There are now multiple phase 3 studies on combination transarterial chemoembolization (TACE) and immunotherapy showing a significant benefit over TACE alone. How do these findings change the hepatocellular carcinoma (HCC) treatment algorithm? In this multidisciplinary episode of the BackTable Podcast, Dr. Richard Finn (Medical Oncologist at UCLA) and Dr. Julius Chapiro (Interventional Radiologist at Yale University) join host Dr. Chris Beck to discuss immunotherapy, TACE, emerging trends in HCC treatment, and the future of the field.
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This podcast is supported by an educational grant from Guerbet.
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SYNPOSIS
The doctors highlight the importance of high quality clinical data and the pivotal studies shaping current best practices. They explore the role of the different players on the multidisciplinary team and compare the oncologic and radiologic perspectives. Additionally, they discuss the synergy between TACE and immunotherapy, the criteria for selecting appropriate treatments, and the ongoing need for research and collaboration.
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TIMESTAMPS
00:00 - Introduction
03:35 - HCC from an Oncologic Perspective
05:33 - Radiological Perspective on Liver Cancer
06:50 - Referral Patterns and Organizing a Multidisciplinary Approach
18:01 - Explaining TACE and Variations in the Procedure
27:27 - Choosing the Right Procedure for HCC
36:13 - Making a Decision on Medical Treatment Candidacy
42:23 - Importance of Data Driven HCC Treatment, Practical Insights, and Studies to Know
55:30 - Planning an Approach for a TACE Procedure
01:02:26 - Final Thoughts and Future Prospects in Liver Cancer Treatment
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RESOURCES
Barcelona Staging System:
https://www.ncbi.nlm.nih.gov/books/NBK569796/table/Ch3-t0001/
TRACE Trial:
https://pubs.rsna.org/doi/full/10.1148/radiol.211806
PREMIERE Trial:
https://www.gastrojournal.org/article/S0016-5085(16)34971-X/fulltext
EMERALD-1 Trial:
https://ascopubs.org/doi/10.1200/JCO.2024.42.3_suppl.LBA432
LEAP O12 Study:
https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(24)02575-3/abstract

What is the key to running an efficient OBL? Dr. Mary Costantino, medical director of Advanced Vascular Centers, joins host Dr. Ally Baheti to share some of the key ingredients in keeping it lean in OBL.

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SYNPOSIS

The doctors delve into strategies in running a cost-effective OBL while upholding clinical excellence. Dr. Costantino shares her personal insights and experiences in minimizing unnecessary costs while maintaining regulatory compliance, high-performing team, and outstanding patient care. She also underscores the importance of having a clear leadership vision and remaining at the forefront of patient care to proactively identify challenges and develop effective solutions to address them. Lastly, she shares her thoughts on navigating the challenges of balancing personal and professional responsibilities in the growing field of outpatient vascular care.

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TIMESTAMPS

00:00 - Introduction

01:46 - Expanding Practices and Partnerships

06:24 - Navigating Regulatory Requirements

12:26 - Building a Lean and Valuable Team

35:01 - Leadership

39:54 - Opportunity Cost in Practice Management

44:32 - Employee Growth and Retention Strategies

46:49 - Building and Maintaining a Successful Practice

01:06:54 - The Financial Wheel and Its Impact on Small Businesses

This week we bring together urologists and radiologists to work towards a shared goal of innovating on kidney cancer care. Dr. Jason Abel, Professor of Urology and Radiology at the University of Wisconsin, and Dr. Louis Hinshaw, Section Chief of Abdominal Imaging Intervention at the University of Wisconsin, join our host Dr. Ruchika Talwar for a multidisciplinary conversation regarding the treatment of renal tumors.
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This podcast is supported by:
NeuWave Microwave Ablation Systems
https://www.jnjmedtech.com/en-US/product-family/neuwave-microwave-ablation-systems
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SYNPOSIS
Their discussion covers the history and benefits of collaboration between urology and interventional radiology (IR), advances in image-guided procedural technologies, and the importance of teamwork in improving patient outcomes. The episode also considers the encouraging, but limited data in IR treatments such as microwave ablation and discusses the lasting role for surgery. Finally, Dr. Abel and Dr. Hinshaw share their experiences in establishing a successful interdisciplinary kidney cancer program. Ultimately, they conclude that the future of renal tumor treatment lies not in silos, but in collaboration.
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TIMESTAMPS
00:00 - Introduction
04:04 - Collaboration Between Urologists and Interventional Radiologists
05:58 - Advancements in Ablation
10:05 - Patient Selection
15:19 - Technical Considerations
26:57 - Post-Ablation Surveillance and Recurrence Management
33:19 - Conclusion

Who is the ultimate candidate for GAE, which technical approach is best, and how do you set your patients up for success? Tune into this week’s episode of BackTable to hear from interventional radiologists Dr. Osman Ahmed (University of Chicago Medicine) and Dr. Siddharth Padia (UCLA Health) as they discuss everything from patient selection to follow-up care, covering pre-procedure imaging, access, embolics, technical challenges, clinical data, and the future of genicular artery embolization.

