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2 Purpose-Driven Mission: A History of the American Society of Neuroradiology…
33
Publications
ASNR’s agship publications are the AJNR and Neurographics, launched in 1980 and 2011, respectively. During its rst decade of publication, the American Journal of Roentgenology co-published articles in the AJNR, reecting the journal’s co­ownership by the American Roentgen Ray Society (ARRS). On January 1, 1986, full ownership of the AJNR passed from the ARRS to ASNR [24].
AJNR has had seven editors-in-chief: Juan M.Taveras (1980–1989), Michael S.Huckman (1989–1997), Robert M.Quencer (1997–2005), Robert I.Grossman (Jan 2006–2007), Mauricio Castillo (2007–2015), Jeffrey Ross (2015–2023), and Max Wintermark (2023–present). Since the 1990s, AJNR has increased in size, article submissions, international authorship, and impact factor. AJNR has grown from 6 to 12 issues a year, began digital publication in September 2000, and launched a mobile app in 2010. In January 2025, AJNR transitioned its pub­lication to an all-digital format. A major update to AJNR’s website “WEB 2.0” in 2010 added “Case of the Week,” “Classic Case,” AJNR Blog, podcasts, and a Fellows’ Club among other features [25]. Manuscript submissions have steadily increased since the 1990s, from 610in 1998 to over 1700in 2020 [26]. By 2007, over 50% of submissions to the journal came from outside the United States [27]. Between 2010 and 2023, AJNR’s impact factor has ranged from 2.9–4.9. Since 2016, the ASNR has offered free or low-cost journal access to developing nations through the WHO HINARI program. Current Editor, Dr. Max Wintermark has introduced the AJNR Academy of Reviewers to elevate the quality of the peer review process, and AJNR “SCANtastic” to promote AJNR content via social media [28].
Neurographics is ASNR’s peer-reviewed, quarterly, educational journal pub­lished online since June 2011, and bimonthly since 2015. Neurographics serves “to supplement the basic and clinical science research published in the AJNR with high-quality neuroradiology educational articles.” [29] Since March 2013, Neurographics has offered Continuing Medical Education (CME) credits. Drs. Quencer and Castillo served as the initial editors and the journal consisted of educational exhibits selected from the annual meeting. Barton F.Branstetter IV MD, then Chair of the ASNR Education Committee, was the rst editor-in-chief. He was succeeded as editor-in-chief by Joshua P.Nickerson, MD in June 2020. In early 2026, Neurographics was rebranded as AJNR Clinical Practice, focused on high-quality, peer-reviewed, practice-oriented clinical content.
The monthly AJNR Podcast reviewing journal highlights began with the November–December 2009 issue. There have been ve podcast editors to date: C.Douglas Philips, MD (2009–2012) Yvonne W.Lui, MD (2013–2017), Wende Gibbs, MD (2017—2021), Courtney Tomblinson, MD (2021), and Keven Hiatt, MD (2021-Present). Mauricio Castillo started the AJNR Blog in January 2009 to provide space for book reviews, annotated bibliography of neuroradiological litera­ture, and other important editorial news. By December 2009, the Blog received about 5000 visits per month [30].
34
J. D. Clemente
Standards, Guidelines, andCurriculum Development
ASNR’s educational, training, and curriculum development activities have advanced to meet the changing needs of neuroradiology professionals, embracing state-of­the-art technology, and ensuring the relevance of continuing education.
Initiatives are as follows: Introduction of the Core Curriculum Course in 1994, development of the Bracco-sponsored Neurocurriculum Live in 2014,5 creation of the Neuroradiology Fellowship Curriculum in January 2021, and a Comprehensive Neuroradiology Course in September 2022 to supplement institutional curricular offerings. Currently, ASNR’s Education Connection platform provides a library of on-demand webinars, podcasts, and other resources. Since its launch in September 2019, ASNR has hosted over 120 webinars and learners have earned over 84,000 CME hours [31].
The Society secured accreditation for neuroradiology fellowships by the Accreditation Council for Graduate Medical Education (ACGME) in 1992, with the objectives of addressing the subspecialty workforce crisis in the late 1990s and adapting training standards to innovative technologies and practice patterns. ASNR advocated for a “Neuroradiology Fellowship Match” in January 2001 which orga­nized and streamlined the trainee selection process, improved fairness, and reduced no-show rates among fellows.
