ACR Bulletin

Covering topics relevant to the practice of radiology

A World of Possibilities in Radiology

The ACR Foundation's International Outreach Committee lays out its plans for expanding the global reach of the specialty.
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Photo: Mary Huff, MD

Mary W. Huff, MD
Guest Columnist

February 01, 2024
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The ACR Foundation International Outreach Committee (IOC) is celebrating its 20th anniversary this year. It was founded to assist in improving radiologic care to low-to-middle-income countries. The mission has not substantially changed since 2004, but the provision of that service looks different. 

Thanks to accelerating global technological advancements, change is happening at an ever-more-rapid pace. Yet, 47% of the global population still has little to no access to diagnostic services. In this environment, we see our role as providing hope for underserved communities by advocating for those in need, facilitating access to care and developing connections.

The ACR has empowered its members-in-training to serve patients and society through the Goldberg-Reeder Resident Travel Grant Program since 2008. The first four recipients traveled to Moshi, Tanzania, where 2015 ACR Global Humanitarian Award recipient, Helmut Diefenthal, MD, HFACR, had established the Kilimanjaro School of Radiology. The grant program has provided an outlet for more than 50 residents to advocate for communities in over 30 countries. Projects have spanned from quality and safety initiatives to advocacy research to education. 

Although our award recipients aim to serve communities in need, they consistently report that their experiences have a had a reciprocal life-changing impact on themselves, both personally and professionally. I can attest that as a 2012 grant recipient, my research in Santiago, Chile, on barriers to mammography screening compliance has directly influenced the way I practice and relate to my patients in breast imaging centers today, particularly the many non-native-speaking patients. 

Not only can our grant program provide value to trainees and the communities they serve, but it can also offer value in promoting diversity in the field of radiology. As one of our committee members, Victoria “Vickie” D. Vuong, MD, aptly states, “International outreach is important in promoting a diverse and equitable radiology workforce, incorporating different perspectives and experiences to drive the field forward into the future.” As affirmed in the ACR vision statement, we recognize diversity as a strength, particularly when there is a common objective.

Not only can our grant program provide value to trainees and the communities they serve, but it can also offer value in promoting diversity in the field of radiology.

—Mary W. Huff, MD

At the IOC, we are currently updating our program structure, funding, application, selection and debriefing processes to ensure we are doing our part to empower the radiologists of the future to advocate for the provision of quality radiologic care in a sustainable and collaborative way. We have noticed a trend in applications received over time to reflect ongoing joint efforts by universities and organizations with international sites, such as the University of Pennsylvania Botswana Partnership. Monica Matsumoto, MD, received a 2023 resident travel grant to help develop an image-guided procedure service as part of the ongoing work of UPenn at the University of Botswana hospitals in Gaborone. 

Further, we are evaluating the capacity for mentorship both before, during and after projects to support the grant recipient and ensure project relevance and success. In Matsumoto’s case, she will be supervised by 2019 Goldberg Reeder Grant recipient Brian Currie, MD, in the second half of her project at Kilimanjaro Christian Medical Center (KCMC) in Tanzania in partnership with RAD-AID International. 

Currie, who is also a committee member, acknowledges: “Radiology is an indispensable clinical service in modern medicine. As imaging technology becomes more available worldwide, there is a massive unmet need for delivering radiology services to deserving communities. I want to be part of the collective effort to deliver this care.” 

This project certainly exemplifies what we are trying to achieve as a committee: a collaborative, relevant and sustainable approach to international outreach. 

Since 2011, the ACRF IOC has been working to help assist the communities in desperate need of radiologic care in Haiti. What started as a needs assessment in Port-au-Prince after the earthquake in 2010 developed into an ambitious effort to help re-establish a radiology residency program at University Hospital through collaborative efforts with RAD-AID and Imaging4Change. 

Haiti had 14 radiologists in practice to serve a population of more than 14 million when we arrived in 2011. Recent civil and political turmoil, gang violence and kidnappings, among other hardships, have landed Haiti on the U.S. Department of State Do Not Travel list. Consequently, where the outreach committee was once involved in facilitating access directly, we have now pivoted to supporting organizations remotely that need our help in their ongoing efforts on the ground.  

Advancements in technology within our field and beyond place us in a unique position to care for patients remotely. In addition to our experience in Haiti, we became acutely aware of this advantage during the COVID-19 pandemic. 

As a result, opportunities are developing in telehealth services. The esteemed international nonprofit public health organization Partners in Health has been working in Haiti since the early 1980s. It is currently trying to remedy the dearth of cross-sectional imaging with a CT scanner. Once the organization has a CT unit working, we plan to help it find volunteer radiologists to interpret those scans. Specifically, we would love to provide the opportunity to retired radiologists who are interested in making a massive impact with their hard-earned professional prowess.

We see our role as bridging the gap in access to quality radiologic care for those who need it most. Moving into the future, we would like to act as a convener to support the needs of radiologists and radiographers in underserved communities globally. We aim to bolster connections of like-minded existing organizations with a particular focus on quality, safety and education. 

The International Society of Radiology (ISR) has complementary objectives with many ongoing initiatives, including some in education, with the International Atomic Energy Agency (IAEA). Further, we have partnered with the Pan American Health Organization (PAHO) on quality and safety initiatives in Central America and the Caribbean. We plan to connect our membership to these types of opportunities.

As international health needs shift from communicable to non-communicable diseases, there is great opportunity for return on investment in terms of employing diagnostic imaging programs for prevention of cancer death. 

Artificial intelligence has also demonstrated potential for bridging the gap of diagnostic imaging capacity in underserved communities. We aim to develop connections between individual providers, researchers, organizations and governmental advocacy groups to make a measurable difference in the future of the provision of high-quality radiologic care. 

As demands on our time and attention as diagnostic and interventional radiologists, radiation oncologists, nuclear medicine physicians and medical physicists are ever increasing, we hope you appreciate the value we see in devoting energy to the important work of inspiring hope, building bridges and establishing long-term relationships globally.

Author Guest columnist Mary W. Huff,  MD, Chair of the ACR Foundation's International Outreach Committee