Thoracoabdominal Imaging Fellowship

The Thoracoabdominal Imaging division is a collaborative group with specialization of expertise by imaging modality or by body systems. The section of Abdominal Imaging resides within the division of Thoracoabdominal Imaging, and will be the area where the bulk of a fellow’s time is spent during this fellowship. It provides the full range of diagnostic imaging interpretation for the abdomen and pelvis with state of the art equipment in both outpatient and inpatient settings. Additionally, the Nuclear Medicine and Chest sections also reside within the Thoracoabdominal Imaging section.  Interested fellows will have the opportunity to interact with staff and clinicians in these busy and dynamic sections as well.

The program is designed to enable abdominal imaging fellows to accumulate a broad base of medical knowledge, to develop progressively independent interpretive and technical skills, and to become proficient in accurate clinical decision making and consulting. 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 radiology or enter a private practice in the role of a well- trained subspecialist. Specifically, the fellowship focuses on providing advanced training in cross-sectional imaging of the abdomen and pelvis with a strong emphasis on abdominal and pelvic MRI. The fellowship will also provide the experience in CT, US, and fluoroscopy related to the abdomen and pelvis. Experience in various interventional procedures, such as CT- and ultrasound-guided biopsies, abscess drainages and if desired image-guided ablations and fluoroscopically-guided GI tract interventions will also be available. 

The abdominal imaging faculty emphasizes that referring clinicians are our valued customers and that patient care is our primary mission as physicians. We also believe that the time spent on every service should be pleasurable and educationally challenging.

Most applicants for Abdominal Imaging fellowships are primarily seeking expert level training in abdominal and pelvic MRI and image-guided procedures. This then is used as a starting point for creating the curriculum of the U of MN Abdominal Imaging fellowship. Magnetic Resonance Imaging and Computed Tomography.

The majority of fellow’s time will be spent interpreting MRI and CT of the abdomen and pelvis. When on this rotation, most fellows choose to focus primarily on MRI where there is a high volume of cases allowing for ample experience in this rapidly changing field. As a leading transplant and research institution the patient population at the University of Minnesota is uniquely challenging and complex, offering a learning experience that is ideal for fellows interested in MRI. There is a strong focus on preoperative (including HCC screening) and postoperative imaging for liver transplantation as well as MRCP evaluation. We are at the forefront of technology in prostate imaging where we work with Urology to identify and target lesions for MRI and ultrasound fusion biopsy.

We routinely perform numerous other MRI exams, including MR enterography, female pelvic MRI, rectal cancer staging MRI and a variety of urological MRI examinations. Fellows will work with residents to protocol and interpret MRI studies. We use state-of-the-art equipment including several 3 Tesla scanners and a variety of MRI contrast agents. The section’s working relationship with the basic science facility of Center for Magnetic Resonance Research/Center for Clinical Imaging Research (CMRR/CCIR) on campus provides additional learning experience and research opportunities.

We have a high volume CT service with a patient population that emphasizes oncologic imaging and pancreaticobiliary imaging. The case load type and volume should result in a high level of confidence in accurately reading a large volume of complicated exams. During the latter portion of the fellowship, as fellows develop confidence, they can progress toward independently interpreting CT exams.

The abdominal section works in conjunction with the interventional radiology section to provide experience to fellows in a wide variety of interventions in the chest, abdomen, and pelvis. Fellows will have the opportunity to perform a large volume of CT and ultrasound guided biopsies, drainages, and tube placements. Fellowship guidance and supervision will be determined on an individual basis depending primarily on the experience and abilities of each fellow. During most procedural rotations, the fellow will be on rotation in interventional radiology.

The ultrasound service covers all areas of abdominal, vascular and pelvic ultrasound examinations. Fellows will have the opportunity to interpret diagnostic ultrasound during their rotations, and will perform a number of ultrasound guided procedures under the guidance of faculty in the abdominal imaging and interventional radiology sections.

Our division offers the full spectrum of fluoroscopic examinations and procedures. Fellows typically are not scheduled on this rotation. Individuals who are interested in this particular procedure or fluoroscopy in general have the opportunity to spend time on this service.

Fellows get 8 optional weeks of elective time throughout the year that can be spent within the division (thoracic imaging, fluoroscopy, diagnostic ultrasound, nuclear medicine). If desired, up to 4 of the 8 weeks may be spent outside the division (cardiovascular imaging, interventional radiology, pediatric imaging, breast imaging, MSK imaging, neuroradiology). Elective time outside the division requires approval of the program director and the section head of that division.

There are regular fellow learning conferences dedicated to fellow-level topics. The typical conference consists of 2-3 interesting cases with extensive discussion. At times, the conference will consist of a didactic presentation by one of the fellows or abdominal imaging faculty, or a discussion of ongoing research or other projects.

Fellows will also participate in the U of MN radiology clinical conferences and tumor boards. This is a critically important component of the fellowship as it provides an excellent learning opportunity. The responsibility and degree of involvement during presentations will gradually increase throughout the year.

The section currently presents cases for the following conferences:

• Colorectal Conference – biweekly
• Pancreaticobiliary Conference - biweekly
• Liver Tumor Conference – weekly
• Inflammatory Bowel Disease/Luminal GI - twice monthly

There are additional conference presentation opportunities in urology, gynecologic oncology, and pelvic floor.

After hours call is not currently incorporated into the fellowship.

The fellows have the opportunity to teach the radiology residents and medical students who rotate through their areas on a daily informal basis. Fellows can attend the 12:00 p.m. residents' conference, and are especially encouraged to attend if related to abdominal imaging. Each fellow is expected to give at least 2 resident conferences per year. For interested fellows, there are additional opportunities to provide lectures to medical students and residents.

Fellows are encouraged to participate in research activities and other academic pursuits. Academic time will be provided for fellows who take an active role in these activities. Fellows attend regular meetings with the Abdominal Imaging Faculty to discuss current journal articles, emerging technology, and current best practices in the fields of gastrointestinal and genitourinary imaging. This is typically done during the Monday morning conference.