STRIC: 20 Years of Advanced Imaging and Interventional Radiology Services

By Jenna Haines
Thursday, September 5, 2019

South Texas Radiology Imaging Centers (STRIC) provides patients in the San Antonio area with access to experienced radiology subspecialist physicians and pioneering imaging equipment.

STRIC began in July 1999 as the result of an innovative partnership between the Methodist Healthcare System and South Texas Radiology Group PA (STRG). Beginning with nine sites and 100 employees, STRIC now employs more than 400 staff at 22 locations in San Antonio, Boerne and Schertz, Texas.

“Creating an outpatient entity owned in partnership between the healthcare system and radiologists to serve the outpatient population focused on providing high quality imaging with the expertise of the same radiologists who read for the hospital had never been done before in a private sector environment,” says David Golden, MD, radiologist and President of STRIC. “The synergies of the two provide a higher level of efficiency and patient satisfaction.”

Specialized Expertise

Gary Woodard, CEO of STRIC

James Gilley, MD

David Golden, MD

STRIC offers a wide range of outpatient diagnostic imaging and interventional radiology services, including pain management, MRI, PET/CT, nuclear medicine, ultrasound, and digital breast tomosynthesis (3D mammography). STRIC also provides specialized imaging studies using MRI, PET/CT and CT that aide in the diagnosis of Alzheimer’s disease, coronary artery disease and liver disease. STRIC was the first to offer MRI elastography in an outpatient setting in San Antonio. MRI elastography is an exam that determines the stiffness of the liver that can predict liver disease. STRIC provides imaging for many research companies conducting studies focused on nonalcoholic steatohepatitis using the MRI elastography technology. Radiologists who specialize in body imaging oversee and interpret this valuable study.

This comprehensive service line is viable due to the experience and expertise of STRG’s physicians. In fact, STRG currently employs more than 60 board-certified radiologists, many of whom are fellowship-trained in subspecialties, such as abdominal/body imaging, breast, cardiac, musculoskeletal, neuroradiology, pediatric, nuclear medicine and interventional radiology.

“Specialty imaging tests are read and interpreted by a radiologist who subspecializes in the associated field,” says James Gilley, MD, musculoskeletal radiologist, former Medical Director of STRIC and former Vice President of STRG. “Traditionally, whoever the radiologist was on-site at the imaging center at the time read the study. Now, we can have imaging for patients with Alzheimer’s disease read by a neuro specialist and imaging for athletic injuries read by a musculoskeletal radiologist.

With the use of a picture archiving and communication system (PACS), radiologists can easily consult other radiology specialists.

“Having such convenient access to an expansive network of radiologists makes us better at what we do and allows us to consult electronically with each other on difficult cases, resulting in better care of our patients,” Dr. Golden says. “We needed a system where, if the patient arrived at the hospital for an appointment and then showed up at an imaging center a week later, all of his or her information would be accessible at both places under the same name. It sounds trivial today, but back in the early 2000s, no one was able to do that. We talked to multiple vendors, but not one was able to create a system that combined all that information together in a single database. Eventually, we found a way to accomplish our goal through our own radiology information system, and it was a huge success among referring physicians.”

PACS is an important tool for the referring physician. STRIC offers PACS XERO, which is easily accessed via a secure website using a network user ID and password and can be viewed on a PC or a mobile device.

“It is important for referring physicians to have access to patient images and reports at their fingertips, in the operating room, or anywhere,” Dr. Golden says.

STRIC implemented PACS in 2004 as CT technology advanced from single detector to multidetector technology, resulting in more slices, or images, and making it difficult to review using film.

“CT and the advancement of other imaging technology was a key driver in our decision to move forward, not to mention the efficiency gains and cost savings by moving off film,” Dr. Golden says. “For example, with the newer CT technology that was coming out, we basically went from 25 images viewed on hard copy film to viewing thousands of images on a monitor, all of which could be instantly reprocessed to better visualize bone, soft tissues, vessels or any other structures in various planes. Reading on PACS was a necessity, but it also allowed us to have a virtual practice that we still enjoy today.”

A History of being First

Since the beginning, STRIC’s leadership and radiologists have collaborated to ensure that diagnostic imaging equipment remained in step with advancements in the field of radiology where it made sense in an outpatient setting.

