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Electives - Radiology

Radiology and Pathology Correlation **Does not count towards 12-week limit of clinical Radiology**

Elective Number: E74bb

Rotation Supervisor: Dr. Juan M. Olazagasti

Coordinator: Sandy Kerns (sk9ef@virginia.edu); 924-9484

Duration: 2-weeks

Available: 4a, 6a, 6b, 7a, 7b, 8a, 8b, 9a, 11a, 11b, 12a, 12b, 13a, 14a &14b

Time to Report: 8:00 am

Place to Report: Residency/Student Elective Office - Room 1832

Typical day: 7:45 am - 5:00 pm

Attendance: Attendance at elective activities is mandatory.

  • Anyone who is ill or has a personal or family emergency must contact Student Affairs and the Attending on Service.
  • Students are allowed to take off up to 1 day per week to interview between November 1 and February 1.
    • Specific days missed must be approved by the Attending on Service.

Number of students per rotation: Min 1/Max 2

Course Description: There will be an early morning “huddle”, where we will have pre-procedural case discussions with clinical presentations and imaging findings, approach to the procedure/biopsy, and consideration of which is the best imaging modality to be utilized. Further dialogue including the informed consent form, pre-anesthesia care, family counseling and literature search of interesting cases will also be performed. In appropriate cases, after the tissue is obtained, there will be interactive pathology slide preparation, discussion regarding the specimen findings and relevant differential diagnosis based on the clinical history and pathology/cytology findings.

Students are expected to be active participants, with pre and post procedure progress note writing, being present during the informed consent and actual procedures and in talking to patients and their families. They will have active discussion with cytology technologies, fellows and pathology faculty. They will also follow up on their cases as the specimens are subsequently tested and results surface, in order to close the loop of diagnosis and further patient care and treatment.

Learing Objectives:

A. Given a clinical case and imaging study, create a differential diagnosis by disease mechanism that may include benign and malignant neoplasia, infectious and inflammatory, degenerative, congenital, and vascular disorders.
B. When given a lesion on imaging, explain how planning for tissue diagnosis and biopsy is performed, including all the steps involved and how to accomplish this in the safest, least expensive manner.
C. Describe the concepts of informed consent, image safety and dose reduction, patient centered care and how these apply to image guided interventions.
D. Given a clinical case and presentation, render an all-inclusive approach to diagnosis, correlating radiologic images with microscopic pathology specimens
E. Compare and contrast pros and cons of different imaging modalities and determine the best method to perform a biopsy for a given case.

A. Given a tissue specimen, determine how to triage for histologic examination and possible ancillary studies.
B. Given a histologic session of a mass lesion, distinguish between the features seen in neoplastic and reactive conditions.
C. Given a tissue diagnosis of a neoplasm, distinguish between the morphologic features of benign and malignant diagnoses and lines of differentiation.

Suggested preparatory reading:
1. http://pubs.rsna.org/journal/radiology - good source of multiple articles on radiologic pathologic correlation, very well done, though some are relatively rare. Use the search tool on the upper right corner and type “radiologic pathologic and the topic of interest.

Below is an example of the site:http://pubs.rsna.org/action/doSearch?SeriesKey=&AllField=RADIOLOGIC+PATHOLOGY

2. https://www.ncbi.nlm.nih.gov/pubmed/27311804 article of how a Radiologic-pathology elective is done in another institution.

3. http://dx.doi.org/10.1016/j.acra.2010.03.001 - Article on using the ACR appropriateness criteria to teach evidence based medicine

4. http://link.springer.com/book/10.1007%2Fb137876 - downloadable book on radiologic-pathologic correlation


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