition of drug, despite full coverage of tumor blood supply with embolic drug delivery vehicle. This indicates that the drug is not deposited in a uniform fashion and highlights areas to improve catheterdirected cancer therapy.

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NaviFUS With the generous partnership of the Focused Ultrasound

Foundation

and

Corporation,

UVA researchers will

NaviFUS explore

the use of sonodynamic therapy for recurrent glioblastoma.

Sonodynamic therapy utilizes

transcranial low intensity focused ultrasound (LIFU) in combination with a sonosensitizing agent that preferentially accumulates within tumor cells. Neither of these therapy components is individually harmful to surrounding brain tissue, but when combined the LIFU activates the sonosensitizing agent to produce free radicals within the glioblastoma cells in hopes of ultimately leading to tumor cell death.

CLI PERFUSION

Joe H. Donahue, MD Associate Professor

Through an industry grant under the direction of John Fritz Angle, MD, UVA is conducting a study on a serious form of advanced peripheral artery disease called critical limb ischemia (CLI), which causes complications from open sores that can lead to persistent pain or limb-threatening infection and gangrene. Left untreated, 50% of patients with CLI will undergo an amputation or die within the first year. While patients can undergo percutaneous revascularization procedures for critical limb ischemia, they may not exhibit the expected wound healing, and reliable methods to predict if an intervention will lead to healing are lacking.

The study investigates whether computed tomography (CT) perfusion of the foot may potentially differentiate responders from non-responders following intervention. After 25 CLI patients underwent intraprocedural CT perfusion, preliminary results

John (Fritz) Angle, MD Professor

show strong correlation. This population is now in follow-up to determine if foot perfusion can predict amputation-free survival.

Intraprocedural CT perfusion of the foot may be a valuable tool in patients with CLI undergoing endovascular treatment.

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TRAUMATIC BRAIN INJURY PREVENTION This last study prompted a site visit to UVA in This last study prompted a site visit to UVA in 2020 by the Deputy Director of the US Special Operations Command, Director of the US Special Operations Command, a three-star admiral, with oversight of all special forces for the US military. That study was the first to demonstrate neuroimaging evidence of neuroinflammation in military service members. Collaborations related to this work have involved investigators from the National Institutes of Health Clinical Center, National Institute of Neurological Disorders and Stroke, National Institute of Nursing Research, Uniformed Services University of the Health

James R. Stone, MD, PhD. For the past 17 years, the laboratory of James R. Stone, MD, PhD, has had an ongoing collaboration with the United States Department of Defense related to exploring the brain effects of blast exposure. This work has made foundational contributions to the field of military-relevant traumatic brain injury. The work has made significant contributions to the understanding of how repetitive low-level blast exposure impacts the brain health of military personnel over their career. Dr. Stone’s laboratory participated in the first neuroimaging study of repetitively blastexposed military personnel in 2007.

That work led to a series of additional efforts including the study of special forces in New Zealand exposed to repeated low-level blast exposure; the study of military breachers exposed to blast over a career; the study of operational personnel exposed to blast overpressure from artillery rounds over a career; and the assessment of members of the US Special Forces who have had significant prior blast exposure. members of 96 the US Special Forces who have had significant

Sciences, Walter Reed Army Institute of Research, the National Intrepid Center of Excellence, and the Naval Medical Research Center.

Work from Dr. Stone’s research program has also helped to support the establishment of a number of programmatic efforts. These have included establishing the Blast Exposure Standards Program through the US Army Joint Program Committee 5 - Military Operational Medicine. Additionally, data from his laboratory was used to help support advocacy efforts that resulted in language within section 734 of the 2018 US National Defense Authorization Act, which served as a formal congressional mandate to develop an improved understanding of the brain effects of blast exposure. Recently, the North Atlantic Treaty Organization has taken up the issue of the effects of blast exposure on brain health and established panel HFM-338, where Dr. Stone serves as a member, to develop guidelines related to this issue. In 2023, Dr. Stone and collaborators published a study that directly demonstrated increased brain inflammation within service members with frequent blast exposure. To read more, click here.

Figure 1: Elevated neuroinflammation in special forces with a history of repeated blast exposure.

