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Radiology

Objectives

The Iowa State University radiology residency program has been designed to provide comprehensive knowledge and in-depth training in all core areas of veterinary diagnostic imaging, as well as related basic sciences. Our program will provide an excellent preparation for active careers in academia or specialty practice through a diverse caseload and broad imaging experience over the three year residency. The overall goals of the program are:

  1. to master the art and science of veterinary diagnostic image interpretation in all core areas, to be able to logically correlate all imaging findings and clinical data in order to formulate accurate conclusions which, in turn, may provide direction for case management and to appreciate the economic and emotional factors related to the health care of veterinary patients.
  2. to provide a firm understanding of the underlying radiation physics and anatomic basis of veterinary diagnostic imaging.
  3. to develop expertise in interpersonal communications for proper colleague and client relationships.
  4. to allow the resident an opportunity to develop teaching skills as they participate in the educational training of veterinary students.
  5. to constantly pursue academic enrichment.
  6. to complete a residency research project, to draft the results in a manuscript suitable for publication, to obtain instruction and guidance in manuscript writing and submission for publication in refereed journals and to present the research findings to an audience of peers in the second or third year of the program.
  7. to satisfy all requirements to sit both the written and oral examinations of the American College of Veterinary Radiology

 

Training Period

 

  • Total length of the training program in months: 36 Months
  • Total duration of supervised clinical training in the program: 30 Months
  • Responsibilities of the resident in the remaining non-clinical portion of the program:
    1. to complete a residency research project, to draft the results in a manuscript suitable for publication, and to present the research findings to an audience of peers in the second or third year of the program.
    2. to successfully complete course instruction in radiation physics and radiation biology.
    3. to participate in instructional delivery of the normal anatomy of veterinary diagnostic imaging to first year veterinary students.

 

Direction and Supervision

Program Director

Director of Residency training: Kristina Miles, DVM, MS, DACVR

Faculty

Listed below are the ISU imaging faculty accepting PRIMARY responsibility for training in each of the following core areas:

Roentgen diagnosis
Faculty: Elizabeth Riedesel, DVM, DACVR
Percentage clinical service: Approx. 65 %
Diagnostic ultrasound
Faculty: Kristina Miles, DVM, MS, DACVR
Percentage clinical service: Approx. 70 %
Computed Tomography
Faculty: Elizabeth Riedesel, DVM, DACVR
Magnetic Resonance Imaging
Faculty: Elizabeth Riedesel, DVM, DACVR
Nuclear Medicine
Faculty: Kristina Miles, DVM, MS, DACVR

 

Mini-CV’s for these faculty members may be found at the end of this document.

Diplomates of other specialty colleges who can be expected to regularly interact with the radiology resident are listed below:

  • ACVIM

    • Robert King, DVM, PhD, Diplo. ACVIM
    • Albert Jergens, DVM, MS, PhD, Diplo. ACVIM
    • JoAnne Morrison, DVM, MS, Diplo. ACVIM
    • Krysta Deitz, DVM, Diplo. ACVIM
    • Wendy Ware, DVM, Diplo. ACVIM (Cardiology)
    • Brett Sponseller, DVM, PhD, Diplo. ACVIM (Equine)
    • David Wong, DVM, Diplo. ACVIM (Equine)
    • Leslie Fox, DVM, MS, Diplo. ACVIM

  • ACVS

    • Karl Kraus, DVM, Diplo. ACVS
    • Scott McClure, DVM, Diplo. ACVS (Equine)
    • Stephanie Caston, DVM, Diplo. ACVS (Equine)
    • William Hoefle, DVM, Diplo. ACVS
    • Jim Toombs, DVM, Diplo. ACVS
    • Kevin Kersh, DVM, Diplo. ACVS
    • Cheryl Hedlund, DVM, ACVS

  • ACVP

    • Amanda Fales-Williams, DVM, PhD, Diplo. ACVP
    • Jesse Hostetter, DVM, PhD, Diplo. ACVP
    • Mark Ackerman, DVM, PhD, Diplo. ACVP

 

Current Residents In-Training
 

 

  • Alex zurLinden, DVM (2009-2012)
  • Jackie Williams, DVM, (2010-2013)
  • Lindsey Gilmour, DVM, (2011-2014)

    •  

    Affiliations

    Some ancillary clinical experiences will be accomplished off-site.

