ISSUE 64 OCTOBER 2015

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Flora Carpenter
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ISSUE 64 OCTOBER 2015 You had to bear with my editorials for more than 7 years, reading (or not) my vision of our Diagnostic Imaging world and listening to my comments.

This month, I have invited Shairoz Kherani to be our guest editor and share her priorities with you.

David Koff Chief of Diagnostic Imaging, HHS Chair, Department of Radiology, FHS Key Accomplishments in Radiation Safety at HHS and SJHH The Integrated Radiation Safety Office (IRSO) was created in

This has been achieved through open, participative communication within and across all Clinical Services city-wide.

It also ensures compliance with applicable Provincial and Federal Regulations and Safety Codes.

1 ISSUE 64 OCTOBER 2015 You had to bear with my editorials for more than 7 years, reading (or not) my vision of our Diagnostic Imaging world and listening to my comments. I think that it is more than time to give other leaders in our Department an opportunity to use this front page to express their own views and give you a different perspective. This month, I have invited Shairoz Kherani to be our guest editor and share her priorities with you. As you all know, Shairoz is our Interim Director, Diagnostic Services and MDU and Site Manager, McMaster University Medical Centre. I ll be back in November. David Koff Chief of Diagnostic Imaging, HHS Chair, Department of Radiology, FHS Key Accomplishments in Radiation Safety at HHS and SJHH The Integrated Radiation Safety Office (IRSO) was created in 2012 to promote Best Practices as it pertains to Radiation Safety, Education and Protection. This has been achieved through open, participative communication within and across all Clinical Services city-wide. Its main goals are to monitor, audit, develop and implement quality improvement plans related to radiation safety, standards of practice and equipment performance. It also ensures compliance with applicable Provincial and Federal Regulations and Safety Codes. Since its inception, the IRSO has laid the foundation for continuous improvement by working tirelessly on a number of initiatives to ensure ongoing radiation safety for both patients and staff. One of the key milestones which the IRSO and DS staff have completed is to standardize radiation doses associated with the Computed Tomography (CT) protocols executed on scanners at Hamilton Health Sciences (HHS) and St Joseph s Hospital Hamilton (SJHH). Over the past twelve months an exhaustive review of common protocols such as a routine head, chest, and abdomen pelvis scans has resulted in consistent doses being received by patients regardless if they were scanned on GE scanners at JHCC and St Joes or Toshiba scanners at the MUMC and HGH sites. Patient doses for complex interventional radiology (IR) procedures were also reviewed for the busiest IR department in the city- JHCC. The most complex procedures which may require fluoroscopy guidance exceeding more than an hour now impart a dose burden to the patient which is up to 50% less in many cases. A review of pediatric doses at MUMC was undertaken which resulted in a 20% decrease in overall radiation dose by implementing weight based protocols Continued on page 2 I NSIDE THI S E DI TION Educational News 3 Rounds Calendar 4 CME Events 5 Congratulations Dr. Melanie Ferri Research Corner 7 THE LAST PAGE 8 6

Continued from page 1 Staff radiation safety has been positively impacted by efforts to provide ongoing education focused on steps to reduce occupational radiation exposure by using safe practice

An e-learning module focusing on radiation safety in the clinical setting has been developed and is now published in the Learning Studio catalogue.

2 Continued from page 1 Staff radiation safety has been positively impacted by efforts to provide ongoing education focused on steps to reduce occupational radiation exposure by using safe practice habits. Radiation Safety in-person education sessions continue to be provided to various departments and services. IRSO has also participated in the Annual Review Days at JHCC, MUMC and HGH. An e-learning module focusing on radiation safety in the clinical setting has been developed and is now published in the Learning Studio catalogue. This module is being assigned to all staff who are designated x-ray workers and is mandatory to be completed on an annual basis. IRSO has implemented a dosimeter alert system that is unique in the province. This alert system involves an automatic notification sent by our dosimetry supplier for any radiation badge readings exceeding set thresholds. High readings are followed by a review and audit of the staff's work environment to assess radiation practice habits and provide a solution for occupational dose reduction. A new Apron Tracking system to be rolled out shortly will allow a robust way of ensuring that the regulatory requirements around quality control for lead garments are adhered to. i.e. it will ensure the lead garment is inspected frequently to assess the integrity and ensure the garment is protecting the wearer. The IRSO continues to monitor, audit and develop creative and innovation solutions to Radiation Safety to ensure both patients and staff are well protected. Please continue to provide them with your support so we can achieve a safe and effective work environment. Shairoz Kherani, MBA; CPA, CMA; MRT(NM); MSc(HQ) candidate Interim Director, Diagnostic Services & Site Manager, DI, MUMC DON T FORGET!! Daylight Savings Time ends Sunday, November 1 st, 2015 at 2 a.m. With each time change, it is an ideal time to test the smoke alarms in your home and change the batteries, if more than one year old. 2 2 M E D I C A L I M A G I N G B U L L E T I N

EDUCATIONAL NEWS VISITING PROFESSOR SERIES - 2015/16 SCHEDULE Dr.

