Tonya Kaltenbach, MD MS – Tonya Kaltenbach, MD MS

Professor of Clinical Medicine, UCSF

PROFESSIONAL OVERVIEW

My Focus is to Detect, Diagnose & Remove Gastrointestinal Polyps, Lesions & Early Cancers – All Using the Endoscope

Procedures Performed: Endoscopic Mucosal Resection (EMR), Endoscopic Submucosal Dissection (ESD), Endoscopic Full Thickness Resection (FTRD), Complex Polypectomy, Third Space endoscopy, Detection of Nonpolypoid (Flat) Lesions, Image Enhanced Endoscopy, Chromoendoscopy, Optical Diagnosis, Endoscopic Balloon Placement, Endoscopic Suturing, Endoscopic Ultrasound, Endoscopic Variceal Ligation, Endoscopic Glue Injection of Gastric Varices Using Cyanoacrylate, Endoscopic Dilation, Endoscopic Botox Injection, Endoscopic Treatment of Zenker’s Diverticulum, Luminal Stenting, Endoscopic Closure of Fistulas, Balloon Assisted Deep Enteroscopy (single and double balloon), Capsule Endoscopy, Radiofrequency Ablation, Cryoablation, Argon Plasma Coagulation of Radiation Proctitis, Endoscopic Hemorrhoid Band Ligation, Endoscopic hemostatic spray

My research interests primarily focus on improving the quality of colon cancer screenings through endoscopic imaging, advanced endoscopic therapies, novel training methods, and the development of evidence-based clinical practice guidelines. I am currently leading the development and implementation of a natural language processing (NLP) algorithm that standardizes the measurement and reporting of colonoscopy quality metrics across the national VA healthcare system. I played a leading role in the international development and implementation of the SCENIC guidelines (Surveillance for Colorectal Endoscopic Neoplasia Detection and Management in Inflammatory Bowel Disease Patients: International Consensus Recommendations) and was a key investigator in the development of the NICE classification system for diagnosing colorectal polyps.

CLINICAL ACTIVITIES

I am integrally active in the clinical and education aspects of our GI program. I attend 3 months of the year on the inpatient GI service, supervising 3 gastroenterology fellows. I perform endoscopy 3 days per week, supervising and training fellows in the techniques of endoscopy, including basic and advanced endoscopy techniques. As the Director of Advanced Endoscopy in the GI Endoscopy unit, SFVA, I have worked closely with our GI nurses and housestaff to improve both quality and experiences of patients, fellows and staff during endoscopy procedures. I also lead a specialized endoscopic imaging and resection practice of complex gastrointestinal lesions and early cancers at UCSF.

ACADEMY OF ENDOSCOPY

I am co-founder of Academy of Endoscopy, a non-profit organization dedicated to enhancing the quality of patient care by improving endoscopy training worldwide. We believe that learning endoscopy should be accessible, efficient, and engaging. We seek to develop a structured, simulator-based mastery learning (SBML) curriculum to teach both training and practicing endoscopists in basic and advanced endoscopic techniques. We designed our SBML curriculum according to the principles of flipped-learning, wherein cognitive content is delivered to the individual through our digital classrooms and technical endoscopic skills are taught in small groups through simulator-based practice in the endoscopy unit. In addition, we incorporate video-based feedback and virtual coaching to ensure that trainees are able to constantly work on their techniques. Our interchangeable hybrid simulators are cost-effective and easy to set up. We have delivered our curriculum to various leading training institutions across the country including San Francisco, Texas, North Carolina, Colorado as well as internationally in Singapore, Indonesia, and the Philippines. We are continuing to develop our curricula for colonoscopy and advanced endoscopic therapies.

Our Website: https://academyofendoscopy.wordpress.com

Our Training Courses:

Optimizing Cold Snare Polypectomy (Singapore 2023)
Optimizing Cold Snare Polypectomy (Tokyo, Japan 2023)
Endocon: Optimizing Cold Snare Polypectomy (Manila, Philippines, 2023)
Train the Trainers, Simulation Based Mastery Learning for Endoscopy (Manila, Philippines, 2022)
Simulation Based Mastery Learning Workshop, From Identification to Resection Techniques (Jakarta, Indonesia, 2022)
Endoscopic Clipping Over the Scope Course (Chapel Hill, NC, 2020)
ENDOSCOPYCON, Optical Diagnosis of Colorectal Lesions (Manila, Philippines, 2019)
Accelerated Upper Endoscopy Program for Novice Trainees (Singapore/ San Francisco, California, 2019)
Standard Upper Endoscopy Workshop (Texas, USA, 2019)
Comprehensive Upper Endoscopy Program for First-Year Trainees (Manila, Philippines, 2019)
Train the Trainers (Manila, Philippines, 2018)

Scientific Publications:

