RSNA 2014: A Century in the Making

This year’s RSNA meeting—its 100^th—promises to be the can’t-miss radiology event of the year.

By C.A. Wolski

While always the anticipated culmination of the professional calendar year, RSNA 2014 is significant for another reason—it is the organization’s 100th meeting—a once in a career opportunity to not only see where the profession has been, but get a significant glimpse of where it is heading.

In addition to its hundreds of exhibits, the RSNA will afford attendees the opportunity to attend refresher courses, view poster sessions, and hear about the latest scientific advances. As it has since 1975, the RSNA’s 2014 session will command the 2.67-million-square-foot McCormick Place in downtown Chicago.

Among the highlights of this year’s meeting will be a look back at the RSNA’s humble beginnings.

Starting at the Beginning

And humble they were. Founded 20 years after Wilhelm Roentgen discovered the x-ray in 1895, the RSNA was originally known as the Western Roentgen Society when it was first established by five radiologists in the St Louis office of Miles B. Titterington, MD, in 1915. Titterington and his colleagues founded the Western Roentgen Society because it was difficult for them to travel to radiologic conferences, which were held primarily on the East Coast.

Just a few months later, from December 15 to December 16, 1915, the first gathering—an organizational meeting—was held at the Hotel Sherman in downtown Chicago. A total of 30 of the 62 founding members, representing 17 states, attended and the name Western Roentgen Society was officially adopted to differentiate it from the American Roentgen Ray Society. Fred S. O’Hara, MD, was chosen as the temporary chairman and Titterington was named secretary. These early meetings were focused on the array of research being done at the time.

The year 1919 was a seminal one for the RSNA and the annual meeting. To acknowledge the growing reach of its membership in Canada, the Western Roentgen Society was renamed the Radiological Society of North America or RSNA, and commercial technical exhibits were added both to display the latest advances in technology and to help support the Society’s operating budget; 19 companies took part in these first exhibits. Also in 1919, the first gold medal was bestowed on Hebar Robarts, MD, credited by his peers with “catching the vision of the science of radiology while it was in its infancy.” To date, 185 individuals, including Marie Curie, have received the gold medal.

In 1933, the Palmer House hosted the RSNA annual meeting for the first time and would remain its home for more than 40 years.

Leonard Berlin, MD, FACR, professor of radiology at Rush University and the University of Illinois, Chicago, remembers attending the RSNA for the first time at the Palmer House, beginning in the early 1960s. The era of the Palmer House was much different than the sprawling conference of today with its thousands of scientific sessions, hundreds of exhibits, and tens of thousands of attendees.

Berlin remembered that there was no exhibit floor. Instead, exhibits were housed in individual guest rooms with attendees going from room to room to see the more compact, portable equipment of that era. The technology was primarily fluoroscopy and x-ray. Nuclear imaging was represented, but was still in its infancy, and ultrasound was just coming out. As in the early days of the annual meetings, the Palmer House and early McCormick Place meetings of the 1960s, 1970s, and 1980s had no overarching theme—it was focused on general radiology, Berlin said—and it was comparatively small with only about 1,000 to 2,000 attendees.

Like today’s meetings, spotlighting new technology was a key aspect of the meetings. Technological innovations, such as CT scanning and interventional techniques among others, were highlighted during RSNA meetings, giving some attendees their first glimpse of technology that has helped radiology evolve over the decades.

“I remember when the CT came out from the EMI Corporation in the early 1970s, and walking the exhibit hall and everybody was looking at it and an older radiologist colleague was with me and I said, ‘Do you think this is ever going to amount to anything?’ He said: ‘It’ll never amount to anything.’ He was obviously wrong,” Berlin said.

If Berlin had to pick one of the seismic technological events of the past half-century that has impacted radiology today—apart from MRI and CT—it would have to be teleradiology.

“Teleradiology was the major revolution. It changed everything,” he said. “With teleradiology, there’s really no excuse not to have a radiological study interpreted by an expert.”

No matter the era, RSNA President N. Reed Dunnick, MD, the Fred Jenner Hodges Professor and chair of the Department of Radiology at the University of Michigan Health System in Ann Arbor, noted that there has been one constant for the RSNA and its annual meetings.

