Department of Radiology

The UTMB Breast Imaging Fellowship provides one year of multidimensional advanced training to qualified applicants seeking specialized knowledge in Breast Imaging. Since its inception in 2003, this fellowship program has produced Mammographers who are proficient in screening and diagnostic mammography interpretation, breast ultrasound interpretation, breast MRI interpretation, and breast interventional procedures including ultrasound and stereotactic guided biopsies. In addition, our breast imaging fellows are trained with state of the art equipment including digital mammography units, a stereotactic unit, and a 3T MRI unit with a breast specific coil.

Candidates applying for this one year fellowship program should have completed a four year Diagnostic Radiology residency and board certification through the American Board of Radiology is preferred.

The UTMB Radiology Department is a facility that is accredited by the American College of Radiology and the Breast Imaging Department is staffed by three specialized Breast Imaging Radiologists who have each been Board Certified through the American Board of Radiology. A wide range of breast pathology is seen through the diverse patient population of UTMB which includes both insured and uninsured patients and detainees in the Texas Department of Criminal Justice. As a member of a seven-hospital University system, we provide approximately 20,000 annual breast exams and procedures through a mobile mammogram van unit and imaging centers located throughout Galveston county.

The objective of this fellowship program is to provide a comprehensive foundation in all aspects of Breast Imaging. This advanced training includes the interpretation of screening and diagnostic mammograms by digital and/or screen-film mammographic technique as well as the interpretation of breast ultrasound and breast MRI. Interventional procedures include, but are not limited to, ultrasound and stereotactic guided needle biopsies and needle wire localizations, fine needle aspirations, galactography, and breast abscess drainage.

Our fellowship program consists of one fellow who divides their time interpreting screening and diagnostic mammograms, breast ultrasounds, MRI's, and performing breast interventional procedures under the supervision of Breast Imaging Faculty. The fellow is also responsible for preparing and presenting breast malignancy cases for the multidisciplinary breast conferences.

At the beginning of the Breast Imaging Fellowship, faculty supervision is intensive, however, with increased training, experience, and knowledge we anticipate more independence and autonomy from the fellow. A member of the Breast Imaging faculty is always readily available for immediate assistance and most importantly, the maintenance of patient safety. Additionally, numerous Breast Imaging textbooks are available upon request for study and review.

Clinical research is an important aspect of the fellowship and the fellow will be involved in any ongoing breast research projects and journal publications. Submission of an abstract, manuscript, or exhibition at a major society meeting and attendance at the annual Radiological Society of North America (RSNA) meeting is also encouraged.

At the conclusion of this one year Breast Imaging Fellowship, the fellow should be confidently interpreting all breast imaging modalities including mammograms, ultrasounds, and breast MRI with correct incorporation of BI-RADS (Breast Imaging-Reporting and Data System) criterion. In addition, the fellow should be comfortable performing any indicated interventional procedures of the breast. Finally, the fellow should be comfortable providing appropriate teaching sessions to radiology residents and medical students in all modalities of Breast Imaging.

We are currently accepting applications, so interested and qualified applicants are encouraged to contact our Breast Imaging Faculty for more details:

Angelica S. Robinson, M.D.,

Assistant Professor of Radiology, Department of Breast Imaging

American Board of Radiology Certified; Breast Imaging Fellowship trained.

Email: an3robin@utmb.

1. Program Host Institution: The University of Texas Medical Branch

2. Program Specialty: Breast Imaging

3. Program Director: Morton Leonard, Jr., M.D., Director

4. Program Address: Department of Radiology 2.470 Clinical Science Building 301 University Blvd. Galveston, TX 77555-0709

5. Program Phone: (409) 772-2496

6. Program Fax: (409) 747-2825

7. Breast Imaging Fellowship Coordinator: Faith McDaniel femcdani@utmb.edu

The Neuroradiology fellowship program has been in existence since 1980. The candidates are required to complete a four-year radiology residency prior to acceptance to the fellowship.

As described in the ACGME directory, our program has duration of one or two years. The first year is ACGME-accredited. Similar to many other neuroradiology programs in the US, we offer an additional one-year of training, non- ACGME accredited, if the fellow desires further knowledge in latest techniques in neuroimaging and angiographic /endovascular embolization therapy. Several of the previous fellows who have completed the 1-year program have undergone this second year of training.

In contrast to the first year of the program, which focuses more on neuroimaging and diagnostic angiography/procedures, the second year concentrates on neurointervention. Procedures would include microcatheter-based interventions such as embolization for aneurysms, AVMs, carotid-cavernous fistulas and epistaxis management; vertebroplasty; and image-guided pain management such as epidural steroid injection, nerve root blocks and facet ablation. Other image-guided procedures such as CT- and MR-guided biopsies, discography and myelography would also be covered. Newer aspects of imaging such as NMR spectroscopy, Diffusion Tensor Imaging, perfusion imaging, 3D CT post-processing and detailed analysis of head and neck radiology will be covered during the 1st year of training with additional experience gained in the 2nd year.

We have an ACGME accredited Neuroradiology fellowship program that offers 1-2 years of training with 2 fellow positions. We have 6 Neuroradiologists, including an experienced and fellowship trained Neurointerventionalist. We go through the NMRP match and use the universal application located on the following webpage: www.apdr.org/residents- _and_fellows.cfm

The training program usually consists of two fellows alternating biweekly on the neuroimaging service and neurointerventional service. All imaging and interventional cases are interpreted and performed along with an attending neuroradiologist. At the start of the fellowship, faculty supervision is more intensive; as the trainee gains experience and knowledge, more independence with supervision will be allowed. The faculty is always available to help provide safe care for the patient.