    1. One semester each of Radiation Physics and Radiation Biology courses – to be completed at the School of Radiograpic Technology, Iowa Methodist Medical Center/Iowa Health – Des Moines. Program Director: Dr. Suzanne Crandall, Ed.D, R.T. (Tuition costs covered by VCS Department.)
    2. Two week Radiation Oncology External Rotation plus one week Nuclear Medicine External Rotation – to be completed at the University of Missouri-Columbia in second or third year. Faculty Contact: Dr. Jimmy Lattimer, Diplomate, American College of Veterinary Radiology / Radiation Oncology.  (Travel and housing costs covered by resident.)
    3. Three week Large Animal Ultrasound External Rotation – to be completed at New Bolton Center Campus, University of Pennsylvania in first year. Faculty Contact: Dr. Virginia Reef, DVM.   (Travel and housing costs covered by resident.)
    4. Three day Nuclear Medicine Short Course – to be completed at the University of Tennessee in second year. Faculty Contact: Dr. Ferderica Morandi, Diplomate, American College of Veterinary Radiology.

     

    Facilities

     

    1. Philips Clinix Radiology & Fluoroscopy (Special Procedures) X-ray Unit: Purchased in 2001, this R&F unit used for special procedures requiring the use of fluoroscopy and/or digital spot films, as well as routine small animal radiography.
    2. Eklin DR digital radiography unit for imaging small animal patients was purchased in 2008 for use with the Philips Clinix R&F unit.  DR images are transferred directly to the Merge Efilm PACS.   
    3. Innovet X-ray Unit: This 2004 unit is a versatile, high volume small animal diagnostic X-ray machine.  The unit has been fitted with an Eklin digital imaging sensor system, purchased in 2008, to provide DR images for the Merge Efilm Picture Archiving and Communication System (PACS).
    4. An additional Fisher X-ray unit may be used for after- hours and emergency small animal cases.  This unit provides standard hard-copy film images.
    5. Philips Overhead Tube & Grid System (Large Animal X-ray Unit): Purchased in 2003, this 1000 mA tube is linked to an overhead rail system and a wall mounted grid to obtain high quality images in large animals.
    6. An Eklin Mark 5 provides DR images to the Merge Efilm PACS from the Philips 1000 mA tube.  Also purchased in 2008.
    7. Equine and bovine distal extremities are obtained with a portable MinXray HF 8015 unit.
    8. Eklin DR-3 digital radiography unit for imaging of equine extremities with the MinXray. Purchased in Sept 2006 and supported by Merge EFilm PACS.
    9. A wall-mounted dental X-ray tube and Schick digital sensor system provide small animal digital dental images to the Merge Efilm PACS.
    10. Toshiba LB (large bore) 16-slice multidetector Computed Tomography unit:  installed in July 2010 in a Phase I dedicated site in the Lloyd Veterinary Medical Center (LVMC).  This new acquisition includes a VITAL software package, bone densitomitry software and a separate Universal Equs large animal CT table capable of integrating with the Toshiba MDCT unit.   The Toshiba MDCT unit replaces the current Philips UltraZ Computed Tomography scanner.  The UltraZ was purchased in 2002 and provided single slice axial and spiral imaging with a gantry table weight limit of 350 pounds.
    11. Philips iU-22 Ultrasound unit: Purchased in Sept. 2005, this unit is used for all small animal abdominal ultrasound exams. A separate Siemens Sequoia ultrasound unit has been obtained for the ISU Cardiology service.
    12. Diagnostic Nuclear Scintigraphy is performed with a new Enhanced Technologies system installed in the Phase I Large Animal hospital portion of the LVMC in October 2009. The gamma camera and dedicated nuclear imaging computer operate under a Mirage software system .
    13. MRI is available on-site utilizing a 1.5 Tesla GE Signa magnet system with EXCITE software. The magnet was installed in a new, permanent suite in the LVMC in August 2008.
    14. Dragon Naturally Speaking voice recognition software system: allows dictation of imaging reports directly into the electronic medical record.
    15. Completion of the LVMC Phase II Imaging service area construction is slated for late December 2010.  The ISU Veterinary Medical Center dedicated the $51 million dollar Large Animal Hospital expansion in October 2008.

