by Donald P. Harrington, M.D., F.A.C.R.
It is hard to believe that time has passed
R ADIOLOGY LETTER
A Radiologist’s Approach to Imaging Vistas n State University of New York at Stony Brook
U. S. Postage
PERMIT NO. 65
R ADIOLOGY LETTER
A Radiologist’s Approach to Imaging Vistas Stony Brook University Fall 2004
The purpose of this program is to provide a forum for exchange DEPARTMENT OF RADIOLOGY
so quickly this year, and the Department Stony Brook
of information and discussion about clinical and basic research Room 120, L4 Health Sciences Center
is about to embark on several new and NY 11790
in the areas of diagnostic radiology and other imaging modali- State University of New York at Stony Brook
exciting ventures. As most of you are
aware, both MRI and CT studies are
ties. Presentations were given by the following residents from
the Department of Radiology, Stony Brook School of Medicine
Stony Brook, New York 11794–8460
CT Coronary Artery Calcium Screening
quickly becoming the imaging modality
of choice, expanding the diagnostic and Winthrop University Hospital, Mineola.
By Erica Posniak, M.D. evaluate pre-clinical coronary artery disease which may
imaging capabilities by imaging the body
Assistant Professor of Clinical Radiology be nonobstructive yet reflected by an overall high
in new and informative ways. As you peruse through this Felix Kravets, M.D.
Division of Cross-sectional Imaging coronary artery calcium score. It has been shown that
issue, you will see that Radiology and Cardiology are Functional MRI Investigation of Limbic System Activation by
traditionally utilized stress tests may not be sensitive to HIGHLIGHTS
collaborating in several initiatives. Cardiac MRI for Emotional Stimuli The Department of Radiology at Stony Brook University
nonobstructive or flow limiting coronary lesions. Such
non-invasive diagnostic studies is being performed to University Hospital and Medical Center, Stony Brook, NY is pleased to announce that we are now providing CT Radiology Seminar 2
patients may also fall in a low-risk category if only tradi-
assist the cardiologists in their diagnosis and treatment Coronary Artery Calcium Screening. The examination is
tional risks are evaluated and calcium scoring may alert
of coronary artery disease. We are also utilizing CT Newrhee Kim, M.D. rapidly performed, requiring only minutes of scan time. MRI Guided Core
health professionals as to clinical cardiac concern. Biopsy 3
technology for cardiac artery calcium evaluation as a National Survey of Radiology Residency Programs It is extremely well tolerated by patients and is painless.
screening technique to evaluate the amount of calcium Contrast material is not administered and the exam can, New Faculty 4
Winthrop University Hospital, Mineola, NY Coronary Artery Calcium Scoring is advocated as a
buildup in the coronary arteries. This procedure is not therefore, be performed in virtually any patient regard- screening exam to evaluate for sub clinical disease and New Residents
currently reimbursed by insurance companies, but we are less of renal function.
Jack Fields, M.D. allow for earlier evaluation of and intervention of coro- and Fellows 4
optimistic that this will change in the near future.
MRI Based Virtual Cystoscopy Using our state-of-the-art, multislice CT scanner and nary artery disease. In addition to its use as a screening
Initially, insurance companies did not reimburse for Residency and
University Hospital and Medical Center, Stony Brook, NY advanced software, the coronary arteries can now be tool and in patients with known cardiac risk factors, this
virtual colonoscopy procedures when used as a Fellow Graduation
well visualized on CT and easily evaluated by our expert exam should be considered in many other patient Dinner 5
screening tool; however, many insurance companies are
Asante Dickson, M.D. team. Each vessel is individually evaluated for its total groups. Including but not limited to patients who are
considering revising their current policy. Presently,
calcium burden which is scored in two ways. Both the currently on statin therapy in order to evaluate for
both screening studies can be performed here at the 16-Channel Multislice CT Discography and Improved Visualization
Agatston method and a volumetric method are utilized to change in calcium scoring overtime reflecting the suc-
Radiology Department at University Hospital. of Disc Pathology
obtain a calcium scan. Subsequently, a global cardiac cess of therapy. Patients with underlying diseases
Winthrop University Hospital, Mineola, NY known to have an increased incidence of atherosclerotic
On the academic side, the newsletter reveals the calcium score is computer generated.
research projects of our residents which were presented disease and women with demonstrated extra cardiac
at the twenty-fifth Annual Radiology Research Seminar. Robert Bernstein, M.D., Ph.D.