ASNR focused on recruiting and supporting future leaders through leadership development programs, targeted meeting features for fellows, and the establishment of the Young Professionals Committee in 2014. Free membership for “Members-in­Training” category, and the development of a Career Center arrived in March 2021.
ASNR has collaborated with other societies, such as SNIS and AANS6 to dene practice standards for neuroradiology, including guidelines for neurointerventional training and articial intelligence standards.
ASNR Digital Presence andSocial Media
ASNR has embraced digital presence and social media as crucial components of its strategy to engage members, disseminate knowledge, and foster community within neuroradiology. The journey began on December 20, 1996, with the launching of its website, marking the start of its online presence. Over the years, ASNR has matured its digital strategy, including major website redesigns in 2008 and in 2022 to improve user experience, searchability, and access to curated content, embracing social media platforms in April 2010 and launching a Facebook page in December 2012 [32].
5
Neurocurriculum Live was rebranded “Neuroradiology Core Education Series” in 2022.
6
Society of Neurointerventional Surgery and American Association of Neurological Surgeons.
2 Purpose-Driven Mission: A History of the American Society of Neuroradiology…
35

Governance

ASNR Executive Leadership
During its early years, a small Executive Committee comprising elected ofcers conducted the Society’s business. ASNR lacked physical headquarters or adminis­trative staff. ASNR presidents relied on their personal staff and resources to fulll their duties. The increasing complexity of the Annual Meeting in the 1970s, coupled with membership growth, led the Society to seek an experienced meeting planner and managerial support. ASNR approached the Radiological Society of North America (RSNA) for help. In 1983, ASNR hired George F.Schuyler, the RSNA’s director of scientic meetings, to assist in planning its annual meeting and other activities. Schuyler was both a “Meeting Consultant” and a “Managing Director.” In that capacity, he remained an RSNA employee and worked for the ASNR part­time [33].
Schuyler retired from RSNA in 1989 and was succeed by Patricia Grosshauser who had served as ASNR’s assistant managing director since 1985. Grosshauser played an instrumental role in gaining ownership of AJNR [34]. In the Summer of 1990, ASNR achieved full independence from RSNA with its own ofce and admin­istrative staff. After Grosshauser left, the ASNR began a search for a new Executive Director.
In 1993, ASNR hired James B. Gantenberg, FACHE to serve as Executive Director. Gantenberg brought a wealth of managerial experience, including 5years as Executive Director of the American Society of Clinical Oncology. Gantenberg brought skills in strategic planning and implementation, organizational develop­ment, corporate relations, fundraising, and scal management to bear on the chal­lenges facing the Society. He built ASNR’s professional staff, from 5 to 17, bringing in experts in functional areas like nance, human resources, technology, and meet­ing planning.
Over the next two decades, Gantenberg and physician leaders oversaw the growth and evolution of ASNR from a radiology subspecialty society operating under the auspices of RSNA into an independent national organization with over 5500 mem­bers and strong international partners. With Gantenberg scheduled to retire at the end of 2016, ASNR conducted a national search and selected Mary Beth Hepp, MBA to succeed him. Hepp came to ASNR with over a decade of executive leader­ship experience, most recently as Executive Director and Foundation President of Helping Hand Center, a large social services organization [35]. In her role as ASNR Executive Director, Hepp oversees a staff of 17 and the work of ASNR’s Board of Directors to ensure that the society remains dedicated to the fulllment of its educa­tional, research, and advocacy missions.
36
J. D. Clemente

ASNR Physician Leadership

The ASNR physician leadership structure has changed in size, structure, and com­position since its founding. ASNR chooses ofcers annually. Until the early 1990s, a “Nominating Committee” made recommendations on a slate of candidates, effec­tively selected the president without input from the members. Historically, ASNR leadership has come from major academic institutions on the east and west coasts of the United States and the Mayo Clinic. In 1992, in response to member feedback that elections were undemocratic, ASNR began soliciting its general membership for nominations for elected positions [12]. In 1995, Dr. Robert Lukin was the rst president of the ASNR elected through this more inclusive member ballot process.
