Dr. Bill W.

Practice Management
Imaging self-referral: An inside manifesto
My name is Bill W. Like the fellow in the AA meetings. I'm a radiologist, and I'm addicted to imaging self-referral. Maybe you know something about this, maybe you participate too, and maybe you don't care. But you should. For your wake-up call, I think it's time to share an inside view of a very ugly issue.
March 18, 2009
2009 03 18 16 29 16 358 Silouette 70
Page 1 of 1
Top Stories
Representative longitudinal chest CT images and five-year parametric response mapping (PRM), pulmonary vascular CT reconstructions, and hyperpolarized xenon-129 (Xe-129) ventilation MRI scans from survivors of nonsevere and severe COVID-19 pneumonia. (A–F) Images in a 68-year-old male survivor of nonsevere COVID-19 pneumonia, (G–L) 62-year-old male survivor of severe COVID-19 pneumonia, and (M–R) 55-year-old male survivor of severe COVID-19 pneumonia. For each participant, the first three columns show coronal chest CT images from the acute phase (A, G, M), two-year follow-up (B, H, N), and five-year follow-up (C, I, O) (left to right). The fourth column (D, J, P) shows a coronal PRM image for each participant at five-year follow-up derived from paired inspiratory and expiratory CT scans, showing the spatial distribution of lung functional categories. Green indicates normal lung tissue, yellow indicates functional small airway disease, and red indicates emphysema. The second-to-last column shows volume-rendered small pulmonary vessel visualization (red) at five-year follow-up per participant (E, K, Q). The column on the far right (F, L, R) shows a hyperpolarized Xe-129 MRI ventilation defect percentage (VDP) map at five-year follow-up per participant. Dark blue represents high Xe-129 signal intensity, corresponding to well-ventilated lung regions, whereas red represents no Xe-129 signal intensity, corresponding to ventilation defects. At five-year follow-up, the 68-year-old survivor of nonsevere COVID-19 pneumonia (top row) showed near-complete radiologic resolution, no respiratory symptoms, and preserved pulmonary function. In contrast, the 62-year-old survivor of severe COVID-19 pneumonia (middle row) showed persistent fibrotic linear opacities without respiratory symptoms and mildly reduced pulmonary function. The 55-year-old survivor of severe COVID-19 pneumonia (bottom row) showed persistent scattered fibrotic linear opacities and focal emphysematous changes in both lungs, with dyspnea and impaired gas exchange function. The VDP values obtained from F, L, and R were 7.7%, 7.1%, and 6.3%, respectively.
CT
What are the effects of COVID-19 pneumonia after 5 years?
After five years, residual lesions persisted in 35.6% of survivors (37 of 104).
Nuclear Medicine
Molecular Imaging
USC researchers develop “plug-and-play" platform for PET tracers
Representative MRI scans for which the independently assigned imaging-derived extranodal extension (iENE) grades differed among the readers. (A) Axial and sagittal images in a 56-year-old male patient with nasopharyngeal carcinoma and cervical nodal metastases. Readers 1 and 3 interpreted the finding as a metastatic lymph node invading the left sternocleidomastoid muscle (arrow) and assessed an iENE grade of 3, whereas reader 2 assigned a grade of 2. After joint review, the radiologists reached a consensus on the absence of definite sternocleidomastoid muscle invasion, and the final iENE grade was 2. (B) Axial and sagittal images in a 52-year-old male patient with nasopharyngeal carcinoma and cervical nodal metastases. Reader 1 interpreted the findings as a single enlarged metastatic lymph node and assessed an iENE grade of 1, whereas readers 2 and 3 interpreted them as two coalescent metastatic lymph nodes (arrows) and assessed a grade of 2. After joint review, the radiologists reached a consensus on the coalescence of the two metastatic lymph nodes, and the final iENE grade was 2.
MRI
Image-based grading system estimates nasopharyngeal carcinoma severity
Astro
ASTRO 2026
ASTRO 2026 to center on translating radiotherapy data into dialogue
Free webinar for radiology leaders
Sponsor Content
Free webinar for radiology leaders
More in Home
What are the effects of COVID-19 pneumonia after 5 years?
By Will Morton
After five years, residual lesions persisted in 35.6% of survivors (37 of 104).
