December 11, 2023

Due to advances in radiology equipment and pediatric imaging protocols, effective Jan. 2, 2024, Texas Children’s will no longer require lead shielding for diagnostic X-ray exams.

“We’ve come so far in technology and our team has been so dedicated to ensuring the optimal radiation dose is used for pediatric images that lead shielding is no longer needed and, in fact, may be harmful,” said Dr. Jay Poston, radiation safety officer. “Health care is always evolving, and this is a great example of an advancement benefitting both the patients and the providers who treat them. This is step in the right direction.”

Removing lead shielding will help:

  • Remove the risk of lead interfering with X-ray equipment sensors.
  • Remove the risk of covering important anatomy that the physician needs to see.
  • Reduce repeat exams and unnecessary radiation doses.

Neither gonadal nor fetal shielding of pregnant patients is required for X-ray exams, starting Jan. 2. Studies have shown lead shielding provides no tangible benefits to patient safety other than easing anxiety about radiation.

The American Association of Physicists in Medicine (AAPM), the American College of Radiology (ACR), and the National Council on Radiation Protection and Measurements (NCRP) updated their guidelines for best practices for patient safety in X-ray imaging, which helped drive this decision.

This will impact any provider that orders X-rays for patients, including providers in the radiology department, TCP locations and urgent cares. While this new process is in effect across all campuses and locations, lead shielding will be available for any patient or family who requests it.

Q&A pamphlets are available for both adult and pediatric patients.

May 4, 2017

With the help of physicians in interventional radiology, anesthesiology and pathology at Texas Children’s Hospital, children in Vietnam suffering from severe and debilitating vascular anomalies are getting the help they desperately need.

At the beginning of the year, a medical team from Texas Children’s traveled to the University of Medicine and Pharmacy Hospital in Ho Chi Minh City, Vietnam to examine and treat patients with vascular anomalies as well as to train medical staff at the University Hospital to perform certain life-altering procedures on their own.

The effort is an extension of the active collaboration between the Vietnam Vascular Anomalies Center (VAC) based in Ho Chi Minh City and the Global Pathology program at Texas Children’s Hospital, launched in 2013 by Dr. Thuy Phung, a pathologist and associate director of Texas Children’s Global Pathology. Global Pathology is based in the Department of Pathology, under the leadership of Texas Children’s Pathologist-in-Chief Dr. James Versalovic.

The Vietnam VAC was established in 2009 by Phung and a team of physicians at Harvard Medical School and Ho Chi Minh City. Its mission is to provide safe and effective humanitarian medical care for underserved Vietnamese children with vascular and pigmented birthmarks, and to promote active collaboration between Vietnamese and U.S. physicians to improve the health of these children.

“We have been thinking about and working on the formation of an interventional radiology team that can work with the Vietnam VAC for some time and feel that our initial efforts have been extremely successful,” Phung said. “The techniques that we are teaching physicians in Vietnam can make a huge difference in the lives of children with vascular anomalies.”

During the team’s week-long visit to Ho Chi Minh City in January, members worked with and trained a local clinical team led by Dr. Tran Quoc Tuan, an interventional neuroradiologist at the University of Medicine and Pharmacy Hospital. Together, they evaluated and consulted on 38 adult and pediatric patients, providing recommendations on how to best manage their vascular anomalies. Of those patients, the clinical team selected 13 to treat using techniques such as embolization, which involves the injection of special medications into abnormal blood vessels under ultrasound and X-ray.

These treatments are common across the globe but can only be appropriately performed by highly trained medical professionals and require an experienced support team, such as a pediatric anesthesiologist, interventional radiologist, interventional radiology nurse practitioner and interventional radiology technologist proficient in the procedures. Texas Children’s brought all of the above to the Vietnam VAC, enabling several children, including a young boy whose vascular lesion was impeding his ability to breathe, to get the appropriate treatment and go home with a chance at a drastically improved life.

“This partnership has enabled us to train our clinical colleagues in Ho Chi Minh City to independently handle vascular anomaly patients and act as a referral center for the country,” said Texas Children’s interventional radiologist Dr. Sheena Pimpalwar. “Due to a large population of children in Vietnam who are affected by vascular anomalies and our ability to treat them in a multi-disciplinary fashion, this program has huge potential for growth.”

Texas Children’s pediatric anesthesiologist Dr. Helena Karlberg emphasized the importance of having a multi-disciplinary approach available to patients at the Vietnam VAC and described the role of the anesthesiologist as one that includes early planning of airway management in patients undergoing procedures of the head and neck regions, and monitoring for, and treatment of any adverse effects by agents used during vascular anomaly care.

“These rather specialized procedures require a great deal of expertise,” Karlberg said. “I am grateful for the opportunity to share my knowledge and experience assisting and instructing others to develop their own skills in caring for this group of patients.”

To ensure that patients receive the highest quality treatment, the Texas Children’s Hospital medical team plans on traveling to Vietnam each year to treat patients and to continue training the medical staff at the Vietnam VAC. In the meantime, the Texas Children’s team will consult with physicians in Vietnam on patient management via email, telephone and video conference.

