Northwestern University Feinberg School of Medicine

Department of Radiology

Neuroradiology

Overview

The Neuroradiology fellowship training program at Northwestern University’s McGaw Medical Center is an ACGME approved, one-year program based at Northwestern Memorial Hospital (NMH) and the main campus of Northwestern University Feinberg School of Medicine, located in the heart of Chicago, between North Michigan Avenue and the Lake Michigan. Fellows also rotate at the Ann & Robert H. Lurie Children’s Hospital of Chicago (Lurie Children's). 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 one-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 two-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 intent of the second year curriculum is to focus on advanced imaging techniques to a greater degree. 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 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. 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. 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 weeks per fellow. 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, and has just recently published a text book on Head and Neck Imaging Variants. 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 three distinct areas: diagnostic catheter angiography, neuroendovascular therapeutics and percutaneous spine procedures.

Each fellow rotates for eight or nine 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 Lurie Children’s Hospital as well as endovascular procedures at NMH and Lurie Children's Hospital. During their eight or nine 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. 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 Lurie Children's, under the direction of Delilah Burrowes, MD. The divisions of Pediatric Neurosurgery and Neurology at the Lurie Children's 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 & 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 NMH is composed of twelve fellowship trained neuroradiologists, all members of the American Society of Neuroradiology. Eleven of the neuroradiologists hold Certificates of Added Qualification (CAQ) and one is 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 & 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 NMH includes two biplane neuroangiography suites including a new biplane flat-panel Siemens unit in a fully-loaded operating suite for use by the growing neurointerventional service. A combined MR-IR suite, the Myabi, is in place and allows for combined MR-IR procedures such as stroke thrombolysis.

There are nine CT scanners in place including two 192-slice Force scanners (one which is the ED), a 128-slice scanner in the ED, a dual-source 64-slice Definition scanner, three 64-slice and two 16-slice scanners. One of the 16-slice scanners is used for CT-guided procedures.

There are fifteen state of the art clinical magnets including four Siemens Avanto units, two Espree units, Symphony and Aera platforms plus six clinical 3T magnets (Veria, Skyra) all with echoplanar imaging and diffusion/perfusion capabilities. A 1.5T Siemens Aera and three 3T, (Siemens Trio, Prisme, Skyre) Research magnets are housed in our Center for Advanced MRI in an adjacent medical school building.

The brand new Lurie Children’s Hospital of Chicago opened in June 2012. The department of Medical Imaging at Lurie Children’s has a total of 2 dedicated CT scanners, 1 PET/CT scanner, 5 MRI scanners and 3 Angiography suites. The CT scanners are Siemens FLASH scanners and a GE scanner located in the Emergency Department. There are 3 MRI scanners located at the main hospital, two Siemens Aera 1.5 and Skyra 3T, and in the outpatient facilities a GE HDX 1.5T as well as a mobile GE HD 1. Two angiography suites, Phillips biplane Allura and a Siemens Axion Artis Single plane unit are located at the main hospital at Lurie Children’s.

A Multidisciplinary Approach

At NMH, a multidisciplinary approach to neuroimaging is the key to an excellent working environment. Northwestern has 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 Michael Hurley, M.D., interventional neuroradiology and Bernard Bendok, MD, endovascular neurosurgery. The Department of Neurology is led by Dr. Jack Rozental. 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.

One MR physicists is a  members of the Neuroradiology Section: Todd Parrish PhD, 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

Mon8-9 amENT Tumor Board
Tue7-8amNeuroradiology Fellows Didactic Conference
9-10amNeuropathology Brain Cutting
1-2pm

Medical Student Lecture (bi-weekly)

Wed7-8amInteresting Case Conference/Fellow Conference/Journal Club/QM and Medical Student Lecture (rotates through all 5)
7-8amEpilepsy Conference (monthly)
Thu7:30-8:30amNeurology Case Conference
Fri7:30-8:30amBrain and Spine Tumor Board

Case & Procedure Volumes

Neuro MRI: 30,000
Neuro CT: 30,000
Neonatal Head US: 700
Diagnostic angiography: 300 (adult), 40 (pediatric)
Endovascular procedures: 200 (adult), 20 (pediatric)
Spine procedures: 700

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 September 1, 2016 thru February 15, 2017. 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 the following:

Program Director

Naidich

Michelle Naidich, MD

Contact Us

Contact Kelli Alderman for additional information about our Neuroradiology Fellowship.

Kelli Alderman
312-695-1292

Housestaff Research Portal

Feinberg has the infrastructure and resources to assist McGaw trainees interested in conducting scientific research. Visit our Housestaff Research Portal to learn more.