IRQ Articles

2020 Gold Medalists 

04-22-2020 16:03

James F. Benenati, MD, FSIR

James F. Benenati, MD, FSIR, is a practicing interventional radiologist, medical director of the noninvasive vascular laboratory and fellowship program director at the Miami Cardiac and Vascular Institute (MCVI) at Baptist Hospital, where he has practiced since 1990. He also serves as head of interventional radiology at Radiology Associates of South Florida. Dr. Benenati also serves as vice chair of the new department of interventional radiology at Florida International University Herbert Wertheim College of Medicine and collaborative professor of radiology at the University of South Florida Morsani College of Medicine. A past-president of SIR, Benenati also chaired the SIR 2005 Annual Scientific Meeting. Dr. Benenati has also worked in a variety of roles within the society, including as chair of the Corporate Ambassadors Program. He delivered the Dr. Charles T. Dotter Lecture in 2014. A participant in numerous clinical research projects and national trials, he lists among his interests peripheral arterial disease, abdominal aortic aneurysm therapy, management of pulmonary embolism, management of acute clot and uterine fibroid embolization.

How/why did you choose interventional radiology?

I chose IR more by accident than by design. I was taking a radiology elective as a med student primarily to take an easy elective and get done early. On that elective, I met a neuro IR attending named Reed Murtagh who brought me into a room to watch a vein of Galen embolization and that got me started. A few years later at Indiana University, Dr. Gary Becker solidified my thoughts, guiding my career plans with exceptional mentoring and great friendship.

Who has been your biggest inspiration?

My biggest inspiration is and was my father, a dedicated physician who always put family first.

What’s the best career advice you’ve received?

Pursue what you love to do and everything else will fall in place.

What hospital or practice has been most influential for you?

I have worked at Miami Cardiac and Vascular Institute for 31 years. I consider this my work home. I love my partners and enjoy their company every day. Barry Katzen recruited me, and over the past 30 years he has been a close friend and role model. Working in this group has afforded me the opportunity to work with fantastic people, do cutting-edge IR and, in many instances, innovate with new procedures and techniques. It has given me the ability to work with trainees and develop a phenomenal training program, as well as allowed for both a clinical practice and growth and development in leadership roles in SIR. Really, in many ways, the perfect job!

What continues to fuel your passion for IR?

My passion is fueled by new opportunities to innovate and work with new devices and ideas.  I am also highly motivated by our trainees who are inspiring and talented. Being able to help mold our future by training our future leaders is the most rewarding part of my practice.

What do you think comes next for IR?

I see a lot of changes on the horizon. More and more clinical involvement is necessary in order to compete with other specialties. New training models for IR residents will have to continue to morph and develop. Continued innovation with industry partners is going to be necessary. I think in the future IR will continue to lead the way in device development, less invasive procedures and timely service, but we will need to improve our registries and trials to demonstrate our value.

What does receiving SIR’s Gold Medal mean to you?

The Gold Medal is the highest professional honor I can receive. It is truly humbling because I know there are so many who also deserve this. I am thankful to those who selected me and appreciative that many years of dedication to SIR has been recognized. It is actually overwhelming and difficult to even express the gratitude I have. With that said, I would like to say that my family (wife Sue and children Lauren, Nick and Matt) are the ones I would like to thank the most. They enabled my career with unconditional love, support and friendship. That was the catalyst for me.


Michael C. Soulen, MD, FSIR

Michael C. Soulen, MD, FSIR, is currently professor of radiology at the Hospital of the University of Pennsylvania, Philadelphia. Dr. Soulen’s practice focuses on neuroendocrine tumors (NETs), the second-most-prevalent GI malignancy. He is the founder of the NET Tumor Board at University of Pennsylvania and is the principal investigator of the RETNET trial, a global multicenter randomized comparison of embolization techniques for NET liver metastases. He has chaired the North American Neuroendocrine Tumor Society Annual Meeting and is the first radiologist to sit on its board of directors. Soulen has 13 years of service on the SIR Executive Council and SIR Foundation Board of Directors, including as part of the Annual Scientific Meeting Committee and on the SIR Foundation Board as Research Education Division chair. He presented the Dr. Charles T. Dotter Lecture in 2010. A champion for the growth of interventional oncology, Dr. Soulen is a founder and past-president of the Society of Interventional Oncology.

How/why did you choose interventional radiology?

As a second-generation IR, I had more exposure than most to what IR was really about. Nonetheless, my route was circuitous. I did basic research in ecology and evolutionary theory. I spent a year in a GI lab. I considered anesthesia before choosing radiology. I loved abdominal imaging. In the end what I liked most was hands-on procedures and being involved longitudinally in patient care.

Who has been your biggest inspiration?

My parents are role models for hard work, integrity, humility, the primacy of science and selfless dedication to contributing to those around them and to society at large.

What’s the best career advice you’ve received?

We have many mentors for many facets of our lives at different times. At Johns Hopkins, Bob White ran a model IR clinic alongside the cardiologists and surgeons long before the turf wars started. Each of my fellowship attendings at Jefferson nurtured a different skill set: technical, clinical, research and life balance. Stan Baum told me not to become a journal editor. Mike Pentecost taught me to eat cocktail weenies with your enemies and look like you are enjoying it, and that everything is shades of gray. That was a very hard lesson to learn.

What hospital or practice has been most influential for you?

