Rob Optican

@DukeRadiology This is why it's crucial for radiologists to join the @RadiologyACR and participate in @RADPAC youtube.com/live/Y6OC32SgE…

@DukeRadiology DUKE W TREMENDOUS SHOUT OUTS AT ACR'S PRESTIGIOUS MORETON LECTURE!

My thoughts on Dr. Nicole Saphier, President Trump’s third nominee for Surgeon General: She has an active medical license and an ongoing clinical practice. (In 2026, we really shouldn’t have to highlight that… but here we are) She is an exceptionally clear communicator - especially effective at reaching conservative audiences who often tune out traditional public health messaging. I’ve worked with her before and found her to be genuinely fair-minded. She at least tries to see both sides. She leans heavily toward “personal responsibility” and is skeptical of government intervention. That’s understandable, but I hope her time leading the Public Health Service and seeing the programs that actually expand healthy options for people who currently have few will soften that stance a bit. You can’t always make the healthy choice when the environment only offers bad ones. She has no apparent experience running a large organization (the U.S. Public Health Service Commissioned Corps has about 6,000 officers). There will be a steep learning curve, but she’s clearly smart enough to handle it, especially if she leans on her experienced senior officers for support. She has publicly pushed back against both RFK Jr. and President Trump (for example, on claims linking Tylenol or vaccines to autism). That independence is refreshing- She’s no sycophant. The challenge will be maintaining that willingness to speak truth to power once she’s inside the administration instead of commenting from a Fox News studio. Hopefully she’ll be allowed to follow the science wherever it leads. Overall, this is a solid pick. I believe she’ll be confirmed and that she has both the clinical background and the temperament to do a good job.👇🏽 washingtonpost.com/health/2026/04…

💯 👏👏👏

Long term follow up of a phase 1 trial of an mRNA tumor vaccine shows that 7/8 patients with pancreatic cancer, who mounted an immune response to the vaccine, are still alive 6 years later. This is breathtaking data and shows the promise of mRNA vaccines. nbcnews.com/health/cancer/…

@MaddiWulfeckMD Video poker comes calling

🚨 Cardiac CT case 🚨 Patient with chest pain👀 ✅LV base: normal-ish ✅LV outflow tract: minding its business ✅LV apex: absolutely JUICED 💪 👇 Drop your answer below. Bonus: what iconic shape does this LV turn into? 🃏 #Radiology #Radres #CardiacImaging #Medtwitter

@MaddiWulfeckMD Mohammed Ali knows.

🐾Animal signs in radiology Continuing on ... what animal sign are we dealing with here? 👇Drop you answer below #Radiology #Radres #Radtwitter

Psychiatric

@MaddiWulfeckMD It helps a little if you rotate your cellphone 45 degrees counterclockwise

🐾Animal signs in radiology 👀 Esophagram coming in HOT. What animal sign are we dealing with here? 🤔 Drop your answers below 👇

@RichDuszak Larry, Zeke, and Curiy

Radiologist here. I'm ready to replace ill-informed hospital administrators with AI.

@MaddiWulfeckMD Even more dangerous if patient on a vent. If the enteric tube creates a bronchial laceration, pulling it out while on positive pressure ventilation is a disaster waiting to happen.

🤔Feeding tube: “I know a shortcut.” 😨Patient’s lung: “absolutely not.” Feeding the lung is never the best idea. Feeding tube went down the trachea and is in the left lower lobe🫁. ❗️Recommend a follow-up CXR after it is pulled to check for a pneumothorax! #Radres #Radiology #Medtwitter

We’re graduating doctors who: ❌ don’t know ACR appropriateness ❌ learn imaging late ❌ yet still rely on it for EVERYTHING Make it make sense 🤯 New podcast episode just dropped 🎙️ This one’s about fixing the educational system, not blaming the learner 👇

@SusieWiles @gtconway3d Best of luck in recovery. Due to amazing research over decades, and dedicated/trained physicians and non physician providers, you will no doubt get lifesaving treatment.

Last week, I was diagnosed with breast cancer. Nearly one in eight women in the United States will face this diagnosis. Every day, these women continue to raise their families, go to work, and serve their communities with strength and determination. I now join their ranks. I am grateful to have an outstanding team of doctors who detected the cancer early and are guiding my care, and I am encouraged by a very good prognosis. I am also deeply thankful for the support and encouragement of President Trump as I undergo treatment and continue serving in my role as White House Chief of Staff.

@MaddiWulfeckMD Take Me Home, Country Roads share.google/ucpIggXlvTUAI2…

🩻 Unknown Case 👷‍♂️A patient with years of occupational exposure presents with slowly progressive dyspnea. CXR below 👇 🫁This is a pattern that forms when many tiny abnormalities slowly merge into something much bigger. 🤔What’s the diagnosis? Bonus: • What exposure classically causes this? #Radiology #RadTwitter #ChestXray #MedTwitter

Almost everything RFK Jr says here is wrong. Reyes’s Syndrome is related to aspirin use particularly after a viral illness, but in children, not in pregnant women. High dose aspirin isn’t recommended during pregnancy because it can cause premature closure of the ductus arteriosis. Low dose aspirin can be used during pregnancy. Ibuprofen is not used during pregnancy because of concerns about harming the fetal kidneys. Acetaminophen is considered safe for use during pregnancy. As always, when you have medical questions, talk to your doctor. The Sec of HHS is not a reliable source of medical information.

As a former U.S. Surgeon General who held an active medical license and practiced medicine while in the role (at Walter Reed and aboard the USS Comfort) it is incomprehensible that the Senate is even considering a nominee for this role who lacks any active license and has never practiced unsupervised. 🤯

📈 New #NeimanHPI study in @JACRJournal: Radiologist turnover rose 61% over the past decade, with clinical workload as the leading factor. Turnover odds doubled in 2020–2022. When workload hits 12,940 wRVUs, turnover starts climbing fast. These insights highlight urgent opportunities to strengthen retention across radiology. #Radiology #HealthPolicy #Workforce #Burnout #MedicalImaging #HPI #JACR #PhysicianWorkforce #HealthcareTrends neimanhpi.org/press-releases…

@anne__rogers Guaranteed to increase bat speed by 1 mph. Couldn't hurt!

New year new look? Jonathan India chopped his locks and reset this offseason, getting back to what he knows and who he is. And now... "I’m excited about [this season] and ready to get after it." mlb.com/royals/news/jo…

@NicoPerrino @gtconway3d They're funneled through the legislative process for another reason also. The Constitution.

As a wise man once told me, “Civil libertarians understand that the manner in which things are done are an important part of the legacy of liberty, not just the outcome.”