An Editor-in-Chief’s Farewell

Robert M. Quencer

With this issue of the American Journal of Neuroradiology, the current Editors and I end our 8-year term with the Journal. As Editors, we have attempted to guide and chart advances in neuroradiology and, in doing so, to contribute in some measure to the knowledge of those in the neurosciences who have particular interest in neuroimaging and neurointervention.

I have been extremely fortunate to have worked closely with four Senior Editors whose contributions to neuroradiology in general and to the AJNR in particular have been enormous. Bill Ball, Bill Dillon, Bob Grossman, and Charlie Strother are the finest group of Senior Editors with which an Editor-in-Chief could ever hope to work. They are internationally respected neuroradiologists and accomplished researchers who combine a deep knowledge of their areas of specialty with strong editorial skills, sensitivity to the concerns of authors, and an abundance of common sense. They have been my confidants over the years, and they have been a source of a number of ideas that have helped improve the Journal. From a personal standpoint, I will miss our frequent interactions and the camaraderie that developed among us.

Effective with the next issue (January 2006), the Editor-in-Chief will be Bob Grossman. The Journal could not be in more capable hands. As President-Elect of the American Society of Neuroradiology (ASNR), Chairman of Radiology at New York University, member of the National Advisory Counsel for Biomedical Imaging and Bioengineering of the National Institutes of Health, and for the past 6 years one of the Senior Editors of the AJNR, Bob has the scientific background, the political savvy, the foresight, the imagination, the experience in research, and the editorial skills to do a superlative job in running the Journal. Expect a new look to the AJNR and new innovations in its pages as Bob moves the Journal to greater heights within the neuroscience community.

A brief reflection on my experience as an Editor seems appropriate. I was fortunate to have followed in the footsteps of two outstanding Editors-in-Chief, Juan Taveras (1980–1989), the founding Editor of the AJNR, and Michael Huckman (1990–1997), Editor Emeritus, and to have served them both as Associate Editor and Deputy Editor, respectively. When Juan asked me in 1984 to join Paul New and him in editing the AJNR, I was stunned; this was a man I had never met but had admired only from a distance. It took me about a microsecond to accept that opportunity. I learned from Juan, not just in terms of neuroradiology but in terms of how to deal with authors and how to deal with politically difficult situations. I was “green” to the position of Associate Editor, but he backed me to the hilt on every decision. All of those in neuroradiology have thrived in large part because he, as the driving force behind the formation of the ASNR and the founding Editor-in-Chief of the AJNR, had a direct, uncomplicated approach to issues and the wisdom to propel our Society and the specialty of neuroradiology forward.

Michael Huckman allowed me another opportunity to continue to serve the Journal after he was selected as Editor-in-Chief in 1989. I initially joined two Deputy Editors (Nick Bryan and Ken Maravilla) and then later joined four Deputy Editors (Nick Bryan, Mauricio Castillo, Bill Ball, and Hugh Curtin) in a position of continued editorial responsibility. Michael was an ideal person with whom to work. He had a worldwide perspective of neuroradiology; he was sensitive in dealing with authors but firm in his decisions. He blended scientific and clinical expertise in neuroradiology with a business acumen that was needed as the Journal went from 6 to 10 issues per year and then became “self-published” in 1991. The strong international position the AJNR now holds as the preeminent journal in neuroimaging can, in large part, be attributed to both Juan’s and Mike’s efforts in developing the AJNR and attracting to the Journal the best research in our field.

At the beginning of my term as Editor-in-Chief in 1998, a new managing editor, Bridget Donohue, began to work for the Journal. She was dependable, competent, and helped move the Journal through difficult situations. She was ably supported by Mary Harder, who fortunately is still with the Journal, and Derrick Leaks, who tragically died earlier this year. Angelo Artemakis, Director of Communications for the ASNR, played an important role in modernizing our systems and dealing with various vendors. Jim Gantenberg, the Executive Director of the ASNR, has constantly given full support to the needs of the Journal because he appreciates that it is the most important and visible product of the Society. Through these past 8 years, I have had the great fortune of working with Sonia Edwards, my assistant here in the Journal’s Miami office. Not only does she possess editorial abilities, but her organizational skills and attention to detail have helped the Journal function smoothly. Because of her uncanny introspection into problems and her calm resolve, I have often turned to her for words of advice. My thanks to them all. And to my wife Christine, who often entered my office at our home while I was working on the Journal to see if I was still alive, I owe a special thanks. She was rock-solid in her support of my work for the Journal and, because of her medical background, took particular interest in what unfolded in every issue. In fact, she often reminded me of articles that I had long since forgotten. It would have been difficult to devote the needed energy to do the job without that support.

