SBI Recommendations for a Thoughtful Return to Caring for Patients

The Breast Imaging Task Force of the WSRS fully endorses the recent statement put forth by the Society of Breast Imaging which outlines a thoughtful and sensible approach to re-opening of breast imaging services during these uncertain times. We strongly encourage anyone considering this to read the “SBI Recommendations for a Thoughtful Return to Caring for Patients.” We also strongly recommended adhering to evolving guidelines issued by State Government to protect patients and healthcare providers from coronavirus infection.

A message from the WSRS Board

Dear Members,

As you are aware, the Washington State government has taken several measures to slow the coronavirus pandemic, such as social distancing and a pause on all elective medical procedures. The latter includes non-urgent imaging studies and screening examinations. The latest data suggests these measures may have succeeded in slowing the spread of the virus. The WSRS continues to support the WA government’s stance on pausing non-urgent imaging until data supports a return to more normal levels of activity.

The WSRS is an all-volunteer organization and the Board and Executive Committee are composed of practicing Radiologists in the academic and private sector as well Fellows and Residents. As such we too are impacted by the state government public health measures. We are familiar with many of the practice-related and wider economic and societal consequences of the shutdown and extend our empathy and best wishes to all members. The pandemic and its consequences may have provided the time and incentive for members to consider taking a role in some of WSRS’s committees including Government Relations, Membership and Professional Development, and Education and Events. Please forward any expressions of interest to the Executive Director Emily Jones at

Stay safe,

Dr. Ruben Krishnananthan, MBBS, MPH
President, Washington State Radiological Society

COVID-19 Response

The Washington State Medical Association (WSMA), Washington state officials, and the state’s health care community have joined the Centers for Disease Control and Prevention in responding to an outbreak of respiratory illness caused by a novel coronavirus (COVID-19). Initially detected in Wuhan City, Hubei Province, China in December 2019, COVID-19 is now spreading in Washington state and other U.S. locations. 

WSMA has a dedicated COVID-19 resource page that features patient and professional resources:

The ACCME has compiled a list of educational resources about COVID-19 for physicians, all of which include CME credit. The education consists of online courses, video, or articles, and most of these resources are free:

Image Wisely 2020

WSRS pledges to endorse and promote the goals of Image Wisely among our members and students:

Image Wisely is committed to raising awareness throughout the medical community of opportunities for eliminating unnecessary imaging exams and to lowering the amount of radiation used in necessary imaging exams to only that needed to capture optimal medical images.

Image Wisely is a joint initiative of the American College of Radiology, Radiological Society of North America, American Society of Radiological Technologists and American Association of Physicists in Medicine. Learn more here.

3D Mammography in the News

The Seattle Times published a front-page article on Oct. 27 about 3D mammography. This piece, which was written by Kaiser Health News and published in USA Today last week, stated that digital breast tomosynthesis (DBT or 3D mammography) was no better than 2D. This is simply not true.

Since you or your fellow team members might receive related questions from patients, we wanted to provide you with talking points about the benefits of 3D mammography.

They include:

  • The Seattle Times article refers to a study published in 2019, which found more cancers in patients getting 3D mammography, but not enough to reach ‘statistical significance.’ Although this Norwegian study involved 30,000 patients, results from a similar study published in The Journal of the American Medical Association (JAMA) in 2014 (Friedewald) looked at 450,000 patients and found a significant increase in cancer detection (29 percent) among Americans who were studied. If the Norwegian study had been larger, it may have reached the same statistical significance.

  • While cancer detection is the reason for screening, it is not the only goal. The Norwegian study confirmed that 3D mammography lowers recall or false-positive rates. In that study, rates dropped 22.5 percent. That is significant for patients and groups that cite false positives as a major risk of screening. The 2014 JAMA study also reported a 15 percent decrease in recall – which saves money, time, radiation and anxiety.

  • Fewer false positives lead to a significantly better positive predictive value (PPV) for 3D compared to 2D mammography. That is also in the Norwegian study, but not mentioned in the Kaiser Health News article. Again, this saves money, time, radiation and anxiety for patients and the health care industry.

  • Other peer-reviewed articles not mentioned in the Kaiser Health News article have shown the simultaneous increase in cancer detection and decrease in false positives. (Skaane, Rafferty, etc.).

  • Lastly, the WSRS does not have any industry related relationships that would bias this recommendation.

