Biography:

In the past E. Stephen Amis has collaborated on articles with Bruce J. Hillman and Evan G. Stein. One of their most recent publications is Original articlesThe future of imaging screening: Proceedings of the Fourth Annual ACR FORUM. Which was published in journal Journal of the American College of Radiology.

More information about E. Stephen Amis research including statistics on their citations can be found on their Copernicus Academic profile page.

E. Stephen Amis's Articles: (5)

Original articlesThe future of imaging screening: Proceedings of the Fourth Annual ACR FORUM

The FORUM is an ACR planning activity focused on a specific topic deemed to be of long-range importance to the college. A select panel of multidisciplinary experts met in 2004 to consider the ramifications of imaging screening from diverse perspectives. Considerations included the nature of screening for disease, its technological issues, and biases associated with the perceived success of screening; potential technologies and target diseases; business and economics; insurance coverage; ethics and the law; how imaging screening could be paired with nonimaging screening; and how the lay public perceives screening. The FORUM participants considered how imaging screening might develop over the next 5 to 10 years and made recommendations to the ACR on actions it might take to benefit both the specialty and patients.

Original articleImprovement in Radiology Education: Joint Efforts of the American Board of Radiology and the Diagnostic Radiology Residency Review Committee

The ABR and the Radiology Residency Review Committee have focused their joint efforts in the past three years to improve radiology education. The new structure and timing of the ABR certifying exams and proposed new training program requirement to support them exemplity the efforts to ensure that training relevant to the imaging needs of an increasingly subspecialized medical environment.

Original articleRadiation Exposure From Medical Imaging in Patients With Chronic and Recurrent Conditions

PurposeAdvances in medical imaging have been associated with increased utilization and increased radiation exposure, especially for patients with chronic and recurrent conditions. The authors estimated the cumulative radiation doses from medical imaging for specific cohorts with chronic and recurrent conditions.MethodsAll patients diagnosed with hydrocephalus (n = 1,711), pulmonary thromboembolic disease (n = 3,220), renal colic (n = 5,855), and cardiac disease (n = 11,072) from January 1, 2000, to December 31, 2005, were retrospectively identified. Each imaging examination that used ionizing radiation from 2000 to 2008 was incorporated into an estimate of total effective dose and organ-specific doses. Patients with high levels of radiation exposure after 3 years (total effective dose > 50 mSv; dose to the ocular lens > 150 mSv) were identified.ResultsThe mean estimated effective doses for the surviving diagnostic cohorts after 3 years were 12.3 mSv for patients with hydrocephalus, 21.7 mSv for those with pulmonary thromboembolic disease, 18.7 mSv for those with renal colic, and 14.0 mSv for those with cardiac disease. Among patients with hydrocephalus, 26.3% (339 of 1,291) had radiation doses > 150 mSv to the ocular lens within 3 years. In all cohorts, the proportion of patients with total effective doses > 50 mSv within 3 years was significantly higher for those diagnosed in 2004 and 2005 than for those diagnosed in 2000 and 2001.ConclusionPatients with hydrocephalus, pulmonary thromboembolic disease, renal colic, and cardiac disease received radiation exposures that may put them at increased risk for cancer. Moreover, the proportion who received estimated total effective doses > 50 mSv within 3 years was significantly higher for those diagnosed most recently. It is the responsibility of institutions and physicians to critically evaluate their infrastructures, diagnostic strategies, and imaging techniques for each individual patient, with an eye toward minimizing cumulative medical radiation exposure.

Original articleApplications of Justification and Optimization in Medical Imaging: Examples of Clinical Guidance for Computed Tomography Use in Emergency Medicine

Availability, reliability, and technical improvements have led to continued expansion of computed tomography (CT) imaging. During a CT scan, there is substantially more exposure to ionizing radiation than with conventional radiography. This has led to questions and critical conclusions about whether the continuous growth of CT scans should be subjected to review and potentially restraints or, at a minimum, closer investigation. This is particularly pertinent to populations in emergency departments, such as children and patients who receive repeated CT scans for benign diagnoses. During the last several decades, among national medical specialty organizations, the American College of Emergency Physicians and the American College of Radiology have each formed membership working groups to consider value, access, and expedience and to promote broad acceptance of CT protocols and procedures within their disciplines. Those efforts have had positive effects on the use criteria for CT by other physician groups, health insurance carriers, regulators, and legislators.

Original articleLeadershipEvaluating an Image Gently and Image Wisely Campaign in a Multihospital Health Care System

AbstractPurposeThe efficacy of an Image Gently®/Image Wisely® radiology departmental campaign consisting of the optimization of CT protocols to reduce dose while maintaining quality, and an educational effort to alter the ordering patterns of referring physicians at a multihospital academic center, was evaluated.MethodsThe numbers of CT, MR, and ultrasound studies performed at inpatient, outpatient, and emergency facilities in the hospital system before and after the initiation of the departmental campaign (2010) were obtained for a 10-year period (2004-2014) using a radiology information system. For the same time period, dose per scan (volumetric CT dose index) was obtained through the Dose Index Registry®/National Radiology Data Registry for frequently performed studies. Descriptive statistics were used to analyze temporal trends in radiation dose and utilization across differing age groups: <20, 20 to 39, and 40 to 59 years.ResultsThe radiology information system yielded 865,879 imaging examinations and 4,508,030 patients. Although patient and imaging volume grew annually over the study period (by 6.8% and 4.9%, respectively), CT utilization as a percentage of total imaging decreased, compensated for by an increase in ultrasound use. This was most marked in the youngest age group. MR use as a percentage of total imaging was unchanged. The median volumetric CT dose index for each study protocol was reduced or stabilized.ConclusionsThe campaign resulted in a reduction in CT utilization, a reduction in radiation dose per study, and a compensatory rise in ultrasound use. An interactive aggressive educational campaign directed toward referring providers combined with protocol dose reduction efforts can be successful in reducing patient exposure from medical radiation.

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