“The RSNA has always been innovative, not only in the ways it provides education, but also in its means of presenting educational opportunities, moving from entirely didactic learning to new interactive technologies such as Diagnosis Live and the Virtual Meeting, to name just a few,” noted Dunnick. “Other ways we have evolved include going from solicited presentations to proffered abstracts of scientific research; we have carefully developed an outstanding refresher course program, which has remained a priority; have grown from approximately 20 companies exhibiting their x-ray technology in the first 5 years to the current Technical Exhibit floor of hundreds of imaging equipment and technology companies; have seen a significant increase in international participation, in both attendance and providing content; and have attracted ever-increasing attention from news media worldwide.”

How to Plan, What to See

While this year’s meeting will be taking stock of the past by looking at radiology’s evolution, it will also remain very much on the cutting edge with more than 4,000 educational offerings, refresher courses covering the entire radiological gamut, poster sessions, special sessions on the evolution of radiology, and a mock trial covering one of the pressing issues in radiology practice today. The event’s catalog online is a testament to how far the RSNA Annual Meeting has come. Gone are the days of general radiology and the small collegial gathering.

Jonathan Berlin, MD, clinical professor of radiology at NorthShore University Health System, Evanston, Ill, who has been attending the RSNA for the past 15 years, said that, from his perspective, each year the meeting seems to be getting a more international flavor and becoming busier, which can leave both first-time attendees and even veteran meeting-goers with a sense of information overload.

“Attendees should set goals about what they want to do,” he said. “The conference is so big and so overwhelming it’s so easy to wander around and not get a lot accomplished. You should look through the schedule and choose the things you want to do and focus on doing those things, and once you do those things, you can wander around and stare at the wonderment of how big the conference is.”

Radiologist Sanjay Jain, MD, MBA, attended his first RSNA meeting in 1997 while he was a resident, and concurs with Jonathan Berlin that the experience was “overwhelming,” but added that it was “impressive” as well.

He also advises that attendees have a game plan in mind prior to attending. “If you want to get certain CMEs, you have to jump on those early because they fill up early,” he said. “There’s a lot of coordinating; you have to have it well planned out. I think there’s always room for review, so the refresher courses are always great. I did go to a few scientific sessions that were way over my head, but this is where the planning comes in, because if there’s something that’s scientific that sounds very interesting, it’s good to know that this could be coming down the pipeline. The scientific sessions help see a window into the future, such as amyloid imaging and molecular imaging.”

Whether you’re a first timer or have attended a dozen meetings, Dunnick had the same recommendation.

“I recommend that all attendees explore the program online before the meeting and build their schedule in ‘My Agenda,’ be sure to visit the technical exhibits, and enjoy the face-to-face contact only a world-renowned meeting like RSNA can provide,” he said.

Jain echoed Dunnick’s comment about the value of networking. “I think the greatest thing is interacting with people,” he said. “The biggest thing is networking, meeting vendors, meeting colleagues, there are residency reunions going on. The greatest joy I get is the networking with the people. The biggest loss is if you don’t network. You don’t want to go to the conference as a ghost.”

Both Dunnick and Berlin had a couple of specific recommendations for those still looking to finalize their RSNA schedules.

“There is so much for everyone at the RSNA meeting that the must-see sessions depend very much on an attendee’s focus; however, the Centennial Showcase will provide something for everyone, including ‘Cases of the Century,’ where attendees can lend a diagnosis to vintage images using the tools of the time,” Dunnick said. “Other Centennial Showcase highlights include areas devoted to RSNA milestones and defining principles, a collection of artistically rendered medical images, a virtual incarnation of Wilhelm Roentgen, and rare pieces of early radiology equipment.”

Berlin recommended a session that he is moderating, a hospital administrator seminar. “That’s a course where we have people talking about new payment systems and shifting from volume to adding value. It kind of mirrors where healthcare is going in general. I think that would be appropriate for anyone who has an interest in that topic. That includes administrators and doctors and technologists,” he said.

Finding the Radiology Continuum

While the practice of radiology is much different than it was in 1915, with new modalities (CT, MRI, nuclear medicine), practices (image-guided surgery and interventional radiology), and concerns (safety and liability), the RSNA annual meeting has provided both a direction and a sense of footing for the profession.

“The explosion of imaging technology in the latter half of the 20th century was remarkable,” Dunnick said. “One new priority is providing opportunities for radiologists to learn more about critical noninterpretive skills. Some of RSNA’s enduring priorities have centered on the importance of providing an exceptional educational experience, presenting cutting-edge scientific research, and providing an unrivaled venue for technical exhibitors.”

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C.A. Wolski is a contributing writer to Axis Imaging News.