Cancer Imaging Fellowship

The Cancer Imaging Fellowship at the University of Washington is a one-year non-ACGME program designed to provide in-depth experience in oncologic imaging across multiple modalities, including MRI, CT, ultrasound, PET-CT, PET-MRI, and image-guided procedures. Fellows will gain hands-on experience with a wide variety of cancers and play a key role in multidisciplinary tumor boards and case discussions. Each year, we recruit two fellows, ensuring personalized training and mentorship.

The six-month rotation in abdominal imaging within the Cancer Imaging Fellowship is designed to provide fellows with comprehensive proficiency in all imaging modalities related to abdominal and pelvic oncology. A significant emphasis is placed on advanced imaging techniques, particularly MRI, for the diagnosis and management of hepatobiliary tumors, pancreas pathologies, rectal cancer, prostate cancer, gynecologic malignancies and sarcoma. Fellows will gain in-depth experience through active participation in numerous interdisciplinary tumor boards, where they will collaborate closely with oncologists, surgeons, and other clinicians. This close working relationship fosters a multidisciplinary approach, enhancing the fellow’s understanding of how imaging impacts patient care and treatment decisions in complex cancer cases.

The main focus of the cancer imaging fellowship’s six-month rotation in Nuclear Medicine will be training in various diagnostic oncologic radiopharmaceuticals utilizing PET/CT, PET/MRI, and SPECT/CT. Cancer imaging fellows will be introduced to theranostics and will receive training in the role of molecular imaging in guiding treatment. The fellows will gain expertise in interpreting various diagnostic radiopharmaceuticals including ¹⁸F-FDG, ⁶⁸Ga-PSMA, ¹⁸F-PSMA, ⁶⁸Ga- Dotatate, ⁶⁴Cu-Dotatate and ¹⁸F-FES as well as some exposure to investigational agents. Fellows are expected to participate in multiple tumor boards, including those focused on prostate cancer, genitourinary cancers, neuroendocrine and endocrine tumors, skin cancer, thoracic malignancies, and colorectal cancer. Additionally, fellows will gain advanced exposure to the principles of radiopharmaceutical therapy.

The Cancer Imaging Fellowship aims to:

• Develop a comprehensive understanding of the role of imaging in cancer diagnosis, staging, treatment planning, and follow-up.
• Train fellows in advanced imaging techniques, including functional and molecular imaging.
• Enhance interpretative skills across multiple cancer types, with a focus on abdominal and pelvic malignancies.
• Provide opportunities for fellows to engage in multidisciplinary clinical teams, including radiologists, oncologists, surgeons, and pathologists.
• Encourage participation in clinical research, with opportunities for publication and presentation at national and international meetings.
• Prepare fellows for leadership roles in oncologic imaging within academic or clinical settings.

Fellows will have access to a diverse and rich clinical environment that includes:

• Imaging Modalities: MRI, CT, PET-CT,  PET-MRI, ultrasound, and image guided procedures with a specific focus on cancer patients.
• Multidisciplinary Experience: Regular participation in tumor boards and clinical case discussions alongside oncologists, surgeons, and other specialists.
• Research Opportunities: Fellows are encouraged to contribute to ongoing clinical trials and research projects within the department, with support for presenting findings at conferences.
• Hands-On Training: Extensive exposure to interpreting oncologic imaging in a high-volume setting, ensuring a robust experience in diagnosing a wide variety of cancers.

• Duration: 1 year
• Clinical Rotations: Fellows will rotate through the following key areas:
  • Molecular imaging, PET-CT, PET-MRI
  • CT
  • MRI
  • Ultrasound
  • Image guided procedures
• Case Volume: Fellows will interpret hundreds of cancer-related imaging cases each month, providing them with the experience necessary to handle even the most complex cases.

University of Washington (UW) graduate medical education (GME) non-ACGME clinical fellowship program.

The program does not adhere to a matching policy and all applications are accepted on a first come, first-accepted and rolling-admissions basis.

1. Fellow candidates must complete an ACGME-accredited residency program, an AOA-approved residency program, a program with ACGME International (ACGME-I) Advanced Specialty Accreditation, or a Royal College of Physicians and Surgeons of Canada (RCPSC)-accredited or College of Family Physicians of Canada (CFPC)-accredited residency program located in Canada prior to starting the fellowship program. Candidates must be eligible to obtain a State of Washington medical license and pass all USMLE steps; or
2. Fellow candidates who complete an international or accredited diagnostic radiology residency in their country of origin must meet the following additional qualifications:
   • Hold diagnostic radiology board certification of their country of origin prior to starting the fellowship program.
   • Hold ECFMG certification.
   • Pass all the steps of the USMLE exam.
   • Be eligible to obtain a State of Washington medical license.

• The Cancer Imaging Fellowship at the University of Washington is committed to supporting international applicants by sponsoring visas. Additionally, the fellowship participates in the ABR-alternate pathway program.

1. • The fellows are rotating through two sites.
   • Fellows attend and present at multidisciplinary tumor boards and conferences, emphasizing professional interactions with radiology and clinical colleagues and compassionate patient care.

• • A national Cancer Institute-designated cancer center, brings together leading research teams and cancer specialists from the Fred Hutchinson Cancer Research Center, Seattle Children’s Hospital, and UW Medicine, including several Nobel laureates. This outpatient rotation offers extensive training with a high caseload of oncology imaging using CT, US, and MR on abdominal imaging rotation and PET-CT and PET-MRI during nuclear medicine rotation. The emphasis is on cancer staging and treatment, and learning the appropriate radiologic workup for various cancers. Fred Hutch clinics are actively involved in both cellular and non-cellular immunotherapy treatments, providing unique opportunities to learn about imaging assessments and complications associated with these new therapies. Fellows participate in multidisciplinary case management conferences for pancreas, colorectal, and sarcoma patients.

1. • The University of Washington Medical Center-Montlake (UWMC-ML), with 450 beds, is the largest facility. It has a busy solid organ transplant service and multiple sub-specialty services, attracting a wide variety of patients. Fellows interpret CT exams of the abdomen and pelvis, gaining experience in specialized CT techniques. They also interpret MR exams, provide consultations, address MR safety issues, and participate in a weekly multidisciplinary tumor board. Ultrasound training includes a variety of abdominal and pelvic exams.

• • • During this rotation, fellows perform ultrasound and CT-guided interventions under the direct supervision of attending physicians staffing the non-vascular Interventional Radiology (NVIR) service. Fellows conduct biopsies, aspirations, and place metallic fiducial markers within hepatic and pulmonary lesions prior to surgery or radiation treatment. Ultrasound is the preferred modality for image guidance due to its real-time navigation capabilities, lack of ionizing radiation, and flexibility in patient positioning.
    • The primary goal of this rotation is for fellows to learn about the safety and feasibility of image-guided procedures, as each request follows a standardized protocol process. Through supervised ultrasound-guided procedures, fellows enhance their scanning skills and hand-eye coordination. They also learn to apply low-dose CT and ultrasound-CT fusion and navigation techniques