Figure 2: Alteration of functional connectivity in military service members with repeated low level blast exposure as compared to controls.

Green = reference DFN Mask DFN Inter-network Connectivity

with DFN in breachers

p < 2e-04 / 0.004

aControl

Red = higher connectivity

Breacher

Resting Activity p < 1e-04 / q < 0.002

aControl

Breacher

97

MRI TECHNIQUE DEVELOPMENT UVA Radiology Research has a long history of MRI technique development. Among our most successful efforts are two MR imaging methods, from researchers John P. Mugler, III, PhD and James R. Brookeman, PhD that are routinely used on MR scanners across the globe for both patient care and multi-center clinical research trials.

The method known as MP-RAGE (for magnetizationprepared rapid gradient echo) is particularly useful for neuroimaging, including structural analysis of the brain and serving as the anatomical basis for functional MRI studies of brain activation (see lower right panel).

Furthermore, an optimized form of three-dimensional turbo/fast spin-echo that uses a variable-flip-angle echo train (known on some manufacturer’s scanners as SPACE), is useful both in the brain and for many other clinical applications (see lower left panel).

These methods have been used in many millions of patient studies. As a result of the developments, Dr. Mugler was elected to the National Academy of Inventors and awarded the Gold Medal of the International Society

98

for

Magnetic

Resonance

in

Medicine.

James R. Brookman, PhD, and John P. Mugler III, PhD

99

Department Alumni Society

The Keats Society

Keats Society presents check to residents with Spencer Gay, MD

The Keats Society is the Department of Radiology and Medical Imaging’s alumni Society. Through the Society we honor the life and legacy of Dr. Theodore Keats, who was a pioneer in the field of radiology and the chair of the department from 1963 to 1991. Today, the Keats Society comprises over 900 former residents, fellows, and faculty members who have walked the hallways of UVA Radiology.

The society supports our trainees in a variety of ways that include the following: • Creating newsletters for our alumni to stay in touch • Granting free participation at the Keats Society Homecoming Reunion Weekend, which is held every two years • Sponsoring the annual Keats Society and Friends RSNA Reception • Organizing Alumni Guest Lectures • Gifting incoming first year residents with quality embroidered fleece jackets • Purchasing electronic and hard copy

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• • • • •

board prep materials for third year residents Funding the annual Breakfast After Boards event for third year residents Stocking the resident lounge with food, as well as decorations during celebratory months Offering financial support for fall and spring Ladyologist gatherings Orchestrating the annual Riddervold Open Golf Tournament Celebrating our departing residents and fellows with graduation ceremonies and gifts

Funding for the above efforts is made available by the generous gifts from our alumni and those wishing to support the Keats Society. If you would like to make a contribution to help support these initiatives, please go here.

Keats Society Homecoming 2022

Alan Matsumoto, MD, and Hans Riddervold, MD

Theodore E. Keats, MD, and wife Patt Keats, with Karen Barden

The Keats Society has been a great resource as both a trainee and now alumni of UVA Radiology. Having networking opportunities as well as learning from alumni about their varied experiences was invaluable as a trainee. Now having the opportunity to come back to UVA and share my own experiences with the support of the Keats Society has been a really cool experience, and I’m grateful to be able to pass it forward.

Ray Norby, MD Integrated IR Resident, 2022 Private Practice in Charlotte, NC

101 Alumni Lecture given by Mark Hiatt, MD

Alumni &

Philanthropy

The department is committed to improving the field of radiology at the University of Virginia and on a global scale. Our philanthropic funds offer current and future generations of radiologists the financial support necessary to develop the field in all of its aspects, whether through educational resources, research funding, professorships, or diversity, equity, and inclusion initiatives.

In addition to championing these causes, the Keats Alumni Society also fosters the social and scientific reunion of current and former residents, fellows, and faculty members of the Department of Radiology and Medical Imaging. It’s thanks to the department’s strong community — made up of members past and present — that these philanthropic funds can contribute to radiology’s future.

