December 2011 - Department of Radiology

U N I V E R S I T Y O F W I S C O N S I N
D E P A R T M E N T O F R A D I O L O G Y
A B D O M I N A L I M A G I N G S E C T I O N
December 2011
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The Fellow Follow-up
Letter From the Editor
Myron Pozniak, MD
How time flies. I hope you're doing well in your practice and that you had time to enjoy this summer and
fall. Another fellow class has come and gone. This year’s group is settling in nicely. They are getting into procedures
and ablations in earnest. Please see the class bios on page four. They have been busy searching for practice
positions next year, but several are still not committed for next year. Perhaps you have an opening and it may be of
interest to them.
We have a new section head. As of July 1, I've stepped down and Louis Hinshaw has taken over. Louis has
trained with us throughout his residency and fellowship. He spent a brief time at the University of Colorado in Denver.
He brings a refreshing youthful ambition to the position. It is time for this crusty curmudgeon to step aside.
Our section has recently experienced some growth. Well, relatively speaking. We've had some additions to
our families. Jessica Robbins and Joe Tavano welcomed Quintin Vincent on November 7th and Lily Elise arrived
on May 15th to parents Pam and Nick Adams. Also, three of last year's fellow class had new additions to their families.
We have something new to announce. Madison as you know is noted for its cycling terrain. Just about every
weekend you can find a charity ride or a race. We’ve come up with a new concept in radiology meetings. Next August
we will host a Radiology / Cycling meeting. This conference will run for 2 1/2 days. Each morning will feature
a 20 to 30 mile supported ride, followed by presentations on the latest and greatest advances in imaging by our UW
faculty. The conference will then dovetail with the Dairyland Dare (Gran Fondo Wisconsin), a major cycling event
with distances to please or challenge all levels of riding skill. If you are a weekend or an avid cyclist, please mark
your calendar. If not, please let those in your practice or your imaging friends who you know are cyclists know
about this meeting. Help us spread the word. Stay tuned for details.
In this issue:
Who’s New at UW 2
Happy holidays and a prosperous new
year to all.
Sincerely,
Fellowship Program
Update
3
Current Fellows 4
Neuwave News 5-6
Myron Pozniak, MD,FACR
In the News 7
Accomplishments 8
www.radiology.wisc.edu

The Fellow Follow-up
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Who’s New at UW
There are babies everywhere in the
Abdominal Imaging Division! Here are
all 7 of the babies new to the division in
the last year. Coffee anyone?
Quintin
Introducing Quintin Vincent Tavano
November 5, 2011 ~ 7 lbs, 8 oz, 20.5 in
Congratulations Jessica Robbins and Joe Tavano
Bernard (Ben) Edward, Meg and
Sam Lubner
Pierce Lucas,
Shelby and
Bo Fishback
Samuel Thomas
Paul & Brooke Stanton
Lily Elise,
Pam & Nick Adams
Ainsley Elizabeth, Dec 6,
Allison Grayev and EJ Borman
Madeline, Cody and Heidi Boyce
www.radiology.wisc.edu

The Fellow Follow-up
Fellowship Program Update-2011
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Not too long ago, I was writing a Fellow Follow-Up piece discussing the transition of the abdominal
imaging fellowship from Fred to me. Now that I have a year under my belt, I am glad to report that the sky did
not fall and in fact, I think we had a great year. To repeat myself from last year,
“There is only one constant and that is change.” This year that change is that I am
also taking on the responsibility of being the Chief of Abdominal Imaging here at
the UW. Once again, I am lucky enough to follow in the footsteps of people who
created something great, but unlucky enough to be in the position where it is hard
to make many improvements. This division has thrived and continuously
improved under the direction of Fred and Myron and I just hope that I can maintain
the current trajectory.
This past year was a lot of fun and we had another talented and dedicated
group of fellows. Although most of our fellows stayed relatively close to home
this year and will presumably immediately improve the radiological care in the
state of Wisconsin (Paul Stanton, Lacrosse, WI; Nathan Zelinski, Marshfield, WI;
EJ Borman, Madison, WI), we did send one great addition to Kansas (Shelby
Fishback, KU) as well, so they owe us. They all performed in a superior manner
as fellows and I am sure that they will do so as radiologists as well. Congratulations.
