ACR Bulletin April 2017
Case of the Month
Authors: C. Eric Gullbrand, DO PGY-1, Radiology Resident, Department of Diagnostic Radiology, Christiana Care Health System, Newark, DE; Kristina A. Siddall, MD Associate Program Director, Department of Diagnostic Radiology, Christiana Care Health System, Newark, DE
Why did you select this case for submission?
Tubular adenomas are rare benign breast neoplasms with an overall incidence ranging from 0.13-1.17% of benign breast lesions. Dr. Siddall and I chose to submit this case as a review of the classic sonographic findings for tubular adenomas.
What should readers learn from this case?
Sonographic evaluation most commonly reveals a well-circumscribed, hypoechoic mass. This is usually effective in confirming the benign nature of the lesion.
What did you learn from working on the case?
Histopathological evaluation of tubular adenomas is currently the gold standard for diagnosis. Clinical, radiologic, and cytological preoperative diagnosis can be unreliable.
How did guidance from senior staff at your institution impact your learning and case development?
Dr. Siddall pointed me in the right direction in order to obtain additional information about differential considerations and imaging findings. At Christiana, senior staff members expose residents to many unusual cases and provide helpful teaching points.
Why did you choose Case in Point for submission of your case?
Case in Point is a fantastic resource for providing concise information about a variety of interesting cases. As this was a relatively rare case that had not been previously described in the CIP archives, we felt this might be a compelling submission.
Are you a regular reader of Case in Point? What are your favorite types of cases?
I review CIP cases regularly in order to learn about interesting cases and to test my current knowledge base. The musculoskeletal cases are usually my favorite.
Is there anything else you’d like readers to know about your case?
Tubular adenomas most commonly affect young women of reproductive age and present as firm, mobile, painless breast masses. Sonographic findings can be very helpful in differentiating benign from malignant breast lesions.
Primer on Radiology Advocacy
"An idea is like a play. It needs a good producer and a good promoter even if it is a masterpiece. . ." — David Bornstein in How to Change the World: Social Entrepreneurs and the Power of New Ideas
Residents and fellows are perfectly positioned to be effective advocates as we are accustomed to championing our patients and specialty from our reading rooms, angio suites and clinics every day; however, most of us are not comfortable pursuing state and national advocacy opportunities. This daunted me, too when I was first getting started, but rest assured, there are countless opportunities to get involved (and options compatible with almost everyone’s time budget).
Let’s review a few pieces of advice I have learned along the way and share some opportunities for you to get started advocating today!
Is There a Doctor on Board?
The thought of this title may send shivers down your non-clinical spine. Colleagues often jest that radiologists are loners hiding in a dark room away from civilization, who have little interaction with any patients.
Social Media Primer
Four years ago, the night before my very first ACR national meeting, I signed into an, until that point, unused Twitter account.
Part I: ACR 2017 Advocacy Essentials and Capitol Hill Day; What You Need to Know
A crucial component to the yearly ACR meeting is advocacy, including the Capitol Hill Day visits. This year, exciting new elements will be unveiled in addition to the traditional programming which has been so effective in our profession’s advocacy efforts.
YPS Executive Committee – Yearly Recap
Over the past year, the ACR YPS Executive Committee (EC) has been busy and productive.
Why I Got Involved
Several years ago as a second year resident, one of my senior residents approached me in the hallway and said, “I think you’d make an excellent leader. You should join the Massachusetts Medical Society.”
Onboarding: Achieving Long-term Success for the Practice and New Radiologist
The many years of education and training physicians undergo provides them with multiple transitions to new environments as learners and professionals.
SIR Annual Meeting Update
The Society of Interventional Radiology Annual Meeting concluded this March and as usual it was a bustling and exciting event for residents, fellows and attendings who share an interest in interventional radiology.
The ACR Rutherford Fellowship Experience
This past month, I had the opportunity to participate in the American College of Radiology’s J.T. Rutherford-Lavanty Fellowship in Governmental Relations in Washington, DC, during a crucial time in our nation’s history, at the epitome of health care reform.
Meet the ACR Leadership: James A. Brink, MD, FACR
This is an installment of a series titled “Meet the ACR Leadership.” Throughout the series, we interview the ACR Leadership to get insight into their background and involvement in the ACR. For this installment, we talk with James A. Brink MD, FACR.
A Primer on 3D Printing
The potential for three-dimensional printing (3DP) models in medicine is virtually infinite. Radiologists are in a unique position to be the leaders in an emerging field, owing to our combined anatomical and cross-sectional imaging expertise.
Speaking Up for Psychological Safety
As radiologists report increasing levels of burnout, how can we support our colleagues and trainees?
At the ACR Annual Conference on Quality and Safety held in Boston this past September, I had the pleasure of sitting down with Steven J. Swensen, MD, medical director of leadership and organization development at the Mayo Clinic and a senior fellow at the Institute for Health Care Improvement.
TBD: Radiology's Role in Alternative Payment Models
Radiology must evaluate its role in the rapid evolution to alternative payment models.
Fifty percent of all Medicare payments will occur through alternative payment models (APMs) by 2018. This ambitious goal was first introduced by the secretary of the Department of Health and Human Services early in 2015.
A New Meaning to Teamwork
How radiologists can build high-functioning teams to improve job satisfaction, performance, and patient care.
To rate value to their practice and to their patients, radiologists traditionally highlighted their individual performance through relative value units (RVUs). They'd isolate themselves in reading rooms to focus on interpreting more images without interruptions.
Staying on Course
As CMS' Quality Payment Program gets underway, radiologists try to reconcile more clerical responsibilities with high-quality patient care.
Asking radiologists what they think of the increased clerical responsibilities inherent in CMS' Quality Payment Program (QPP), the care delivery mechanism of the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA), will yield many colorful answers.
The Time is Now
Improve your time management skills with these pro tips.
There's no time like the present. However, when you're a radiologist tasked with clinical, administrative, research, and teaching responsibilities, it can be difficult to manage the present effectively.
Know Your Councilors
Meet some of the members of the ACR Council.
The success of the College depends on an informed and engaged membership. In May, the ACR Council will convene at the Crossroads® to consider resolutions and elect the next group of leaders for the College.
How do you define value in your daily practice?
Value, quality, cost: these are somewhat amorphous terms trumpeted routinely in the context of the recently passed Medicare Access and CHIP Reauthorization Act.