Kaltenbach T, Holmes I, Nguyen-Vu T, Malvar C, Balitzer D, Fong D, Fu A, Shergill A, McQuaid K, Soetikno R. Longitudinal Outcomes of the Endoscopic Resection of Non-Polypoid Dysplastic Lesions in Patients with Inflammatory Bowel Disease. Gastrointest Endosc. 2023 Jan 14: S0016-5107(23)00023-8.doi: 10.1016/j.gie.2023.01.019. Online ahead of print. PMID: 36649745
Gupta S, Earles A, Bustamante R, Patterson OV, Gawron AJ, Kaltenbach TR, Yassin H, Lamm M, Shah SC, Saini SD, Fisher DA, Martinez ME, Messer K, Demb J, Liu L. Adenoma Detection Rate and Clinical Characteristics Influence Advanced Neoplasia Risk After Colorectal Polypectomy. Clin Gastroenterol Hepatol. 2022 Oct 19:S1542-3565(22)00960-0. doi: 10.1016/j.cgh.2022.10.003. Online ahead of print. PMID: 36270618
Trivedi M, Godil S, Demb J, Earles A, Bustamante R, Patterson OV, Gawron AJ, Kaltenbach T, Mahata S, Liu L, Gupta S. Baseline Characteristics and Longitudinal Outcomes of Traditional Serrated Adenomas: A Cohort Study. Clin Gastroenterol Hepatol. 2022 Oct 12:S1542-3565(22)00928-4. doi: 10.1016/j.cgh.2022.09.030. Online ahead of print.PMID: 36243354
Asokkumar R, Chiu HM, Kaltenbach T, Matsuda T, Soetikno R. Proximal serrated polyp detection rate and interval post-colonoscopy colorectal cancer risk. Lancet Gastroenterol Hepatol. 2022 Oct;7(10):907. doi: 10.1016/S2468-1253(22)00237-0. PMID: 36087592
Keswani RN, Wood M, Benson M, Gawron AJ, Kahi C, Kaltenbach T, Yadlapati R, Gregory D, Duloy A.Endosc Int Open. 2022 Mar 14;10(3):E232-E237. doi: 10.1055/a-1529-5574. eCollection 2022 Mar.PMID: 35295238
Keswani RN, Kahi CJ, Benson M, Gawron AJ, Kaltenbach TR, Yadlapati RH, Gregory DL, Duloy A. Cecal retroflexion is infrequently performed in routine practice and the retroflexed view is of poor quality. BMC Gastroenterol. 2021 Jul 31; 21(1):307. PMID: 34332538. PMCID: PMC8325794
Chan WPW, Tan YB, Shim HH, Kaltenbach T, Soetikno R. Practice pattern variability among gastroenterologists in colorectal cancer surveillance and management of colorectal dysplasia in inflammatory bowel disease. J Dig Dis. 2021 Aug; 22(8):463-472. PMID: 34173325
Kaltenbach T, Gawron A, Meyer CS, Gupta S, Shergill A, Dominitz JA, Soetikno RM, Nguyen-Vu T, A Whooley M, Kahi CJ. Adenoma Detection Rate (ADR) Irrespective of Indication Is Comparable to Screening ADR: Implications for Quality Monitoring. Clin Gastroenterol Hepatol. 2021 09; 19(9):1883-1889.e1. PMID: 33618027
Gawron AJ, Yao Y, Gupta S, Cole G, Whooley MA, Dominitz JA and Kaltenbach T. Simplifying Measurement of Adenoma Detection Rate for Colonoscopy. Dig Dis Sci 2021 Sep;66(9):3149-3155 doi: 10.1007/s10620-020-06627-2.PMID: 33029706
Holmes I, Ha NB, Peng Y, Kaltenbach T. A Dermoid Cyst Presenting as a Hypoechoic Pancreatic Mass. Am J Gastroenterol. 2021 03 01; 116(3):449. PMID: 32453050
See full list at: PubMed.gov

AWARDS AND HONORS

2021, Master Endoscopist Award, American Society for Gastrointestinal Endoscopy

2016, Presidential Poster, Screening Indication for Colonoscopy May Not Be Necessary to Measure Adenoma Detection Rate, American College Gastroenterology

2014, Distinguished Educator Award, American Society for
Gastrointestinal Endoscopy

2014, Education Audiovisual Award, Chromoendoscopy with Targeted Biopsy to Detect Nonpolypoid Colorectal Neoplasm in IBD, American Society for Gastrointestinal Endoscopy

ACADEMIC UNIVERSITY AFFILIATION

Associate Professor of Clinical Medicine, University California San FranciscoN

TRAINING

Endoscopic Submucosal Dissection Externship 2009
National Cancer Center Hospital, Tokyo, Japan
Mentor: Takuji Gotoda, MD PhD

Advanced Endoscopic Imaging & Therapy Fellowship 2007-2008
California Pacific Medical Center, San Francisco, CA
Mentors: Roy Soetikno MD MS & Kenneth Binmoeller MD

Gastroenterology & Hepatology Fellowship 2004-2007
Stanford University, Palo Alto, CA
Mentor: Roy Soetikno MD MS

Internal Medicine Residency 2001-2004
Stanford University, Palo Alto, CA
Director: Kelley Skeff, MD

EDUCATION

Masters in Education of Health Professions Candidate Johns Hopkins University School of Education, Baltimore, MD

Masters in Clinical Research University of California, San Francisco, CA

Medical College Thomas Jefferson Medical College, Philadelphia, PA

Undergraduate University University of Pennsylvania, Philadelphia, PA