Bill Klaproth (Host): This is Columbus Community Hospital Healthcasts. I'm Bill Klaproth. With me is Dr. Matthew Pieper, a radiologist at North Central Radiology, as we take you through a behind-the-scenes look at how radiology drives accurate diagnoses and supports comprehensive patient care at Columbus Community Hospital. Dr. Pieper, welcome.

Matthew Pieper, MD: Thanks for having me, Bill. Good to be here.

Host: You bet. Thank you so much for your time. So, let's start with this. How do you and your team at North Central Radiology collaborate with other providers to solve diagnostic challenges and support overall patient care in our community?

Matthew Pieper, MD: Well, kind of the crux of our job is to take the information that clinicians have about signs or symptoms that their patients are experiencing and to help them find the best test to get the next answer to continue treating their patient. So, it's really the crux of what we do every day.

Host: So, that whole team, it's all kind of baked in then.

Matthew Pieper, MD: Exactly. Everybody from our sonographers to our x-ray technologists and CT and MRI scanners know how to help clinicians order the right test and get the right study so that we can answer the clinical question at hand.

Host: Absolutely. So, you read everything from x-rays to CT MRI, PET scans, ultrasounds, and more. Can you walk us through what goes into interpreting complex imaging and how it helps clinicians pinpoint a diagnosis?

Matthew Pieper, MD: Yeah, absolutely. So in all of our studies, which there's a wide range, it's important for us to be systematic so that we look at everything. It can be our tendency to look just for the main problem, just to answer the question, but it's important that we look at everything the same way every time, whether we're looking at imaging of the head or imaging of the chest, because we wouldn't want to miss something that might not be causing problems now, but could cause problems in the future. So, incidental findings are common, and it's also possible that there are some red herrings with symptoms. So, maybe the big problem for the patient isn't the thing that brought them in for this study. So, we kind of try to look at every study the same way every time and look at every part of the body that's imaged so that we make sure we don't miss anything.

Host: And I would imagine incidental findings sometimes can be life-saving.

Matthew Pieper, MD: Absolutely, yes. Sometimes they're absolutely incidental and nothing needs to be done or worried. We just follow them up or ignore them. But other times, they're something that would've been a silent killer. So, there are lots of things like vascular aneurysms that don't cause symptoms until it's catastrophic or cancers that don't cause symptoms until they're too late to be treated. So, people don't usually have a symptom, that we just get lucky and find them on imaging done for another reason, and that can really make a difference in a patient's quality of life.

Host: Well, we're glad you're scanning everything. That is for sure. So, medical imaging is evolving quickly, just like it seems like all of technology in our lives. What recent innovations or improvements in radiology have made the biggest impact on accuracy, safety, and patient comfort?

Matthew Pieper, MD: Yeah, I think there are always lots of changes in each modality that we do, so it's hard to pick one. But I think a good, although kind of niche example, we're doing some new imaging with ultrasound to evaluate people with liver disease that's allowing us to give some more quantitative measurements to their doctors about the state of their liver.

For a long time, the only way to kind of truly measure liver disease was to do a biopsy and take tissue out of the liver. And as you can imagine, it's not really good for patients to be doing lots of biopsies. But if we can develop this method of non-invasively giving a quantitation of their liver disease, then that can help clinicians and patients know that things are getting better or if things are getting worse and treatment needs to change. So, that's kind of, hopefully, going to be a big improvement for patients..

Host: Yeah. That is good news to look forward to. So, we all love living in a smaller community. How does working in a smaller community shape the way you practice radiology and interact with patients and providers?

Matthew Pieper, MD: Yeah, it's one of my favorite things about practicing here. We personally know virtually all of the referring clinicians, which allows us to call if we have a question about whether we're doing the test the right way. Or if there's something that isn't adding up in the imaging, we can call and ask for corroboration of physical exam findings or history. We know how the orthopedic surgeons like to practice. So, a lot of times, we know how they want things done, which is a lot simpler than in a bigger place where there's too many referring providers for you to know. So, I think it helps to have a nice, tight knit medical community. I think it helps us deliver very high quality care.

Host: So, radiologists often help crack difficult cases. You're able to go in there and see the things that we can't see from the outside. Can you share-- maybe without breaking confidentiality-- an example of a diagnostic dilemma where imaging played a role in helping kind of crack the case and help the team find answers?

Matthew Pieper, MD: Absolutely. Sometimes there are very elaborate examples of that, but I think there was a good example just last week. In the emergency department, a patient came in with right-sided pain and it was hard clinically to know whether they were having a problem, like with an infection or a stone in their kidney or if it was a problem with their bowels or their appendix. So, we were able to do a CT scan, let the provider know exactly what the problem was, and they were able to go to surgery and have everything cleaned up without any, "Do we need to give antibiotics and wait?" Kind of just very cleanly gave an answer and they got the treatment that they needed right away.

Host: I love that story. That so good to hear. I imagine that that happens more often than not. Would that be true?

Matthew Pieper, MD: Well, I think it is true that, lot of times, when patient's have pain, it can be a differential diagnosis for the referring provider. They know they can narrow it down to two or three or four things, but it's hard often to narrow it down to, "I know for sure This is the problem." So, the imaging can help them have a lot more clinical confidence that they're definitely treating somebody the right way, and they don't have to kind of hedge or try to treat two things and hope things get better. The imaging can really give them a lot of confidence that they're going in the right direction.

Host: Absolutely. And that is a good feeling. So because radiology touches nearly every field, you're part of a broad care network. What does teamwork look like between radiology and other specialties at Columbus Community Hospital? And how does that collaboration benefit patients?

Matthew Pieper, MD: Well, I think we have an excellent team of technicians in the radiology department, radiologists and schedulers at the front that know how to get in touch with other parts of the hospital in particular or other members of the outpatient care community through our general practice providers and the outpatient surgical teams. So, we're able to kind of narrow the gap in communication and make sure that open-ended things get closed. Things don't fall through the cracks that way. So, I think it's really nice to have that small, tight-knit community.

Host: Communication is so important. And when you say it helps so things don't fall through the cracks, that's really important. So, thank you for sharing that. So again, as we move into the future, technology is evolving. Everything is evolving. What changes do you anticipate in the field over the next few years? And specifically, how is North Central Radiology preparing to meet the evolving needs of the Columbus community?

Matthew Pieper, MD: Yeah. Well, we're always trying to stay on the front lines of having top of the line equipment. The hospital is great about making sure we aren't using outdated equipment, which radiology equipment is expensive. So, it requires capital investment. We are currently with the building of our cancer center. We're adding a PET CT scanner, which is a service we've provided through a mobile service for the past few years, but having it in-house will allow ease of scheduling for patients. We also continue to provide new CT and MR services so they aren't new scanners, but new services through those scanners that can help our clinicians stay on the cutting-edge of diagnoses as we go forward.

Host: This has been fascinating. Thank you for talking to us about radiology and the work that you do. Before we wrap up, is there anything you'd like to add?

Matthew Pieper, MD: No I just really encourage people to continue to get care through their clinicians. They know how to be in contact with us in radiology to make sure they're getting what they need.

Host: Absolutely. Dr. Pieper, thank you so much for your time.

Matthew Pieper, MD: Thanks, Bill. I appreciate you.

Host: You bet. Once again, That is Dr. Matthew Pieper. And for more information and resources you can visit columbushosp.org/clinics/north-central-radiology. It's all there for you right there. And if you found this podcast helpful, please share it on your social channels and check out the entire podcast library for topics of interest to you. This is Columbus Community Healthcasts. Thanks for listening.