Philadelphia University + Thomas Jefferson University

Abdominal Imaging Fellowship
(formerly Ultrasound/CT/MRI)

The Thomas Jefferson Abdominal Imaging Fellowship offers a clinically comprehensive experience in an academically intense environment.  Thomas Jefferson University Hospitals, ranked 16th best in the nation on the US News and World Report 2017-2018 Honor Roll, has 951 licensed acute care beds with major programs in a wide range of specialties.  Jefferson abdominal imaging fellows benefit from a widely diverse and balanced case mix from:

  • Our Center City quarternary/tertiary hospitals (Thomas Jefferson University Hospital and Jefferson Hospital for Neuroscience),
  • Methodist Hospital, our community hospital in South Philadelphia,
  • Our 2 Center City campus outpatient imaging centers,
  • Our 3 additional suburban outpatient imaging centers and
  • A number of affiliated imaging centers in the suburban area, New Jersey, the Virgin Islands and Armenia.

Abdominal Imaging Clinical Faculty

Oksana Baltarowich, MD
Sandeep Deshmukh, MD
Rick Feld, MD
Flavius Guglielmo, MD
Ethan Halpern, MD
Stephen Karasick, MD
Alfred Kurtz, MD
Andrej Lyshchik, MD, PhD
Don Mitchell, MD
Levon Nazarian, MD
Laurence Needleman, MD
Patrick O’Kane, MD
Christopher Roth, MD, MS-HQS
Sharon Segal, DO
Santosh Selvarajan, MD
Pranshu Sharma, MD
Terri Tuckman, MD
Annina Wilkes, MD

TJUH (the main hospital) is a level 1 trauma center and in fiscal year 2017, there were 117,746 total emergency department visits.  In addition to the high-volume ED and inpatient activity, there are numerous robust clinical programs in liver and kidney transplantation, gastroenterology and hepatology, pancreaticobiliary surgery, urology, oncology, gynecology and others.

Abdominal imaging fellows are trained in the comprehensive use and interpretation of imaging modalities and interventional techniques as applied to diseases of the gastrointestinal tract, the genitourinary system and the intra- and extra-peritoneal organs of the abdomen and pelvis. Fellows participate in state of the art body imaging with Ultrasound, CT, and MRI of the chest, abdomen, and pelvis, with additional focused training in gastrointestinal, genitourinary and cardio-thoracic imaging. Every year, four fellows participate in a twelve-month program divided into 13 four-week blocks comprised of the following components:

Body MRI (5 blocks)
Body CT (2 blocks)
Ultrasound (2 blocks)
PET/CT (0.5 blocks)
Electives (1 blocks)
Interventional (1.5 blocks)
Advanced Imaging Applications (1 blocks)
Vacation (4 weeks)

The educational component of the department’s mission is taken very seriously by the faculty of the abdominal imaging section.  Fellows have the opportunity to work alongside highly esteemed, world-renowned academic radiologists on clinical rotations.  Faculty members also serve as research mentors for the fellows who are encouraged to engage in cutting edge research during the fellowship year.

For more information click on Apply Now in the blue box on the right or call the program coordinator, Isabella Corcoran at 215-955-6028.

Curriculum

Body MRI

While rotating on the body MR service, fellows will participate in the protocol development and image interpretation of all studies (~10000 exams/year), performed on the 12 1.5 Tesla, two 3 Tesla and 1 PET/MRI Jefferson systems and scanners operated by numerous affiliated centers.

Upon completion of training, fellows will:

  • Integrate CT, MR and ultrasound effectively in patient management decisions
  •  Understand when to recommend a particular diagnostic imaging modality
  • Understand how to choose a particular modality for an invasive procedure
  • Learn the basic principles of MR physics, and apply these principles toward constructing examination protocols
  • Incorporate advanced MR techniques to optimize imaging protocols
  • Interpret advanced MR applications including MR enterography, prostate MR with post-processing, MR elastography, MR for rectal cancer staging, MR for pelvic floor dysfunction
  • Effectively prioritize and triage patients requiring imaging studies according to clinical urgency

Body CT

While rotating on the CT service fellows will participate in the protocol development and image interpretation of all studies (over 30,000 exams/year) performed on 2 512-slice, 1 256-slice, 1 64-detector and 4 16-slice CT scanners in the Jefferson system and additional scanners operated by affiliated partners.

