Cutting Edge Mini-Symposia Program

Contrast Materials
Moderator | Matthew Davenport

Debate: For Or Against Serum Creatinine Screening Being Relevant For Iodinated Contrast William Shuman vs. Olga Brook
Use Of Multi-Energy CT & Low kV Imaging To Minimize Iodinated Contrast Dose Bhavik Patel
The Business Case For Minimizing Injected Contrast Volume Matthew Davenport
Approaches To IV Contrast Media Delivery Bhavik Patel
Evidence Base For The Use Of Oral Contrast In Cancer & Abdominal Pain Benjamin Yeh
Joint Commission Rules On Multi-Dose Vials, Contrast Warming, Etc. Olga Brook
Evidence Base On Use Of Epinephrine By Radiologists Matthew Davenport
Debate: For Or Against The Pre-Medication Of High Risk / ED Patients Remaining Standard Of Care Olga Brook vs. Matthew Davenport

Mobile CT Michael Lev
Point Of Care Cone Beam CT Systems Norbert Pelc
High-End Features In Low To Mid-Range Scanners Mathias Prokop
Photon Counting CT: What Is It And What Can It Do? Cynthia McCollough
Ultra-High Resolution Imaging: Where Are We At? Mathias Prokop
Improved Outcomes Using Metal Artifact Correction Software Charles White
Low Dose Whole Body CT To Replace Radiographic Bone Surveys Katrina Glazebrook
Automatic Exposure Control In One-Beat Cardiac Volume Acquisitions TBA
Debate: Will Cone Beam CT Image Quality Approach Conventional CT & Erode Referral Base? Willi Kalender vs. Katrina Glazebrook
The Value Potential Of Always On Multi-Energy Imaging Tim Leiner
Novel Workflows For The Busy CT Technologist KT Stockton
Intuitive Workflows In MECT Tim Leiner
Advanced Volume Rendering For Lifelike Image Presentation Elliot Fishman
Texture Analysis & Morphological Biomarkers In CT Ronald Summers
Use Of 3D Printing For Treatment Planning & Patient Education Elliot Fishman
Debate: Spatial Resolution - Have We Reached A Practical Limit? Norbert Pelc vs. Mathias Prokop

High Impact CT: Outcomes & Value Creation
Moderators | Pari Pandharipande & Geoffrey Rubin

Value Defined Geoffrey Rubin, MD
Why Measure & Document Value Pari Pandharipande, MD
Defining Quality In The CT Value Equation Benjamin Harvey, MD
Defining Costs In The CT Value Equation Geoffrey Rubin, MD
Evidence Base In CT: What's Missing? Martin Gunn, MD
CT Outcomes: Physician Decision Making In The ED Pari Pandharipande, MD
CT Outcomes: Physician Decision Making In Primary Care Pari Pandharipande, MD
Waste & Overutilization: Is It Problem? If So, How Big? Martin Gunn, MD
Debate: Funding The Evidence - Who Should Be Responsible? Judy Yee vs. Pari Pandharipande, MD
Research To Practice: Translating Comparitive Effectiveness Benjamin Harvey, MD
Evidence Based Decisions: Compliance & Override Martin Gunn, MD
The Role Of Value In Care Bundle Design Benjamin Harvey, MD
Progress In CT: An Overview Joseph Schoepf, MD
Investing In CT: The Choices Geoffrey Rubin, MD
Valuing New CT Technology Geoffrey Rubin, MD
Debate: New CT Technologies - Hype Or High Value? Dushyant Sahani, MD vs. Joseph Schoepf, MD