Characterization of MS Lesions by MRI
Faculty & Staff Paul R. Fisher, M.D.
Associate Professor of Clinical Radiology
Corazon J. Cabahug, M.D.
Assistant Professor of Clinical Radiology
Director, Division of Nuclear Medicine
Laurette Sauter, M.D.
Assistant Professor of Clinical Radiology
Division of Breast Imaging
It has been shown that aggregate coronary artery calci- vascular calcification as seen on other modalities includ-
Congratulations are in order for Dr. Paul Fisher, Chief of um often reflects underlying soft plaque burden within ing mammography may also benefit, allowing for earlier
Donald P. Harrington, M.D., F.A.C.R. Division of Diagnostic Radiology and
Breast Imaging and Director of the Radiology Third- University Hospital and Medical Center, Stony Brook, NY Professor and Chairman of Radiology Breast Imaging Bruce M. Chernofsky, D.O. G. Lucy van de Vegte, M.D. the coronary arteries although not necessarily its exact workups and additional evaluations3.
Professor of Biomedical Engineering Director, Breast Imaging Assistant Professor of Clinical Radiology Assistant Professor of Clinical Radiology
year Medical Student Program on being named by the Division of Neuroradiology Division of Cross-sectional Imaging
Alan Bennie, M.D. Gene R. Gindi, Ph.D. For more information on this examination, please feel
University as the recipient of the Aesculapius Award in Associate Professor of Radiology and
Harris L. Cohen, M.D., F.A.C.R. Eddie Fiore, M.D. Paul L. Vitulli, D.O. The coronary artery calcium score can greatly aid in the
recognition of his outstanding teaching contribution to Performance Evaluation of a Multi-Slice Stepping Gantry CT Professor of Radiology Electrical Engineering Assistant Professor of Clinical Radiology Assistant Professor of Clinical Radiology free to contact Dr. Erica Posniak at (631) 444-8193.
Associate Chair of Research Activities Division of Cross-sectional Imaging Division of Special Procedures and prediction of future coronary events especially when
the University. University Hospital and Medical Center, Stony Brook, NY Director of Body Imaging Elaine S. Gould, M.D. To schedule a CT Coronary Calcium Screening exam,
Interventional Radiology Procedures and considered in addition to traditional cardiac risk factors.
Chief, Ultrasound Associate Professor of Clinical Radiology please contact Dr. Paola Carvelli or Dawn at 444-1022.
Dinko Franceschi, M.D. Diagnostic Radiology
Chief, Pediatric Body Imaging Director, Core/Orthopaedic Radiology Coronary artery calcium scoring offers the ability to
One last item of interest is Stony Brook University Assistant Professor of Clinical Radiology
Jean Delbrune, M.D. James V. Manzione, M.D., D.M.D. Division of Nuclear Medicine Mark E. Wagshul, Ph.D.
Hospital installing the first 3 Telsa high-field strength Arie E. Kaufman, Ph.D.
Associate Professor of Clinical Radiology Assistant Professor of Clinical Radiology 1 Girshman and Wolff.
Low Dose Lung CT as Early Lung Cancer Screen Professor of Radiology and Computer Science
clinical MRI imager in Suffolk County. The enhancement and Neurological Surgery Margaret Johnstone, M.D. Director of MRI Research
Techniques for Quantifying
Jerome Z. Liang, Ph.D.
Chief, Neuro Interventional Assistant Professor of Clinical Radiology
of diffusion studies, such as spectroscopy, fat University Hospital and Medical Center, Stony Brook, NY Professor of Radiology and Computer Science Division of Breast Imaging Zengmin Yan, M.D. Coronary Artery Calcification
suppression techniques, breast tumor detection and Harold L. Atkins, M.D.
