Clinical Fellowship

The program is accepting new applications for academic year 2023-2024 and 2024-2025.

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Pediatric Radiology Clinical Fellowship Program

 

Erika Rubesova, MD
Clinical Professor of Radiology
Program Director, Pediatric Radiology

David Phan, Program Coordinator
Department of Radiology
Stanford University School of Medicine

pedradfellowship-coordinator@stanford.edu 

(650) 497-7335

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Overview

The Stanford name is recognized and respected around the world.  Stanford Childrens Health and Lucile Packard Children’s Hospital (LPCH) facilities has 397 licensed beds and 590,000 annual clinic visits, over 65 Bay Area locations, high volume emergency department and obstetrical/neonatal service, the nationally designated Stanford Cancer Institute which runs numerous clinical trials and has a strong stem cell transplant program, a robust childrens heart center, and a Level 1 pediatric trauma center. 

The Stanford University School of Medicine and the Lucile Salter Packard Children’s Hospital are pleased to offer an outstanding Pediatric Radiology Fellowship to qualified candidates. The Division of Pediatric Radiology at the Stanford University and the Lucile Salter Packard Children’s Hospital leverage vast resources of Stanford University, the School of Medicine, Stanford Childrens Health, and LPCH the next generation of pediatric radiologists.  Stanford Pediatric Radiology Fellows are exposed to a wealth of clinical case material in an organized, structured, hands-on educational approach.

Fellowship Structure

The Pediatric Radiology faculty are devoted to teaching, patient care, and translational research, and include subspecialists with expertise in pediatric neuroradiology, pediatric cardiovascular imaging, musculosketal imaging, body imaging, nuclear medicine, fetal/obstetrical imaging and pediatric interventional radiology. The fellowship provides a comprehensive educational curriculum, including didactic lectures, case conferences, and multi-disciplinary imaging conferences. In addition, elective rotations and research time are provided, and a second year of fellowship to further subspecialize may be available.

Fellows rotate through various services, including MRI, CT, fluoroscopy, ultrasound, neuroradiology, nuclear medicine, interventional radiology, and general radiography. 

Fellowship Rotation Schedule

  • Ultrasound : 6 weeks
  • Ultrasound hands on scanning: 2 weeks
  • Radiography : 5 weeks
  • Fluoroscopy : 6 weeks
  • CT/MR : 13 weeks
  • Interventional Radiology : 2 weeks
  • Neuroradiology:  4 weeks
  • Nuclear Medicine : 2 weeks
  • Research : 4 weeks
  • Electives - 4 weeks: options include cardiovascular imaging, OB ultrasound, musculoskeletal imaging, and customized electives
  • Vacation - 4 weeks 
Core Rotations

Body CT/MR

The body CT/MR rotation entails exam protocoling, optimization, and interpretation with a high degree of progressive independence and responsibility for the fellow.  The case mix is varied covering emergency department, oncology, gastroenterology, pediatric surgery, transplant surgery, cardiovascular medicine, rheumatology, orthopedics and sports medicine, pulmonology, infectious disease, and more.  Case complexity is high, and exams are performed on a range of 1.5T and 3T systems, including hybrid procedures with the pediatric IR service and PET-MR procedures with the nuclear medicine service.  The service interprets exams for patients of all ages, ranging from neonates to adolescents to adults that are seen at LPCH specialty clinics. Exams are interpreted with attendings who have subspecialty expertise in fetal, body, musculoskeletal, and cardiac imaging.  By the end of the fellowship, the enterprising fellow will have had a broad exposure to challenging cases and will gain confidence in exam optimization.

Cardiovascular Imaging

The pediatric cardiovascular imaging rotation gives experience protocolling, monitoring data acquisition, post-processing, interpretating, and reporting of pediatric cardiac CT and MR, under the supervision of faculty with dedicated cardiovascular expertise.   The fellow will be exposed to a wide breadth of pathology including pre- and postoperative complex congenital heart disease, adult congenital heart disease, cardiomyopathy, valvular heart disease, cardiac masses, coronary anomalies, and myocardial ischemia evaluation, both through a busy clinical service and weekly conferences.  Consultation with referring providers including cardiothoracic surgeons, cardiac interventionalists, echocardiographers, and cardiologists is encouraged and valued.  The fellow will be immersed in the latest advances in pediatric cardiac imaging, including multispectral CT, 4D flow acquisitions, deep learning reconstructions, ferumoxytol blood pool imaging, and ultrashort/zero echo time imaging, with ample opportunities for research. 

Radiography and Fluoroscopy

The Radiography and Fluoroscopy rotation provides exposure to a high volume of exams; the service handles thousands of radiographs each month, encompassing the broad spectrum of pediatric diagnoses.  Radiography indications range from common childhood fractures to pediatric malignancies to the most complex congenital heart diseases in the country. Hundreds of fluoroscopy studies are performed monthly;  the studies range from outpatient upper GIs to complex exams on post-surgical patients. Patients range from the youngest preemie to young adults and expectant/postpartum patients. With a significant variety across four hospitals and greater than ten outpatient and urgent care sites, each day brings new learning opportunities.

