Looking Ahead From ACR 2021

Amy L. Kotsenas, MD, FACR, American College of Radiology® (ACR®) Council Speaker, contributed this piece.

As I step into the role of ACR Council Speaker, I’m overwhelmed with gratitude for all who have contributed to the success of our second virtual annual meeting. ACR 2021 included a robust agenda full of opportunities to engage with ACR governance, advocacy, health equity efforts and more.

The ACR Council worked tirelessly to consider 48 resolutions, adopting a total of 44. The vote to adopt Resolution 48 supports parental, caregiver and medical leave during training residents in diagnostic radiology, interventional radiology, radiation oncology and nuclear medicine. The resolution includes support for 12 weeks of family/medical leave for residents without extension of training. Additional information on Council activity is available on acr.org and in the Report of Final Council Action (login required).

After an exciting election with a runoff, the ACR introduced several new officers. Internationally renowned radiologist and ultrasound expert Beverly G. Coleman, MD, FACR, was elected president – the first African-American in the nearly 100-year history of the ACR. I look forward to working with Dr. Coleman in the coming year.

The ACR proudly recognized a record 156 fellows during the virtual Convocation ceremony. These honorees are members in good standing who have demonstrated a history of service to the ACR, organized radiology, research or teaching. Only 10% of members have been awarded fellowship. Congratulations to this year’s recipients!

Gregory N. Nicola, MD, FACR, and William Donovan, MD, FACR, led the Economics Forum, which provided a venue to walk through the process from the time that a billable code is introduced or re-evaluated, through the actual valuation of a service. We also learned about change on the horizon in regard to payment for use of artificial intelligence, the trend toward corporatizations, and the impact of the COVID-19 pandemic on the future of teleradiology.

Health equity remains of paramount urgency for the ACR, as highlighted in several sessions, including a two-part CME opportunity focused on health equity and the Moreton Lecture. In her Presidential Address, Geraldine McGinty, MD, MBA, FACR, challenged radiology professionals to act to advance health equity in her Presidential Address, unveiling the Radiology Health Equity Coalition. This new, community-wide effort supports radiologists who aim to address health disparities in research, advocacy efforts, artificial intelligence development and medical student recruitment. I encourage you to learn more about the coalition, and commit to act today.

During the Moreton Lecture, Reshma Jagsi, MD, DPhil, presented a data-driven view of just how equitable the fields really are — or are not — and challenged attendees to think about how we can all do more to improve equity in our practices.

The success of this year’s meeting was made possible by the hard work and collaboration of ACR staff working alongside, you, our volunteers. I would especially like to thank the ACR Governance staff, Trina Behbahani, CAE, Catherine Herse and Tom Hoffman, JD, CAE, as well as Mr. Jim Jones, our parliamentarian and my predecessor, Richard Duszak Jr., MD, FACR. The work of this dedicated team at command central in Reston was critical to another successful annual meeting.

As we move forward on the heels of ACR 2021, I’m eager to get to work to further support our radiology community. I’m truly looking forward to what we will accomplish together over the next few years, and don’t forget – save the date for ACR 2022, April 24 to 28. I look forward to seeing you back at the Washington Hilton!

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Health Equity Is Radiology’s Lane

Geraldine McGinty, MD, MBA, FACR, Immediate Past-President of the American College of Radiology® (ACR®), contributed this piece.

Looking back on my time serving as ACR President, I’m proud of the more inclusive and member driven, highly engaged organization we’ve become. I am thrilled to be succeeded by Beverly G. Coleman, MD, FACR, the first African American woman elected as president of the ACR and look forward to seeing what we will continue to accomplish together.

In 2014, the ACR outlined a very critical goal, aspiring for all members to be universally recognized as leaders in the delivery and advancement of quality healthcare. Since setting this goal seven years ago, I think we’ve made impactful strides towards advancing the quality and practice of radiology, but there’s more work to be done.

The COVID-19 pandemic has starkly highlighted the inequities in our healthcare system. We’ve seen Black and Hispanic mortality at rates two to three times that of their white counterparts, and other minorities, such as the Native American community, disadvantaged in access to quality care. Compound that with a recognition that racial injustices are happening in our healthcare system as well as in our communities at large, and it has become very clear that the efforts to address these issues require the support of our entire profession. As radiology touches nearly all components of patient care, we are uniquely positioned to spearhead efforts to address these disparities and accommodate diverse patient population needs — and we must come together to do so.

During my Presidential Address at the ACR 2021 Annual Meeting, I shared the launch of a new, community-wide coalition effort to address health disparities and measurably change outcomes — the Radiology Health Equity Coalition. This coalition brings together representatives from the ACR, American Roentgen Ray Society, Association of University Radiologists, Radiological Society of North America, Society of Chairs of Academic Radiology Departments, Society of Interventional Radiology and the American Board of Radiology. It will extend to engage with all major stakeholders in radiology. This community-wide effort will collect and disseminate resources and best practices, advocate for and connect with patients and community members, and collaborate on programs and services to empower others to act.