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SYNPOSIS

Dr. Ahmed and Dr. Padia debate their approaches to patient selection criteria, the use of MRI and cone beam CT, permanent vs. resorbable embolic materials, how many arteries to embolize, and the relevance of pain metrics post GAE. They also delve into follow-up considerations and the potential for GAE as a long term treatment.

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TIMESTAMPS

00:00 Introduction

01:08 MRI for Patient Selection in GAE

08:53 Access Techniques: Femoral vs. Pedal

17:07 Cone Beam CT in GAE Procedures

27:20 Embolization Strategies

39:30 Challenges and Complications in Embolization

44:50 Follow-Up and Pain Metrics in Clinical Practice and Research

01:06:30 Repeat GAE Procedures: When and Why?

01:11:13 Post-Total Knee Replacement and GAE

01:21:01 Advice for IRs Looking to do GAE

01:24:32 Conclusion and Final Thoughts

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RESOURCES

GENESIS Trial: https://pubmed.ncbi.nlm.nih.gov/33474601/

Landers et al Trial: https://pubmed.ncbi.nlm.nih.gov/37051829/

Are you thinking about pursuing a new diagnostic radiology gig? Get the download on the current job market, how to evaluate different compensation models, and what to look out for when considering your next job offer in this week’s episode of BackTable, featuring guests Dr. Ned Holman (Neuroradiologist at Alaska Imaging) and Dr. Mike Romeo (Radiologist and President of West Reading Radiology).

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SYNPOSIS

The doctors begin by exploring various employment models, including private practice, academic positions, and hybrid arrangements that combine elements of both. They share valuable insights on job transparency and the significance of leveraging professional connections to gain honest, firsthand perspectives on potential employers. They also provide advice on key questions to ask during job interviews and strategies for negotiating contracts. The doctors conclude by sharing tips to help make informed decisions to ensure job satisfaction and professional growth.

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TIMESTAMPS

00:00 - Introduction

04:30 - Employment Models

06:32 - Compensation Structures

08:43 - Evaluating Job Offers

19:05 - Red Flags in Employment

27:13 - Private Equity Jobs: Pros and Cons

31:36 - Navigating Job Boards and Resources

42:03 - Final Advice for Job Seekers

The road towards financial literacy and financial freedom does not need to be a solo, do-it-yourself, figure it out as it goes type of journey. Guest Dr. Jim Dahle (practicing emergency medicine physician and Founder of the White Coat Investor) joins host Dr. Chris Beck to help better illuminate the process of becoming financially literate and securing financial freedom for physicians and others in similar professional arenas.

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This podcast is supported by:

RADPAD® Radiation Protection

https://www.radpad.com/

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SYNPOSIS

Dr. Dahle begins the episode by driving home how sound and solid financial education coupled with early, prudent financial behaviors can be worth millions over a career. The doctors discuss writing investment plans, goal setting, and understanding of asset allocation to ensure long-term financial success. Dr. Dahle also delves into the Mega Backdoor Roth IRA, practical tips for handling savings and expenses, as well as how to integrate real estate into your investment portfolio. The episode concludes with helpful resources, programs, and conferences available through the White Coat Investor.

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TIMESTAMPS

00:00 - Introduction

04:30 - Savings Tips and Strategies

13:22 - Retirement Goals and Savings Targets

28:20 - Real Estate as an Investment

32:30 - Mega Backdoor Roth IRA

42:59 - Advice for New High-Income Earners

46:09 - Teaching Financial Literacy to Kids

48:15 - Addressing Physician Burnout

53:53 - Common Financial Mistakes by Doctors

58:11 - White Coat Investor Book Giveaway Program

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RESOURCES

White Coat Investor:

https://www.whitecoatinvestor.com

BackTable VI Episode #194 - Financial Basics from the White Coat Investor with Dr. James Dahle:

https://www.backtable.com/shows/vi/podcasts/194/financial-basics-from-the-white-coat-investor

White Coat Investor Champions Program (For Students):

https://www.whitecoatinvestor.com/wci-champions/

Navigating the intricate world of medical billing can be challenging, and knowing the steps needed to ensure fair reimbursement can be even more challenging. Guests Dr. Bret Wiechmann and Dr. Jerry Niedzwiecki (private practice interventional radiologists) join host Dr. Ally Baheti to discuss how IRs in the OBL setting can legislatively rally behind the office-based facility concept and improve physician reimbursement in the light of developments addressed at the recent OEIS meeting.