September 24, 2026
Representative longitudinal chest CT images and five-year parametric response mapping (PRM), pulmonary vascular CT reconstructions, and hyperpolarized xenon-129 (Xe-129) ventilation MRI scans from survivors of nonsevere and severe COVID-19 pneumonia. (A–F) Images in a 68-year-old male survivor of nonsevere COVID-19 pneumonia, (G–L) 62-year-old male survivor of severe COVID-19 pneumonia, and (M–R) 55-year-old male survivor of severe COVID-19 pneumonia. For each participant, the first three columns show coronal chest CT images from the acute phase (A, G, M), two-year follow-up (B, H, N), and five-year follow-up (C, I, O) (left to right). The fourth column (D, J, P) shows a coronal PRM image for each participant at five-year follow-up derived from paired inspiratory and expiratory CT scans, showing the spatial distribution of lung functional categories. Green indicates normal lung tissue, yellow indicates functional small airway disease, and red indicates emphysema. The second-to-last column shows volume-rendered small pulmonary vessel visualization (red) at five-year follow-up per participant (E, K, Q). The column on the far right (F, L, R) shows a hyperpolarized Xe-129 MRI ventilation defect percentage (VDP) map at five-year follow-up per participant. Dark blue represents high Xe-129 signal intensity, corresponding to well-ventilated lung regions, whereas red represents no Xe-129 signal intensity, corresponding to ventilation defects. At five-year follow-up, the 68-year-old survivor of nonsevere COVID-19 pneumonia (top row) showed near-complete radiologic resolution, no respiratory symptoms, and preserved pulmonary function. In contrast, the 62-year-old survivor of severe COVID-19 pneumonia (middle row) showed persistent fibrotic linear opacities without respiratory symptoms and mildly reduced pulmonary function. The 55-year-old survivor of severe COVID-19 pneumonia (bottom row) showed persistent scattered fibrotic linear opacities and focal emphysematous changes in both lungs, with dyspnea and impaired gas exchange function. The VDP values obtained from F, L, and R were 7.7%, 7.1%, and 6.3%, respectively.
USC researchers develop “plug-and-play" platform for PET tracers
By Will Morton
Preliminary work suggests the approach can generate tracers targeting fibroblast activation protein.
September 24, 2026
Nuclear Medicine
Image-based grading system estimates nasopharyngeal carcinoma severity
By Amerigo Allegretto
The four-tier grading system showed excellent reliability and good prognostic value for patients with nasopharyngeal carcinoma.
September 23, 2026
Representative MRI scans for which the independently assigned imaging-derived extranodal extension (iENE) grades differed among the readers. (A) Axial and sagittal images in a 56-year-old male patient with nasopharyngeal carcinoma and cervical nodal metastases. Readers 1 and 3 interpreted the finding as a metastatic lymph node invading the left sternocleidomastoid muscle (arrow) and assessed an iENE grade of 3, whereas reader 2 assigned a grade of 2. After joint review, the radiologists reached a consensus on the absence of definite sternocleidomastoid muscle invasion, and the final iENE grade was 2. (B) Axial and sagittal images in a 52-year-old male patient with nasopharyngeal carcinoma and cervical nodal metastases. Reader 1 interpreted the findings as a single enlarged metastatic lymph node and assessed an iENE grade of 1, whereas readers 2 and 3 interpreted them as two coalescent metastatic lymph nodes (arrows) and assessed a grade of 2. After joint review, the radiologists reached a consensus on the coalescence of the two metastatic lymph nodes, and the final iENE grade was 2.
ASTRO 2026 to center on translating radiotherapy data into dialogue
By Will Morton
Radiopharmaceutical therapy will feature in a dedicated hands-on workshop alongside a roundtable.
September 23, 2026
Astro
PACS workstations add to power consumption in radiology departments
By Amerigo Allegretto
PACS workstations consume about 25 kW when active while also consuming power cumulatively in powered down states.
September 23, 2026
Radiologist Dictating (1)
X-rays reveal severe aortic calcification in dialysis patients
By Will Morton
The findings reinforce lateral lumbar radiography's potential as an accessible, low-cost tool for opportunistic cardiovascular risk stratification in dialysis care.
September 22, 2026
Lumbar Spine
Podcast: OSHA report reveals more about 2023 MRI accident
By Amerigo Allegretto
MRI experts dive into Cal/OSHA's report on a 2023 MRI accident in which a nurse was pinned between an ICU bed and an MRI scanner.
September 22, 2026
The Invisible Force Podcast Album Cover
Ex-NFL QB Matt Hasselback points brain imaging study
By Will Morton
The trial’s main goal it to establish methods for diagnosing chronic traumatic encephalopathy (CTE) in the living, rather that by postmortem exams.
September 21, 2026
Structural Mri
Telix inks deal to acquire ITM for $1.65B
By Erik L. Ridley
The deal would create a combined company with significant radioisotope manufacturing, distribution, and radiopharmaceutical development capabilities.
September 21, 2026
Isotopes1
Connectivity, wellness, education at center of SDMS annual meeting
By Amerigo Allegretto
Kevin Rooker outlines what attendees can expect at the 2026 SDMS annual meeting in Atlanta.
September 21, 2026
Georgia Atlanta Map Pin (1)
Better risk scoring could predict cirrhosis, HCC in patients with SLD
By Amerigo Allegretto
One proposed risk score, SAFE, showed modest benefit in patients with imaging-confirmed steatotic liver disease (SLD).
September 21, 2026
Liver Cancer 400
FES-PET guides second-line therapy decisions in breast cancer
By Will Morton
FES-PET/CT results led to therapeutic management changes in 37.8% of patients.
September 18, 2026
Breast Cancer
Page 1 of 251
Next Page