Members of the Texas Children’s Hospital medical team that recently traveled to Vietnam include:

  • Dr. Alex Chau, interventional radiologist
  • Heather Cleveland, advanced clinical specialist and interventional radiology technologist
  • Dr. Helena Karlberg, pediatric anesthesiologist
  • Dr. Thuy Phung, associate director of Texas Children’s Global Pathology
  • Dr. Sheena Pimpalwar, interventional radiologist
  • Holly Phan Tran, vascular anomalies nurse practitioner
November 1, 2016

11216drgeorgeverghese175Texas Children’s is proud to announce Dr. Verghese George as the new division chief of women’s radiology at Texas Children’s Pavilion for Women.

George, who also serves as associate professor of Radiology at Baylor College of Medicine, received his medical degree from the Armed Forces Medical College in India. After completing four years of residency training in Obstetrics and Gynecology in India and the United Kingdom, he pursued residency training in Diagnostic Radiology at the University of Manchester in the United Kingdom. Subsequent to this, he moved to the U.S., and completed three fellowships: Abdominal Imaging (University of Washington), Body MRI (Yale University) and Nuclear Radiology (Yale University).

As new division chief of women’s radiology, George will merge his prior Ob/Gyn training with his clinical interest in Women’s imaging. His research interests include placental and pelvic floor imaging, and imaging of chronic pelvic pain including pelvic congestion syndrome and vulvodynia. His work focuses on multimodality abdominopelvic radiology in the adult population.

January 20, 2015

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Imagine a trauma patient gets sent to a community hospital where their scans show the need for higher acuity care than is available at the hospital. The patient is transferred to Texas Children’s for the right care, but, as for most trauma patients, time is of the essence, and a matter of minutes could make all the difference in the outcomes.

The MRIs, CAT scans, or x-rays which are usually sent via CD and could easily be lost or misplaced, can now be uploaded directly from the referring hospital into a cloud software now available at Texas Children’s called LifeIMAGE. In the digital age, LifeIMAGE streamlines the process of receiving and evaluating images from other physicians and hospitals. These images can be quickly, easily and safely uploaded to the system straight from the imaging device.

“It has allowed us to provide more timely interpretations of outside studies,” said Dr. George S. Bisset, radiologist-in-chief. “Before the patient even gets here, the clinical care team is prepared.”

“The software allows our providers to review any imaging studies performed at the transferring hospital prior to the patient’s arrival,” said Trent Johnson, director of Ambulatory Services. “This means that we can better anticipate the care needs of the patient before they ever arrive. This saves us valuable time, which is of the essence for seriously injured patients.”

On top of time savings, the new system reduces radiation exposure for the patient who before could be subject to new scans upon arriving here. The double dose of radiation was costly and kept physicians from acting as quickly as possible. The benefits have been seen across the system.

“In the outpatient clinic setting, it has reduced the amount of time that our clinic staff and providers must wait to download and view an outside image or study,” said Johnson. “This increases patient and provider satisfaction by improving the throughput and efficiency.”

The use of this image-sharing network could also help prevent unnecessary transfers. For example, a patient visiting their community hospital in Midland can get their scans directly transferred to Texas Children’s for physicians here to determine if a transfer is necessary.

The system also allows for patients from around the globe to receive second opinions without ever having to leave their home country.

June 17, 2014

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Texas Children’s Radiology Department is taking part in an initiative to create a better patient experience. After noticing access to radiology services was becoming more difficult, the department took on an initiative called Creating a Remarkable Experience, C.A.R.E. The initiative targeted several areas for improvement.

The first step was getting patients an appointment time. The team realized there were multiple points of entry for a patient family seeking a radiology appointment. Each campus offering these appointments was using a different scheduling method, creating a different patient experience from campus-to-campus.

The department looked at the best methods for easy access. One phone line was created which directs patients to a group of schedulers who can make an appointment at any of the three sites providing radiology services, including Main Campus, West Campus or the Pavilion for Women. The number, 832-TC4-XRAY (832-824-9729), gives patients one phone line with access to all scheduling.

“Since we implemented our new and improved scheduling system, patients have better access to our services. We’re able to better accommodate their schedules and get their radiology examinations performed in a timely manner,” said Dr. George Bisset, chief of Pediatric Radiology. “All of this has a direct impact on patient satisfaction.”

The initiative looked at cycle times and determined how to reduce the percentage of times the MRI cases were started late. After making a few adjustments to scheduling patients and the patient flow, the team went from experiencing 73 percent late starts to 27 percent. Wait time in nuclear radiology went from more than 100 minutes to 22 minutes.

“Once we were able to streamline the process to schedule patients, we wanted to ensure that our patients continued to have excellent service when they arrived at our doors,” said Maryam El-Bakry, the initiative lead. “Our patient families’ time is valuable and we wanted to avoid having long waits and provide the best service.”

The department also took on a major clean out of the radiology areas across the system to reorganize and follow joint-commission standards. Bisset believes the new initiative allows the team to be better prepared, and reenergized about their roles in patient care.