3 EDUCATIONAL NEWS VISITING PROFESSOR SERIES /16 SCHEDULE Dr. Michael Laniado, Professor and Chairman University Hospital Dresden at the Technical University Dresden Institute and Department of Diagnostic Radiology, Dresden, Germany Tuesday, Oct 6 th, :00 p.m. Incidental Findings in Abdominal Imaging How to Deal with this Increasing Phenomenon? Wednesday, October 7 th, :30 a.m. - Imaging of Postoperative Complications How Accurate is CT? 12:00 p.m. The Role of PET-CT in Urogenital Tumours St. Joseph s Healthcare Hamilton CAMPBELL Auditorium Level 2 Room T2202, Juravinski Tower Tuesday November 3 rd and Wednesday November 4 th Dr. Ania Kielar Emergency Radiology Tuesday January 12 th and Wednesday January 13 th, 2016 Dr. Anne M Covey Interventional Radiology Tuesday February 2 nd and Wednesday February 3 rd Dr. Zoran Rumboldt Neuro/Head and Neck Tuesday March 1 st and Wednesday March 2 nd Dr. Vincent Mellnick Abdomen/Pelvis Tuesday April 5 th and Wednesday April 6 th Dr. Costantine Raptis Thoracic Tuesday May 3 rd and Wednesday May 4 th Annual W Peter Cockshott Lecture Dr. Zehava Rosenberg - MSK EMERGENCY RADIOLOGY GRAND ROUNDS - Dr. Ania Kielar Tuesday, November 3 rd - 6 pm - Complications after bariatric surgery Wednesday, November 4 th - 7:30 am - MRI of acutely ill pregnant patients 12 noon - Abdominal errors in the ER: a Canadian perspective St. Joseph s Healthcare Hamilton - Campbell Auditorium See page 4 to view last months Visiting Professor photo and visit our Visiting Professor Program web page to view all of Visiting Professor group photos with our Radiology Residents at: M E D I C A L I M A G I N G B U L L E T I N

4 4 4 M E D I C A L I M A G I N G B U L L E T I N

Welcome to RSNA 2015 Meeting Central This is your destination to register, browse courses and

org/exhibitor list, discover courses, and view the Virtual org/ Pitfalls in Imaging of Bowel and

Patlas, MD, FRCPC, Ania Kielar, MD, FRCPC For additional information go to: http://www.

5 Welcome to RSNA 2015 Meeting Central This is your destination to register, browse courses and events, build your agenda, explore the exhibitor list, discover courses, and view the Virtual Meeting program. Go to: list, discover courses, and view the Virtual Meeting program. Go to: Pitfalls in Imaging of Bowel and Mesenteric Injury on Tuesday, March 15, 2016 from 9:15 AM to 9:50 AM. Michael N. Patlas, MD, FRCPC, Ania Kielar, MD, FRCPC For additional information go to: Annual Meeting April 17 22, 2016 Los Angeles, CA CT of Appendicitis Dr. Michael N. Patlas, MD, FRCPC M E D I C A L I M A G I N G B U L L E T I N

Ferri has accepted the role of Director of the MCQ component of the exam, beginning in June 2016. The Residents with Dr.

6 The Royal College of Physicians and Surgeons examination in Diagnostic Radiology is composed of 3 components: oral, OSCE and MCQ, all of which take place annually each June. Dr. Ferri has accepted the role of Director of the MCQ component of the exam, beginning in June The Residents with Dr. Shorvan, Dr. Allan and Dr. Sommers at the September Visiting Professor Rounds. View all of the Visiting Professor group photos at: M E D I C A L I M A G I N G B U L L E T I N

RESEARCH CORNER Do You Need Help???? Are you struggling to get your literature search done? Do you need help completing your IRB application? Can t find time to collect all the data you need?

