Imaging Informatics Fellowship Curriculum: a Survey to Identify Core Topics and Potential Inter-Program Areas of Collaboration.

New consumer technologies and interoperability standards have dated the first standardized curriculum for imaging informatics fellowships suggested by the Society for Computer Applications in Radiology (SCAR) in 2004 (Journal of digital imaging 17(4):244-248, 2004). Last year, analysis from this institution characterized current state fellowship graduation requirements and broad curriculum topics for the first time in over a decade (SIIM Strategic Plan 2017-2020). However, an updated "core" curriculum has not yet been developed. Using the recent current state analysis as a baseline, we aimed to perform a focused assessment and propose that this would work towards an updated consensus "core" curriculum as outlined by the Society for Imaging Informatics in Medicine (SIIM, previously SCAR) strategic plan. A secondary aim was to identify individual program strengths and weaknesses to foster inter-program collaboration. Using sub-topics from the National Imaging Informatics Curriculum (NIIC), a week-long introductory course for residents, we expanded the original 29 broad curriculum categories identified in last year's current state analysis into 114 sub-topics. We surveyed imaging informatics fellowship directors to identify sub-topic prioritization on a 5-item Likert scale, teaching methods for each sub-topic, cross-departmental partnerships, and individual program strengths and weaknesses. Only 8% of sub-topics (10/114) received a "definitely" rating with 100% agreement while the majority of sub-topics 77% (88/114) had mixed grading defined by two or fewer "definitely" ratings. These sub-topics mapped to only 4 of the original 29 broad fellowship curriculum categories including Standards, Programming/Development/Software, Infrastructure, and PACS/RIS/Reporting. Our plan is to use consensus topics to build a "core" informatics fellowship curriculum and initiate discussion surrounding mixed grading topics. Knowledge of individual program strengths and weaknesses can be used to foster inter-program collaboration.

A Survey of Imaging Informatics Fellowships and Their Curricula: Current State Assessment.

In a 2016 survey of imaging informatics ("II") fellowship graduates, the surveyed fellowship graduates expressed the "opinion that II fellowships needed further formalization and standardization" Liao et al. (J Digit Imaging, 2016). This, coupled with the fact that the original published "standardized" curriculum is about 15 years out of date in our rapidly changing systems, suggests an opportunity for curriculum improvement. Before agreeing on improved structural and content suggestions for fellowships, we completed a current-state assessment of how each fellowship organizes its education and what requirements each have for fellowship completion. In this work, we aimed to collect existing information about imaging informatics fellowship curricula by contacting institutions across the country. A survey was completed by phone with the fellowship directors of existing imaging informatics fellowships across the country. Additionally, we collected existing documentation that outlines the curricula currently in use at institutions. We reviewed both the interview responses and documentation to assess overlapping trends and institutional differences in curriculum structure and content. All fellowships had suggested reading lists, didactic lectures, and a required project for each fellow. There were required practicum activities or teaching experience each in two fellowships, and one fellowship had a mandatory certification requirement for graduation. Curriculum topics in Technical Informatics or Business and Management were covered by a majority of institutions, while Quality and Safety and Research topics had inconsistent coverage across fellowships. Our plan is to reengage II fellowship directors to develop a core curriculum, which is part of the Society of Imaging Informatics in Medicine strategic plan.

A Prototype Body-Mounted MRI-Compatible Robot for Needle Guidance in Shoulder Arthrography.

A novel compact and lightweight patient-mounted MRI-compatible robot has been designed for MRI image-guided interventions. This robot is intended to enable MRI-guided needle placement as done in shoulder arthrography. The robot could make needle placement more accurate and simplify the current workflow by converting the traditional two-stage arthrography procedure (fluoroscopy-guided needle insertion followed by a diagnostic MRI scan) to a one-stage procedure (streamlined workflow all in MRI suite). The robot has 4 degrees of freedom (DOF), two for orientation of the needle and two for needle positioning. The mechanical design was based on several criteria including rigidity, MRI compatibility, compact design, sterilizability, and adjustability. The proposed workflow is discussed and initial MRI compatibility experiments are presented. The results show that artifacts in the region of interest are minimal and that MRI images of the shoulder were not adversely affected by placing the robot on a human volunteer.

Inducible pRb2/p130 expression and growth-suppressive mechanisms: evidence of a pRb2/p130, p27Kip1, and cyclin E negative feedback regulatory loop.

The retinoblastoma family of proteins, pRb/p105, p107, and pRb2/ p130, cooperate to regulate cell cycle progression through the G1 phase of the cell cycle. Each of the family members realize their common goal of G1-S checkpoint regulation through overlapping and unique growth regulatory pathways. We took advantage of a tetracycline-regulated gene expression system to control the expression of RB2/p130 in JC virus-induced hamster brain tumor cells to study in vivo the molecular mechanisms used by pRb2/p130 to elicit its growth-suppressive function. We have previously used this system to demonstrate that induction of pRb/ p130 expression suppresses tumor growth in vivo by overcoming neoplastic transformation mediated by the large T-antigen oncoprotein of JCV (JCV TAg). Here we found that induction of pRb2/p130 in vivo specifically inhibits cyclin A- and cyclin E-associated kinase activity and by doing so induces p27Kip1 levels presumably by inhibiting p27Kip1-targeted proteolysis by cyclin E-Cdk2 phosphorylation of p27Kip1. RB2/p130 induction also decreased cyclin A and the transcription factor E2F-1 while increasing cyclin E at both the transcriptional and protein levels of expression. The growth inhibitory activity of pRb2/p130 also correlated with its E2F-binding capacity. Furthermore, p27Kip1 and pRb2/p130 were found to be targets of the JCV TAg oncoprotein and to interact in vivo with each other independently from the presence of TAg. Interestingly, pRb2/p130 expression negatively modulated the binding of p27Kip1 to JCV TAg. These data suggest that pRb2/p130 and p27Kip1 may cooperate in regulating cellular proliferation, and both may be involved in a negative feedback regulatory loop with cyclin E.