Hot Topics In Cardiac CT
Moderator | Koen Nieman

Clinical Interpretation Of Coronary CT Angiography: What Drives Management? Koen Nieman
Update On Cardiac CT Acquisition Guidelines Joseph Schoepf
Evolving Considerations For The Diagnosis & Management Of Coronary Artery Anomalies Tessa Cook
Contrast & Radiation Use In Contemporary Cardiac CT Joseph Schoepf
Triage Of Acute Chest Pain Kien Nieman
First Pass Myocardial Perfusion: Should It Be Considered For Routine Practice Koen Nieman
Clinical Implementation Of CT-FFR Jonathan Liepsic
Update On Reporting Guidelines: CAD-RADS Geoffrey Rubin
Debate: Is Coronary CT Angiography Under-used Or Over-used For Stable Coronary Disease? Tim Leiner vs. Jonathan Liepsic
CT As A Gatekeeper To The Cath Lab (Conserve) Koen Nieman
Role Of Calcium Scoring In The Asymptomatic Patient Maros Ferencik
An Update On TAVR Guidance Jonathan Liepsic
Complications In Circulatory Support Systems Lynne Koweek
Prosthetic Valve Issues Lynne Koweek
Plaque Quantification: Will There Be Clinical Impact? Maros Ferencik
Debate: Is CT-FFR Or CT Perfusion Imaging The Way Forward? Koen Nieman vs. Joseph Schoepf

Hot Topics In Lung Nodules & Cancer
Moderator | Charles White

Follow-up On The NSLT: Economic Implications & Use For Nodule Risk Analytics Charles White
Pending Lung Screening Trials: The NELSON & Other International Trials Mathias Prokop
Building The Optimal Lung Screening Program Caroline Chiles
New Nodule Follow-up Guidelines From The Fleischner Society Ann Leung
Latest Concepts Regarding The Subsolid Nodule Brett Elicker
Lung Cancer Radiomics & Radiogenomics Ann Leung
Debate: Should Management Of A Lung Cancer Screening Program Reside Exclusively Within The Radiology Department? Caroline Chiles vs. Jared Christensen

Hot Topics In Multi-Energy CT
Moderator | Dushyant Sahani

Evidence In Favor Of MECT For Pulmonary Vascular Imaging Tim Leiner
Evidence For MECT In Liver Lesion Evaluation Lakshmi Ananthakrishnan
Renal Mass Evaluation: Benefits & Challenges With MECT Aaron Sodickson
MECT Alternatives To MRI: Bone Edema & Silicone Imaging Katrina Glazebrook
New Management Guidelines & MECT In Gout Savvas Nicolaou
Reduced Iodine Dose Aorto-Iliac CTA Dushyant Sahani
Debate: Why Should My Practice Invest In MECT? Savvas Nicolaou vs. William Shuman

Moderator | Stephen Kee

CT-Guided Lung Biopsy Breath-Hold vs. Free Breathing: Complications & Outcomes Jared Christensen
Advantages Of CT Fluoroscopy For Thoracic Interventions Scott Genshaft
Pneumothorax Reduction Techniques In Percutaneous Lung Biopsy Jared Christensen
Never Say No: Tricks For That Impossible Access For Biopsy & Drainage Olga Brook
Advanced Thoracic Interventions, Thermal & Cryoblations Scott Genshaft
Disasters To Avoid When Performing CT-Guided Abdominal Biopsies & Drainage Robert Kerlan
Liver Ablations: Techniques & Tips Evan Lehrman
How Much Does Radiation Dose Matter When Performing CT-Guided IR Procedures? Jared Christensen
Debate: Pros & Cons Of Cross-Sectional IR & CT Interpretation As Two Different Services Arun Krishnaraj vs. Stephen Kee

Machine Learning & Imaging Informatics
Moderator | Arun Krishnaraj

Artificial Intelligence & Imaging Jose Morey
Current State Of Machine Learning/AI In Radiology Eliot Siegel
Value Creation Through Imaging Informatics Rasu Shrestha
Deep Learning Eliot Siegel
Automated Image Analysis & Pattern Recognition Ronald Summers
Toward Fully Automated CT Interpretation Of The Abdomen Ronald Summers
Toward Fully Automated CT Interpretation Of The Head Michael Lev
Supervised vs. Unsupervised Learning Jose Morey
Debate: Man With Machine vs. Machine Eliot Siegel vs. Rasu Shrestha
Automated Decision Support For The Radiologist Tarik Alkasab
Patient Oriented Radiology Reporting Tessa Cook
Leveraging EHR Data To Drive Value Tarik Alkasab
Automated Radiology Recommendation Tracking Tessa Cook
Privacy In The Era Of Artificial Intelligence Jeffrey Mendel
Innovation In The Era Of Big Data Rasu Shrestha
Debate: Who Controls Patient Data In The Era Of AI: Man Or Machine? Eliot Siegel vs. Tarik Alkasab