Regularly scheduled interdepartmental conferences are held in which the fellow is required to participate, which include: weekly Neuro-radiology/Neurosurgery, Neurology, Neuro-Oncology, Pathology and ENT conferences along with a quarterly Neuro-Ophthalmology conference. Within the section, we hold biweekly journal clubs and lectures.

The trainee is encouraged to participate in ongoing and/or on new research in the section. At least one abstract or manuscript sub-mission to a major societal meeting or journal is expected. The faculty would be available for guidance and mentoring.

The trainee is expected to supervise residents and teach medical students who rotate in the section. He/she is also required to deliver a lecture on neuroanatomy to the first year medical students.

The trainee is encouraged to attend the annual American Society of Neuroradiology meeting.

Numerous up to date textbooks are available to the trainee in the reading room and faculty offices. These include the latest on Imaging of the CNS and spine, head and neck radiology, temporal bones, NMR Spectroscopy, angiography and therapeutic interventions, and STAT DX. Teaching files are available to the trainee in the faculty suites (film and PACS based).

Teaching Staff Gregory Chaljub, MD. Professor of Radiology Director of Neuroradiology Section and Neuroradiology Fellowship Program Director Val Runge, M.D. Professor of Radiology John Sealy Distinguished Chairman of Radiology Rudiger von Ritschl, M.D. Assistant Professor of Radiology Deputy Director of Neurointerventions Roy Riascos, M.D. Associate Professor, Department of Radiology Tomas Uribe, M.D. Assistant Professor, Department of Radiology Andreas von Ritschl, MD. Assistant Professor, Department of Radiology

1. Program Host Institution: The University of Texas Medical Branch

2. Program Specialty: Neuroradiology Fellowship Program

3. Program Address: Department of Radiology 2.804 John Sealy Annex Building 301 University Boulevard Galveston, Texas 77555- 0709

4. Program Phone: (409) 772-2230

5. Program Fax: (409) 772-2303

6. Program E-mail: gchaljub@utmb.edu

7. Program Director: Gregory Chaljub, M.D., Director

8: Alternate Program Contact: Faith McDaniel, Neuroradiology Fellowship Coordinator femcdani@utmb.edu

The Interventional Radiology section is currently approved for three fellowship positions per year. All fellows will work primarily in the main hospital at Galveston. Over 3,000 cases are performed annually.

We have two angiography suites, including a biplane unit, and will soon get a new state-of-the-art Siemens biplane angiography unit. We also have rooms for US procedures ,minor vascular procedures and also access to a CT room for procedures.

The goal of the program is to produce well trained interventional radiologists able to fulfill duties of clinical practice, research, and teaching. Fellows will actively participate in all aspects of clinical practice including pre-procedural work-ups, consults, and post-procedure follow-ups. Time will be available for electives and research for those interested.

We have close relationships with referring departments including transplant surgery, urology, gastroenterology, ob-gyn, and oncology. An IR clinic is active and supported by two nurse practitioners. We perform the full gamut of vascular and non-vascular interventional procedures. Lists of performed procedures includes (but not limited to):

1) Comprehensive venous access (PICCs, ports, hickmans, triple lumens, dialysis catheters etc) including placement, removal, and maintenance/troubleshooting.

2) Comprehensive dialysis access procedures including fistulograms, angioplasty, embolization, and declots.

3) Aortic, pulmonary, mesenteric, renal, and peripheral angiography, angioplasty, and stent placements. Carbon dioxide angiography.

4) Arterial and venous thrombolysis

5) Comprehensive biopsy services (US, CT, and fluoro guided), percutaneous, transjugular

6) Comprehensive hepatic interventional oncology treatments including chemoembolizations (conventional, drug-eluting beads, bland), radiofrequency ablations, and soon radio-embolizations.

7) IVC filter placements and retrievals

8) Uterine artery embolization

9) Nephrostomy, ureteral stents

10) Transhepatic cholangiograms, biliary stents

11) TIPS procedures

12) Drainage procedures

13) Percutaneous gastrostomy

On-line evaluation of the fellow by the faculty would be performed every quarter. A procedure log for each trainee would be checked monthly.

A yearly summary evaluation of each trainee by the fellowship program director will be provided.

Quarterly evaluations of the faculty will be anonymously completed by the fellow.

The main hospital on campus has about 450 beds with accredited residency programs in Neurosurgery, Orthopedics, Oncology, Neurology, ENT, Internal Medicine, Surgery, Pediatrics, Family Medicine and other subspecialty disciplines. Two new surgical towers are in the planning stages. The projected equipment on the main campus will include, as of 2011-12, three 1.5 T units, one 3 T unit (impending installation), 6 CT's (two 64 detectors and a 128 detector ( installation pending), two biplane angiography suites (installation pending of a new state of the art unit) and one CT/PET unit. This includes the latest high end MR and neuro/interventional angiography systems. Breast Imaging is equipped with state of the art film screen system and digital mammography units, ultrasonography and Mamotome Biopsy and Breast MRI.

There is one stand alone Diagnostic Imaging Center and an additional larger advanced imaging department as part of a 100,000 square foot Ambulatory Surgical Center (ASC). These two sites are located off the island in Pearland and League City (Victory Lakes) that opened in 2010. They are located about halfway between Galveston Island and Houston. The equipment is state of the art with a new 3 T Siemens Verio, an open 1.5 Siemens Espree, a new 1.5 GE MRI, two 64 detector CT's (one dual energy), biplane Siemens and single plane angio suites, and a SPECT CT. A PET/CT unit will be added in two years, for use when the stand alone Oncology Center is finished.