W R Hendee

Mayo Clinic - Rochester, Rochester, Minnesota, United States

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Publications (152)476.77 Total impact

  • [Show abstract] [Hide abstract]
    ABSTRACT: This article summarizes the proceedings of a portion of the Radiation Dose Summit, which was organized by the National Institute of Biomedical Imaging and Bioengineering and held in Bethesda, Maryland, in February 2011. The current understandings of ways to optimize the benefit-risk ratio of computed tomography (CT) examinations are summarized and recommendations are made for priority areas of research to close existing gaps in our knowledge. The prospects of achieving a submillisievert effective dose CT examination routinely are assessed. © RSNA, 2012.
    Radiology 09/2012; 265(2):544-54. · 6.34 Impact Factor
  • William R Hendee, Michael K O'Connor
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    ABSTRACT: During the past few years, several articles have appeared in the scientific literature that predict thousands of cancers and cancer deaths per year in the U.S. population caused by medical imaging procedures that use ionizing radiation. These predictions are computed by multiplying small and highly speculative risk factors by large populations of patients to yield impressive numbers of "cancer victims." The risk factors are acquired from the Biological Effects of Ionizing Radiation (BEIR) VII report without attention to the caveats about their use presented in the BEIR VII report. The principal data source for the risk factors is the ongoing study of survivors of the Japanese atomic explosions, a population of individuals that is greatly different from patients undergoing imaging procedures. For the purpose of risk estimation, doses to patients are converted to effective doses, even though the International Commission on Radiological Protection warns against the use of effective dose for epidemiologic studies or for estimation of individual risks. To extrapolate cancer incidence to doses of a few millisieverts from data greater than 100 mSv, a linear no-threshold model is used, even though substantial radiobiological and human exposure data imply that it is not an appropriate model. The predictions of cancers and cancer deaths are sensationalized in electronic and print public media, resulting in anxiety and fear about medical imaging among patients and parents. Not infrequently, patients are anxious about a scheduled imaging procedure because of articles they have read in the public media. In some cases, medical imaging examinations may be delayed or deferred as a consequence, resulting in a much greater risk to patients than that associated with imaging examinations. © RSNA, 2012.
    Radiology 08/2012; 264(2):312-21. · 6.34 Impact Factor
  • Medical Physics 08/2012; 39(8):5302-3. · 2.91 Impact Factor
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    Journal of the American College of Radiology: JACR 04/2012; 9(4):290-2.
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    ABSTRACT: Health care disciplines have always held resolutely to a commitment to professionalism and high ethical standards. With the present emphasis on public accountability, professionalism and ethics are receiving enhanced attention in health care education and practice. A challenge for radiologists, radiation oncologists, and medical physicists is to define the scope and depth of knowledge about professionalism and ethics that are necessary for the practice of the disciplines. A further challenge is to develop accessible educational materials that encompass this required knowledge. About 2 years ago, the ABR Foundation decided to address these challenges through the development of an ethics and professionalism curriculum and production of a series of Web-based educational modules that follow the curriculum. Six organizations agreed initially to contribute financially to construction of the curriculum and modules and were later joined by a seventh. The curriculum was developed by the ABR Foundation and included in a request for proposals that was widely distributed. Teams of authors for each of 10 modules were selected from respondents to the request for proposals. As the modules were developed, they were reviewed in 3 successive stages, including peer review by members of the ACR Committee on Professionalism and the RSNA-ACR Task Force on an Ethics Curriculum. After revisions were prepared in response to the reviews, the modules were translated into a format compatible with the e-learning platform on which they are mounted. The modules are now available to all who wish to study them.
    Journal of the American College of Radiology: JACR 03/2012; 9(3):170-3.
  • Anthony B Wolbarst, William R Hendee
