Tuesday was a long day, but a good one. It started early with an R2 users group breakfast meeting. We've had our mammography CAD system for about six months, and I highly recommend it. I need all the help I can get with mammograms. I read about 14,000 a day, which is close to the break-even point on reimbursement. The R2 people are developing some very nice teaching enhancements -- not much use to me, but still very important. They're also doing some things which will greatly improve our QA programs. This is a feature I want ASAP.

Drs. Shreve, Wahl, and Lowe gave a really good presentation on interpretation of FDG-PET scans. In my home state of Virginia, we still require a CON for any big-ticket purchase. We had to go to several boards, do miles of paperwork, and juggle three bowling balls, so that next week we can start having a mobile PET scanner one day a week. Now that it is actually coming, we're making sure we do it right. This particular lecture couldn't have been more useful. The problem is, I want to hear it three more times.

After lunch, Dr. Valerie Jackson gave the Annual Oration in Diagnostic Radiology. She gave a great talk about controversies in screening mammography. Briefly summarized, with apologies to Dr. Jackson: It is the number one reason we get sued. We lose money on every one. The Canadians proved lousy mammography doesn't save lives, and the Holy Grail of research, the randomized control study, may be impossible. Every year, more women want them, fewer facilities provide them, and it is the rare radiologist who wants to read more. Finally, some one at The New York Times must have a personal axe to grind with mammography. Jackson illustrated how they cover mammography with the finesse of the National Enquirer.

I was signed up for a great refresher course in the afternoon but decided to turn in my ticket and go buy some brownie points on Chicago's magnificent/decadent mile. Education is important, a happy spouse even more so. In my rural community, there are several places you can buy clothes, jewelry, and accessories. The nicest is Kmart. You know that 20 pounds of catalogs you get in the mail? My wife is personally responsible for keeping most of those companies afloat. I'm not a good catalog shopper, but I really like the stores in Chicago. The feeling is obviously mutual, as every salesperson asks if I'm with the radiology show. The RSNA is serious cash for Chicago. As an aside, my wife Deana aced her boards last week and became a registered mammography tech. I would really appreciate it if every radiologist in the world would e-mail her congratulations (dtipler@medicaltees.com).

I met coworkers at Hitachi night for some nice sushi and socializing. We don't have any Hitachi equipment, but we're looking for an open MRI, a field they seem to dominate. Then it was off to the Philips party at the art institute. That event alone is worth the trip to Chicago. As usual, we stayed pretty much to the end. Any sane person would have called it a night, and one person in our group did. The rest of us went to Jilly's, a jazz club, to help Berlex celebrate the 15th birthday of Magnevist. The company that constantly increases my diagnostic accuracy for neurological disease helped me kill off a few neurons last night.