Undergraduate students are a great asset to research projects and are often willing to help on the tasks that you may not have time to complete.

7 RESEARCH CORNER Do You Need Help???? Are you struggling to get your literature search done? Do you need help completing your IRB application? Can t find time to collect all the data you need? Does your data need organizing before it can be analyzed? Students, in particular medical students, who are looking for a research project to volunteer their time with, frequently contact me. Undergraduate students are a great asset to research projects and are often willing to help on the tasks that you may not have time to complete. These students are able to assist with items such as detailed literature searches, data collection and organization, and questionnaire design. In return, there are numerous benefits for students who get involved in research as it allows them to better understand published works, learn to balance collaborative and individual work, and determine an area of interest. When starting your research project, consider how you may use this resource to assist you. If you would like to know more about how you can team up with a student, please contact Jane Castelli, MIIRC@M Project Manager, at jane.castelli@miircam.ca. 7 7 M E D I C A L I M A G I N G B U L L E T I N

THE BACK PAGE OCTOBER 12 SWEET POTATOES Sweet potatoes, available in supermarkets year round, are nutritional powerhouses.

The beta-carotene found in sweet potatoes is thought to have strong antioxidant powers that help the body fight disease.

For a new twist on pancakes, try adding ½ cup of pureed sweet potatoes, ¾ cup of apple juice and 1 teaspoon of pumpkin spice to ¾ cup of multi-grain pancake mix.

Thinly slice 1 large sweet potato and arrange on a baking sheet. Brush with 2 tablespoons of vegetable oil and sprinkle with salt to taste.

For a tropical twist, slice a sweet potato into 8 spears and grill, cut-side down, on a lightly-oiled grill rack (use your outdoor grill or a grill pan on the stovetop).

Arrange the grilled sweet potatoes on a platter, sprinkle with the juice of half a lime, a few tablespoons of chopped cilantro and salt and pepper to taste.

8 THE BACK PAGE OCTOBER 12 SWEET POTATOES Sweet potatoes, available in supermarkets year round, are nutritional powerhouses. They are an excellent source of vitamins A and C, and a good source of potassium and fiber. The beta-carotene found in sweet potatoes is thought to have strong antioxidant powers that help the body fight disease. Sweet potatoes are filling yet fat free, cholesterol free and very low in calories. How to Use Sweet Potatoes Sweet potatoes make a delicious, healthy breakfast. For a new twist on pancakes, try adding ½ cup of pureed sweet potatoes, ¾ cup of apple juice and 1 teaspoon of pumpkin spice to ¾ cup of multi-grain pancake mix. Then cook pancakes as usual. They taste great topped with pumpkin butter. O C T O B E R 31 In the mood for a good-for-you snack food? Bake your own sweet potato chips. Thinly slice 1 large sweet potato and arrange on a baking sheet. Brush with 2 tablespoons of vegetable oil and sprinkle with salt to taste. Bake at 400 F for about 15 minutes or until slightly brown. For a tropical twist, slice a sweet potato into 8 spears and grill, cut-side down, on a lightly-oiled grill rack (use your outdoor grill or a grill pan on the stovetop). Cook for about 8 minutes, or until grill marks are visible and the potatoes are cooked through (check with a sharp knife for doneness). Arrange the grilled sweet potatoes on a platter, sprinkle with the juice of half a lime, a few tablespoons of chopped cilantro and salt and pepper to taste. Substitute sweet potatoes for regular spuds in your favourite mashed potato recipe for a burst of colour, sweetness and added nutrients. Place in a serving bowl and sprinkle with cinnamon and nutmeg before serving. Optional: Top with a dollop of fat-free yogurt or drizzle with a tablespoon of maple syrup. UPCOMING DATES OF INTEREST Oct 3, 2015 OAR CME Emergency Radiology Oct 6-7, 2015 Visiting Professor Dr. Michael Laniado Liver Pancreas Nov 3-4 Visiting Professor Dr. Ania Kielar Emergency Submissions to: Marguerite Jackson McMaster Site, HSC - Room 4N-49 jacksonmar@hhsc.ca 8 8 M E D I C A L I M A G I N G B U L L E T I N

University of Pennsylvania Environmental Health and Radiation Safety. Diagnostic Energized Equipment Radiation Safety Manual

University of Pennsylvania Environmental Health and Radiation Safety Diagnostic Energized Equipment Radiation Safety Manual (Reviewed: September 2012) I. Proper Operating Procedures A. Radiographic Units