In its 61-year history, ASNR has made strides, particularly in the last decade, to improve the diversity of the senior leadership to reect the changing membership, and the elevation of women, and community practitioners. To date, ten women have served as president. The rst woman to serve as president was Anne G.Osborn, MD in 1988–89. Another 17 years would pass before a second woman, Patricia A.Rhyner, MD, was elected president in 2005. Since that time, eight other women have served as president, including Tina Young Poussaint, MD, FACR, and Past President Yvonne W.Lui, MD FACR [36]. In 2018, Robert M.Barr became the rst private practice neuroradiologist to be elected ASNR president.
7

ASNR Executive Committee

The ASNR Executive Committee (The “Ex Comm”) had been the society’s princi­pal decision-making body since October 1962. The Ex Comm functioned like a traditional corporate board of directors empowered to conduct the society’s busi­ness, controlled funds and “the safe keeping or sale of property.” [37] For many years, the Ex Comm consisted of the president, president-elect, vice president, sec­retary, and treasurer. All standing committees of the ASNR reported up to the Ex-Comm. By the early 1990s, members raised concerns that the Ex Comm had become too insular, unresponsive to the needs of subspecialists and private practi­tioners, inadequately defended turf, and lacked participation in reimbursement pol­icy decisions. In 1992, the ASNR revamped its governance structure to allow for greater member representation, greater authority, and expansion into new elds of public policy and practice standards [38].
By 1994, the Ex Comm had grown to include the senior elected ofcers, one member-at-large, the three most recent past presidents, the chair of the Rules Committee, and representatives of the Subspecialty Groups recognized by the Executive Committee [39]. That year, a small “Administrative Committee” was
7
An appendix provides a full list of ASNR past presidents.
2
Purpose-Driven Mission: A History of the American Society of Neuroradiology…
37
established.8 The Ex Comm was empowered to carry out business between meet­ings of the membership. Whereas the Society empowered the Administrative Committee to conduct business between meetings of the Executive Committee [40].
Over the next decade, ASNR’s Ex Comm expanded to incorporate representa­tives of preexisting standing committees and those of newly formed committees created over the years to address various issues such as health policy, research, and fellowship training. By 2014, the Ex Comm had 22 voting members and 11 non- voting members [41]. The Ex Comm became a valuable component of the ASNR leadership, fostering collaboration among various regional and subspe­cialty societies and including input from committee chairs, the ACR council, and other societies. It had also become unwieldy. ASNR needed a smaller, nimbler group to oversee management and functions and to improve the efciency and focus of leadership [42].
In 2015, ASNR restructured its governance, rebranding the Administrative Committee as the “Board of Directors” (BOD). The new BOD consisted of the president, president-elect, vice-president, secretary, treasurer, rst, second, and third president, executive director (ex-ofcio, non-voting), Chair of the Foundation of the ASNR Board of Trustees, editor-in-chief of the American Journal of Neuroradiology (AJNR), and up to three additional members chosen by the Board [43].
Four years later, in 2019, ASNR underwent another signicant leadership reor­ganization, replacing the Ex Comm with the Board of Directors and a new Advisory Council (“AC”). The BOD retained its composition and duciary responsibilities, while the larger AC (comprising the elected ofcers and chairs of the standing com­mittees) functions to advise the Board in meeting strategic goals and initiatives and has some specic authorities. ASNR redened terms of service of its ofcers, and assigned the vice president as chair of the AC [44].

ASNR Committee Structure

ASNR’s committees are necessary to promote the Society’s mission and fulll its vision. Hundreds of dedicated neuroradiology professionals have volunteered their time and energy to serve on various committees. Whereas the ASNR BOD steers the ship, the committees have provided the power to generate ideas, solve problems, implement programs, and serve as a training ground for the Society’s future leaders. Headquarters administrative staff—who provide critical liaison services including facilitating planning, communications, advice on policy and procedures, and pro­gram implementationhave assisted ASNR committees.
8
The Administrative Committee consisted of the president, president-elect, vice president, secre-
tary, treasurer, rst past president, and the executive director (ex-ofcio, non-voting).
