What are your current areas of research?
One of my current areas of research is the use of carbon dioxide as a contrast agent for visualisation of blood vessels for diagnosis and endovascular procedure, and a safe gas delivery method without air contamination. Conventional contrast materials containing iodine can be toxic to the kidney when its function is poor and may cause allergic reaction. However CO2 is a natural bi-product and therefore, has no chance to injure the kidneys and cause allergic reaction when administered into the vascular system. CO2 is a proven safe contrast agent in patients with compromised renal function and a history of allergic reaction to iodinated contrast material. It often provides additional diagnostic information and in some areas the gas is superior to iodinated contrast medium. CO2 should not be used in the thoracic aorta, coronary and cerebral circulation.
What are your views on how complications are currently measured in interventional radiology?
Documentation and review of procedure-related and outcome complications are important in improving patient care quality. There has been no standardisation of measurement of complications in interventional radiology. I believe that a comorbidity-adjusted complications risk should be incorporated in the current system provided by the SIR Standards of Practice Committee since more and more complex and high-risk patients are being referred to interventional radiology. The SIR Standards of Practice Committee have published a number of quality improvement guidelines for specific interventional radiologic procedures. Overall the documents are excellent and should be used for the VIR fellowship training and quality assurance programme.
If you had a wish-list on three areas you could improve in interventional radiology, what would they be?
I believe that interventional radiology is a victim of its own success. Interventional radiology practice and healthcare delivery, and the education of its trainees will need to be redefined for the future of interventional radiology. It is known that our procedures are safer and effective, benefitting both patients and interventional radiologists. Before considering a wish-list I want to briefly discuss the challenges that interventional radiology faces. The two main challenges are migration of endovascular procedures to other disciplines and often insufficient support from the academic departments and healthcare leadership while the number and variety of vascular and nonvascular interventional procedures have increased. Furthermore, the complexity of the cases performed in interventional radiology has significantly increased, often requiring intervention and hospital admission after hours. In brief, interventional radiology practice requires performance of interventional procedures, writing pre- and post-procedure notes, generation of procedure reports, admission, inpatient ward rounds, clinic follow-up, and outpatient clinic. Interventional radiologists have many other responsibilities including teaching, research, and participation in the local, regional and national committees.
Here is my wish-list: first, interventional radiology practice needs strong support from the healthcare leadership and radiology department chair with regard to equipment, space and support staff. Second, once adequate support staff is available, we should expand both interventional radiology inpatient and outpatient practice. Third, I strongly believe that in the cardiovascular centre setting, fragmentation of academic medicine should be avoided and multidisciplinary, coordinated patient care practice should be instituted. The healthcare leadership must promote a team concept and creation of multidisciplinary collaboration to achieve compassionate interventional radiology clinical practice and excellence in education and research.
In summary, interventional radiologists may face significant challenges in their practice in the coming years. Many interventional radiologists will suffer from inadequate support from their own radiology departments and healthcare leadership. Interventional radiology will witness continuous migration of endovascular procedures as vascular surgeons, cardiothoracic surgeons, and interventional cardiologists continue to expand their endovascular practices. Since interventional radiology is involved in the healthcare business, it must be prepared to provide comprehensive patient care.
What are your interests outside of medicine?
Outside of medicine I enjoy spending time with my wife Young and our three children, Cathy, David and James. My interests include playing the violin, tennis, racketball, gardening and golf. I try to practise the violin every day. Golf is interesting, challenging and also rewarding, like my profession.
1960–66 Catholic University, Medical School, Seoul, Korea, MD
1982 Professor, Radiology University of Michigan Medical School
1997–present Director, Radiology Animal Imaging Lab, University of Michigan, Medical School
2005–present Consulting physician, VA Medical Center, Ann Arbor
1989–1992 Consultant to editor, Journal of Interventional Radiology
1990–2001 Consultant to editor, Journal of Cardiovascular and Interventional Radiology
2001–present Managing editor, Emedicine, Interventional Radiology
1980–present Reviewer, American Journal of Roentgenology
1991–2000 Reviewer, Journal of Vascular Surgery
1992–2001 Reviewer, Journal of Cardiovascular and Interventional Radiology
1990–present Reviewer, Journal of Vascular and Interventional Radiology
2002–present Chief editor, eMedicine, Interventional Radiology
2005–2008 Assistant editor, American Journal of Roentgenology
Selected honours and awards
1982 Award for Outstanding Teaching of Radiology Residents University of Michigan Hospitals
2003 Lifetime Achievement Award in Medical Education, University of Michigan Medical School
1999 William Martel Collegiate Professor of Radiology (Endowed Professorship)
University of Michigan Medical School
July 2000 Distinguished professor of Radiology, Department of Radiology, The Catholic University, Seoul, Korea
2011 JVIR Editor’s Award for Distinguished Reviewer
Selected membership in professional societies
- American College of Radiology
- American Medical Association
- American Roentgen Ray Society
- Radiological Society of North America
- Society of SIR, fellow
- Society of Gastrointestinal Radiology
- Fellow of American College of Radiology
- Advisor, the Vascular and Interventional Radiology Foundation, Hong Kong