New Ways To Manage Radiation
Moderator | Cynthia McCollough

What's An SSDE & Why Do I Care? Cynthia McCollough
Dose Monitoring Systems Jia Wang
Emerging Trends In CT Doses Across The US Dianna Cody
The Value Of Automated Exposure Control For Dose Reduction Willi Kalender
Automated Tube Potential Selection: When Is Lower Better Joel Fletcher
Making Sense Of Iterative Reconstruction Techniques Norbert Pelc
Extending The Life Of Older Scanners Using Image Based Denoising Joel Fletcher
Cardiac CT: Acquisition Decisions That Balance Dose & Diagnosis Christoph Becker
Debate: Is Referral Of Repeat Abdominal CT Exams To MRI Better For The Patient? Bhavik Patel vs. Julia Felding
How Low Can We Go In Abdominal CT? Joel Fletcher
Dose Optimization Using Phantoms Andrea Ferrero
How Low Can You Go In Neuro CT? Michael Lev
Dose Management Strategies: The Low Hanging Fruit Mathias Prokop
Nodule Detection Performance At Ultra Low Doses Joel Fletcher
Explaining Radiation Doses & Risk To Concerned Patients & Family Members James Kofler
Debate: Is It Time To Stop Worrying About Dose & Focus On Diagnostic Performance? Joseph Schoepf vs. Aaron Sodickson

Understanding & Maximizing CT's Internal Value Chain
Moderator | Arun Krishnaraj

Understanding CT's Value Chain Geoffrey Rubin
Entering The Chain: Appropriateness & Radiology's Role Arun Krishnaraj
Costing CT Geoffrey Rubin
The Impact Of Workflow Les Folio
Making The Most Of The Visit With Effective Intake Jeffrey Mendel
Standardization & Implementation Of CT Protocols: Acquiring The Right Scan Myron Pozniak
The Patient's Journey In CT Garry Choy
Assuring Quality and Safety: Dashboards and Scorecards Jason Itri
Debate: The Department Or The Health System - Who Should Be Responsible For Radiology's Value Chain? Jeffrey Mendel vs. Jason Itri
Image Processing & Quantification Bhavik Patel
High Quality & Effective Peer Review Jason Itri
Actionable Reporting & Communication Arun Krishnaraj
Data Mining & Business Intelligence Jason Itri
Redesigning Reporting With A Clinic For Direct Patient Consultation Garry Choy
Revenue Sources & Their Impact On CT's Value Chain Jason Itri
Debate: Is Disrupting The CT Image Acquisition Workflow A Good Idea? Julia Fielding vs. Geoffrey Rubin

Cutting Edge Mini-Symposia Session Highlights

High Impact CT: Outcomes and Value Creation

As U.S. healthcare costs continue to rise and payment reforms take hold around the world, radiology is increasingly being asked to justify its value in the broader health care value chain. This session focuses establishing the value of CT from the perspectives of patients and payers. Engaging leaders in health services research, the session delves into how overall value and the key elements of quality and costs are defined, the rationale for measuring and documenting the value of CT, and an examination of the current evidence base for CT’s impact beyond the radiology department. The significance of waste and over-utilization in CT, the translation of research findings into clinical practice, and the use of value information in designing care bundles and associated revenue distributions are additionally addressed. Finally, the session focuses on CT technology and investigates the relationships between value and investment in new CT technologies.

Topics to be debated include, who should be responsible for funding the evidence of CT’s value? and Are new CT technologies high value or hype?

CT in 2017: What's New? What's Trending?

While the slice wars of the early 2000s are well behind us, CT is not standing still. Many innovations are being introduced that impact image quality, safety, and care delivery. Topics to be discussed include:

  • Mobile CT
  • Point-of-care cone beam CT
  • High end features in low and mid-range scanners
  • Photon counting detectors
  • Ultra-high resolution imaging
  • The impact of metal artifact educational to improve outcomes
  • Low dose CT as a replacement for bone surveys
  • Automatic exposure control for one-beat cardiac CT
  • Novel workflows for multi-energy CT
  • Novel workflows for the busy CT technologist
  • Advanced volume rendering
  • Texture analysis and morphologic biomarkers in CT
  • 3D Printing

Machine Learning & Imaging Informatics

Machine learning, deep learning, and artificial intelligence have all been prominently featured in the lay press and in the writings and presentations of influential healthcare leaders. Radiologists and would-be radiologists have been left wondering whether they will be replaced by machines or if machines will finally help us to be better and happier interpreters of CT scans. This session welcomes the world’s top experts in the application of artificial intelligence and informatics to CT, image interpretation, and image reporting to discuss this timely topic. Specific topics include the prospects of fully automated CT interpretation, fundamentals of deep learning, value creation through informatics, automated tracking of report recommendations, and patient-oriented results reporting.