This year is starting with a bang. We are once again lucky enough to have two of our exceptional
residents joining us (Meghan Hanson and Heather Webb), but in addition, we have managed to steal one and a
half of Michigan’s best residents (Julie Ruma and Shane Wells (MRI fellowship primarily)) and have additions
from Maine (Scott King) and St. Joe’s (Lucas Ludeman) as well. The talent is impressive and I look forward
to seeing them develop and excel over the year.
We are looking forward to another great year and hope this finds everyone healthy and well. Please
drop us a line and let us know how you are doing and if you are in the area, drop in for a visit.
-J. Louis Hinshaw
J. Louis Hinshaw, MD
P.S. We had another incredible “Fishing Meeting” last summer. For those of you who weren’t able to make it,
we had 70+ trophy fish caught, the best weather
you can possibly imagine in northern Canada,
lots of quality time together, and a great array
of lectures. Please try to join us in the summer
of 2013 for the next iteration…
2013 Fellow Recruitment
We currently have two
remaining fellowship
position for 2013. Please
send any interested
residents to our website.
2010-2011 Fellow Class
www.radiology.wisc.edu

The Fellow Follow-up
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Meet the 2011-2012 Fellows
Meghan Hanson, MD
Meghan Hanson was born and raised
in Sturgeon Bay, WI. She did her
undergrad and medical school at the
University of Wisconsin, followed by
internship and residency at UW Hospital
and Clinics. Her interests include
female pelvic imaging, ultrasound,
and ultrasound guided interventions.
She has done a fair bit of
research on extracolonic findings at CT colonography.
She currently lives in Stoughton with her husband, Ben,
and their small menagerie of 3 dogs and a cat, but will be
moving closer to home next summer when she joins
Green Bay Radiology.
Scott King, MD
Scott King joined the UW Abdominal
Imaging team from Maine
Medical Center in Portland, Maine,
where he completed his residency
training. Prior to residency, he attended
Medical School at the University
of Nevada. He is joined by his
wife, Sarah, and their two young
boys, Alex (3.5 yrs) and Ryan (11
months). He grew up in Kenai, Alaska, and is no stranger
to frigid winters, ice fishing, pond hockey and snow
blowers. In addition, Scott enjoys to fish, golf and is a
football fan. Scott is currently planning to work in private
practice either in the Upper Midwest or the West.
Ideally, his future practice would encompass diagnostic
CT, US, Body MRI, Virtual Colonoscopy and imageguided
procedures.
Luke Ludeman, MD
Lucas Ludeman originates from a
small town in southwestern Minnesota
(Tracy, MN). After completing his
undergraduate work at the University
of Minnesota, he attended medical
school in Milwaukee, WI at the Medical
College of Wisconsin. He then
completed residency at St. Joseph's
Hospital in Milwaukee, WI. He is pursuing a fellowship
in body imaging at UW Hospital to fulfill his interests in
body MRI and image guided interventions. His wife's
name is Laura and has two boys ages 5 and 2. After the
fellowship year, he will be practicing with St. Paul Radiology,
St. Paul, MN.
Julie Ruma, MD
Julie Ruma is originally from Omaha, Nebraska.
She made her first move to Wisconsin
for her undergraduate studies at the University
of Wisconsin-Milwaukee, where she
also played soccer. She headed back home
for medical school at the University of Nebraska
and then completed her residency at
the University of Michigan. She is excited
to be back in WI and reconnecting with
many old soccer friends. After fellowship, Julie will be moving
back to Michigan to join her fiance, Brian, who practices Emergency
Medicine in the greater Detroit area. She is open-minded
to both academics and private practice with an emphasis on advanced
abdominal CT and MRI imaging and cross-sectional
interventional procedures
Heather Webb, MD
Heather Webb is originally from Bremerton,
WA, a small town outside Seattle.
Following her undergraduate studies at
BYU, she attended Washington University
Medical School in St Louis. She completed
her radiology residency at the University
of Wisconsin in 2011. After this fellowship
year, she hopes to enter private practice,
preferably “somewhere out west.” She
enjoys hiking, biking, reading, and traveling, and has been
known to drag family members and friends to various exciting
and obscure locations around the world, often on short notice.