38
J. D. Clemente
The modern committee structure of ASNR has its origins in the early 1970s, which, broadly speaking, has consisted of standing, ad hoc, and annual meeting program-related committees reporting up through the Ex Comm [45] and, after 2019, through the BOD. The number of ASNR standing committees has risen steadily from 6in 1962 (Executive, Auditors, Rules, Membership, Program, and Nominating) to 31in 2015–2016. The Society has formed new committees to over­see increasingly complex daily business (e.g., Finance, Publications, and Commercial Relations committees) and through the strategic planning process (e.g., Fellowship Directors and Social Media committees).
In 2013–2014, ASNR underwent a major expansion of its standing committees, many of which existed for years. Committees were grouped into ve broad catego­ries: Core Missions (Health Policy, Research, and Education), Meeting-related (Program and Technical/IT), Social Engagement (Membership, Commercial Relations, ASNR Foundation, Publication, Infrastructure, and Intersociety Relations), Administrative (Admin and Ex Comm, Human Resources, Audit, Finance, Rules, Nominating), and Honoric (Honorary Membership, Outstanding Contributions in Research, and Gold Medal Award) [46]. The three long-standing Health Policy subcommittees on “Economics,” “Quality Safety and Value,” and “Standards and Guidelines” were all elevated to committee status reecting the complexity of practice and payor issues. Among the new committees formed were “Computer Science and Informatics,” “Website and Online CME,” “Young Professionals,” and “International Collaborations.” [47]
Further restructuring and consolidation of committees occurred between 2017–2023, to align those with similar purposes such as “Website” with “Social Media” or to incorporate important committees like Health Policy and the Special/ Regional Societies into the Advisory Committee. In 2020, ASNR BOD established a standing committee on “Diversity and Inclusion “to ensure that the ‘increasingly diverse and complex’ nature of the Society was incorporated into its many pro­grams, functions and activities.” [48] Most recently, in 2023, the AJNR editor-in­chief position was removed from the Board of Directors, to reect best practice and consistency with other societies’ practices. The editors-in-chief of all ASNR publi­cations (currently AJNR and Neurographics) remain on the ASNR Advisory Council [49].
Evolution oftheASNR Constitution
The foundational governance document of ASNR is its “Constitution,” rst codied in April 1962 and updated on a near-annual basis. Over six decades, its basic struc­ture has remained stable; dening the Society’s objectives, roles, and terms of of­cers, membership criteria, and functions of major committees. Since the 1980s, ASNR’s Constitution has become more detailed. These changes reect a commit­ment to maintaining a dynamic and relevant professional organization and a contin­ued evolution of the society’s governance and operational procedures, aiming to
Purpose-Driven Mission: A History of the American Society of Neuroradiology…
2
39
provide transparency and exibility, and to reect current and best practices. ASNR has made some major changes to its constitution.
Elections In 1992, ASNR decided to increase its role in socioeconomic issues,
public relations, interaction with government and private payers, and explore inter­society collaboration. The Society therefore undertook “extensive constitutional reform, to improve the operational efciency of a larger society and democratiza­tion of the selection of [its] leadership.” [50] From that point, ASNR made an open call to its membership for nominees for ofcers [51].
Objectives Between 1969 and 1994, the ASNR constitution added four new objec-
tives: (1) providing for an annual scientic and educational meeting, (2) promoting close cooperation with other related specialties, (3) establishing a channel to pub­lish neuroradiology research, and (4) promoting understanding of neuroradiology among patients, the public, and other medical specialists [52].
Membership Before 1990, membership was by “invitation only” and for fellowship­trained neuroradiologists. As membership plateaued, the Society sought to attract new members from neuroradiology, the broader neuroscience research community, and from outside North America. Periodically, ASNR has amended its membership categories to be more inclusive and to streamline the application process. Achieving the milestone of subspecialty certication required the ASNR to compromise with organized radiology by allowing all qualied individuals actively engaged in the professional practice of neuroradiology to sit for the exam. In 1995, the ASNR con­stitution was amended to create a new route for “Junior” members to advance to “Senior” membership and also enabled any radiologist who had received a subspe­cialty certication in Neuroradiology from the ABR to be eligible for senior mem­bership [53]. Since 1962, ASNR has admitted international physicians designating them “corresponding members” until 1999 when they were folded into the “Member” category. In 2014, the Society created a new member category called “International Outreach” to include individuals from developing countries with an annual per-per­son GDP of $10,000 or less [54]. As of 2024, there were seven member categories.