New Ways to Manage Radiation

With the revelation of increasing radiation dosages to the worldwide population from the growth of CT scanning, CT manufacturers have taken extraordinary steps to implement tools to manage and substantially reduce radiation dose. Jointly presented by medical physicists and radiologists, this session focuses on current trends in radiation dose across the U.S. and methods for monitoring and tracking radiation dose. A variety of specific tools for dose mitigation will be discussed along with the challenge of balancing diagnostic quality against dose reduction across a variety of CT applications and patient types.

Topics to be debated include: “Referral of repeat abdominal CT exams to MRI is better for the patient” and “It's time to stop worrying about dose and focus on diagnostic performance”

Understanding & Maximizing CT's Internal Value Chain

From accepting referrals to image patients through imaging, reporting, and informed decision making from CT scanning, the delivery of CT services and interpretations is a complex endeavor involving a diverse team of radiologists, technologists, and administrators. Pressured by declining reimbursements, radiology practices and departments are consistently challenged to assure that internal resources are applied as effectively and efficiently as is possible. This session focuses upon building the value of CT from the perspective of the CT practice and department by articulating the radiology value chain and navigating through it to derive value across each element. Topics include costing, radiology’s role in determining appropriateness, protocol standardization, patient intake, imaging workflow, the patient journey, monitoring quality and safety, post processing and quantitation, peer review, actionable reporting and communication, data mining, direct patient consultation, and the impact of revenue sources.

Interventional CT

For the first time, the ISCT introduces a session dedicated to interventional procedures in the CT scanner. Jointly presented by interventional radiologists and radiologists who perform interventions but are primarily imagers, the session covers topics that span a spectrum of CT techniques applied for the performance of biopsies, drainages, and ablations in the chest, abdomen, and pelvis.

Hot Clinical Topics

Four hot topic sessions will focus on CT applications with important updates in the evidence base and guidelines. Unlike the case review presentations in the “Read-out with the Professor” sessions. These hot topic sessions will focus on the evolving clinical data and its impact on CT practice

Contrast Material Usage

This session highlights recent data on the existence of iodinated contrast-induced nephropathy, CT tools for minimizing iodine dosing, evolving methods for iodine delivery, the necessity of oral contrast, the value of corticosteroid prophylaxis, and joint commission rules on contrast handling and delivery.

Multi-Energy CT Applications

Whether it is called multi-energy, dual-energy, or multi-spectral CT, evidence is mounting in favor of its use in a spectrum of CT applications. This evidence will be presented and discussed across CT for pulmonary embolism, liver lesions, renal masses, bone edema, gout, and aorto-iliac CT angiography. Whether to invest in multi-energy CT technology is the debate topic.

Lung Nodules & Cancer

Lung nodules are ubiquitous and their impact is growing with the development of lung cancer screening centers. This session encompasses topics related to the development of lung cancer screening programs, evolving evidence from lung cancer screening trials, the first revision and major update to the 2005 Fleischner Society Guidelines for incidental nodules to be published in 2017, evolving concepts regarding sub-solid nodules, and the emerging application of radiomics and radogenomics in lung cancer.

Cardiac CT

No area of CT has seen more evidence growth than cardiac CT. Topics include the acquisition and interpretation of coronary CT angiography in acute and stable chest pain, imaging myocardial perfusion, the use of CT-FFR, transarterial aortic valve replacement (TAVR), guidance for atrial appendage closure, assessment of prosthetic valves and ventricular assist devices. Debates include “Coronary CT angiography is underused versus overused for stable coronary disease” and “The way forward is CT-FFR versus CT perfusion imaging”.

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