Steven Perlmutter, M.D., F.A.C.R. Assistant Professor of Clinical Radiology Seminars US/CT/MR, Vol 24
Professor Emeritus of Radiology Associate Professor of Clinical Radiology Seth O. Mankes, M.D. Division of Neuroradiology and Diagnostic (1) 2003, pg 33-38.
needle biopsies performed under MRI guidance are Associate Chair, Academics Assistant Professor of Clinical Radiology Radiology
Jack S. Deitch, M.D. Division of Diagnostic Radiology and Cross- Division of Cross-sectional Imaging 2 Rumberger, Simmons et al.
examples of 3 Tesla imaging. An improved signal to Professor Emeritus of Clinical Radiology sectional Imaging Marlene Zawin, M.D. Circulation 92:2157-2162,
noise allows the scanner to be faster and with greater Morton A. Meyers, M.D. Director, Residency Program Hong Meng, M.D. Assistant Professor of Clinical Radiology 1995.
resolution. The slices are also thinner and of a higher THE R ADIOLOGY LETTER Professor Emeritus of Radiology
Patricia E. Roche, D.O.
Assistant Professor of Clinical Radiology
Assistant Professor of Clinical Radiology
Division of Cross-sectional Imaging and
Division of Cross-sectional Imaging
Chief , Computed Tomography 3 Pecchi A. et al. Association
matrix. This magnet will be operational in late fall and H. Oster, M.D. Diagnostic Radiology of Breast Arterial Calcification
The Radiology Letter is published by the Department of Professor Emeritus of Radiology Division of Neuroradiology Chief, Body MRI Wei Zhao, Ph.D. detected by mammography
will be utilized for both clinical and research endeavors Radiology, School of Medicine, University at Stony Brook, Assistant Professor of Clinical Radiology
Robert G. Peyster, M.D. Clemente T. Roque, M.D.
and coronary artery
with a new valuable tool in disease detection. These Stony Brook, New York 11794 (631) 444-2480 Professor of Radiology and Neurology Associate Professor of Clinical Radiology and William H. Moore, M.D.
calcifications quantified by
Associate Chair, Clinical Neurosurgery Assistant Professor of Clinical Radiology
are exciting and challenging times and Stony Brook Donald P. Harrington, M.D. Chairman Director, Division of Neuroradiology Division of Diagnostic Radiology multi-slice CT in a population
Division of Neuroradiology
Radiology in collaboration with Stony Brook University Chief of Thoracic Imaging ADMINISTRATIVE STAFF of post-menopausal women.
Michael J. Cortegiano Administrator Terry M. Button, Ph.D. Thomas H. Smith, M.D Radiol Med, 2003,
Hospital is at the forefront of the latest imaging Christine R. Hubbard Editor and Staff Writer Associate Professor of Clinical Radiology Associate Professor of Radiology and Roxanne B. Palermo, M.D. Michael J. Cortegiano Oct.106(4):305-12.
Director of the Medical Physics Track Figure 1: Image of the coronary arteries on a noncontrast Figure 2: CT scan demonstrates calcified coronary arteries.
techniques and modalities. Pediatrics Assistant Professor of Clinical Radiology Administrative Officer
in Biomedical Engineering Division of Diagnostic Radiology CT scan. There is no significant coronary artery calcifica- LAD (left anterior descending), LCX (left circumflex), 4 Sevrukov, et al, Electron Beam
Division of Cross-sectional Imaging and
John A. Ferretti, M.D. Chief, Pediatric Radiology Breast Imaging Patricia George tion. LMCA (left main coronary artery), LAD (left anterior LMCA (left main coronary artery)4 CT of the Coronary Arteries
Associate Professor of Clinical Radiology Medical Practice Plan Administrator descending artery, LCX (left circumflex coronary artery)4 AJR:177, Dec. 2001.
Associate Chair, Quality Sol Spector, M.D. Erica J. Posniak, M.D.
