Neuroradiology
Program Director
Eric J. Russell, MD
Northwestern Radiology
676 North St. Clair St., Suite 800
Chicago, Illinois 60611
Phone: 312-695-5103
Fax: 312-695-5645
Introduction
The Neuroradiology fellowship training program at Northwestern University’s McGaw Medical Center is an ACGME approved, one-year program based at Northwestern Memorial Hospital and the main campus of Northwestern University’s Feinberg School of Medicine, located in the heart of Chicago, between North Michigan Avenue and the Lake Michigan. Fellows also rotate at the world-renowned Children’s Memorial Hospital in the Lakeview neighborhood 2 miles from campus. The program is offered to physicians who have completed their radiology residency, and are American Board of Radiology (ABR) board certified/eligible. A total of six positions are available.
The purpose of the 1-year program is to train fellows in all aspects of diagnostic Neuroradiology with an emphasis on advanced imaging techniques, minimally invasive diagnostic and therapeutic spine procedures and catheter angiography. The fellows will gain experience in therapeutic neuroendovascular techniques
through participation in that service and will be supported to pursue academic interests. A 2-year program is available for interested individuals. The second year is not a repeat of the first year but rather an individualized program aimed at meeting the needs and interests of the second-year fellow. The curriculum is created through a series of meetings with the fellow, the Program Director and the Section Chief and laid out a year in advance. Interested applicants should make their interests known early.
Commitment
We realize that your choice of a Neuroradiology Fellowship is difficult and that considerations include the academic program, faculty, work environment, geographical location and other personal issues. We also recognize the personal commitment it takes on your part to extend your training and improve your skills. Please know that we take your commitment seriously and commit to train you as best we know how. Finally, it is our responsibility to help guide you in your job search and to help you obtain the job of your choice.
Training Program
Neuroimaging training
Neuroimaging training includes all aspects of neuroradiology of the head, neck and spine including magnetic resonance imaging, computed tomography, myelography, PET/CT, ultrasound and catheter angiography. The fellows spend approximately 28 weeks on rotations that cover CT, MR, advanced techniques and post-processing the majority of which is in MRI and advanced techniques.
Extensive training in advanced imaging techniques is the cornerstone of our fellowship and includes MR Spectroscopy, MR Perfusion, CT Perfusion, fMRI, DTI and CSF flow analysis. PET/CT imaging as it is applied in dementia and HN imaging is a new component of the training program and will further enhance the educational experience. Non-invasive vascular imaging is critical to the expert neuroradiologist: at Northwestern, your experience will include training in a variety of techniques including high-resolution CT Angiography, positional/provocative CTA, 3DTOF MRA, ultra-short TE 3DTOF MRA, contrast–enhanced MRA, time-resolved MRA, CT venography and 2D TOF MR venography.
Familiarity with various post-processing equipment is essential to be nimble, thorough and accurate. The Department has vast 3D resources including a 3D Lab with Tera Recon (2), Vitrea (5), Leonardo(8) and Advantage Windows workstations(1). The Tera Recon resources include a thin client platform that allows for access and all PACS and remotely. All platforms are maintained at a high level with regard to version/platform and in-hospital support maintains the systems. The fellows are encouraged to utilize the workstations and become independent of the technologists even though the 3D techs routinely create the 3D and post-processed images.
Dedicated Head/Neck training includes 8-9 weeks per fellow the majority as the only trainee on the service. The Head and Neck Section, led by Dr. Achilles Karagianis, has grown into arguably the most sought after rotation in Neuroradiology. The success of this rotation lies in the case material, individual attention and dedication to teaching of the attending staff: Dr. Karagianis was selected as the 2007 Teacher of the Year by the Radiology Residents. PET/CT imaging as it is applied in head/neck cancer is a growing component of the training program and will further enhance the educational experience. The Head/Neck Section performs some procedures including relevant biopsies and sialography.
Procedure training
The procedure experience can be subdivided into 3 distinct areas: diagnostic catheter angiography, neuroendovascular therapeutics and percutaneous spine procedures.
