Our Division & Goal
The division of Pediatric Radiology comprises 4 fellowship trained staff radiologists. In addition, there are radiologists in other divisions with pediatric expertise that collaborate with our section.
Our goal as a program is to provide extraordinary clinical care to our patients and community, as well as expertise to our referring clinicians and colleagues. University of Minnesota Masonic Children’s Hospital is a quaternary care hospital that has a high percentage of complex patients, including bone marrow and solid organ transplants, cardiac disorders, and oncology. In addition, there is a large, level 4 NICU that provides services for much of the surrounding area.
The hospital, including the clinicians and patients, provides an excellent environment for teaching pediatric radiology. Our goal as a section is to aid the fellow in building upon their knowledge base and refine their skills. The fellowship also provides teaching and research opportunities adjusted to an individual’s special interests and talents.
Upon completion of the fellowship, the graduate will have the foundation to build an academic career in pediatric radiology or enter a private practice in the role of a well- trained subspecialist.
The curriculum for pediatric radiology is divided into 48 weeks (52 minus vacation). Of those 48 weeks, the majority will be spent at M Health University of Minnesota Masonic Children's Hospital, participating in the everyday work flow. Each week will have a different focus. In addition, Children’s Minnesota has agreed to provide 8 weeks of training in the areas of fluoroscopy and emergency medicine. While the fellow will be “assigned” certain topics each week, the workload may or may not reflect those teachings.
Fellows get 8 weeks of elective time, in which they can focus on reading specific studies and review more in-depth curriculum. For instance, if a fellow expressed interest in cardiac imaging, increased involvement with the cardiac services and increased exposure of cardiac MRI and CTA physics/imaging would be scheduled. Elective time outside the division requires approval of the program director and the section head of that division.
The pediatric division is not currently large enough to have dedicated subdivisions where time can be solely focused on a particular subject. Our daily routine is typical for private practice pediatrics or smaller academic departments, in which staff read the breadth of studies that are performed in our department or elsewhere in our system.
When at Masonic, the fellow should arrive in the reading room between 7:30 and 8:00 am. The fellow should work with the residents to actively protocol and plan for the day, answering questions and discussing with staff as needed. In addition to complex cross-sectional imaging the fellow will be expected to contribute to the interpretation of ultrasound, radiographs, and aid in fluoroscopy. The fellow is encouraged to serve as a resource and teacher for our residents and medical students. The bulk of our work is during typical hours and will often be heavy in the morning due to PICU and NICU rounds. In the evening, the fellow should aid in getting the residents out by 4:30 p.m.
Thoracic, gastrointestinal, genitourinary, and nuclear medicine are broad subcategories that encompass the majority of our workload. This subsection includes all modalities, including MRI, CT and PET. Daily work is mostly filled with chest x-rays, but cross-sectional imaging is a significant component, and includes MR enterography, MR urography, pancreatitis workup, and MIBG SPECT, to name a few. Fluoroscopy and pediatric ultrasound are essential modalites in pediatrics. Pediatric radiology education focuses on ALARA and our ability to aid the referring clinician without the use of sedation. Hands on education and exam acquisition is a daily occurrence in our department and critical to the development of a pediatric radiologist.
Pediatric MSK trauma radiographs make up the bulk of the workload. Vascular malformations, rheumatologic, oncologic and congenital anomalies are often what we encounter with MSK MRI. We also work in conjunction with our adult MSK colleagues to provide coverage for MSK trauma MRI, including sports medicine.
Cardiac imaging services have expanded over the last two years, thanks to a growing surgical staff. CT angiograms and cardiac MR imaging are routinely obtained, with post-processing performed by the attending radiologist. Pediatric cardiology works in conjunction with radiology and there is a multidisciplinary conference that reviews recent imaging prior to therapy/surgery.
While the majority of our fetal imaging is through ultrasound, fetal MRI is often obtained for congenital malformations, or to assess for placental abnormalities. The pediatric radiology group works directly with local MFM and obstetrics.
Pediatric radiology works closely with our interventional radiology colleagues. A large volume of interventional cases in pediatrics are routinely performed, including line placement, biopsy, recannulation, and sclerotherapy. During an interventional rotation or case the fellow will adhere to the expectations of that service.
Neuroradiology is a busy subspecialty that focuses on assessment of oncologic, metabolic, and congenital abnormalities through MRI and CT. There are two pediatric neuroradiologists in our department that often are present at the children’s hospital. In addition to cross-sectional work, invasive procedures are commonly performed, including Spinraza injections.