Shane Wells, MD
Shane Wells is originally from Huntington,
WV, the proud home of the Thundering
Herd of Marshall University. Prior to attending
medical school at Marshall University,
Shane completed undergraduate degrees in
both Nursing (’97) and Biology (’02) also at
Marshall. He practiced nursing, as a RN, for
7 years, primarily in the ICU. After medical
school, Shane completed residency training at the University of
Michigan where he served as chief resident from 2010-2011. He
and his family transitioned to Madison, WI for fellowship training
in MRI and abdominal imaging in 2011. Shane has practice
interests in advanced CT (CT colonography, CT enterography,
CT urography), MRI (hepatobiliary, pelvic) and cardiac
(Coronary CT, cardiac MRI) applications, in addition to a particular
interest in cross-sectional interventions. Outside of work,
Shane enjoys spending time with his wife, Lisa, and children,
Rian (7) and Luke (4) and playing sports, golf in particular.

Technological Advances—NeuWave Medical, Inc
.
NeuWave Medical, Inc. - A spin-off company from The
University of Wisconsin Abdominal Radiology written by Fred Lee
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In the mid-1990’s I became increasingly disillusioned with the radiofrequency ablation devices that were clinically
available. The ablation zones were too small, too unpredictable, and took too long to create. What really bothered
me however, was the hype that the companies put out on the street, and how poorly their marketing materials correlated
with the results. In 1997 I decided to do something about it, and along with an engineering PhD student (Dieter
Haemmerich, now at the Medical University of South Carolina), invented a multiple probe RF unit. The idea was that
the use of multiple RF probes would help create larger and more predictable ablation zones. Over the course of the
next several years, we (Chris Brace, Paul Laeseke, Lisa Sampson, and Dieter) refined the device, tested it, and eventually
it was licensed by a large medical device manufacturer, Covidien (Previously Tyco Healthcare, Boulder, CO). In
2004 the device was released as the Covidien Switching Controller (Catchy name, huh?) and has been in widespread
clinical use ever since. Despite the name, it is now the most widely used ablation device in the United States.
Unfortunately, my wife’s attempts at naming the machine (The Therminator, the DieLeeTer) were summarily rejected
by Covidien for some strange reason. Another trivia fact: Louis Hinshaw was the first person in the world to do a
clinical case with the unit when he was a fellow.
I wish that the moral of the story was that everyone lived happily ever after, but if any of you have had any
dealings with a large company, you know that this is rarely the case. Even though the device has been a huge commercial
hit, Covidien has not been an easy partner to deal with, and the University and the company are still at odds over
the business arrangements. Based on this, I decided that if I was ever involved with another significant invention, I
would start my own company to avoid being at the mercy of corporate America.
In 2001 I was at Dieter’s PhD thesis defense where he presented our multiple probe RF work. One of the other
committee members (an engineering professor, Dan van der Weide) started questioning Dieter about the use of RF
energy for this purpose: wouldn’t microwave work better? We were intrigued by this possibility, and after some discussion
of what it would take, Dan actually built a functioning MW ablation unit out of a microwave oven, WWII
spare parts, and a spinal needle. Lisa and I were recently recalling the first ablation that we actually made with this
unit: While she and I were cowering behind a wall, after some puzzled consultation Dan made the first ablation zone
by pushing the “popcorn” setting on the MW oven. Everything was going fine until the unit started to smoke and
eventually blew up in the middle of our lab. This incendiary start motivated us to write some grants to build a more
“stable” power supply and get some graduate student help (eventually Chris Brace and Paul Laeseke). Chris defended
his thesis in 2005, and is now an assistant professor
here in our department (as well as Medical Physics
and Engineering), and after Paul received his MD-
PhD he went on to a radiology residency at Stanford
University.
Within the next year, it became clear that
we had a best-in-class device on our hands, despite
the prototype nature of our system. Paul and Chris
had done a ton of development, inventing, and animal
studies to show the potential of the device, and
Dan and I realized that we were at an important
cross-roads: do we follow the earlier path of giving
the invention to the university to license to a commercial
partner like Covidien, or do we gut it out
and do it ourselves? After much soul searching, we
decided to form our own company, which Dan
named Micrablate, LLC.