9
Constitutional Crisis Changes to the ASNR Constitution have seldom generated controversy. In 2007, the ASNR Executive Committee’s proposal to include non­neuroradiologists as “Senior Members” caused great consternation among the Society’s members [55]. An earlier decision by ASNR to add a dues assessment of $1800 on top of regular member dues to fund the Society’s philanthropic foundation had the unintended consequence of a 5–10% attrition in membership. Some mem­bers chose not to renew, while others converted to a less expensive member category.
9
These categories are Senior Member, Junior Member, Member-in-Training, International
Outreach Member, Research Scientist Member, Emeritus Member, and Honorary Member.
40
J. D. Clemente
ASNR leadership had strategized ways of increasing member ranks by removing nancial and bureaucratic barriers and eliminating the perception of a “second class status” of non-senior members who lacked voting rights or the ability to chair com­mittees. Societal growth helped introduce fresh ideas and new potential leaders, fostered collaboration with other specialties, and increased international participa­tion at a time when over 50% of AJNR manuscripts came from outside the United States. A larger ASNR also meant greater inuence within organized Medicine. David M.Yousem, MD, then president-elect of the ASNR, noted “This is not just about money. It is about expanding the sphere of inuence of the ASNR, making it a broader more scientic, international, and far-reaching society.” [ 56]
Member sentiment was decidedly against the proposed changes, fearing that it would dilute the inuence of neuroradiologists, devalue senior membership status, and open the Society up to domination by non-neuroradiologists. Furthermore, as written, ASNR would no longer require Senior Members to practice neuroradiology 50% of their time, be board-certied, or reside in North America [56]. ASNR quickly rescinded the dues increase and took other measures to control costs such as decreasing the length of the annual meeting and limiting spending on social events. The 2007 amendments did not pass and instead the Society later created “Member­in- Training” and “Research Scientist” member categories to encourage fellows and neuroscientists to join the Society [57].
Modernization In 2019, ASNR undertook a comprehensive review of its
Constitution and made substantial changes to reect current best practices, clarify­ing governance roles of the Executive Committee, and afrming its important advi­sory role. Extensive wordsmithing to the Constitution improved its clarity and consistency and introduced gender-neutrality. The Society created a new “ASNR Policy and Procedure Manual” to contain operational procedures and logistical details of committee structures that were previously in the Constitution. This change was meant to streamline the document and improve the exibility of ASNR for growth and innovation.

Research

“Those who do the research, control the eld.” [58] ASNR has long recognized the critical importance of research for the future of neuroradiology [59]. The Society has been proactive in supporting neuroradiological research through various initia­tives starting with a Fellowship in Basic Science Research Award in 1986 to foster the scientic development of young researchers [60], the creation of a Research Committee in 1991 to oversee research activities, and the establishment of a philan­thropic foundation in late 1994 to secure nancial resources necessary to ensure research and educational opportunities for its members.
Expansion of the ASNR’s role in education and research and the need for aggres­sive fundraising to support research independent from members’ donations, other
2 Purpose-Driven Mission: A History of the American Society of Neuroradiology…
41
radiology organizations, government and corporate sources have been consistent with the Society’s strategic plans. Around 2010, ASNR recognized that it had “lost the lead in neuroimaging research” and that the Society needed to grow its Foundation and develop a sustainable structure for research, including projects that beneted community-based neuroradiologists [61]. The 2018–2021 Strategic Plan highlighted the need to develop the governance and interoperability of the ASNR Board, its Foundation, and the ASNR Research Committee so that the research agenda was aligned with strategic initiatives, and that research priorities cascaded throughout the Society [62].
Foundation oftheASNR (FASNR)
The Foundation of the ASNR (FASNR) began operating as a tax-exempt, non-prot organization in 1995 [63]. The Foundation was governed by a small Board of Trustees that was expanded in 2002 to include more representation by community neuroradiologists [64]. From 1994 until 2014, the Foundation’s Board had a single Chair: Burton P.Drayer, MD (1995–2001), A.James Barkovich, MD (2001–2007), Eric J.Russell, MD (2007–2010), and Howard A.Rowley, MD (2010–2014).