Upon completion of training, fellows will:

  • Interpret advanced CT applications including:
    • CT angiography
    • CT urography
    • CT colonography
    • Multiphasic imaging of the liver, pancreas, and kidneys
    • Dual-energy CT
  • Integrate CT, MR and ultrasound effectively in patient management decisions:
    • Understand when to recommend a particular diagnostic imaging modality
    • Understand how to choose a particular modality for an invasive procedure

Ultrasound

While rotating on the Ultrasound service fellows will participate in scanning and image interpretation of all studies (~60000 exams/year) performed on 30 ultrasound machines on the Jefferson campus, in additional to numerous teleradiology studies.

Upon completion of training, fellows will:

  • Interpret advanced ultrasound applications including:
    • Gray scale and Doppler ultrasound examination of abdomen/pelvis
    • Doppler examination of vascular structures and transplant organs
    • Sonohysterography
    • Prostate imaging and biopsy
  • Learn hands-on advanced scanning techniques for obtaining high quality ultrasound images (transabdominal, transvaginal, and transrectal) by scanning patients together with more senior physicians and technologists, and getting feedback form the attending staff
  • Interface with referring physicians to obtain clinical information and tailor studies

Interventional

Fellows are assigned to the Biopsy Center in the main hospital, which is staffed by abdominal imaging and interventional radiology faculty members charged with performing all types of imaging-guided interventions using ultrasound, CT and fluoroscopic guidance.  Fellows gain experience performing procedures under the guidance of both abdominal imaging and interventional faculty members and also learn to manage pre- and post-procedural issues.  A wide spectrum of procedures is performed in the biopsy center, presenting fellows with exposure to:

  • Image-guided liver biopsy,
  • Image-guided renal biopsy,
  • Image-guided lung biopsy,
  • Abscess drainage procedures,
  • Ultrasound-guided thyroid biopsy,
  • Paracentesis and thoracentesis,
  • Image-guided lesion ablation procedures.

Advanced Imaging Applications

All PACS stations in the department are equipped with the TeraRecon thin client.  Additionally, the Dynacad workstation is used to postprocess prostate MR studies for Uronav MR/ultrasound-guided fusion biopsy and GE Gemstone Spectral Imaging (GSI) viewer is used for post-processing dual-energy CT exams in selected cases.

Fellows will participate in protocol development and imaging of CT, MRI and Ultrasound advanced applications including:

  • CT Angiography (including cardiac CTA)
  • CT Colonography
  • CT Enterography
  • CT Urography
  • MR Angiography
  • MR Enterography
  • MR Urography
  • CT and Ultrasound guided interventions
  • Sonohysterography
  • Advanced Musculoskeletal Ultrasound

Lectures & Conferences

The first two months of the year feature daily morning lectures oriented to abdominal imaging fellows with topics including various topics in MR physics, prostate MR, CT colonography, cardiac CT, transplant US, aortic CTA and elastography.  In addition to a core series of daily lectures given during the first two months of fellowship, fellows participate in the following conferences throughout the year:

  • Metastatic Uveal Melanoma Conference
  • Hepatocellular Oncology Conference
  • Hepatocellular Hepatology Conference
  • Gastrointestinal Multidisciplinary Conference
  • Pancreaticobiliary Conference
  • CVIR-MR Correlation Conference
  • CT-MR Interesting Case Conference
  • Ultrasound Case Conference
  • Diagnostic Error Conference
  • Monthly Grand Rounds Conference
  • Chairman’s Series (noninterpretive curriculum—quality and safety, practice management, health policy, etc.)
  • Abdominal Radiologic Pathology Conference (city-wide case conference held quarterly)

Call

Fellows rotate through the abdominal imaging division late shift for five 1-week blocks, which are scheduled during CT and US rotations.  Late shift hours are 11AM through 8PM and fellows work in concert with faculty members.  The fellows also work together with a faculty member on weekends and holidays from 8AM to 8PM and are assigned to a research day on the following Monday.  Weekend call is split between the 4 abdominal imaging fellows and the 1 body MRI fellow and call frequency is approximately every 5th weekend.