Will you join the coalition? I urge you to commit to act at acr.org/healthequity.

Together, we can — and will — move our communities towards quality, equitable care.

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Leading the Nation’s Only Military Radiobiology Research Facility

Mohammad Naeem, MD, FACR, Co-Chair of the American College of Radiology® (ACR®) General, Small, Emergency and/or Rural Practice (GSER) Network Military Subcommittee, contributed this piece.

In July 2020, I was tapped to be the 20th director of America’s most prestigious military radiobiology research facility, the Armed Forces Radiobiology Research Institute (AFRRI). AFRRI is a unique national asset, celebrating its 60th anniversary this May 2021. The institute, under the command and control of the Uniformed Services University of the Health Sciences (USUHS), is responsible for preserving and protecting the health and performance of U.S. military personnel operating in potentially radiologically-contaminated multidomain conventional or hybrid battle spaces and urban environments. AFRRI engages in research, education and operational training to advance the understanding of the effects of ionizing radiation, in line with the 21st-century dynamic threat landscape and national security threats posed by non-state actors, hostile state actors and near-peer adversaries. In addition, AFRRI provides rapidly deployable radiation medicine expertise in response to a radiological or nuclear event domestically or abroad.

Radiologists and radiology organizations are in a unique position to be leaders in radiation accident preparedness and response. Our in-depth understanding of ionizing radiation, radiation-induced injury and principles of radiation protection postures us well to serve as experts to our hospitals and other medical authorities. As the first radiologist and first ACR Fellow to lead AFRRI, I feel that AFRRI and the ACR can very closely cooperate in the arenas of emergency radiology and disaster preparation education at the national level.

On May 12, 1961, Secretary of Defense Robert McNamara established AFRRI based on two cold war ground realities of that time – the threat scenario of numerous Soviet infantry divisions overcoming the Fulda Gap defenses in West Germany and overtaking western Europe, and the use of nuclear weapons on the battlefield by the North Atlantic Treaty Organization forces particularly enhanced radiation weapons rich in neutron output, to halt such a massive assault from the Warsaw Pact countries.[i]

AFRRI is the U.S. Department of Defense’s (DoD’s) only medical research and development facility dedicated to nuclear and radiological defense. The Institute’s touchstone research projects, as a key component of USUHS, include biodosimetry, combined injury, internal contamination and metal toxicity, effects of low dose radiation and radiation medical countermeasures development. It routinely collaborates with other military and government organizations in the arenas of civilian radiological-accident response and with the National Aeronautics and Space Administration on the safety of astronauts exposed to cosmic radiation.[ii]

The Institute has also been at the center of medical and radiobiological matters pertaining to radiological-nuclear incident response, maintaining a rapidly-deployable team of radiation subject matter experts, including physicians and physicists, to support medical response and actions taken in military and civilian nuclear or radiological incidents, either domestically or abroad. During the U.S. DoD response to the Fukushima Daiichi reactor incident, Operation Tomodachi, the Medical Radiobiology Advisory Team, which is the operational arm of AFRRI located at Naval Support Activity Bethesda in Maryland, provided guidance and advice to the U.S. military leaders in Japan. This support helped ensure the safety of U.S. service members, family members and civilians, and supported the humanitarian relief in a coordinated effort with the Government of Japan.[iii]  AFRRI routinely trains military and civilian healthcare providers, disaster-preparedness personnel and operational planners on the medical effects of ionizing radiation and the logistical and medical responses to radiation exposures.

In today’s complex international security environment, non-state actors may attempt to detonate radiation dispersal devices, such as dirty bombs or improvised nuclear devices, in major urban centers. [iv] Near-peer adversaries or hostile state actors may use tactical or low-yield nuclear weapons in a battlespace against the U.S. and its allies. A nuclear weapon detonated in earth’s low orbit by a near-peer adversary can create a massive electromagnetic pulse, rendering the electronic equipment ineffective on an unimaginable scale.[v] This clear and present danger needs our immediate attention and preparation. AFRRI proudly stands ready as the frontline radiobiological research center and medical operational asset in the radiological defense of the nation for 60 years.

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[ii] National Research Council 2014. Research on Health Effects of Low-Level Ionizing Radiation Exposure: Opportunities for the Armed Forces Radiobiology Research Institute. Washington, DC: The National Academies Press. https://doi.org/10.17226/18732.

[iii] VanHorne-Sealy J, Livingston B, Alleman L. DoD’s Medical Radiobiology Advisory Team: experts on the ground. Health Phys. 2012 May;102(5):489-92. doi: 10.1097/HP.0b013e31824acb08. PMID: 22469928.

[iv] https://www.wjperryproject.org/

[v] https://www.militaryaerospace.com/communications/article/16709112/todays-battle-for-the-electromagnetic-spectrum