Body Imaging (St. Michael's Hospital)

(Formerly Cross-sectional Imaging)

Supervisor: Dr. Guan Huang and Dr. Anish Kirpalani,

St. Michael's Hospital is one of the principal teaching hospitals of the University of Toronto and is a busy multi-specialty urban tertiary care centre with world-class expertise in gastroenterology, urology, renal transplant, trauma, infectious diseases, oncology, orthopedic surgery, and rheumatology.

The Body Imaging fellowship in the Department of Medical Imaging at St. Michael's provides excellent exposure to multi-modality abdominal, chest, and musculoskeletal imaging with a heavy emphasis on Abdominal MRI and CT. We offer 4 one-year fellowship positions in Body Imaging each year.

The Abdominal MRI service at St. Michael's is a highlight of the fellowship program, and encompasses a broad and modern mix of complex clinical cases on state-of-the-art MRI equipment. Abdominal MRI studies (approximately 80-85% of the fellows’ MRI volume) include pancreatico-biliary MRI and MRCP, liver MRI (including MR elastography, assessment of diffuse liver disease and use of liver-specific contrast agents), kidney MRI, MR enterography, prostate MRI, pelvic floor MRI (MR defecography), staging MRI of gynecologic and rectal malignancies, MRI for endometriosis and benign gynecologic disease, whole body MRI, abdominal emergencies in pregnancy, and body MR angiography. Musculoskeletal MRI studies (approximately 15-20% of the fellows’ MRI volume) at St. Michael's reflect the broad clinical expertise of our referring orthopedic and rheumatology colleagues. All cases are interpreted under the supervision of fellowship-trained University of Toronto faculty radiologists in the Abdominal and Musculoskeletal Imaging divisions. We perform over 100 such MRI exams per week in an MRI department with 4 scanners (2 Siemens 3.0T Skyra wide-bore scanners + 2 Philips 1.5T Achieva dStream scanners).

The Abdominal CT service is a high volume and dynamic mix of chest, abdominal and pelvic studies with breadth of cases supporting: one of the busiest emergency and trauma departments in the country, oncology, urology, general medical and surgical services, and family practice. We perform approximately 250 such CT exams per week on 3 scanners (GE Revolution, Optima, and LightSpeed VCT scanners). Exposure to chest CT is predominantly in trauma and oncology and is approximately 20% of the total CT volume.

Approximately 15-20% of the total fellowship time is spent on Ultrasound service, where all types of examinations are performed including abdominal and pelvic studies, small parts, neck, abdominal and extremity Doppler, and obstetrical US.  There are 9 ultrasound rooms encompassing a mix of Canon Aplio500 and Philips iU22 modern scanners.

Our fellows participate in a variety of procedures including ultrasound-guided biopsies, sonohysterography, and MRI arthrography. Fellows also have the potential opportunities to arrange short electives in Interventional Radiology and Neuroradiology to enhance their skill sets depending on their future practice settings.

There is approximately 20% of protected time for research in the fellowship. Research opportunities in Body Imaging are abundant with dedicated Abdominal Imaging faculty radiologists available to supervise research projects and an on-site departmental Medical Imaging research office including research MRI technologists, research coordinator, and statistical support.

In summary, the breadth of cases, volume, and hands-on experience in our Body Imaging fellowship will fully prepare trainees for independent practice in either academic or community/private practice environments.