Each fellow rotates for 8 or 9 weeks on the angiography service. They are responsible for all aspects of patient care including the work-up, plan and performance of the angiogram, post-operative care and follow-up. Graduated responsibility results in independence in the angio suite while under the direct supervision of attending staff. There is an emphasis on the technical and interpretive aspects of catheter angiography with correlation to non-invasive exams. The fellows easily surpass the RRC requirement of 50 angios per fellow and further exceed that number by participating in diagnostic catheter angiograms at Children’s Memorial Hospital as well as endovascular procedures at NMH and CMH. During their 8-9 week angio experience, the fellows actively participate in therapeutic endovascular cases along with the endovascular fellow (neuroembolization). The diagnostic portion along with initial elements of the therapeutic component are frequently performed by the Neuroradiology fellow (i.e. you do more than flush and hold wires!).
The fastest growing procedure service in Neuroradiology is The Spine Service. The Spine Service is a comprehensive program that encompasses diagnostic and therapeutic spine services. Diagnostic services include CT, MR, CT myelography, discography and any spinal/paraspinal aspiration/biopsy. Our myelography experience goes beyond the typical case and often requires creative approaches to complex spinal problems. Any spine/paraspinal fluid, soft tissue or bone lesion requiring aspiration or biopsy is performed by our section. We utilize ultrasound, fluoroscopy and CT for the majority of these procedures. MR guidance is our newest frontier. Pain management procedures include kyphoplasty, vertebroplasty and steroid injections of any kind including translaminar ESI, transforaminal ESI, selective nerve root blocks and facet injections. Blood patches are performed in three distinct scenarios: post-LP spinal headache, post-operative dural tear and spontaneous intracranial hypotension. For a comprehensive overview of this service, visit The Spine Service website.
Pediatric training
Each fellow spends two consecutive months at the busy Pediatric Neuroradiology section at Children’s Memorial Hospital, under the direction of Francine Kim, MD. The divisions of Pediatric Neurosurgery and Neurology at CMH are excellent, and there is a close working relationship with all interrelated specialties. The fellows are exposed to all facets of Pediatric Neuroradiology including CT, MR and invasive procedures.
Research and academic production
Participation in research and attendance at annual scientific meetings is encouraged and fully supported. Consistent academic time is provided throughout the year. A full medical and neuroradiology library is available for fellows, as are a complete spectrum of teaching files and electronic media covering all aspects of neuroimaging and intervention. The fellows’ office, located alongside the attending’s offices, maintains the Neuroradiology fellow library, ancillary educational material and desktop computers with internet and hospital systems access. The fellows may utilize any other department resources including the Section’s administrative assistant, graphic artists, webmasters and IRB support personnel to name a few.
The Neuroradiology Section
The Neuroradiology Section at Northwestern Memorial Hospital is composed of 11 fellowship trained neuroradiologists, all members of the American Society of Neuroradiology. Nine of the neuroradiologists hold Certificates of Added Qualification (CAQ) and two are pending. In addition to the neuroradiology fellows, four radiology residents rotate with us each month.
Fellows fully participate in all clinical, educational and academic activities. Participation in the teaching of residents and medical students is required. Elective time is available by mutual agreement.
Our faculty is dedicated to excellence in clinical neuroradiology, as well as education and research. Members of the section serve on the editorial board of the American Journal of Neuroradiology, and have produced an extensive list of peer-reviewed publications in diagnostic and interventional neuroradiology and head and neck imaging.
NMH equipment and facilities
NMH occupies a modern inpatient/outpatient facility, with an integrated Picture Archiving and Communication System (PACS) system permitting full filmless practice. Voice recognition is in place in addition to the electronic medical record. Home access to these systems allows for flexibility.