In 2014, the Foundation restructured its leadership into two branches with Co-Chairs for “Research and Grants” and “Funding and Development.” This reor­ganization intended to facilitate the evaluation and administration of an increasing number of grants, develop a “more inspired approach to fundraising,“ [65] and a sustainable framework for ASNR-sponsored research [66]. Pina C. Sanelli, MD, MPH, FACR served as Co-Chair (Research and Grants) from 2014–2023 and was succeeded by Christopher P.Hess, MD, PhD in 2023. Laurie A.Loevner, MD has served as Co-Chair (Funding and Development) from 2014 to present. The Board of Trustees currently consists of two Co-Chairs, the ASNR President, the President­elect/Program Chair, two Members-at-Large, and the ASNR Executive Director. In 2020, the ASNR entered into a new nancial and management agreement with the Foundation to simplify the contractual terms around use of the Society’s staff and administrative resources [67].
Individual member donations, periodic nancial support from growth in ASNR nancial reserves, and corporate sponsorship have been the Foundation’s principal funding sources. Historically, 7–10% of ASNR members have donated to it. During Fiscal Year 2022 alone, 214 individuals donated a total of $158,000 [68]. In 2018, the ASNR BOD began sponsoring a matching grant for rst-time donors, yielding a 17% increase in such donors [69]. Corporate sponsors to the FASNR have included Target Therapeutics, Berlex Pharmaceuticals, and Bracco, among others. In 2023, the FASNR received a $four million charitable contribution to establish the Aldon Mark Berger Fund for Research and Education in Mental Health to develop com­petitive research grants and education related to mental health [70].
In 2019, the FASNR established three giving circles: the Leadership Circle, the Chairman’s Society, and the Corporate Giving Circle. The goals of the giving circles
42
J. D. Clemente
include increasing Foundation giving (annual, major, and planned gifts), creating an organizational identity, and building camaraderie among philanthropists who con­sistently support the Foundation. Recently, the FASNR redesigned its website to highlight donors and grant recipients [71]. The ASNR and its Foundation remain nancially strong, with over $11 million in reserve as of 2021 [72].
Since 1995, the FASNR has awarded over $8.83 million in grants; with 75% of funding awards made through the Boerger Research Fund for Alzheimer’s Disease and Neurocognitive Disorders ($2.12m), the Basic Science Award ($1.82m), and Scholar Award in Neuroradiology Research ($1.75m) [73]. More than 116 indi­vidual researchers have been funded since 1987. FASNR awards over $340,000in grants annually [74].
As of 2024, the FASNR offers The Foundation Grant Program (for promising young researchers), the Alzheimer’s’ Association/Foundation of the ASNR Imaging Grant in Alzheimer’s Disease and Neurodegenerative Diseases, the Trainee Research Grant in Neuroradiology, the Aldon Mark Berger Mental Health and Neuropsychiatry Imaging Research Grant, and the Women in Neuroradiology Leadership Award (funds attendance at the ACR’s annual Radiology Leadership Institute Summit) [75]. The Foundation has also recently established an “Innovative Research Fund” to support research in AI, clinical data analytics, comparative effectiveness, novel neuroimaging techniques, and translational research.
The Foundation has a tripartite mission to support excellence in patient care, research, and education. The FASNR has funded some of the advocacy work of the Health Policy Committee, which has beneted all members, and educational activi­ties such as Neurographics, eCME, Neurocurriculum Live, and the annual meeting Symposium [76]. In 2016, the Foundation provided $150,000in support to the neu­roradiology subspecialty societies to develop research programs. The FASNR has fostered relations with the NIH (2006, 2010), collaborated with ISMRM (2007), and co-sponsored grants with the RSNA (2013) and ARRS (2014). To keep mem­bers up-to-date on emerging neuroimaging techniques, such as fMRI and diffusion tensor imaging, the Foundation introduced “hands-on workshops” at the 2014 Annual Meeting.
ASNR Research Committee
The ASNR Research Committee, established in the early 1990s, is “responsible for fostering research in neuroradiology, for overseeing researchers and research activi­ties funded by or through the Society.” [77] The Committee evaluates applications for competitive grants, makes recommendations on grant recipients to the Foundation’s Board of Trustees, and monitors the progress of research by funded individuals. The Research Committee has played a vital role in developing strate­gies to increase NIH funding and fostering intersociety collaboration with the RSNA, ISMRM, the Organization for Human Brain Mapping (OHBM), and the Society for Neurosciences (SfN).