RADxx Rising Star: Imaging Informatics Not Only Increases Efficiency, But Also Career Flexibility

December 22, 2020
Whitney J. Palmer

Imaging informatics can be an effective tool in meeting clinical needs, but it can also be a vehicle for increasing flexibility in radiology, says Carol Wu, M.D., RADxx Rising Star 2020 Awardee.

For the past roughly five years, the RADxx awards have recognized the contributions of women to the field of imaging informatics. And, it is critical to keep the pipeline going to ensure the specialty reflects the contributions and insights of female providers.

That is where the RadXX Rising Star comes in, recognizing a woman who has been proactive in furthering the career of women in this specialty. This year, RADxx selected Carol Wu, M.D., a cardiothoracic radiologists with MD Anderson Cancer Center, as the recipient.

Diagnostic Imaging spoke with Wu about her clinical activities and her involvement in professional organizations, highlighting how her efforts can further encourage the participation of women in medical imaging informatics.

Diagnostic Imaging: What led you to your interest in medical imaging informatics?

Wu: When I worked at Massachusetts General Hospital, I noticed that we had a very specific rule. We were told that if we wanted to make a recommendation for further imaging or further action, we had to make a separate field of recommendation so that it would be easy for referring physicians to identify. But, when I looked at that, I realized that not everyone is making the same recommendation for the same findings because people have different practice. I realized that I wanted to study that further. That led to having to use informatics tools to collect the information in order to be able to data mine.

It was really from that data mining that I started to talk more to some of the informatics people and realized the power of informatics not just in helping with research, but also in helping us to be more consistent in improving patient care. That’s how I got interested. That may be different from other people who are in informatics, but I didn’t come from a computer science or computer engineering kind of background. I studied biology in college, so the way I look at informatics is very much in how we can use it clinically or in research to help address the issues that we face as radiologists.

Related Content: 2020 RADxx Award Winners

Diagnostic Imaging: With that as a backdrop, what is your focus now? What led to your being selected as the RADxx Rising Star?

Wu: I am, foremost, a clinical chest radiologist. And, I think a lot of artificial intelligence development has been done in the field of chest radiology just because the issues we tackle happen to lend themselves very easily to being worked on by some artificial intelligence or informatics tools. I am trying to serve as the bridge between the chest radiology community and the informatics and data science community to perhaps build some of the groundwork or building blocks. For example, I am very involved with the American College of Radiology (ACR) Data Science Institute® Use Cases creation for thoracic imaging, and I’m involved also in the Common Data Element Creation for Thoracic Imaging. So, those are the building blocks for more artificial intelligence or informatics tools development that are related to my sub-specialty.

Recently, because of COVID-19, I’m also part of the Medical Imaging and Data Resource Center – that’s a collaboration between the ACR, RSNA, and American Association of Physicists in Medicine – to try to create imaging and clinical data for COVID-19. We hope, in the future, that infrastructure will allow data sharing for other disease processes. I’m very excited to be part of that because I think it will be great for the imaging community.

Diagnostic Imaging: What do you anticipate will be the impact of the imaging informatics work you are doing on the daily level for radiologists?

Wu: I hope it will bring us more efficient and better care. Lately, we’ve talked about the amount of work that has been increasing over the years. We’re imaging more patients, so we have more images to go through. I think with this groundwork and with the development of informatics and artificial intelligence tools, hopefully we will be able to read exams and check our reports more efficiently with higher accuracy and higher diagnostic confidence. Hopefully, it will improve not only the quality of our work and the impact of our work, but also maybe our lifestyle so that we could get through our work in a reasonable amount of time.

Diagnostic Imaging: What are some of the offices you hold that have impacted your work in imaging informatics? Can you highlight what you do in those capacities?

Wu: The one that I think was the start of everything is the Big Data Community of the Society of Thoracic Radiology (STR). I’m very appreciative that the leadership of the STR recognized early on several years ago the impact deep learning is going to have on thoracic radiologists to make sure the development of the products are useful to us. I’m grateful that they found me and let me have the chance to participate and to be involved. I think that is the starting point. That is probably how I am known to people in the ACR and RSNA – as a representative from chest and thoracic imaging.

Diagnostic Imaging: From your perspective – as someone who is relatively early in their career – why is it so important to bring more women into the fold with medical imaging informatics?

Wu: For imaging informatics and for artificial intelligence, we’ve always talked a lot about diversity and using all the resources. In terms of users of the technology and the design of the technology, we have to keep in mind that many of the radiologists are women. There are issues that we are perhaps more aware of, and unless women are involved, we maybe will not think about them. I talk a lot about efficiency. There’s a lot of times I think women in radiology have to be more efficient because we have to multi-task. We must have women involved in order to cater to users.

But, I think also having women represented helps other women realize that it’s something they can be involved with. I remember the first time I went to an ACR Informatics retreat a few years ago, and I was only one of two women. I think the other one was an ACR staffer. It was very intimidating. Since then, we’ve had a lot more women involved in that role, and it’s been a lot easier for me to feel comfortable. That wouldn’t have happened without the conscious effort on the part of Dr. Geraldine McGinty and other ACR radiologists. Definitely, the sponsorship and organizations, like RADxx, and the conscious effort on the part of the leadership of these big organizations make a huge difference.

Diagnostic Imaging: You mentioned things like efficiency and making sure that attention is paid to specific issues that women do face that are different from male providers. Looking forward, specifically for imaging informatics, what type of goals do you hope to reach in your career?

Wu: I tend to take little steps and move forward as I go. Overall, I want to make sure that practicing thoracic imagers are well represented, to be sure that we’re involved, and that end products are being developed to address the clinical needs that we have.

One of the things I have noticed when I’m talking to artificial intelligence developers or computer scientists is that sometimes their understanding of the clinical issues we face is perhaps incomplete. It’s helpful to have the input of clinical radiologists. That is something I try to bring in and try to foster – to make sure that we are involved. For example, maybe they’re trying to develop an algorithm to distinguish X from Y, but as clinicians sitting in the reading room, we’re not actually trying to do that, we want to distinguish ABC from X and Y. I just mostly want to be the bridge and make sure that we have good communication and good products.

Diagnostic Imaging: When you think about the future of imaging informatics, what would you like to see occur? Are there changes you would like to see made as more women continue to express their own interest in this specialty?

Wu: We touched upon the issue of more flexibility in the work schedule and working from home. That would make our field of radiology more attractive for a woman. I think, on top of that, there is also the additional issue of being able to communicate directly to patients and to maintaining the communication and interaction with our colleagues and referring clinicians. I think all of these things will require more advances in informatics. It’s not just the job of radiologists, but also of the technologists.

There are also developments in remote scanning or faster scanning. That will also increase flexibility for people who work with us. Not only would that be good for increasing the participation of women, but I think it’s also beneficial for all radiologists to have more flexibility in their work schedule. It could lead to increased efficiency.

I do feel like some radiologists have been worried about artificial intelligence replacing us. I just don’t quite see that happening. I think it just makes our job more interesting. I don’t think we’ll be replaced.

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