Current equipment at Northwestern Memorial Hospital includes two biplane Siemens Neurostar angiography suites and the Myabi system, a combined MR-IR suite designed for combined procedures. Eight computed tomography (CT) scanners are in place including two state of the art Siemens Sensation 64-slice CT scanners, a dual energy scanner (Definition CT) and two 16-slice Siemens CT scanners. A portable CT scanner has recently been deployed for use in the neuro-ICU. A 128-slice CT scanner will be operational I the ED in Fall 2008. There are ten state of the art clinical magnets including the two Siemens Avanto units, two Espree units, Sonata, Symphony and Horizon platforms, all with echoplanar imaging and diffusion/perfusion capabilities. A 1.5 T Siemens sonata and a 3T, whole body, Siemens Trio Research magnet are housed in our Center for Advanced MRI in an adjacent medical school building. Equipment at CMH includes two GE Signa 1.5T MR scanner with spectroscopic capabilities, two GE CT scanners, and a new neuroangiographic suite.
A Multidisciplinary approach
At NMH, a multidisciplinary approach to neuroimaging is the key to an excellent working environment. Hunt Batjer, MD, a world-renowned expert in vascular neurosurgery leads a busy and growing neurosurgery department. Case material includes aneurysms, AVMs, dural AVFs, primary and metastatic brain tumors, stimulator implants, spinal deformity and minimally invasive spine techniques. A wealth of angiographic/interventional cases are available. The neuroendovascular service is co-directed by Guilherme Dabus, MD, interventional neuroradiology and Bernard Bendok, MD, endovascular neurosurgery. The Department of Neurology is led by Dr. Jack Kessler, a researcher with expertise in stem cells and spinal cord regeneration. Areas of strength include stroke neurology, neuro-oncology, neurodegenerative disorders such as Alzheimer’s disease and multisystem atrophy, motor neuron disease including amyotrophic lateral sclerosis, demyelinating disease and stem cell transplants for treatment of multiple sclerosis and lupus. Two MR physicists are members of the Neuroradiology Section: Tim Carroll, Phd and Todd Parrish PhD, each supported by NIH RO1 Grants. A cooperative effort with cognitive neurologists, led by Marsel Marek-Mesulam, MD, has led to the development of a clinical and research program in functional imaging of the brain, supported by Todd Parrish, PhD, and investigations centered on neurovascular imaging and perfusion imaging are conducted by Tim Carroll, PhD. Weekly Conferences
| Mon | 4:30 pm | Case of the Week |
| Tue | 7-8am | Neuroradiology Fellows Didactic Conference |
| 9-10am | Neuropathology Brain Cutting | |
| Wed | 7-8am | Interesting Case Conference/Journal Club/QM and Medical Student Lecture (rotates through all 4) |
| 5:00-6:30pm | Neurovascular Conference | |
| Thu | 8-9am | Head and Neck Tumor Board |
| 7:30-8:30am | Neurology Case Conference | |
| Fri | 7:30-8:30am | Brain and Spine Tumor Board |
| 4pm | Neuroradiology Resident Conference |
Case and procedure volumes
Neuro MRI: 30,000
Neuro CT: 20,000
Neonatal Head US: 700
Diagnostic angiography: 350 (adult), 40 (pediatric)
Endovascular procedures: 250 (adult), 20 (pediatric)
Weekly rotations
Feinberg MRI: inpatient and outpatient MRI
Ontario MRI: outpatient MRI
CT: inpatient and outpatient CT, LPs and myelography
Functional: MR Spectroscopy, MR Perfusion, CT Perfusion, CT Angiography, fMRI, DTI, CSF flow studies, neonatal head US
Head and Neck: inpatient and outpatient CT, MRI, PET/CT
Procedures: diagnostic angiography, spine procedures, endovascular therapy cases
Application Requirements
Applications for the fellowship will be accepted through March 1, 2008. Offers for personal interviews will be made upon completion of the application, so we encourage prompt submission. Completion of an accredited four-year radiology residency program is a prerequisite for acceptance.
If you are interested in applying to the neuroradiology fellowship program, send a
- Completed Application
- Curriculum Vitae,
- Personal Statement
- USMLE Step Scores
- A small, current passport sized photo of yourself
- Three letters of recommendation addressed to:
Michelle Naidich, MD
Associate Director, Neuroradiology Fellowship Program
Northwestern Radiology
Department of Radiology
676 North St. Clair St., Suite 1400
Chicago, Illinois 60611
For More Information
If you need further information please call (312) 695-1292 or email: Neuroradiology Fellowship Coordinator