Radiology

The Department of Radiology of the First Affiliated Hospital of Dalian Medical University was founded in 1948. It has continued to expand with the rapid development of modern medicine, computers, imaging technology and other fields, and comprises three divisions: radiological diagnosis, interventional therapy, and cardiovascular imaging examinations. The divisions have clearly defined responsibilities while collaborating and supporting one another. Today, the department has become an important clinical basic department representing the hospital’s level and standard of medical care. It is recognized as the Liaoning Provincial Key Clinical Specialty, Dalian Key Discipline, Key Discipline of Dalian Medical University, Dalian Radiological Diagnosis Quality Control Center, Dalian Interventional Therapy Quality Control Center, Promotion and Training Base for Interventional Therapy of the Chinese Medical Association, Peripheral Vascular Interventional Diagnosis and Treatment Training Base of the National Health and Family Planning Commission, China Diabetic Foot Cell and Interventional Therapy Technology Alliance, and a member institution of the Asian Society of Cardiovascular Imaging.

(1) Department equipment During the 13th Five-Year Plan period, the hospital successively invested nearly RMB 100 million in the department’s infrastructure and in introducing and updating equipment, including 3.0 T MRI and high-end MSCT systems, such as spectral CT, Force dual-source CT and Revolution CT. As a result, the level of our department’s imaging equipment has remained at the forefront in China.

(2) Department personnel structure This discipline has a strong, highly qualified medical and technical team, consisting mainly of doctors with doctoral and master’s degrees and with a rational staffing echelon. There are currently 38 established radiological diagnosis physicians, with an average age of 39 years; 7 are professors and 13 are associate professors, and the proportion holding senior professional titles is 52.6%. Among them are 2 doctoral supervisors and 6 master’s supervisors. The educational structure is rational, with postgraduate degrees accounting for 95%; there are 8 doctors with doctoral degrees and 28 with master’s degrees. Interventional therapy physicians: there are currently 16 physicians, with an average age of 36 years, including 2 professors, 5 associate professors, 3 attending physicians and 6 physicians; all hold at least a master’s degree. The imaging technology group has 48 members, including 8 with associate-senior or higher professional titles (17%) and 4 with master’s degrees; the average age is 40 years, 10.4% of those with senior professional titles are under 50 years old, and there are 3 master’s supervisors. The radiological diagnosis nursing team has 15 members, including 14 charge nurses; the interventional ward nursing team has 18 members, including 1 associate chief nurse, 5 charge nurses and 12 nurses.

According to the needs of medical services and disciplinary development, the Department of Radiology is divided into 7 subspecialty directions: the Abdominal Imaging Group, Neuro–Head and Neck Imaging Group, Cardiothoracic (Breast) Imaging Group, Musculoskeletal Imaging Group, Imaging Technology Group, Big Data and Intelligent Development Group, and Interventional Therapy Group (neurointervention, peripheral vascular intervention and tumor intervention). Each subspecialty group has its own academic leader and personnel echelon. All subspecialty leaders are key professionals in their fields. Twelve department members serve as deputy chairpersons, standing committee members or committee members of national and provincial professional societies and study groups, and the department has a certain influence in national academic circles. Each group has 3–5 junior- or mid-career physicians or technologists responsible for specific medical work and implementation of research projects. Every subspecialty has a clearly defined and relatively stable research direction and follows the cutting-edge academic developments in its field.

(3) Clinical work and development of new technologies The department undertakes a heavy workload of imaging examinations and diagnoses every year, completing more than 600,000 examinations annually on average. To ensure that patients receive diagnosis and treatment as soon as possible and to shorten the average length of hospital stay, all radiology staff work without distinction between holidays and weekends. Overtime, flexible working arrangements and additional posts are adopted at all positions to ensure maximum utilization of the equipment. MR has shown the most obvious growth; regular overtime is worked on Saturdays and flexible overtime on Sundays. The enormous workload created for signing professors by the increasing number of CT and MR reports has placed considerable pressure on them. The department has adjusted the division of work among signing physicians to relieve, as far as possible, the per-professor signing burden and accelerate report issuance.

Relying on advanced equipment and a strong staff, the department took the lead in developing many imaging diagnostic technologies that were at the forefront in China, with significant results that were subsequently introduced into clinical practice. It has been at the forefront in China in research on small lung cancer, small liver cancer, brain functional imaging, pulmonary embolism and CT angiography, and has received the second- and third-class Science and Technology Progress Awards of the Liaoning Provincial Government and the Science and Technology Progress Award of the Provincial Education Commission. In recent years, it has achieved notable results in dual-energy CT spectral imaging, MR functional imaging, and localization of pulmonary micronodule biopsy, among other areas:

① Dual-energy CT spectral imaging technology: Since the introduction of a high-end gemstone spectral CT in 2011, the department has actively conducted related clinical and research work and filled several research gaps in this field. It published the world’s first Atlas of Clinical Applications of Spectral CT and received the Inaugural People’s Liberation Army Book Design Award and the 2015 First Prize for Scientific Works of Dalian. Related research was funded by the National Natural Science Foundation of China; the research results received the Inaugural Liaoning Medical Award (Clinical Application Award) in 2015 and the Third Dalian Science and Technology Progress Award in 2016. More than 50 papers related to spectral CT have been published in Chinese core journals, and 7 articles have been indexed by SCI. Since 2012, several abstracts related to spectral CT from the department have been accepted by the Annual Meeting of the Radiological Society of North America (RSNA) each year; the number accepted ranked among China’s first-class teams for four consecutive years. Relying on spectral CT technology, the department has trained 21 master’s postgraduate students, including international students, and has successfully held for four consecutive years the only continuing education course in China centered on spectral CT imaging technology. In recognition of its outstanding achievements in the clinical application of spectral CT, the department was awarded the Asia-Pacific Gemstone Spectral CT Clinical Training Base and the High-End Revolution CT Global Clinical and Research Base. It has made an indelible contribution to the clinical promotion of CT dual-energy imaging technology, its broad acceptance and recognition by specialists and peers, and the incorporation of CT dual-energy imaging technology into professional textbooks.

② Clinical application of new MR technologies: The department has consistently remained at an advanced level in China. The clinical application of research software ranging from MR structural and functional imaging, including brain functional imaging, MRS, PWI, DWI, DTI, DKI and SWI, to non-contrast MRA, including cerebral, renal artery and portal vein angiography, has achieved excellent results. In parallel with domestic and international developments, it has conducted quantitative MRI assessment of brain iron content, which received the Third Dalian Science and Technology Progress Award in 2017, as well as cardiac MR examinations, contrast-enhanced MRI of the inner ear, and precise quantitative MR research on tumors. Trans-tympanic puncture MR Gd-DTPA imaging of the membranous labyrinth of the inner ear received the hospital’s Second Prize for Clinical New Technology Application in 2015, in cooperation with the Department of Otorhinolaryngology, and has now become a routine diagnostic and treatment item for otorhinolaryngology specialists at our hospital. (2) CT and MR imaging of pulsatile tinnitus provided definitive evidence for detecting the causes of clinical pulsatile tinnitus and can effectively guide treatment; it received the hospital’s Third Prize for New Technology in 2016.

③ Preoperative lesion localization and needle biopsy for lung nodules before CT thoracoscopic surgery: This has been an important new technology developed by our department over the past 3 years, with nearly 300 procedures completed annually. The Clinical Application of CT-Guided Hooked-Wire Navigation for Focal Ground-Glass Opacity (fGGO) Nodules in the Lung, conducted in cooperation with the Department of Thoracic Surgery, received the hospital’s First Prize for New Technology in 2012.

④ Cardiovascular imaging diagnosis (MRI): The department was also among the earlier institutions in China to use new MRI technologies to assess myocardial structure and function, focusing mainly on ischemic cardiomyopathy, hypertrophic cardiomyopathy and drug-induced myocardial toxicity. CT coronary angiography technology received one Second Prize for Science and Technology Progress from the Ministry of Health, and the department undertook 4 projects of the Liaoning Provincial and Dalian Municipal Science and Technology Commissions. At the same time, it trained several hundred medical imaging professionals from hundreds of hospitals across China in CT coronary angiography technology.

⑤ Early diagnosis and comprehensive treatment follow-up of breast cancer: Through the breast subspecialty’s combined use of palpation, breast ultrasonography, mammography and breast MRI, large numbers of early cancers without clinical symptoms or with atypical clinical symptoms can be detected. Diagnosis can then be made promptly through localization, biopsy and other methods. Individualized treatment plans are developed according to the patient’s condition, and imaging-based follow-up is conducted regularly after treatment in accordance with guidelines. This has greatly improved therapeutic efficacy and survival rates and reached an advanced level in China.

⑥ Interventional therapy: The department began interventional therapy in the early 1990s and has treated more than 10,000 patients. It has 40 beds and two treatment groups and has developed a pattern in which interventional treatment of neurological, tumor, vascular and nonvascular diseases advances concurrently. The department undertakes more than 50% of the interventional procedures in southern Liaoning. Treatment of cerebrovascular diseases has formed a distinctive professional strength and ranks first in Northeast China in both the number and quality of procedures. While completing clinical work, the department emphasizes personnel training and academic exchange, and has held several influential national academic conferences and national continuing medical education programs. It actively conducts research and has undertaken numerous projects, including key research projects of the Ninth, Tenth and Eleventh Five-Year Plans. It has received 1 Second Prize from the Chinese Medical Association, 1 Second Prize and 1 Third Prize for Science and Technology Progress from the Liaoning Provincial Government, and 4 Dalian Medical New Technology Awards.