Director, Interventional Radiology Associate Professor of Clinical Radiology Assistant Professor of Clinical Radiology Maria Wolfe, R.T.
Chief, Vascular Interventional Chief, GI/GU, Emergency Division of Cross-sectional Imaging Hospital Director of Radiology and Cardiology
2 FALL 2004
MRI Guided Core NEW FACULTY Iakovos Koutras,
M.D. received his Fellows Residency and Fellow Graduation Dinner
Biopsy at Stony Brook— William Moore,
medical degree at
New York University Punit Aghera, M.D completed a four-year
Another First! M.D. joined the
faculty staff as an
School of Medicine Radiology residency at SUNY Stony Brook
in July and has stayed on as a
The Residency Graduation Dinner was held on June
17, 2004 at the Port Jefferson Country Club in Port
It is not surprising that Dr. Paul Fisher was the
recipient of the “Teacher of the Year Award”. He
in New York, New
Assistant Neuroradiology fellow. Jefferson. The event was sponsored by Fuji Medical also received the “Teacher of the Year Award” in
By Paul R. Fisher, M.D. York, completed a
Professor of Systems, U.S.A., Inc. Fuji Executives John Weber, 2000, 2002 and 2003. Dr. Ferretti’s “Unknown
Director, Breast Imaging one-year Internal
Clinical Radiology Senior Vice President of Operations, Paul Genovese, Case Contest” was won by Alan Bennie, M.D. who
in the Division of Senior Vice President Sales, and Tony Brady, received a textbook of his choice. Dr. Robert
at Bellevue Hospital Kevin Klayman,
As another example of regional leadership in Breast Diagnostic Account Manager were present. It was good to see Bernstein received the “Roentgen Resident/Fellow
Center, New York, New York and is a first-year D.O. is a fellow in
Imaging, physicians at the Carol Baldwin Breast Radiology and is Dr. Harold Atkins and former alumni Drs. Jayne Research Award” (RSNA Research and Educational
Radiology resident at the University Medical the Abdominal
Congratulations Center of University Hospital at Stony Brook recently Chief of Thoracic Bernier, Harold Parnes and Maryanna Mason. Fund) for his accomplishments in radiological
Center at Stony Brook. Radiology (Cross-
performed two MRI guided core biopsies, the first in Imaging. Dr. Moore received his medical Congratulations to Punit Aghera, M.D., Robert investigation.
this region. Breast MRI is more sensitive in finding degree from the Albany Medical College in Ashton, M.D., Ph.D., Jean Delbrune, M.D., and
Donald P. Division. He Many thanks to Dr. Steven Perlmutter, Director of the
breast cancer than the other typical modalities, such Albany, New York, followed by an Internal Vaibhav Mangrulkar, William Moore, M.D. in completing their four year
received his med- Residency Program, and Linda Erickson, Coordinator
as mammography and ultrasound. However, until M.D. received his Radiology Residency Program.
Medicine Internship in Albany, a Diagnostic ical degree at the of the Residency Program for their efforts. Also,
Harrington, recently the biopsy options for lesions found on medical degree at
Radiology Residency at Stony Brook and a New York College Govindarajan Narayanan, M.D. completed a Special many thanks to the faculty and support staff for
Breast MRI have been limited to surgery or observing the UMDNJ - Robert
Dr. Paul Fisher has been presented with the Thoracic Radiology fellowship at the of Osteopathic Procedures fellowship, Rita Ratani, M.D. completed their hard work and dedication.