“One of STRIC’s key strengths is that growth is locally driven,” says Gary Woodard, CEO of STRIC. “Many imaging companies make technology decisions based on price or group purchasing decisions that are removed from the community they serve. At STRIC, those decisions are made collaboratively with our administrative team and the local radiologists who have years of subspecialty experience and understand the needs of the patients and physicians in our community.”

For example, STRIC was one of the first outpatient imaging centers in San Antonio to offer a new PET/CT with “time of flight” technology. PET/CT is widely used for diagnosis and staging of cancer. STRIC was also the first outpatient, private practice in the San Antonio area to purchase 3 Tesla (3T) MRI technology.

“This MRI is double the strength of a traditional MRI and produces clearer images of a patient’s organs, spine, blood vessels and soft tissues,” Dr. Gilley says. “STRIC uses 3T MRI for a variety of studies, including imaging of the prostate and intricate cartilage. STRIC was the first to offer stereotactic breast biopsy services in an outpatient setting. Harvey Goldstein, MD, is a breast and body radiology specialist, and he started the stereotactic breast biopsy program in San Antonio. Breast biopsy is a minimally invasive procedure performed under imaging guidance, and the removed tissue is then sent off to pathology for diagnosis.”

Maintaining the Edge

STRIC continues the legacy of offering patients access to the latest technology. STRIC’s Northwest Imaging Center location houses the Siemens SOMATOM Definition Flash, a dual source CT scanner with 256 detectors that is capable of scanning the entire heart within five heartbeats. In 70–80% of patients receiving coronary CT angiography, the exam is performed without the need for beta blockers to slow down the heart. This saves time for the patient and provides excellent images with a radiation dose-lowering technique. STRIC just recently installed five open-bore Siemens MAGNETOM MRIs — the first installation in the country with this new technology.

Aside from offering an array of high-tech imaging modalities, STRIC focuses heavily on its women’s imaging program.

“We identify over 1,000 breast cancers a year through our mammography program,” Woodard says. “The development of the Boutique Mammography Center concept was designed to offer screening mammography in a spa-like environment, with little to no wait time for busy ladies who spend their time caring for others rather than themselves. We hope to make an otherwise unpleasant exam more desirable and encourage women to not skip this important annual screening.”

STRIC offers digital breast tomosynthesis equipment at its mammography locations.

The Future of STRIC

Twenty years after inception, STRIC has no intention of slowing down. The organization plans to gradually expand into more communities in the San Antonio and surrounding areas and continue to develop more ways of improving the accuracy and turnaround time of its services.

One of those ways, according to Dr. Golden, involves the use of advance augmented intelligence (AI).

“AI is going to play a larger interpretative role in radiology,” Dr. Golden says. “Some of the AI tools can help radiologists identify small changes that are almost impossible to see with the naked eye. Additionally, as AI improves, these tools will be able to make more strategic, personalized recommendations based on the patient’s medical history.”

“At its core, radiology is an information technology business,” Dr. Golden says. “This means that the future of radiology is interwoven with the future of technology in order to provide the highest level of care and the correct diagnosis for the patient. All of this advancement in technology is about improving the level of care and getting the right diagnosis the first time to help clinicians make important clinical care decisions that impact the patients and their families.”

Radiology in Athletics

In addition to serving everyday patients coming in for routine screenings, specialists with South Texas Radiology Imaging Centers (STRIC) frequently work with athletes, from NBA stars to high school football players, who are recovering from sports-related injuries. In fact, according to James Gilley, MD, a musculoskeletal radiology specialist at STRIC, former Medical Director of STRIC and former Vice President of South Texas Radiology Group, STRIC’s musculoskeletal radiology specialists can often be found on the sidelines of the local professional and college football and basketball games.

“Some of these professional athletes take a lot of abuse to their bodies, but their livelihoods rely on their ability to stay in the game,” Dr. Gilley says. “As a result, it is important for them to have access to imaging reviewed by radiologists with musculoskeletal expertise, as well as advanced therapeutic interventions. For instance, a common service we provide to many of our elite athletes in conjunction with the sports medicine physicians is the injection of platelet-rich plasma, which helps accelerate the healing of a muscle tear.”

STRIC offers a variety of interventional procedures to reduce pain and promote healing.

For more information about STRIC, visit or call 210-575-6703.