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    ABSTRACT: This letter suggests a formalism, the medical effective dose (MED), that is suitable for assessing stochastic radiogenic risks in diagnostic medical procedures. The MED is derived from radiobiological and probabilistic first principals, including: (1) The independence of radiation-induced biological effects in neighboring voxels at low doses; (2) the linear no-threshold assumption for stochastic radiation injury (although other dose-response relationships could be incorporated, instead); (3) the best human radiation dose-response data currently available; and (4) the built-in possibility that the carcinogenic risk to an irradiated organ may depend on its volume. The MED involves a dose-risk summation over irradiated voxels at high spatial resolution; it reduces to the traditional effective dose when every organ is irradiated uniformly and when the dependence of risk on organ volumes is ignored. Standard relative-risk tissue weighting factors can be used with the MED approach until more refined data become available. The MED is intended for clinical and phantom dosimetry, and it provides an estimate of overall relative radiogenic stochastic risk for any given dose distribution. A result of the MED derivation is that the stochastic risk may increase with the volume of tissue (i.e., the number of cells) irradiated, a feature that can be activated when forthcoming radiobiological research warrants it. In this regard, the MED resembles neither the standard effective dose (E) nor the CT dose index (CTDI), but it is somewhat like the CT dose-length product (DLP). The MED is a novel, probabilistically and biologically based means of estimating stochastic-risk-weighted doses associated with medical imaging. Built in, ab initio, is the ability to link radiogenic risk to organ volume and other clinical factors. It is straightforward to implement when medical dose distributions are available, provided that one is content, for the time being, to accept the relative tissue weighting factors published by the International Commission of Radiological Protection (ICRP). It requires no new radiobiological data and avoids major problems encountered by the E, CTDI, and CT-E formalisms. It makes possible relative inter-patient dosimetry, and also realistic intercomparisons of stochastic risks from different protocols that yield images of comparable quality.
    Medical Physics 12/2011; 38(12):6654-8. · 2.91 Impact Factor
  • William R. Hendee
    Radiological Society of North America 2011 Scientific Assembly and Annual Meeting; 11/2011
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    W Hendee
    Biomedical Imaging and Intervention Journal 10/2011; 7(4):e29.
  • William R Hendee
    Medical Physics 09/2011; 38(9):i. · 2.91 Impact Factor
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    William Hendee
    Medical Physics 05/2011; 38(5):2311-2. · 2.91 Impact Factor
  • Medical Physics 01/2011; 38(6):3794-. · 2.91 Impact Factor
  • William R Hendee, Michael G Herman
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    ABSTRACT: Beginning in the 1990s, and emphasized in 2000 with the release of an Institute of Medicine report, healthcare providers and institutions have dedicated time and resources to reducing errors that impact the safety and well-being of patients. But in January 2010 the first of a series of articles appeared in the New York Times that described errors in radiation oncology that grievously impacted patients. In response, the American Association of Physicists in Medicine and the American Society of Radiation Oncology sponsored a working meeting entitled "Safety in Radiation Therapy: A Call to Action." The meeting attracted 400 attendees, including medical physicists, radiation oncologists, medical dosimetrists, radiation therapists, hospital administrators, regulators, and representatives of equipment manufacturers. The meeting was cohosted by 14 organizations in the United States and Canada. The meeting yielded 20 recommendations that provide a pathway to reducing errors and improving patient safety in radiation therapy facilities everywhere.
    Medical Physics 01/2011; 38(1):78-82. · 2.91 Impact Factor
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    ABSTRACT: The growth in medical imaging over the past 2 decades has yielded unarguable benefits to patients in terms of longer lives of higher quality. This growth reflects new technologies and applications, including high-tech services such as multisection computed tomography (CT), magnetic resonance (MR) imaging, and positron emission tomography (PET). Some part of the growth, however, can be attributed to the overutilization of imaging services. This report examines the causes of the overutilization of imaging and identifies ways of addressing the causes so that overutilization can be reduced. In August 2009, the American Board of Radiology Foundation hosted a 2-day summit to discuss the causes and effects of the overutilization of imaging. More than 60 organizations were represented at the meeting, including health care accreditation and certification entities, foundations, government agencies, hospital and health systems, insurers, medical societies, health care quality consortia, and standards and regulatory agencies. Key forces influencing overutilization were identified. These include the payment mechanisms and financial incentives in the U.S. health care system; the practice behavior of referring physicians; self-referral, including referral for additional radiologic examinations; defensive medicine; missed educational opportunities when inappropriate procedures are requested; patient expectations; and duplicate imaging studies. Summit participants suggested several areas for improvement to reduce overutilization, including a national collaborative effort to develop evidence-based appropriateness criteria for imaging; greater use of practice guidelines in requesting and conducting imaging studies; decision support at point of care; education of referring physicians, patients, and the public; accreditation of imaging facilities; management of self-referral and defensive medicine; and payment reform.