Keats Society RSNA Alumni Reception, 2023

102

Table of Contents

The Keats Society

The Keats Society Educational Endowment 102 The Keats Society Discretionary Fund 103 The Keats Society Professorship in Radiology 103 Eduard and Francesca de Lange UVA Radiology Residency Diversity and Inclusion Fund 104 Charles, J. Tegtmeyer, MD, Lectureship in Interventional Radiology 105 Pediatric Imaging Research and Education Fund

105 Spencer B. Gay, MD, Resident International Education Fund 106 Alan H. Matsumoto, MD, and Julie A. Matsumoto, MD, Endowment to Advance the Missions and Science of Radiology 107

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The Keats Society

EDUCATIONAL ENDOWMENT The Keats Society’s Educational Endowment Fund that started in 2012 with the primary goal of supporting the educational mission of our trainees.

Spencer Barrett, MD, and Ray Norby, MD, Alumni Lecture 2023

The Keats Society’s Educational Endowment Fund is a restricted fund that started in 2012 with the primary goal of supporting the educational mission of our trainees.

The endowment’s mission includes funding Board prep materials

including materials

such as books and online subscriptions materials, as well as hosting trainee events including alumni lectures and networking opportunities. To give to this fund, click here.

104

$13K Generated annually to support the resident educational mission.

The Keats Society

DISCRETIONARY FUND

Summer 2023

Transitions

by Alan Matsumoto, MD, Chair

It has been my great honor and privilege to have served as the chair of the department for 15 years, following in the footsteps of Drs. Cooper, Archer, Keats, Hillman, Brant, and Dake. And no, I am not retiring; I am stepping down from my current role and will continue as a faculty member in the Department.

However, I will be assuming a national leadership role as the Chair of the Board of Chancellors for the American College of Radiology, effective April 17, 2024.

In my time as the Department Chair, I have felt extremely fortunate to have received such great support from all of the alumni, faculty, trainees, staff, and UVA Health and UPG leadership. I am especially appreciative to those of you who have had the courage to talk with me about what is important to you. You have shared your honest and constructive perspectives and wisdom about what we could be doing better to advance patient care; research and innovation; operational, educational and quality improvements; advocacy;

and stewardship. Your insights and input have made a difference for the department and my own leadership growth.

These past 15 years have been interesting times during which we experienced many changes and challenges (renovating the department, providing services up north, expansion of our outpatient imaging and research services, starting a new Residency, COVID-19, and the contrast shortage— to name just a few!), which forced us to be more creative, resilient, and adaptable. While we often focused and worked on the current topic at hand, we also tried to advance our academic missions.

In these efforts, we learned that we are stronger working together as a team and motivated by a strong desire to do the right thing. We have also been able to recapture some of that needed sense of community which had faded during the pandemic. We should all feel very proud for helping to elevate the Department to a better place, while also nurturing a culture of respect and inclusiveness. Yet despite these achievements, the Department still has many more opportunities for improvement and to make an even bigger impact in all of our missions.

The Keats Society raises unrestricted funds to support the functions needed to run the society including all newsletters and communication material, maintaining our alumni database, providing event underwriting, and gifts to trainees upon their departure. To give to this fund, click here.

Newsletters

THEODORE E. KEATS PROFESSORSHIP IN RADIOLOGY continued on page 2

Page 1

The Theodore E. Keats Professorship in Radiology was established in honor of Dr. Theodore Elliot Keats, who served as chair of the department of Radiology and Medical Imaging from 1964 to 1992. Dr. Alan H. Matsumoto was elected to the professorship in 2011 and has since led the department’s financial growth and faculty expansion.

Theodore E. Keats, MD

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EDUARD AND FRANCESCA DE LANGE UVA RADIOLOGY RESIDENCY DIVERSITY AND INCLUSION FUND In 2017, the Eduard and Francesca de Lange UVA Radiology Residency Diversity and Inclusion Fund was established by Dr. Eduard E. de Lange, a UVA Radiology faculty member for 35 years, and his wife, Francesca. This fund serves to encourage prospective residents who have an interest in enhancing diversity and inclusion in the field of radiology to come to UVA for training and join the department’s efforts in these areas. A diversity representative is chosen from each residency class and is expected to help lead and contribute to departmental and institutional efforts to promote diversity, inclusion and a culture of respect in the workplace environment and community. To give to this fund, click here.

