Abdominal Radiology Fellowship (ACGME)

To produce outstanding sub-specialty trained Abdominal Imaging radiologists with expertise in MR, CT, ultrasound, and image-guided procedures through education and experience in a diverse and collegial clinical environment.

1. Train exceptional clinical radiologists specialized in Abdominal Imaging, proficient in conventional diagnostic imaging techniques and procedures, including CT, ultrasonography, MRI, and common percutaneous non-vascular image-guided procedures. Emphasis areas include oncologic, surgical, and obstetric imaging.

2. Foster sub-specialty abdominal imagers who maintain close, collaborative relationships with referring clinicians through multidisciplinary tumor boards and multimodality diagnostic imaging and image-guided procedure consultations.

3. Develop future academic radiologists specialized in Abdominal Imaging who contribute to the University of Washington’s research missions through translational research experiences.

4. Promote lifelong learning and peer learning practices by providing opportunities to attend regional and national society meetings and participate in departmental Peer Learning conferences.

The fellowship utilizes state-of-the-art imaging equipment across various rotation sites, including the latest devices from GE, Siemens, and Phillips. All sites, except the Puget Sound Veterans’ Affairs Hospital, are connected through an integrated PACS system (Visage Imaging) accessible remotely for on-call tasks.

The fellowship includes seven rotations at four sites, with fellows rotating through each multiple times to consolidate knowledge and skills. Training covers traditional diagnostic applications of abdominal cross-sectional imaging and specialized areas such as transplant medicine, high-risk obstetrical and contrast-enhanced ultrasound, dual energy CT, functional pelvic floor MR, MR elastography, iron and fat quantification, MR lymphangiography, image-guided biopsy procedures including fusion technology, and image post-processing. Additional training in vascular imaging with CT and MR, or other endovascular image-guided procedures within Interventional Radiology, is available upon request.

Fellows attend and present at multidisciplinary tumor boards and conferences, emphasizing professional interactions with radiology and clinical colleagues and compassionate patient care. Faculty members are experienced in abdominal imaging and are recognized locally, nationally, and internationally.

Abdominal Rotations at UWMC-Montlake

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, with a focus on transplant Doppler ultrasound and high-risk obstetric ultrasound.

By the end of the fellowship, fellows should be proficient in scanning patients, interpreting complex exams, and understanding the strengths and limitations of various ultrasound applications.

Image-Guided Procedures at UWMC-Montlake

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.

CT/MR/US at Harborview Medical Center (HMC)

In this 431-bed Level 1 trauma center, which is the largest trauma specialized and designated disaster control hospital in the region, all imaging modalities and image guided procedures are applied in one rotation. Fellows receive additional ultrasound training in abdominal, pelvic, obstetrical, thyroid, and scrotal ultrasound centered mainly on trauma and outpatients. HMC includes a large population from the International Clinic as well, where patients of diverse backgrounds are referred for sonographic liver tumor screening, prenatal care and other ambulatory indications. In addition, fellows gain experience in interpretation of contrast-enhanced ultrasound, abdominal CT and MR with an emphasis on trauma and indigent patients from high-risk populations. Fellows also perform image-guided biopsies of tumors and fine needle aspirations of fluid collections and abscesses. Multidisciplinary tumor boards are covered by fellows and attendings.

CT/MR/US at Fred Hutch Cancer Center

The Fred Hutch Cancer Center, 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. 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.

CT/MR/US at Seattle VA Puget Sound Health Care System (VAPSHCS)

The VAPSHCS rotation provides instruction in abdominal and thoracic applications of advanced medical imaging for various disease processes, particularly in oncology, gastroenterology, hepatology, and urology. Fellows also have opportunities to participate in rehabilitation medicine and orthopedic/sports medicine care through the interpretation of musculoskeletal MR and CT studies.

Fellows have the opportunity to engage in an abdominal imaging research project under the guidance of section faculty members during the academic year. The section has numerous active research programs, offering projects in basic science, clinical science, outcomes research, quality improvement, and informatics. These projects are expected to result in at least one scientific or educational paper in a peer-reviewed journal.

However, please note that this is a clinical fellowship, and evaluations will focus on the six ACGME core clinical competencies rather than research. Additionally, fellows are expected to demonstrate teaching excellence by presenting case conferences to radiology residents and uploading teaching cases to our educational repository.