    Radiology 10/2010; 257(1):240-5. · 6.34 Impact Factor
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    ABSTRACT: The AAPM Professional Council approved the formation of a task group in 2007, whose purpose is to develop recommendations for an ethics curriculum for medical physics graduate and residency programs. Existing program's ethics curricula range in scope and content considerably. It is desirable to have a more uniform baseline curriculum for all programs. Recommended subjects areas, suggested ethics references, and a sample curriculum are included. This report recommends a reasonable ethics course time to be 15-30 h while allowing each program the flexibility to design their course.
    Medical Physics 08/2010; 37(8):4495-500. · 2.91 Impact Factor
  • William R Hendee
    Journal of the American College of Radiology: JACR 04/2010; 7(4):306-8.
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    ABSTRACT: There are several types of serious nuclear or radiologic emergencies that would require a specialized medical response. Four scenarios of great public health, economic, and psychologic impact are the detonation of a nuclear weapon, the meltdown of a nuclear reactor, the explosion of a large radiologic dispersal device ("dirty bomb"), or the surreptitious placement of a radiation exposure device in a public area of high population density. With any of these, medical facilities that remain functional may have to deal with large numbers of ill, wounded, and probably contaminated people. Special care and/or handling will be needed for those with trauma, blast injuries, or thermal burns as well as significant radiation exposures or contamination. In addition, radiologists, nuclear medicine specialists, and radiation oncologists will be called on to perform a number of diverse and critically important tasks, including advising political and public health leaders, interfacing with the media, managing essential resources, and, of course, providing medical care. This article describes the medical responses needed following a radiologic or nuclear incident, including the symptoms of and specific treatments for acute radiation syndrome and other early health effects. (c) RSNA, 2010 Supplemental material: http://radiology.rsna.org/lookup/suppl/doi:10.1148/radiol.09090330/-/DC1.
    Radiology 03/2010; 254(3):660-77. · 6.34 Impact Factor
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    ABSTRACT: LEARNING OBJECTIVES Learning Objectives: Appreciate the need for and the process of the FDA in approving equipment for breast imaging. Appreciate the role of post market evaluations. Understand the role of technology assessment studies as a subset of comparative effectiveness studies. Learn the potential for a technology assessment institute.
    Radiological Society of North America 2009 Scientific Assembly and Annual Meeting; 12/2009
  • Gary Jay Becker, Jennifer Bosma, William Hendee
    New England Journal of Medicine 12/2009; 361(23):2289-90; author reply 2291-2. · 54.42 Impact Factor
  • William R. Hendee, Anthony B. Wolbarst
    08/2009; , ISBN: 9783527600434
  • William R Hendee
    [Show abstract] [Hide abstract]
    ABSTRACT: OBJECTIVE: The complexity of diagnostic imaging has expanded dramatically over the past two decades. Over the same period, the time and effort devoted to teaching physics (the science and technology of the discipline) have diminished. This paradox compromises the ability of future radiologists to master imaging technologies so that they are used in an efficient, safe, and cost-effective manner. This article addresses these issues. CONCLUSION: Efforts involving many professional organizations are under way to resolve the paradox of the expanding complexity of medical imaging contrasted with the declining emphasis on physics in radiology residency programs. These efforts should help to reestablish physics education as a core value in radiology residency programs.
    American Journal of Roentgenology 05/2009; 192(4):855-8. · 2.90 Impact Factor

Publication Stats

524 Citations
476.77 Total Impact Points

Institutions

  • 2012
    • Mayo Clinic - Rochester
      Rochester, Minnesota, United States
  • 2002–2012
    • Medical College of Wisconsin
      • • Department of Radiology
      • • Department of Physical Medicine and Rehabilitation
      • • Department of Radiation Oncology
      Milwaukee, WI, United States
  • 2007–2011
    • University of Kentucky
      • • Department of Radiology
      • • College of Medicine
      Lexington, KY, United States
  • 2009
    • Johns Hopkins University
      Baltimore, Maryland, United States
  • 2006
    • Georgetown University
      • Department of Radiation Medicine
      Washington, D. C., DC, United States
  • 2002–2006
    • University of Wisconsin - Milwaukee
      Milwaukee, Wisconsin, United States
  • 1979–2002
    • University of Colorado Hospital
      • Department of Radiology
      Denver, Colorado, United States
  • 1974–1983
    • University of Colorado
      • Department of Radiology
      Denver, Colorado, United States