ACR Breast Imaging Toolkit

“Talking to Patients about Breast Cancer Screening” CME Toolkit from ACR

The ACR strongly encourages radiologists to download these materials now available on their website. This toolkit contains informative materials designed to better inform patients and help providers assess the breast cancer screening needs of their patients.

  • Customize them with your branding
  • Share with your referring clinicians and advise them of CME availability!
  • Place patient materials on your website and in your waiting room
  • Print and include in correspondence with patients and referring providers

WSRS President’s Viewbox: May 2019

Dear Members,

The first quarter saw the Executive Committee undertake activities involving political advocacy and networking both locally and in Washington D.C.

At the annual Olympia Day held on January 23rd this year, our delegation visited several State House and Senate members to discuss our concerns regarding proposed legislation on Balance Billing and Wrongful Death expansion. A more detailed account of our activities was provided in the prior legislative update from February. Please click on the link to the May State Legislative Update for more information on how these bills fared.

We have just returned from the annual ACR meeting in Washington D.C., from May 18 – 22. The ACR’s Hill Day was a success for the WSRS; our members met in person with Senators Patty Murray and Maria Cantwell as well as representatives Cathy McMorris-Rogers and Dr. Kim Schrier. We also met the aides for representatives Pramila Jayapal, Denny Heck and Adam Smith. A Federal Legislative Update will be posted shortly.

One of our new goals this year is to share ideas on advocacy with other physician groups with the aim of fostering alliances and possibly furthering our legislative priorities. To that end, I had dinner with Dr. Dominque Coco, the President of the Washington State Society of Pathologists and Dr. Robert Hsiung from the Washington State Society of Anesthesiologists. The gathering was fruitful, and we will continue to discuss working together on advocacy and organizational issues.

Another goal for the year is to raise the profile of the WSRS by participating in charity events relevant to our patients. The WSRS will be a corporate sponsor at the annual Susan G. Komen “More Than Pink” Breast Cancer Walk on June 2nd in Seward Park. I would like to encourage as many members as possible to sign up and join the WSRS group.

The annual meeting this year will be co-hosted with the WSMA on October 12th, approximately 3 weeks earlier than usual. Dr. Jeff Robinson is developing the program that will include speakers from the ACR and those provided by the WSMA.

Successful networking events were held by both the YPS and Women In Radiology (WIR) sections.

The WSRS Board and Executive Committee are all volunteers; we are practicing Radiologists from both the private and academic sector. We are always looking for fresh volunteers to provide new energy and ensure the viability of the organization. If you would like to participate, please contact our Executive Director at

Best wishes for the summer, and I hope to see you at the Susan G. Komen walk.

Dr. Ruben Krishnananthan, MBBS. MPH
President, WSRS, 2018-2020

Ruben Krishnananthan, President of WSRS with Dominique Coco, President of WA State Pathologists Society and Robert Hsiung from WA State Anesthesiologists Society”.


ACR Annual Meeting

The 2019 ACR Meeting in Washington DC was a success.  This important meeting included the annual Capitol Hill Day visits with our Washington State legislators. The WSRS delegates had the opportunity to meet with our legislators in Washington DC on May 22, 2019 to advocate on behalf of our Washington State Radiological Society members on issues that are important to us. If you would like to get more involved in WSRS Advocacy please contact Dr. Jonathon Medverd, WSRS Government Affairs Chair to learn more.

Bill Keyes, Rachel Gerson, John Medverd, Ruben Krishnananthan & Eric Stern visit with Congresswoman Kim Schrier
Bill Keyes and Ruben Kirshnananthan talk with Rep. Cathy McMorris Rodgers

WSRS launches website to answer patient & provider breast density questions

The WSRS Breast Imaging Task Force has created a new website to provide information and answer questions regarding the Washington State Bill 5084, passed in 2018, which requires mammography facilities to inform patients of their breast density beginning January 1st, 2019.  Pages targeted at healthcare providers, facilities, techs/sonographers and patients are available now and will be updated over the next several months.  Please help us spread the word about this very valuable resource.   The website is found at:

Gold medal Chapter Recognition Award

ACR Chapter Recognition Program. ACR IS pleased to announce that WSRS has been selected to receive the award for Excellence in Meetings & Education in Division D. Your chapter’s commitment to excellence in Meetings & Education has not gone unnoticed by ACR.

WSRS President Ruben Krishnananthan and the WSRS Executive Council accept the award on behalf of WSRS Membership at the ACR Annual Meeting May 20, 2019