Stu Schroff , MD (PGY 3) Robert Lieberman, MD, MBA (PGY4) Aaron Schein, MD (PGY5, Chief Resident) Andrew Kim, MD (PGY5, Chief Resident) Sebastian Sugay , MD (PGY5, Chief Resident). LAC-USC Radiology. Topics The Department of Radiology Radiology as a Consult Service
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Stu Schroff, MD (PGY 3) • Robert Lieberman, MD, MBA (PGY4) • Aaron Schein, MD (PGY5, Chief Resident) • Andrew Kim, MD (PGY5, Chief Resident) • Sebastian Sugay, MD (PGY5, Chief Resident) LAC-USC Radiology
Topics The Department of Radiology Radiology as a Consult Service Risks of Radiation/ALARA Optimal Imaging Strategy LAC-USC Radiology
Topics The Department of Radiology Radiology as a Consult Service Risks of Radiation/ALARA Optimal Imaging Strategy LAC-USC Radiology
“Radiology is a medical specialty that employs the use of imagingto both diagnose and treat disease visualized within the human body.” - wikipedia The field of radiology • Radiograph of the Left hand of Anna Roentgen (wife of Wilhelm Roentgen) on November 8, 1895 in Wurzburg, Germany.
This is an enormously busy hospital • 28 percent of trauma victims in the region • 39,000 inpatient discharges/year • 150,000 emergency department visits/year • 1 million ambulatory care visits/year • LAC+USC Medical Center Final Budget FY 2011-2012: $1.189 billion Department of Radiology
2010-2011 Statistics • 60,015 CTs • 12,227 MRIs • 18,751 Interventional Procedures • 20,281 Nuclear Medicine Studies • 71,244 Ultrasounds • 239,807 Radiographs LAC+USC Department of Radiology
DOR Divisions • We are a subspecialized department • Body imaging (abdomen and pelvis) • CT, US, MRI, and Plain film/fluoroscopy (barium studies) are separate reading areas • Cardiothoracic imaging (CXR, CT chest, cardiac MRI)
DOR Divisions • Neuroradiology (Brain, spine, ENT, angiography) • Musculoskeletal imaging (X-ray, MRI, CT, arthrograms and biopsies) • Nuclear medicine (PET/CT, cardiac SPECT, bone scans, V/Q scans…)
DOR Divisions • Pediatric imaging • Women’s imaging (breast imaging, pelvic US and MRI) • Vascular and Interventional Radiology (angiography, liver/biliary interventions, neprhostomies) • CT and US guided procedures are handled by the pertinent division, not IR
LAC+USC Department of Radiology Hours of Operation, Mon-Fri: 8AM-4PM (Normal workday— All staff/fellows/residents in house) 4PM-10PM (On call resident and staff/fellow in house) 10PM-8AM (On call resident in house; staff/fellow at home)
LAC+USC Department of Radiology • Hours of Operation, Weekends and Holidays: • 8AM-8PM (On call resident and staff/fellow in house) • 8PM-8AM (On call resident on call in house; • staff/fellow at home)
Staging CTs “Need a prelim before morning rounds”—There must be an urgent clinical concern to justify an overnight prelim Old studies Didactic Non-Emergent Interpretations
The more useful information you provide – the more valuable information you will get out of an imaging study. Symptom location and duration Sidedness!! Prior pertinent interventions Possible ddx Radiology Consult
The more useful information you provide – the more valuable information you will get out of an imaging study. Symptom location and duration Sidedness!! Prior pertinent interventions Possible ddx CONTACT Info Radiology Consult
Radiology Consult For example… Ordering Dx: 34yo M h/o Crohn’s s/p partial SB resxn new RLQ abd pain x 1day Chief Complaint: Abscess, SBO, perf. Physican #: Reliable physician #, team VOIP preferred
Topics The Department of Radiology Radiology as a Consult Service Risks of Radiation/ALARA Optimal Imaging Strategy LAC-USC Radiology
First, a note on radiation. Radiation Computed Tomography – An Increasing Source of Radiation Exposure. The New England Journal of Medicine. 2007; 357;2277-84.
