1 on 1 with a Third-Generation Radiologist

drmcbreamy

“I am a third-generation radiologist. I remember going in as a young boy and helping hang films for my father when he was on call.”

Dr. Peter Bream Jr. ( @drmcbreamy ) has been fascinated with medical images since he was a young boy. He studied psychology at Davidson College and became enthralled with computer imaging. During medical school he authored a computer program on embryology. Since becoming an Interventional Radiologist, he has amassed a large teaching file in his role of program director for the Interventional Radiology (IR) fellowship. He’s currently an Associate Professor of Medicine and Radiology at the Vanderbilt University Medical Centre.

Technology and interventional radiology

In our inaugural Figure 1 on 1, people asked Dr. Bream about emerging technology in interventional radiology, including 3D printing, virtual reality devices, and remote radiologic interventions.

“Absolutely! There is a huge opportunity for 3D printing to be used to create custom stents, occlusion devices, and catheters for unique anatomical situations. Virtual reality is another space where preoperative planning of embolizations by being able to ‘fly’ through the vessels would be very helpful. Right now, we have to translate 2D into 3D in our heads.”

“There are two new robots out on the market right now, allowing the IR physician to get away from the radiation and steer catheters and wires from across the room. I can see a future where that could be taken offsite. Perhaps we could have IR doctors who perform the highest number of certain cases be able to do these remotely.”

Dr. Bream was also asked how he keeps abreast on current best practices and the latest research:

“I read 2-3 journals a month, most importantly Journal of Vascular and Interventional Radiology (JVIR) but also Radiology and Radiographics. I stay up on Twitter. I lecture and attend meetings all year. Plus, we are always trying new things. Not a week goes by that I don’t learn or try something new.”

A career in IR?

One medical student considering a career in radiology asked how much interaction an interventionalist has with patients:

“Great question! This is why I became an Interventional Radiologist. We have tons of patient contact. I see patients in clinic on Mondays, and perform procedures the rest of the week. I took an IVC filter out of a patient today. I placed it in November, followed the patient, saw them in clinic after I ordered doppler ultrasounds on the patient. I then took it out today. Good example of this.”

Pediatric radiation exposure

A Registered Nurse working in pediatrics asked @drmcbreamy what special risks there are to consider for pediatric patients, and how he explains the risks involved:

“I work at the Monroe Carell, Jr. Children Hospital at Vanderbilt. Radiation exposure is a forefront concern, hence the “Image Gently” campaign. In IR, luckily the radiation equipment is high energy. This means that it passes through the patient and less radiation is deposited. Using this modern equipment cuts radiation exposure tremendously. We do discuss with parents, always.”

Three month old with chylous effusion
“Three month old with chylous effusion s/p thoracic duct ligation.” Click to see the full case from @drmcbreamy.

 

Click here for the full Q&A with Dr. Peter Bream.