(4) Scientific research and achievements The department attaches importance to discipline development and sustained growth, as well as to research and its clinical translation. Over the past 10 years, department staff have led or participated in the completion of 47 research projects at various levels, including 8 projects funded by the National Natural Science Foundation of China. It has received 1 Second Prize from the Chinese Medical Association and 8 provincial- and municipal-level Science and Technology Progress Awards. In addition, 21 municipal-level new technology projects were approved, 8 of which received awards. More than 400 papers have been published in domestic professional academic journals such as the Chinese Journal of Radiology, including 52 SCI papers for which a department member was first or corresponding author. Department members have served as chief editor or contributing editor for 7 medical imaging textbooks and more than 20 medical academic works. The department has successfully hosted various forms of international and domestic academic conferences and continuing education courses on many occasions, including 9 national conferences and continuing education courses and 8 provincial conferences and continuing education courses. To train young physicians, the department has sent physicians abroad for further study every year in recent years; 10 have now completed or are currently undertaking overseas training. The department also encourages young physicians to attend important professional academic conferences in China and abroad, including the RSNA Annual Meeting, the Annual Meeting of the International Society for Magnetic Resonance in Medicine (ISMRM), and the annual meeting of the Radiology Branch of the Chinese Medical Association. Since 2012, the department’s annual numbers of submissions to and accepted papers by RSNA have ranked among the leading institutions in China. Approximately 40 person-times attend international and domestic academic conferences or continuing education programs each year.

(5) Standardized training of residents In 2009, the Department of Radiology passed the review of the subspecialty of the specialist physician training base. Resident standardized training in radiology follows national requirements, strictly complies with all hospital resident-management systems, and has gradually developed a management system and model with its own characteristics, together with a relatively complete training plan and standardized rotation and assessment programs. The department has established a resident standardized-training leading group, with the director of the Radiology Teaching and Research Section as the overall person in charge and the heads of the three-level disciplines as responsible persons; the training secretary is responsible for the daily work of residents in training. Physicians at or above the attending level are assigned as supervising teachers for residents in training, with each teacher supervising 1 resident. This ensures that residents in training master basic clinical skills and the diagnosis and management of common diseases seen in radiology outpatient and emergency services, develop a certain capacity for clinical research, clinical communication and research collaboration, can read professional literature in foreign languages, and can undertake teaching duties for undergraduate practical training.

Radiology residents in standardized training must rotate regularly through each subspecialty group, master imaging examination standards for common diseases, and complete a specified workload of medical tasks, including preliminary reports for general radiography, CT and MRI. Assessment includes a standardized end-of-rotation examination: a skills assessment (50 points), a theoretical examination (30 points), and an assessment of daily performance (20 points), including attendance, work attitude and workload. Regular basic professional knowledge lectures, report-writing standards for each system and case-analysis sessions are arranged for residents in training, as are Thursday lectures on transcribing and reading English literature, Monday postgraduate case follow-up and English mini-lectures by physicians of our hospital, Wednesday-noon analysis of misdiagnosed cases, follow-up and discussion of cases consulted at the morning meeting, and training and assessment in CT shadowing, among other activities. At present, several residents in training have published research papers before graduation; the highest number is 16 papers over the past 3 years. Over the past 3 years, the radiology training base has recruited and trained 39 residents, with a 100% graduation qualification rate. Graduates have become the mainstay in major hospitals throughout China and have won unanimous praise from employers for their strong clinical practical abilities.

(6) Teaching The Radiology Teaching and Research Section undertakes teaching tasks for five levels and more than 10 courses across the university, with an average of more than 1,500 teaching hours per year. The section attaches great importance to reviewing its teaching work and encourages teachers to apply for teaching projects, summarize teaching achievements, write teaching papers and compete for teaching awards. Over the past 5 years, the section has led 5 university-level or higher teaching projects and received 2 provincial teaching awards; 2 people received the hospital-level title of Teaching Master; 2 people participated in hospital- or university-level teaching competitions and received awards; and 1 person was named Chief Clinical Skills Training Teacher.

Over the past 10 years, the department has trained nearly 100 postgraduate students, including more than 10 international students. During their studies or after graduation, radiology postgraduates published more than 100 papers, including more than 10 SCI papers. One outstanding master’s student has been trained. Twelve postgraduate students were selected by the department to attend international academic conferences for exchange and give conference presentations.

Future development goals: The Department of Radiology will continue to focus on major national needs, remain grounded in the forefront of the discipline, and follow the standards of internationally outstanding research hospitals. With difficult, critical and severe diseases as its focus, it will actively develop and apply advanced imaging technologies from China and abroad to provide patients with convenient, precise, intelligent and efficient imaging diagnosis and treatment services; conduct high-level medical research; improve subspecialty development; and create a first-class domestic and internationally renowned team for radiological diagnosis and interventional therapy. It will uphold modern medical management concepts, attach importance to resident training, and build an imaging technology center with excellent management and continuous innovation; expand high-level digital imaging medicine; create a convenient and efficient teleconsultation platform; establish an imaging specialty alliance; and create a medical imaging specialty renowned throughout China.