Neuroradiology

The neuroradiology rotation provides training in neuroimaging of the fetus, infant, child, adolescent, and expecting/post-partum patient.  Fellows learn both core pediatric neuroimaging CT/MRI, as well as advanced imaging methods, including fMRI, PET-MR, DTI, perfusion, susceptibility imaging, and intra-operative MRI.  Cases are diverse and complex, including pediatric strokes, tumors, congenital anomalies, vascular malformations, and ear/airway disorders, fetal conditions, and others. Through mentoring by four pediatric neuroradiologists, multi-disciplinary clinical conferences, and didactic lectures, fellows learn modern clinical neuroscience, neuroradiology concepts, and the latest technical developments.  Further, fellows also gain initial exposure to the many clinical and technical neuroimaging research projects, which can be furthered through dedicated research rotations. 

Nuclear Medicine

The pediatric nuclear medicine rotation exposes the fellow to complex exams on a state of the art hybrid SPECT/CT, a dual head SPECT gamma camera, and a PET/MR.  All of the scanners and the reading rooms are co-located, enabling the fellow to not only gain experience in exam interpretation, but also to participate actively in supervising and optimizing exams.  Additionally, a dedicated radiotherapy room enables trainees to participate in these effective treatments.  The fellow covers the breadth of nuclear medicine and molecular imaging diagnostic studies in all organ systems  (e.g. brain, MSK, GI, GU cardiac, pulmonary, endocrine), and various diseases (congenital, neoplastic, traumatic, infectious, inflammatory, metabolic, vascular, iatrogenic). 

Ultrasound

The ultrasound rotation provides a rigorous exposure to both common and advanced techniques and conditions in a friendly setting.  The fellow works closely with attending radiologists and highly experienced sonographers.  By the end of fellowship, the fellow will have experience with ultrasound elastography, contrast enhanced ultrasound (CEUS), vascular exams, and musculoskeletal procedures.  Additionally, fellows practice their scanning skills in addition to reading a high volume of complex studies.  There is opportunity to collaborate with Stanford engineers to test newest ultrasound techniques in children, as well as get involved in research projects that can be expanded in research rotations.

Fetal imaging

Lucile Packard offers comprehensive multi-disciplinary obstetrical care for both high risk and normal obstetrical patients. There is a high level of integration between the radiology and maternal fetal medicine services. OB ultrasound is a high-volume service performing 36000 exams/year, which include first trimester screening, anatomy scans, targeted exams for a wide range of fetal anomalies and high risk pregnancies including the placenta accreta spectrum. Innovative in-utero interventions are offered. Pediatric radiology fellows receive training in the full spectrum of obstetrical ultrasound studies.  Responsibilities include performance and interpretation of exams with oversight by pediatric radiology faculty.

Fetal and maternal MRIs are performed on GE 1.5 and 3 T systems for fetal anomalies and placenta accreta spectrum disorders.  Fellows are responsible for protocoling, monitoring, and interpretation of MRI exams with oversight by pediatric radiology and neuroradiology faculty. Fellows are given high level responsibility for presenting ultrasound and MRI imaging studies at the weekly multidisciplinary fetal conference.

Interventional Radiology

On this rotation, you will work with an experienced and dedicated team of pediatric interventional radiology faculty, techs, and nurses to manage a wide range of patient diseases and acuity.  Although some procedures may be similar to those performed on adult patients, the disease processes and techniques differ, sometimes substantially.  The diagnosis and treatment of vascular malformations is integral to the practice of pediatric IR.  Trainees participate in a monthly multispecialty clinic for vascular anomalies and weekly treatments in our clinical practice; together these offer a tremendous learning opportunity.   Procedures such as Dynamic Contrast Enhanced Direct Intranodal MR Lymphangiography in both congenital and cardiac lymphatic disorders are almost exclusively performed in children, also offering a unique educational opportunity for trainees.  Other procedures, such as osteoid osteoma ablation, percutaneous biliary drainages, thrombolysis, embolizations, biopsies and chest tube placements have unique indications and needs in pediatric patients that are substantially different than adults.  Vascular access procedures are performed on patients from 500 grams to over 50 kilograms, thus requiring development of a high level of skill.  

Clinical Imaging Facilites

 

CT

  • Dual source CT

Fluoroscopy

  • 3 Fluoroscopy systems
  • 16 C-Arms

Interventional Radiology

  • 1 bi-plane, neuro-hybrid suite

Informatics

  • 3D Quantitative lab with various software licenses
  • Sectra PACS
  • MiM, Ambra
  • iMorgan (in deployment)
  • Powerscribe
  • 3D printing

MRI

  • 1.5T, 3 3T, iMRI
  • PET-MR
  • 2 new MRI suites in construction/planning

Nuclear Medicine

  • SPECT CT
  • Gamma camera
  • PET-MR
  • DEXA
  • radiotherapy in-patient suite

Ultrasound

  • 14 systems, including contrast-enhanced US
  • Elastography capabilities

Xray

  • 20 systems
  • 2 EOS
  • 1 Panorex
Dedicated Research Facilites

 

Human Research Scanners

  •  2 Whole body 3T sytems
  • 7T Whole body scanner
  • 3T PET-MR scanner

 

Small animal imaging systems

  • Micro PET/CT
  • Micro PET/MR
  • Small bore 7T MRI
  • Magnetic particle Imager
  • Animal optical imaging
  • Photoacoustic imaging
  • Animal ultrasound

 

 

Outpatient Clinics and Services