Company Co-Founders Dan van der Weide and Fred T Lee, Jr. posing
with the Certus 140.
www.radiology.wisc.edu

NeuWave Medical, Inc continued
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The first couple of years of Micrablate were very humble, indeed. We started in a space owned
by another of Dan’s companies, and eventually moved into his basement lab. Our first employee was a
dynamite biomedical engineer from Minneapolis (Matt Thiel, brother of our ex-resident Jennifer Bergin).
Matt did everything from cleaning the toilets to tuning antennas, and somehow kept us moving forward
We eventually secured more federal grant funding, followed by venture capital funding from a local
company (Venture Investors), and attracted a world class CEO (Laura King) who used to run OEC for GE Medical.
An interesting fact about Laura is that in the 1990’s when she was in charge of GE mammography, she was the single
person responsible for moving mammography from analog to digital, a decision for which she took tremendous heat
from GE leaders. Guess who was right about that one? After the hiring of Laura, the company really started to take
off. We renamed the company NeuWave Medical, moved into a wonderful facility on the east side near the airport (now
15,000 sf), hired a great chief engineer (Rick Schefelker, also from GE Medical), a leading sales/commercial expert
(Ginger Sands from Ohmeda), and an operations leader who was responsible for building the E9 ultrasound unit while at
GE Medical (Eric Clyse). This team rapidly turned the early prototypes into the best ablation unit in the world (in my
humble but biased opinion). Prior to clinical release, Meg Lubner, Louis, Paul, Chris, Erica Knavel (Med student, soon
to be one of our radiology residents), Anita Andreano (a visiting resident from Italy) and Lisa did the original animal
testing of the unit, and presented the first results at various meetings in 2010.
The Certus MW ablation device was FDA approved in October 2010, and ready for clinical and commercial
launch in December 2010. Once again, Louis Hinshaw was the first person to perform a clinical case with the device,
and it went spectacularly. This September, Louis and Tim Ziemlewicz performed the first lung ablation case at UW
without a pneumothorax or other complication. Since that time, the leading ablation centers in the country have bought
the device, and it is now in use at UW, Sloane Kettering, the entire Mayo system
(Rochester, Jacksonville, Scottsdale), Duke, UTMB, University of Florida (Shands
Hospital), UCLA, Brown University, and Wayne State University (Karmanos Cancer
Center) among others. We have a number of enhancements and new devices (mostly
invented by Chris Brace) in the pipeline for introduction over the next several
years. The fellows that graduated in July 2011 all had the opportunity to use the device,
and they had the full effect of the before/after with the older RF devices. Our
ablation times now rarely exceed 5 minutes, and the number of probes that we use is
way down due to the high power available with the Certus.
Well, that’s the short history of NeuWave Medical. One thing that I am very
proud of is the large number of local jobs that NeuWave has brought to the Madison
area, how almost all the parts are built locally (everything is made in the USA) and
how we have pumped large amounts of money into the local economy. One failure: I
tried like crazy to get the Michigan fight song as the notification tone, but was shot
down by all of the highly biased Wisconsin types. What use is it in founding your
own company if you can’t even pick out the notification tone??
If any of you are interested in starting your own company, feel free to contact
me. It has been a tremendously rewarding experience, but it has taken years of sweat
equity, a lot of money, and more than a little good luck. If I’ve learned anything from
this experience, it’s been that getting the right people into the right spots is the most
important factor governing success. I’ve actually contributed little to what I hope
will eventually be a big success story, and if it hadn’t been for Dieter, Chris, Paul,
Lisa, Dan, Matt, Laura, Rick, Ginger, Louis, Meg, Tim, Marci, Jan, Erica, Anita, and
Eric we’d still be looking at a promising concept built from a microwave oven and
WWII surplus parts.
The Certus 140 was approved by the
FDA in October 2010.
www.radiology.wisc.edu

The Fellow Follow-up
Abdominal Imagers in the News by Katie Teresi
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Article recognized by both the HealthImaging.com and the Journal of the American College
of Radiology (JACR)!
UW’s Kristie Guite, M.D., J. Louis Hinshaw, M.D., Fred T. Lee, Jr, M.D., Frank Ranallo, Ph.D., and Mary
Lindstrom, Ph.D., authored the article, titled "Ionizing Radiation in Abdominal CT: Unindicated Multiphase
Scans Are an Important Source of Medically Unnecessary Exposure." The work discusses the commonality
of medically unnecessary multiphase CT exams and the potential of these exams to deliver excess radiation
exposure. This overexposure led the authors to call for an end to routine use of "one-size-fits-all" multiphase
protocols for abdominal and pelvis exams.