M.D., was the lesion over time. In a technique first described by Wood Johnson
Aesculapius Award in May 2004 for recognition of New York University in New York City. Medicine in Old Westbury, New York and an Abdominal Radiology fellowship, and Ann Rose
outstanding teaching. radiologists at Memorial Sloan-Kettering Hospital, a Medical School in
Dr. Moore is Board Certified in Diagnostic completed his Radiology residency at the Thomas, M.D. completed an MRI fellowship.
named President 10-gauge needle is introduced into the lesion while Piscataway, New
Radiology. He is a member of the Jersey, completed a Nassau County Medical Center in East
the patient is in the MRI magnet, and after its posi- American Board of Radiology, American
of the Society Transitional intern- Meadow, New York.
tion is confirmed, a small sample of tissue is College of Radiology, American Medical ship at Saint
obtained. This is less expensive, faster, and less Association, New York State Medical
of Chairmen Barnabas Medical
painful than surgical biopsy, and it leads to less scar- Society, Radiological Society of North Center in Livingston, New Jersey and is a first- Ron Mark, M.D. is
ring (which itself can hide a cancer). The Carol America and Society of Thoracic Radiology.
of Academic year Radiology resident at the University a MRI Research
Baldwin Breast Center also led the way with digital
Medical Center at Stony Brook. fellow. He
mammography (the first in an academic center in
Radiology New York State), computer-aided detection (first on received his med-
Anna Elissa Nidecker, ical degree at the
Long Island), and MRI computer-aided detection M.D. received her
Departments (first in the region). NEW RESIDENTS medical degree at
On September 14, a groundbreaking ceremony was
AND FELLOWS the Albany Medical
College in Albany,
of Medicine in
held for the new Ambulatory Care Pavilion, which will New York, completed Guadalajara,
Paul C. Lauterbur, Ph.D., winner of the 2003 Nobel prize in include the Carol Baldwin Breast Care Center and a a Preliminary Mexico and completed his Radiology resi- John Ferretti, M.D., (left) and Donald P. Harrington, M.D.
Physiology or Medicine for his pioneering work concerning
Magnetic Resonance Imaging gave a lecture as part of the
new state-of-the-art outpatient imaging center. The
Cancer Center will occupy the 2nd level of this
Residents Medicine internship
at the University of
dency at the Bridgeport Hospital in
Graduating Radiology residents Punit Aghera, M.D., Robert Ashton, M.D., Ph.D.,
William Moore, M.D., Steven Perlmutter, M.D., Director of the Residency Program congratulate Govindarajan Narayanan, M.D. (middle) in
completing his Special Procedures and Interventional fellowship
Bridgeport, Connecticut. and Donald Harrington, M.D., Chairman (left to right)
President’s Lecture Series on “To There and Back Again:
Pavilion. When the new Center opens in 2006, we Washington, Seattle
Adventures from Molecules to Man and Back”. Ekta Gupta, M.D.
will have three MRI magnets (including an open and is a first-year
MRI). By being adjacent to the Baldwin Breast Care received her Radiology resident at the University Medical
medical degree Paulito Tactacan,
Center, one of these MRIs will be available for the Center at Stony Brook.
at SUNY Stony M.D. is a fellow in
Breast Care Center patients.
Brook, completed the Angiography
Adina Sonners, M.D. and Interventional
a one-year Internal
A Breast MRI with a received her medical Division. He
biopsy needle sheath Medicine intern-
degree at the Robert received his med-
in place. Once the ship at North
location of the sheath
Johnson Medical ical degree from
is established, a core School in Camden, the Far Eastern
biopsy can be safely Hospital in New Jersey, com- University in
performed. Manhasset, New York and is a first-year pleted a Preliminary Quezon City,
Radiology resident at the University Medical Medicine internship Philippines and completed his Radiology
Center at Stony Brook. at the Jersey residency at the St. Lukes Medical Center in
University Medical Harold Cohen, M.D. (left), Donald P. Harrington, M.D. congratulate Rita Ratani, William Moore, M.D., Punit Aghera, M.D. and
Quezon City, Philippines.
M.D. (center) in completing her Body Imaging Fellowship Donald P. Harrington, M.D. congratulate Paul Fisher, M.D.
Congratulations Veronica and Punit Aghera who wed Center and is a first-year Radiology resident at Teacher of the Year Award recipient
on September 5, 2004.
the University Medical Center at Stony Brook.
3 FALL 2004 THE RADIOLOGY LETTER 4 DEPAR TMENT OF RADIOLOGY 5