In the January 2005 issue, a date that marked the 25th anniversary of the AJNR, I briefly mentioned the major milestones the Journal experienced during the first quarter century of its life. Let us now look at how the Journal has evolved over the past 8 years in both its content and its production. Since 1998, the cover of the Journal has featured illustrations that draw attention to an article within that particular issue, and an editorial section has been part of every issue. These editorial pages enliven the Journal and allow for the expression of varying opinions and the airing of controversial subjects. It is hard to remember what the Journal was like without those features. Original research review articles, commentaries, case reports, and technical notes continued as they had in the past, but the mechanics of submitting a paper to the Journal, having it peer-reviewed, and ushering it into publication were simplified by the “magic” of the Internet. The number of submissions to the Journal doubled during the past 8 years, and what is most impressive is not only the high quality of most of these papers but the fact that currently over half of all submissions come from outside North America. The contributions to the AJNR from our colleagues in Europe and the Far East have been enormous; the AJNR is truly the international journal of neuroradiology. The online availability of the Journal, which started 5 years ago, means that now it is more widely read and cited. The AJNR has strengthened our discipline and has moved neuroradiology to the forefront of clinical neuroscience.

Radiology in general and neuroradiology in particular are flourishing these days and are central to the diagnosis and care of the vast majority of patients with neurological disorders; however, all is not rosy. Other subspecialties covet what traditionally has been under the roof of neuroradiology. Control of a field such as neuroradiology will gravitate to that specialty that contributes most significantly to the advancement of that discipline. It is therefore imperative that research in our field remain a major priority. These research endeavors must be supported by every member of the ASNR, both by their financial support of the Neuroradiology Education and Research Foundation and, in institutions where research is performed, by encouraging such investigations, making that a major departmental goal. Standards in neuroradiology training must be kept at the highest level, but it is not sufficient to have simply as our goal the sending into practice of well-trained neuroradiologists. We must strive to go beyond that and in every trainee try to bring out and encourage a career that encompasses both clinical and important investigative work. While the current economics of radiologist compensation would seem to augur against an academic career, situations and economics change over time. Younger neuroradiologists should be encouraged to develop a sense of obligation to give back to their profession by encouraging them to pursue a career that is intellectually stimulating, not one that is simply financially rewarding.

Of major concern to our Society is the future role of the neuroradiologist as interventionalist (INR). Few neuroradiology fellows opt for continued training in INR, and current diagnostic radiology and neuroradiology training programs are not structured, to any significant level, toward patient care and management. The result is that in most situations, the interventional neuroradiologist lacks both the training and the credentials to establish and maintain a clinical practice. This handicap, combined with the small number of neuroradiologists interested in interventional training and the rapid expansion of the numbers of neurosurgeons, vascular surgeons, and cardiologists with training and interest in minimally invasive techniques, makes it unrealistic to have much optimism about the future role of our specialty in this discipline. Short of major changes in the training of radiologists so that significant clinical expertise can be obtained as well as significant modifications in the infrastructure of Departments of Radiology so that clinical care can be provided, we are likely to witness the default of INR to colleagues in neurosurgery, neurology, vascular surgery, and cardiology.

Given all of these considerations, the Journal assumes a pivotal role in the dynamics swirling around our specialty. The best research must dominate its pages. The AJNR may continue to publish a few papers of general interest in an educational format, but it must always devote its energy and almost all of its pages to original scientific observations and emerging technology. To do less would be a disservice to the Society, to its members, and to the worldwide neuroradiology community. Of equal importance to the viability of the Journal is to keep all those disciplines that constitute our society—interventional neuroradiology, pediatric neuroradiology, head and neck radiology, spine radiology, and functional neuroradiology—under the banner of the AJNR. Although some may practice primarily in just one area of neuroradiology, we all must learn from each other; for example, a neurointerventionalist must know the newest developments in diagnosis, and similarly the diagnostic neuroradiologist must know of the latest advances in intervention. The Journal is the prime, if not the only, vehicle to accomplish that. The establishment of new, narrowly focused journals should be firmly discouraged. We all benefit from the publication of a spectra of articles in neuroradiology in one journal.

Leaving the journal in an official capacity after 21 years (13 years as a Deputy Editor and 8 years as Editor-in-Chief) is bittersweet; the deadlines and editorial responsibilities are relentless and continuous, but there is the great satisfaction of seeing the end product of one’s work each month. So with this editorial, I bid farewell to the Editor’s Chair of the AJNR. The ASNR gave me an opportunity to serve its members in a capacity that I never would have imagined possible; for that, I will always be grateful.