JACR originally published "Ionizing Radiation in the Abdominal CT" in its November issue, and named it
the best article published in the journal’s Clinical Practice category in the past year. HealthImaging.com
also featured the piece as one of its top stories.
Grants
We are excited to announce that a National Institutes of Health R01 grant proposal
prepared by UWSMPH Radiology's Drs. Perry Pickhardt and David Kim has been
awarded $965,137 over the next five years. The awarded project, titled "Comparative
Effectiveness of Virtual and Optical Colonoscopy for CRC Surveillance," impressively
scored within the 1st percentile. The grant is part of a multi-center trial which includes
the UWSMPH, Mayo Clinic Rochester, and Fox Chase Cancer Center.
Kristie Guite, MD
Dr. Pickhardt is serving as the UWSMPH principal investigator for the project while
the co-investigators include Dr. Kim and Dr. Sam Lubner from clinical oncology.
The Renal Transplant Research Group has been awarded their third NIH grant for $1,250,000. This
RO1 is titled "Role of Nox2 in CNI-induced renal fibrosis" and will investigate the roles of oxidative
stress, renal perfusion and oxygenation on the development of chronic renal disease in patients
with transplanted organs. Drs. Elizabeth Sadowski (Radiology), Sean Fain (Medical Physics) and
Aji Djamali (Nephrology) have collaborated on multiple projects over the past 10 years, receiving
nearly $5,000,000 in grant funding for their work.
Dr. Meghan Lubner has been selected as a recipient of the highly prestigious Association of University
Radiologists GE Radiology Research Academic Fellowship Award (GERRAF).
Each year, up to four GERRAF Fellows are selected based on their commitment to research careers,
the creativity and quality of their proposed research projects, and the support provided by their institutions.
The GERRAF Board of Review felt that Dr. Lubner's work, "Volumetric Tumor Measurement
for Assessing Treatment Response: Too Good to RECIST?" showed outstanding credentials in
all these areas. She was assisted by several talented mentors: Dr. Perry Pickhadt from Abdominal
Imaging, Dr. Beth Burnside of Breast Imaging, Dr. Daniel Sullivan of Duke University, and Vikas
Singh of the UW Biostatistics and Computer Sciences departments.
This highly sought-after award grants each recipient a two-year, $140,000 fellowship, paid directly to
the recipient's institution for salary, education, and research support. In the past, this money has
helped sponsor original clinical and health services research on decision analysis, health and
economic outcome methods, and technology assessment.
www.radiology.wisc.edu

The Fellow Follow-up
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Accomplishments
Dr. Sadowski Promotion
David Kim, MD qualified to compete in the
Boston Marathon in April 2013 by a solid finish in
the Milwaukee Lakefront Marathon.
With a time of 3:09:51, a 7:15 mile pace, Dr. Kim
placed 106th overall and 22nd in his division.
Jessica Robbins, MD On Monday, April 19th
just over twenty three thousand runners raced in the
114th Boston Marathon. Assistant Professor Jessica
Robbins, MD finished the race in only 3 hours and
27 minutes, beating her personal best by 10
minutes!
Do you have an accomplishment or news
item you would like to share with us and
other alums? Please email Myron Pozniak at
mpozniak@uwhealth.org.
We are pleased to announce the promotion of
Elizabeth Sadowski to Associate Professor. In
addition to her groundbreaking
research in
NSF and pelvic and renal
MRI, Dr. Sadowski
is highly involved in
resident education,
specifically in the area
of profession development
and mentorship.
She is the 2009 recipient
of the AAWR Professional
Leadership
Award and has been instrumental in receiving
substantial NIH funding for the renal research
transplant group at UW. Congratulations Liz!
2012 Conference Schedule
For additional information
and brochures
please visit our website
or contact Ann Schensky
at:
asensky@uwhealth.org
36th Annual Ski the
Sky
January 22-25, 2012
Big Sky, Montana
WOW-Cardiothoracic
Imaging
April 14, 2012
Madison, WI
www.radiology.wisc.edu