Neuroradiology Fellowship Schedule & Rotations
Fellows rotate through the different rotations in weekly blocks. The day shift rotations are Monday through Friday from 7am to 3pm, with one academic day per week.
The call rotation is from Friday to Thursday from 3pm to 10pm. The nine fellows share call responsibilities equally, with a frequency of approximately one weeknight in nine and every ninth weekend. As St. Joseph’s Hospital is home to a radiology residency program, a radiology resident is in house to review imaging studies performed after 10pm. On-call responsibilities for fellows primarily involve performing emergent procedures and occasionally providing assistance to the on-call residents.
Explore our dedicated rotations
This dedicated vascular imaging rotation provides exposure to state-of-the-art imaging for acute stroke and other vascular pathologies. The Barrow Neurological Institute is one of the most experienced and expert stroke programs in the country, caring for more stroke victims and participating in more clinical stroke treatment and prevention research trials than any other center in the southwestern United States. Uniquely at Barrow, we have a dedicated MR scanner in the emergency department, allowing us to use MR as our default imaging modality for acute stroke. Our exclusive, ultra-fast stroke MR protocol allows full imaging of the brain and vasculature from the aortic arch through the circle of Willis in 9 minutes. We perform over 3,500 dedicated stroke MRI examinations per year. Every month, we utilize MR to image over 100 candidates for endovascular intervention using perfusion imaging and RAPID software analysis. Additionally, our cerebrovascular neurosurgery program has pioneered surgical and endovascular procedures for treatment of aneurysms, vascular malformations, and cerebro-occlusive diseases. This allows the fellow the opportunity to gain experience imaging microsurgical approaches, novel minimally invasive endovascular techniques, and unique intracranial arterial bypasses.
Our MR experience is unparalleled in terms of both volume and breadth of pathology. We perform over 29,500 neuro MRI examinations per year at Barrow, with an additional 8000 neuro MR examinations performed at our children’s hospital. At Barrow, 75% of our MR imaging is brain, and includes advanced imaging techniques such as quantitative perfusion imaging in brain tumors, black-blood vessel wall imaging, MR neurography, and diffusion tensor tractography. Our case load is complex and high level, as neurosurgeons and neurooncologists are our top referents. Fellows are not expected to protocol routine MR examinations. Our workflow places the responsibility for protocoling routine studies on the MR technologists so that fellows may concentrate on image interpretation. Fellows are only called to assist in protocoling when an unusual issue arises.
Our CT rotation provides exposure to both large volume and complex cases. At Barrow, we perform over 30,000 neuro CT examinations per year, and half of these are complex inpatient CT examinations performed on neurosurgical inpatients. Additionally, Barrow is a level one trauma center, providing fellows exposure to CT in high-level traumatic injuries. Barrow is also a leading center for minimally invasive spinal surgery and thoracolumbar corrective spine surgery, allowing fellows to gain experience in correctly interpreting spinal CT in the setting of the latest techniques in spinal fusion. Our ENT experience is also centered around this rotation and involves interpretation of the neck CT and PET/CT examinations of patients with head and neck cancer from our dedicated oncology hospital, the University of Arizona Cancer Center. We also have an active head and neck endocrine service with a high volume of 4D CT examinations for hyperparathyroidism. Finally, our neuro-otology service is at the cutting edge of hearing restoration surgeries and results in experience with temporal bone CT examinations both in patients with hearing loss and in patients with cochlear implants for optimization.
Fellows are trained in state-of-the art, image-guided diagnostic and therapeutic procedures. We perform a large variety of spine and non-spine interventional procedures. During this rotation, our fellows are supported by a team of dedicated IR technologists and nurses, who are specifically assigned to spine/neuroradiology procedures. Two dedicated neuroradiology procedure rooms with flat panel detectors and rotational cone beam CT capabilities are at the disposal of the procedural fellow, including a 3D biplane system. Our procedure mix is very diverse, providing fellows with experience beyond traditional lumbar punctures, myelograms, and fluoroscopic pain procedures. We perform digital subtraction myelography and have a significant volume of CT guided procedures, including spine biopsies, transforaminal fibrin glue injections, as well as transfacial and skullbase biopsies. Catheter angiography is not a part of our diagnostic neuroradiology fellowship, but experience in endovascular procedures can be arranged by elective on an individual basis.
Fellows gain their pediatric experience at our dedicated children’s hospital. The pediatric rotation involves six dedicated weeks at Phoenix Children’s Hospital, named one of the “Best Children’s Hospitals” eight years in a row by U.S. News and World Report, ranking in 10 out of 10 specialties. Phoenix Children’s Hospital is a 433-bed facility and the only level one pediatric trauma center in Arizona. Children are transferred to Phoenix Children’s Hospital from across the southwest. This patient referral base provides our fellows with exposure to a large clinical volume with a diverse mix of common and uncommon pediatric neurological and neurosurgical diseases. Six dedicated pediatric neuroradiologist participate in daily one-on-one read outs at the PACS station and didactic lectures. Additionally, fellows participate in neuroradiology departmental and multidisciplinary conferences, case-based reviews, interesting case conference and Journal Club.