Daily case review
The neuroradiology fellow is expected to arrive for work by 7:30 a.m. to begin case review and organize section activities for the day.
The fellow is in charge of protocol prescription for MR and CT studies; much of this activity is to be shared with radiology residents according to their abilities. Complex or difficult protocols are to be discussed with neuroradiology faculty.
The fellow is expected to review 25 or more CT or MR imaging cases on those days where no interventional procedures are performed. For each case they will learn the relevant clinical history, independently review the imaging study, compare the imaging study to relevant prior studies, and formulate an interpretation of the study. They will then review each study with an attending neuroradiologist. Faculty neuroradiologists are expected to use this time for one-on-one teaching relevant to the clinical case material and imaging techniques. The resident will report critical findings to the necessary persons. They will dictate the imaging report and edit the transcribed report for accuracy. neuroradiology faculty will evaluate the reports and provide constructive criticism. The daily clinical material ideally serves as a springboard for further reading in advanced topics.
Invasive procedures
The fellow is expected to perform invasive diagnostic and therapeutic procedures under the direct supervision of a neuroradiology faculty member. Interventional procedures will require a 7:00 a.m. start on some days. There will be graded responsibility given depending on fellow experience and abilities. For example, at the beginning of the fellowship the fellow may be primarily responsible for handing the faculty the necessary equipment, and by the final months of the fellowship be performing the procedure with the faculty member watching from the control room.
Responsibility for procedures includes pre-procedure patient management, including review of the clinical history, performance of relevant physical examination, and review laboratory and imaging studies. The pre-procedure workup will be directly supervised by neuroradiology faculty and the plan discussed. Post-procedure evaluation will similarly performed and supervised. The fellow is required to maintain a procedure log of the invasive procedures that they have performed. The fellow is to participate in department and division QA activities.
It is expected that the fellow will complete more than 50 diagnostic cerebral angiograms, perform more than 50 percutaneous biopsies and spine procedures, and participate in more than 10 neurointerventional procedures.
Rotations
| General neuroradiology | Ten 4-week blocks |
| Interventional neuroradiology | Integrated with general neuroradiology |
| Head and Neck radiology | Integrated with general neuroradiology |
| Pediatric neuroradiology | Integrated with general neuroradiology |
| 3D/postprocessing | One two-week block |
| PET | One two-week block |
| Vascular lab | One two-week block |
| fMRI lab | One two-week block |
Didactic neuroradiology conference
The fellow will attend the three monthly didactic neuroradiology lectures given by the neuroradiology faculty. These lectures occur from 12:00 - 1:00 p.m. as part of the Radiology Department lecture series. A total of 36 such conferences are given each year. The curriculum follows a two-year cycle and includes both didactic lectures and case conferences at which fellow participation is required. The fellow will often be asked to expand upon questions asked of the residents. The fellow will deliver several didactic conferences as part of this series each year.
Didactic lectures given in the past two years include:
- Basal ganglia lesions
- Brain attack
- Cerebrovascular anatomy and imaging
- Cerebrovascular intervention
- CNS infections
- Congenital malformations
- Craniocerebral trauma
- Cystic neck masses
- Degenerative disease of the spine
- Extra-axial brain tumors
- Extradural spine lesions
- Functional MRI
- Hydrocephalus
- Inflammatory sinonasal pathology
- Intramedullary spine lesions
- Intra-axial brain tumors
- Neuroanatomy
- The orbit
- Pediatric brain tumors
- Salivary glands
- Sella and parasellar lesions
- Sinonasal neoplasms
- Solid neck masses
- Spine anatomy and congenital anomalies
- Spine tumors
- Spine trauma
- Temporal bone anatomy and pathology
- Vascular malformations
- Vertebroplasty and kyphoplasty
Other conferences
The fellow is required to attend the following educational conferences:
- Neuroradiology case review (weekly)
- Interesting case conferences (periodic)
- Cerebrovascular conference (weekly)
- Pediatric neuroradiology conference (biweekly)
- Neuroradiology journal club (periodic)
- Interventional M&M conference (monthly)
- Neurology megarounds (weekly)
- Neurology grand rounds (weekly)
- Brain cutting (weekly)
- Diagnostic radiology QA (bimonthly)
For the cerebrovascular and pediatric conferences, the fellow is responsible for presenting the cases and is to review the cases with a faculty member prior to the conference.
Other conferences attended by neuroradiology faculty that the fellow should attend periodically:
- Neuro-oncology tumor board
- Endocrinology conference
- Epilepsy conference
- Head and neck tumor board