A diverse patient population deserves a diverse team to deliver their health care, in an environment in which they can see themselves and that honors their differences. Embracing a philosophy of “everybody in” helps us better adapt our care models to meet the needs of and create a greater sense of hope for the patients we serve. To learn more about UVA Radiology’s DEI initiatives, click here.

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CHARLES J. TEGTMEYER, MD, LECTURESHIP IN INTERVENTIONAL RADIOLOGY The Tegtmeyer Endowed Lectureship was established in 2009 to honor Charles J. “Tunk” Tegtmeyer with a donation from his wife, Virginia. This project provides the financial support for the Division of Vascular and Interventional Radiology to support a lecture in the field of interventional radiology; scholarly or educational activities for trainees, including financial support for trainees to attend meetings or educational courses; and initiatives committed to the advancement of interventional radiology. Go here to watch the Tegtmeyer Endowed lectures from 2023. To give to this fund, click here.

PEDIATRIC IMAGING RESEARCH AND EDUCATION FUND The Pediatric Imaging Research and Education Fund was established in 2023 by the department to support the mission within the Division of Pediatric Imaging. To give to this fund, click here.

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SPENCER B. GAY, MD, RESIDENT INTERNATIONAL EDUCATION FUND The vision is to have an established and sustainable health care education elective for UVA radiology residents that positively impacts both the trainees and underserved international communities.

Formed in Dr. Gay’s honor in 2014, this fund supports the growing interest in international work among UVA Radiology residents, as well as a desire on the part of the department for residents to have the opportunity to “give back” on a global scale. The department has partnered with the Mbarara University of Science and Technology in Uganda. Future plans include expanding this program into Tanzania. To give to this fund, click here.

Learn More

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First Trip

ALAN H. MATSUMOTO, MD, AND JULIE A. MATSUMOTO, MD, ENDOWMENT TO ADVANCE THE MISSIONS AND SCIENCE OF RADIOLOGY

Alan H. Matsumoto, MD, and Julie A. Matsumoto, MD

In recognition of Drs. Alan and Julie Matsumoto for their more than 32 years of service and commitment the Department of Radiology and Medical Imaging, the department has created a $3 million endowment in their honor through philanthropy and matching dollars from the department. The intent is to create an endowment from which the average yearly projected investment returns are being distributed to the department and used to advance innovation and/ or clinical programs and education in diagnostic and interventional radiology and imaging sciences. Whether these funds are used to support faculty effort, infrastructural costs and/or leadership development will be at the discretion of the chair of the Department of Radiology and Medical Imaging. To give to this fund, click here.

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Our Teams

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Our Future

Colin P. Derdeyn, MD On January 2, 2024, Colin Derdeyn, MD, will become the eighth chair of the Department of Radiology and Medical Imaging.

Dr. Derdeyn is a national leader, clinician scientist and pioneer in advancing stroke care. Most recently, Dr. Derdeyn has served as chair of the Department of Radiology at the University of Iowa Hospitals and Clinics since 2015.

Dr. Derdeyn said he could not pass up the opportunity to return to the institution that helped shape him; he remembered how UVA’s former chair of the Department of Neurosurgery played a particularly formative role in instilling leadership values. “John Jane Sr., MD was a wonderful role model and mentor,” said Dr. Derdeyn. “He was a tremendous example of excellence in clinical care, research, and education, and was a great leader. He motivated people by his expectations of them. His expectations inspired confidence and you did not want to let him down.”

Dr. Derdeyn added, “While it was my past that moved me to look at this position, it was the future that made this opportunity so compelling. This is such an exciting time to join the department.”

“There are so many strengths on which to build - outstanding faculty, trainees, and staff, and strong relationships with other departments. There is visible momentum and support for advancing clinical care, research and education for the department and across the enterprise. Finally, it is such an honor to lead this department. The past chairs are remarkable examples of great leadership in the field: Ted Keats, Bruce Hillman, Mike Dake, and Alan Matsumoto, as are many current and former faculty and trainees.”

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We must acknowledge that our work is never finished and if we are not moving forward, we are moving backwards.

-Alan H. Matsumoto, MD, MA

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University of Virginia Health System Department of Radiology and Medical Imaging Box 800170 Charlottesville, VA 22908

Radiology and Medical Imaging