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SYNPOSIS

Dr. Wiechmann and Dr. Niedzwiecki begin the episode by defining several key-terms and processes in physician reimbursement in the outpatient setting to help orient us to the issue at hand. After explaining why and how reimbursement for more advanced procedures in the OBL setting has been lagging behind, the doctors introduce the concept of creating an office-based facility concept. This would help stabilize payments for complex procedures done in the OBL space. The episode concludes with emphasis on more physician involvement and advocacy in pushing reform forward, underscoring how a unified effort is essential for long-lasting, meaningful change.

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TIMESTAMPS

00:00 - Introduction

01:42 - Medicare Physician Fee Schedule

05:46 - Challenges with Current Reimbursement Models

11:28 - Proposing the Office-Based Facility Concept

17:58 - Legislative Efforts and Congressional Involvement

26:53 - Call to Action: How You Can Help

36:40 - Conclusion

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RESOURCES

Outpatient Endovascular and Interventional Society:

https://oeisweb.com

What are the 10 Commandments of Being a Female Interventional Radiologist? Guest Dr. Maureen Kohi (Chair of Radiology at University of North Carolina Chapel Hill) sits down with host Dr. Ally Baheti to discuss the details of her popular lecture topic and how these 10 rules are actually applicable to all current and future interventional radiologists.

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SYNPOSIS

Dr. Kohi begins by going through each of the 10 points - offering detailed advice throughout, while also acknowledging nuances and challenges women and men can encounter in medicine and best approaches. Dr. Kohi also speaks on how to build and navigate strong relationships with industry. The episode concludes with several more pearls of wisdom as Dr. Kohi shares the last of the 10 commandments.

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TIMESTAMPS

00:00 - Introduction

01:08 - 10 Commandments of Being a Female IR

23:06 - Importance of Involvement in Professional Societies

24:46 - Childcare Concerns in Professional Settings

28:58 - Making the Leadership Leap

35:24 - Navigating Gender Bias in Professional Environments

41:51 - Prioritizing Health, Family, and Personal Fulfillment

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RESOURCES

From Good to Great (Book):

https://a.co/d/gXWW1Qp

Start With Why (Book):

https://a.co/d/hgaadIt

In honor of the 50th annual meeting of the Society of Interventional Radiology (SIR) in Nashville, let’s take it back to the beginning of IR and review how the field became what it is today. Guest host Dr. Andrew Niekamp (interventional radiologist at Miami Vascular) sits down with esteemed guest Dr. Barry Katzen, who began his training at the advent of IR, to discuss the origins and development of the field since its inception.

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This podcast is supported by:

RADPAD® Radiation Protection

https://www.radpad.com/

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SYNPOSIS

The doctors discuss challenges and innovations that shaped IR’s growth, and the importance of clinical practice and patient-centered care. Dr. Katzen shares insights from his extensive career, including his early involvement in advancing image-guided therapies, his role in founding Miami Cardiac & Vascular Institute, and strategies to overcome turf-wars and complacency in medicine. Dr. Katzen emphasizes the need for continuous innovation and dedication towards improving patient outcomes in the evolving landscape of IR. The episode concludes with Dr. Katzen’s advice for future and early-career IRs.

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TIMESTAMPS

00:00 - Introduction

03:39 - Early Innovations and Training in Europe

09:08 - Founding the Miami Cardiac and Vascular Institute

17:13 - Challenges and Innovations

25:24 - Importance of Clinical Responsibility

34:07 - Birth of a Specialty

40:35 - Advice for Future Interventional Radiologists

43:29 - Conclusion

Is social media an effective patient acquisition tool for interventional radiologists? In a word: absolutely. Learn how to reach more patients in this week’s BackTable Podcast, where Dr. Gustavo Elias joins Dr. Ally Baheti to discuss the benefits he has seen with social media, and the content strategies that he uses in his medical practice.

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SYNPOSIS

The episode begins with Dr. Elias sharing his journey of overcoming initial reservations around posting content. The doctors emphasize the importance of individuality and passion in showing what IR can offer to the public in easily-digestible ways. Dr. Elias then discusses the impact of social media on patient engagement, and shares practical tips for physicians who are looking to enhance their online presence. Dr. Elias also touches on optimal posting schedules, collaboration tips, and balancing professionalism with approachability.

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TIMESTAMPS

00:00 - Introduction

04:02 - Social Media for Interventional Radiologists

08:56 - Building a Social Media Presence

19:24 - Optimal Posting Strategies

21:58 - Collaborations and Platforms

25:27 - Conclusion