My one and only job has been at the Hospital of the University of Pennsylvania. I hit the trifecta—Stan Baum, MD, FSIR, was my chair, then-SIR-President Mike Pentecost, MD, was section chief and Stan Cope, MD, FSIR, was my partner. For many reasons there is no better place for academic IR. The physical location in the heart of an Ivy League university, itself surrounded by the University City science district, provides endless opportunities for collaboration across departments, schools and institutions. The place is a giant culture medium for anyone with the fire in their belly to take root and grow.

What continues to fuel your passion for IR?

Right now it is clinical trials and IR advocacy in the clinical realm. Controlled trials are the only way to move the needle as far as practice and guidelines. It is a huge deficiency in IR. 70% of what appears in our journals wouldn’t even be reviewed by a high-impact clinical journal. We have so many barriers to overcome, starting with a dearth of trained clinical trialists. When I joined the faculty of the RSNA Clinical Trials Workshop, there was one IR student. In the past 5 years we have trained 30 students. We must continue to feed this pipeline. Clinical trials cost a fortune, require huge amounts of infrastructure and time, and depend on multicenter collaboration—all things historically lacking in the IR world. They are on a scale our usual industry partners are not used to funding. New relationships will be required to meet these needs.

Our voices need to be heard in disease states dominated by internal medicine specialties. The Society of Interventional Oncology cooperative groups and NCCN task forces have made major strides injecting IR into these influential organizations. Similar advocacy in the domains of stroke, spine, vascular diseases and women’s heath are essential for the future of IR.

What do you think comes next for IR?

Bigger and better! Most of what I did as a fellow no longer exists, and most of what I do now did not exist back then. Technology will make us less invasive and more precise. The marriage of biology with image guidance will transform us from hammers into avatars of precision medicine. AI and robots will make us better but never replace us.


David M. Williams, MD, FSIR

An international authority on endovascular treatment of aortic dissection and central venous recanalization of the IVC and SVC and their major tributaries, David M. Williams, MD, FSIR, is the Kyung J. Cho Professor of Radiology and professor of internal medicine at Michigan Medicine, University of Michigan, Ann Arbor.

How/why did you choose interventional radiology?

Through medical school I had a difficult time deciding between radiology and general surgery. I got the medical school and radiology bug in the U.S. Navy, working in a radiology department as a radiation physicist and safety officer at the Navy Regional Medical Center in San Diego. Unexpectedly, I found during my clinical rotations as a medical student how much I liked the surgical specialties; that was the surgery bug. I ranked surgery right under radiology for Match Day, and radiology picked me first. As first-year residents, we spent the night in the ED, and in lulls between cases I would wander around the department seeing what was going on. Once, I wandered into a room where Kyung Cho, MD, and his team were looking for a GI bleeder, and I was bitten by the IR superbug, and I aimed at interventional radiology ever after.

Who has been your biggest inspiration?

In my early years my biggest inspiration was Dr. Cho, IR at Michigan for over 30 years. I joined IR while it was making the transition between diagnostic radiology and an interventional subspecialty. Dr. Cho was an advocate of performing exams that conclusively answered clinical questions—i.e., careful attention to the physics of imaging, limitations and strengths of the imaging devices, patience and dogged persistence, and the biology of the organ and its disease proclivities were assimilated and orchestrated to justify the technical risk of an invasive study.  

What’s the best career advice you’ve received?

It was to try to correlate operative and pathological findings to our imaging studies. What accounts for what we see? What are we missing? I remember being puzzled by diffuse abdominal organ failure in patients with aortic dissection. Although at the patient’s autopsy these aortas showed the two channels we expected, the channels sat together nicely and the walls looked normal with little of the ugly and misshapen atherosclerosis we saw routinely in the aortas of older patients—everything looked so benign. The first time I viewed a live dissection using intravascular ultrasound, I saw the dissection flap up against the front wall of the aorta obstructing the celiac and superior mesenteric arteries like a curtain and thought, “Ah, now I see.”

What hospital or practice has been most influential for you?

I have only practiced at University of Michigan, where my clinical practice has flourished because of close cooperation among IR, thoracic surgery and vascular surgery.

What continues to fuel your passion for IR?

In vascular diseases like aortic aneurysms and dissections, the challenge for IR is to match devices to ultimately delicate vascular tissues. How can you improve devices, device–tissue conformability and device deliverability?

What do you think comes next for IR?

From the viewpoint of my clinical practice, the major challenge is negotiating small paths of neutral territory winding between structures carrying high-pressure blood or critical nerves. Intravascular ultrasound is an excellent instrument, but it has a small field of view and you can only use it where you have already delivered the carrier wire. It can verify that you have achieved a safe passage, but it cannot independently guide you there. From my clinical vantage, I need a recanalization needle or other device that is integrated into fluoroscopy and fused CT imaging to allow safe recanalization in the groin, at the brim of the pelvis, and immediately above and below the heart.

What does receiving SIR’s Gold Medal mean to you?

I think the SIR Gold Medal acknowledges that a person has added an important tool or procedure to the general stock of medical and specifically IR knowledge. Look at the stethoscope in general medicine. Look at stents. At one time stents were exotic, revolutionary and daring; stent deployment was almost a religious rite. Now senior residents implant them without raising their heartrate, and stents have diffused out into urology and gastroenterology, to say nothing of cardiology, vascular surgery and thoracic surgery. The notion that some of your work has entered the general stock of IR practice is awesome.

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This article is part of Connecting Everywhere, a special section of the spring 2020 IR Quarterly, highlighting how SIR and IRs have responded to the global COVID-19 crisis with teamwork, agility and innovation.

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