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The Neuroradiology Fellowship at Beth Israel Deaconess Medical Center (BIDMC) is a one year, ACGME-accredited program with four fellows, which includes a three-month rotation at Tufts Medical Center (TMC) and a two-week elective time at Massachusetts Eye and Ear infirmary.
Tufts Medical Center is a 450-bed world-class academic medical institution affiliated with Tufts Medical School, which includes the Floating Hospital for Children with major strength in neurosurgery (including pediatric neurosurgery).
Fellows rotate through neuroradiological subspecialties, with progressive independence as they gain experience over the year. During their training, fellows successfully take independent home call, actively teach medical students and peers, complete quality improvement projects, participate in multidisciplinary conferences and tumor boards, and pursue research and other scholarly activities . Fellows also are provided the opportunity to develop skills in global health, medical education, health policy, research and quality improvement.
Graduates of this program are expected to be:
Clinically exceptional radiologists with solid diagnostic and interventional skills;
Compassionate and empathetic professionals with strong interpersonal skills and an ability to excel as members of healthcare teams;
Valuable contributors to patient care through a broad understanding of the complexities of the U.S. health care system and mastery of essential non-interpretative skills.
BIDMC's Neuroradiology Fellowship provides training in the performance and interpretation of all aspects of diagnostic neuroradiology, including hands-on experience in advanced CNS imaging techniques such as quantitative MR spectroscopy, ASL, MR perfusion, fMRI, DTI tractography, phase-contrast CSF flow imaging as well as CT perfusion and angiography.
There are close collaborative relationships between the Neuroradiology Service and the Departments of Neurology and Neurosurgery in clinical and academic activities at both institutions. Additionally, correlative brain cutting sessions are held monthly at BIDMC.
Weekly multidisciplinary conferences at both institutions provide a valuable learning experience for our neuroradiology fellows, in which comprehensive care of patient is discussed in conjunction with imaging findings.
The neuroradiology section at BIDMC performs approximately 60,0000 RVUs per year with slightly more MR than CT. Neuroradiologic services (CT and MRI) are also provided at Beth Israel Deaconess Hospital-Needham, by PACS. We have made a department-wide commitment to PACS (McKesson).
Our Facilities at BIDMC
11 helical multidetector CT instruments across the sites, including at the Emergency Departments.
10 human MR systems, eight 1.5T, two 3T.
2 small bore high field MR systems.
1 PET/CT, 1 SPECT/CT.
1 biplane angiography suite dedicated for diagnostic and interventional neuroangiography and spinal procedures.
State-of-the-art 3D laboratory with dedicated workstations: GE AW, Vitrea and Tera Recon.
A multidisciplinary approach to neuroradiology training is emphasized. There is a close interrelationship of the clinical and academic activities of the Neuroradiology Service with the Departments of Neurology, Neurosurgery, and Neuropathology. Correlative brain cutting sessions are held monthly.
7 neurosurgeons with expertise in all major areas:
Vascular – Drs. Ogilvy and Thomas
Functional – Drs. Alterman, Arle, Papavassiliou
Spine – Drs. Papavassiliou and Stippler
Trauma – Dr. Stippler
1,100 - 1,200 open surgical cases per year
250 open vascular
Average neurosurgery inpatient census is approximately 25 - 30 patients
2 vascular (1 spine and 1 neuro-oncology)
Surgical Residency program
The neuroradiology service provides routine clinical fMRI and DTI for treatment planning of brain tumor and functional neurosurgery cases. Routine Arterial Spin Labeling perfusion images using a technique developed in house is also performed in brain tumors. FDG PET, Thallium Spect and MR Spectroscopy are routinely used for evaluation of brain tumors.
There is a strong training in angiography and endovascular techniques with approximately 600 diagnostic and interventional angiography cases per year. Training in vertebroplasty and spine biopsies is also offered. There is an active stereotactic radiosurgery program at BIDMC with approximately 200 cases annually.
The training at Tufts Medical Center complements the educational experience at BIDMC with strong clinical expertise in
Pediatric neurological diseases
Neurosurgery (including surgery of brain tumors and the spine)
Endovascular Surgery and ENT
There are residency programs in
The weekly multidisciplinary head and neck cancer center is a valuable learning experience for the neuroradiology trainee, in which comprehensive care of the head and cancer patient is discussed including discussion of imaging findings.
To provide comprehensive educational experiences in the selection, performance and interpretation of diagnostic neuroradiological studies of brain, spine and otolaryngology, enabling fellow graduates to independently function as high quality consultants in academic or private practice settings.
