Terry DuBose

Terry J. DuBose, MS, RDMS, FSDMS, FAIUM, has recently retired from his post as Director of the Diagnostic Medical Sonography Division at the University of Arkansas for Medical Sciences (UAMS). He has relocated from Little Rock, Arkansas, to Austin, Texas.

How did you become interested in the field of sonography?

I had a BS in Business Administration, and after I came back from Vietnam, I spent two years protesting the Vietnam War fulltime. When I decided I wanted to get into health services, I went to a career counselor at the Texas Hospital Association. He looked at my background, which included photography and silk screening, and recommended radiography. I entered school, and then went to work at Seton Hospital. I heard about ultrasound (sonography now) from some colleagues who had been at the University of California and started requesting the hospital buy a machine. When the first sonographic machine in Austin showed up, I was on the loading dock. They basically put me in a cubicle in ICU and told me to figure it out. I got a text book, Sample and Sarti, and started scanning myself until I could duplicate the liver and gallbladder in the book. I was doing special procedures at the time, and I began doing more and more sonography. 1979 was the last time I took an X-ray.

What are the most significant technological advances you’ve seen over the course of your career?

I think there were really three that were the greatest sonographic advances. The first is real-time, and the second is color Doppler and spectral Doppler integration, and the third is 3D.

What do you expect to see over the next 10 years?

I think that image fusion, integrating sonography with CT and MRI, and the use of 3D will continue to develop. 3D imaging is an interesting case of a solution in search of a problem.  3D images of a baby’s face help a lot when communicating a diagnosis to parents, especially in case of something like a cleft palate. But diagnostically, we can see that with 2D. Volumetric studies will lead to great advances in estimating fetal cranial volume and age. Also, the fetal liver volume will tell us more about maternal diabetes and fetal responses. Luis Gonçalves has done fetal heart reconstruction using power Doppler with 3D acquisition and then inversion, so you only see the blood flow of the fetal heart and great vessels, and you’re able to rotate in real time while viewing the beating. Refined, this will gives us incredible views of the fetal heart. We’re doing things we couldn’t do before, and sonography  is better for the fetus than MRI and CT.

What has been your most rewarding or memorable experience in sonography?

Getting the Kenneth Gottesfeld Award for published research in 1985 from the Journal of Diagnostic Medical Sonography gives me the most satisfaction. Frank Hadlock and Larry Waldroup were the peer reviewers on that article. However, it is also one of the most frustrating experiences, because we are still not using 3D imaging to get measurements of the fetal cranium to calculate fetal age.

Do you have any advice for new sonographers?

Definitely go to an accredited program for your education because you will get the proper clinical education. Realize that this will be a lifelong learning situation, because the sonographic instrumentation is advancing rapidly, and you will always be learning something new.

What do you plan to do with your retirement?

UAMS made me an Associate Professor Emeritus, so I’ll still teach one course a semester online – at least until they decide they’re tired of me! I have relocated back to Austin, Texas and will play with my grandchildren.

Dr. Thierry de Baere, MD

Thierry de Baere, MD, is head of the Department of Interventional Radiology at the Institut Gustave Roussy in Villejuif, France. Dr. de Baere has practiced interventional radiology for 19 years, with a focus in oncology. His main interests are tumor ablation, portal vein embolization, intra-arterial therapies and digestive tract intervention. In addition, he is a reviewer for JVIR, CVIR, Radiology and European Radiology.

When and how did you become interested in the field of interventional radiology and radiofrequency treatment?

About 19 years ago, in 1990, I became interested in interventional radiology, and in 1997, we started treating with radiofrequency.  This is really the only treatment for small tumors outside of surgery, and with radiofrequency, we can treat patients who are poor surgical risks. Patients with poor lung function or poor kidney function can be treated and cured, and they might not have been eligible for surgery.

What do you consider the most rewarding aspects of your career?

We are able to cure patients with minimal side effects — patients are cured without scars, without going through chemotherapy.

What has been the most challenging part of your career?

Dealing with cancer every day, in a cancer center, makes it common place for you, but it’s a unique and difficult situation for every patient that you treat. It can make it a bit strange, because it is common to you but uncommon to your patients.

What do you find significant about radiofrequency ablation as compared to other types of treatments?

The side effects of radiofrequency ablation are much less difficult to deal with than other treatments, and it requires less time on the patient’s part — you can go in one day and go out the next. The tumor is completely ablated in one treatment, and there is no other treatment like that. With surgery, you will be in the hospital for days and recovering at home after that; chemo and radiation both require multiple courses.

What technological changes do you expect in the field over the course of the next 10 years?

First, I expect continued improvement in image-guidance. Over the last 15 years, we’ve seen faster image acquisition and better quality plus image fusion. The quality is boosted every year. Second, we’ll see improvement in the tools we’re using for ablation and new drugs dedicated to local delivery.