     

    Clinical Resources

    Approximate number of patients seen annually by ISU Veterinary Medical Center

    • Small Animal Patients: Approx. 11,762
    • Large Animal Patients: Approx. 5,745
    • Total Patients: Approx. 17,507

    Annual imaging caseload

    • Small Animal Exams: Approx. 6,982
    • Large Animal Exams:Approx. 989
    • Total Exams:Approx. 7,971

    Approximate breakdown of the patient population in imaging according to species

    • Small animals (canine, feline): Approx. 4,855
    • Large animals (equine and food animals): Approx. 688
    • Exotic animals (predominantly raptors): Approx. 50 (ISU Wildlife Care Clinic)

    Approximate annual imaging caseload of the program

    • Small Animal Radiology exams: Approx. 6,982
    • Large Animal Radiology exams: Approx. 688
    • Abdominal Ultrasound exams: Approx. 1,000
    • Computed Tomography exams: Approx. 275
    • Nuclear Medicine exams: Approx. 46
    • Magnetic Resonance Imaging: Approx. 70
    • Other (specify): I-131 Treatment: 20

    Training Content

    Percentage of preliminary reports generated from the imaging caseload by the resident:

    1. Year One: 45 %
    2. Year Two: 60 %
    3. Year Three: 75 %
    Percentage of resident reports reviewed by the imaging faculty prior to finalization of the report: 100 %

     

    Distribution of the CLINICAL experience the resident receives in full time equivalent months:

    Topic   Approximate number of cases
    Small Animal Radiology 14 8,145
    Large Animal Radiology 3.5 289
    Abdominal Ultrasound 5.5 1,010
    + Cardiac Ultrasound    
    (ISU-Dr. Wendy Ware, DACVIM) 0.5  
    Computed Tomography 3 322
    Nuclear Medicine 0.75 90
    (+ external rotation at UMC) 0.25  
    Magnetic Resonance Imaging 1 220
    Elective (any of above) 0 40
    Required elective (specify): see below    
    a. large animal ultrasound external rotation (Tuft’s) 3 weeks 150
    b. radiation oncology external rotation (University of Missouri-Columbia) 2 weeks 15
    + ISU Feline I-131 Therapy Program 1 week 25
    Total 30 10.306

    Course number and unit assignment required to meet the educational objectives for formal instruction

    Topic Course Number Units
    Radiobiology: RAD 215
    and
    Radiobiology, Radiation Protection, and Risks vs. Benefits
    Carl D. Elliston, David J. Brenner and Eric J. Hall    		 Methodist Medical Center/Iowa Health – Des Moines

    School of Radiologic Technology
    8-11 Wednesdays
    Spring Semester, Year 1
    World Wide Web-Based Education Program of the Radiological Society of North America (RSNA): Web-Rad-Train
    http://www.web-rad-train.org
    Radiation physics: RAD 205
    and
    Interactions of Radiation with Matter    		 Methodist Medical Center/Iowa Health – Des Moines

    School of Radiologic Technology
    8-11 am Wednesdays
    Fall Semester, Year 1
    World Wide Web-Based Education Program of the Radiological Society of North America (RSNA): Web-Rad-Train

    The Physics of:

    Topic Course Number Units
    Diagnostic Radiology: RAD 205 Methodist Medical Center/Iowa Health – Des Moines

    School of Radiologic Technology

    8-11 am Wednesdays
    Fall Semester, Year 1
    Nuclear Medicine: Nuclear Medicine Short Course University of Tennessee
    Three day Short Course
    Contact Hours: Approx. 17
    Ultrasonography: The Physics of Ultrasound Kremkau, Frederick, PhD. Five disc short course series produced by Wake Forest University, Dept. of Radiology
    CT: CT Technology, Principles & Techniques with an Emphasis on Multidetector CT

    A Symposium Presented by Siemens Medical Systems    		 CT Lecture Series (Six of thiry-eight lectures) at www.CTisus.com produced by the Advanced Medical Imaging Laboratory (AMIL). AMIL is a multidisciplinary team dedicated to research, education, and the advancement of patient care using medical imaging with a focus on spiral CT and 3D imaging. The AMIL is headed by Elliot K. Fishman, M.D.

    In addition to:
    See MRI listing
    External classes and short courses will be supplemented with monthly resident review sessions to assure knowledge-base, understanding and familiarity with the above listed Physics topics.

    Research Environment

    Average number of peer reviewed publications over the last 5 years on which the IMAGING faculty are included as authors: Three

    Number of publications/submissions expected of a resident completing the program: One

    Advanced degree requirement at ISU to complete radiology residency program: Not at this time

    Educational Environment

    Number of lectures or scientific presentations expected of each resident during the course of their training: Three

    Evaluation

    Resident performance will be evaluated at 3 month intervals the first year, with six month intervals for the remainder of the program.

    Known Case Conference (KCC)

    Known Case Conference discussions will be held every three weeks.

    Literature Resources

    Nearest medical library:
    The primary medical collection for the ISU Library is located on-site (both paper and electronic collection). Additional materials are available through the main ISU Parks Library on campus (2 miles). Further materials can be obtained through interlibrary loan from the University of Iowa or other locations.

    Appendix