To provide comprehensive educational experiences in the selection, performance and interpretation of invasive neuroradiogical procedures such as cerebral angiography, spinal angiography, myelography, spinal canal access for spinal fluid analysis, chemotherapeutic injections and, image guided biopsies, including some exposure to interventional techniques such as thrombolysis and cerebral aneurysm and AVM embolization.
To provide teaching opportunities and skills to the fellows such as instruction and lectures for medical students and radiology residents.
To provide opportunities and skills to the fellows for Quality Assurance (QA) activities in neuroradiology.
To provide opportunities and skills to the fellows in scholarly projects in neuroradiology.
BIDMC (Boston) / BID-Needham: Neuroradiology
Rotation 1 (Inpatient/ED): The fellow will be responsible for advanced CT (CTA, CT perfusion) and MRI imaging of emergency and inpatient cases, including trauma, infection, stroke and tumor imaging. Once these cases are signed out, the fellow will be responsible for outpatient studies.
Rotation 2 (Procedures and fMRI): The fellow will participate in Diagnostic and Interventional Neuroangiographic studies, diagnostic spinal procedures. Fellow is also responsible for processing and interpretation of functional MRI studies. In between such cases, the fellow will be expected to read outpatient studies when time permits.
Rotation 3 (Outpatient Imaging and Conferences): The fellow will be responsible for presenting cases in the Monday morning 7:30am Neuro-oncology cases and in the 9:30am Thursday Neuroradiology Case Conference. In addition, the fellow will be responsible reading outpatient studies.
BIDMC – Pain Clinic
The neuroradiology fellow will observe fluoro-guided spine procedures, such as facet injections, in a one-week observership with Anesthesiology.
Tufts Medical Center
Adult and Pediatric Emergency: In addition to exposure to emergency, inpatient and outpatient neuroradiology studies, the neuroradiology fellow will be responsible for presenting Neuro-oncology, Neurosurgery and ENT case conferences. The fellow will also participate in diagnostic procedures ranging from lumbar puncture, myelography and biopsies.
Massachusetts Eye and Ear Infirmary
Adult and pediatric head and neck imaging.
Routine Conferences / Lectures
Neuro-oncology (required for Rotation 3)
Childrens' neuroradiology at Boston Children's Hospital
Fellow teaching conference (required rotation)
CME Neuroradiology Case Conference at BIDMC (required rotation)
Neuroradiology Case Conference (required for rotation 3)
Morbidity and Mortality
Seizure Clinic Conference
ENT (Tufts; required rotation)
Fellows' Conference (required rotation)
Journal Club (required rotation)
Weekday and weekend evening home call/resident back-up (no overnight in-house call)
Coverage of urgent fluoroscopic guided lumbar punctures or myelograms for BIDMC Boston and TUFTS (infrequent)
No angiography responsibilities
Weekend and holiday day call – readout of BIDMC Boston and BID-Needham inpatient and emergency department MRI and CT (7:30 a.m. – 3 p.m. and later as needed)
Assigned for one week (Monday 5 p.m. through following Monday 8 a.m.), with additional day when covering holidays; Q4 rotation
Trainee / Program Evaluation
Quarterly, the fellows complete anonymous evaluations of the program and its rotations at both training sites, as well as of each member of the teaching faculty.
In the spring, fellows also complete a separate Annual Program Evaluation survey, which is standardized across all training programs in the Department of Radiology and are asked about their experience thus far to help identify areas of improvement.
At the end of the year, all data – including results from the quarterly evaluations, the APE survey, annual ACGME resident and faculty surveys, feedback obtained during the annual internal review process with the institution's GME Office as well as direct feedback from the fellows obtained during bi-annual meetings with the program director – is reviewed by the program leadership and the Program Evaluation Committee to develop an action plan for the upcoming academic year. We analyze this data in comparison with recent years to identify trends and areas for improvement. Progress on action plans each academic year is tracked regularly through bi-annual meetings with the fellows and faculty, as well as quarterly meetings of the Radiology Educational Operations Committee (which is comprised of education leaders across our department).
The neuroradiology section at BIDMC is made up of clinicians dedicated to providing our patients the cutting edge in neuroimaging to care for their health, while training future leaders in neuroimaging and developing neuroimaging techniques to further the management of neurological disorders.
In collaboration with our colleagues in neurology, neuro-oncology and neurosurgery, our physicians strive to provide the best care, while advancing the practice of clinical neuroimaging.