Piedmont Heart Advanced Cardiovascular Imaging Fellowship
Mission Statement
The goal of the Piedmont Heart Advanced Cardiovascular Imaging Fellowship is to train fellows to become safe and independently competent multimodality imaging cardiologists and future leaders in the area of Advanced Cardiovascular Imaging which includes Cardiovascular CT and Cardiovascular MRI.
The 1-year fellowship will be under the direct supervision of Director Dr. Roshin Mathew and will consist of a combination of clinical work and research as determined by the fellow’s specific interests.
Requirements
- Individuals must have successfully completed 3 years of an ACGME-accredited U.S. general cardiology fellowship program (or equivalent) prior to commencement of the program in order to be eligible.
- Applicants should be board eligible/board certified in cardiology and be eligible for a GA state medical license.
- Individuals must have a committed interest to obtain skills in advanced cardiovascular imaging and advance clinical utility of advanced imaging techniques.
- Applicants must be required to have at least COCATS Level II echocardiography skills as defined by the 2019 ACC/AHA/ASE advanced training statement on echocardiography (J Am Coll Cardiol. 2019 Jul, 74 (3) 377–402) with written confirmation by a Level II echo director or program director.
How To Apply
Contact Director Dr. Roshin Mathew at roshin.mathew@piedmont.org.
Overview
Piedmont Hospital in Atlanta, GA is a 488-bed acute care tertiary referral center in metro Atlanta, GA with the highest acuity (case-mix index) of any non-academic hospital in the United States. We perform a high number of advanced cardiovascular procedures including left ventricular assist devices, heart transplantation, complex percutaneous interventions, pulmonary vein isolation, VT ablation, transcatheter endovascular repair, and transcatheter valve replacement or interventions. This is supported by a very robust clinical advanced imaging program that includes echocardiography, nuclear cardiology, cardiac and vascular computed tomography (CCT), and cardiac and vascular magnetic resonance imaging (CMR). We perform approximately 4,000 non-contrast and contrast cardiovascular CT and 1,200 cardiovascular MRI on a yearly basis. Our program faculty includes 6 multimodality imaging cardiologists with additional years of imaging training.
Faculty
Roshin Mathew, M.D.
Cardiology & Cardiovascular Imaging
Program Director for Advanced Cardiovascular Imaging Fellowship
Raul Blanco, M.D.
Cardiology & Cardiovascular Imaging
Chief of General and Preventative Cardiology COE, Piedmont Healthcare
Fellowship Objectives
Cardiovascular CT and MRI imaging Program
Cardiovascular/Structural CT
- i.Knowledge of the appropriateness criteria for Cardiovascular CT.
- ii. Understand the absolute and relative contraindications to contrasted cardiovascular imaging.
- iii. Ability to acquire contrasted and non-contrasted CT images.
- iv. Knowledge of protocols to ensure the clinical questions is answered with CT imaging modality.
- v. Learn patient preparation for CCT.
- vi. Knowledge of artifacts and parameters to optimize image quality and reduced radiation exposure which includes, but not limited to, electrocardiographic gating, delayed imaging, contrast timing, and adjustments in KV and slice thickness.
- vii. Understand post processing of raw images and the various imaging reconstruction option.
- viii. Analysis and measurements of reconstructed images using advanced postprocessing software.
- ix. Learn accurate analysis, interpretation, and reporting of cardiovascular CT images with and without contrast. The studies include, but not limited to, vascular CT, preoperative planning CT with and without delayed imaging, structural CT, CT evaluation of LVAD, 4D Valve CT, coronary CT, and calcium scores.
- x. To achieve the case load and case logs to exceed the minimum requirements for eligibility of the CCT boards.
- xi. To become Level III CCT and to obtain the skills to independently acquire and interpret cardiovascular CT imaging.
Cardiovascular MRI
- i. Knowledge of the appropriateness criteria for cardiovascular MRI.
- ii. Understand the absolute and relative contraindications to cardiovascular MRI.
- iii. Learn MRI protocols and sequences to properly evaluate the clinical question.
- iv. Learn patient preparation for Cardiovascular MRI.
- v. Learn AICD and pacemaker adjustments prior to MRI scanning.
- vi. Learn to acquire specific sequences in both contrasted and non-contrasted imaging.
- vii. Learn MRI parameter adjustments to improve image quality or lower breathhold timing
- viii. Learn post processing techniques to assess valvular dysfunction and chamber volumetrics.
- ix. Be able to properly interpret a cardiovascular MRI study.
- x. To achieve the case load and case studies to exceed the requirements dictated by the CMR governing board in order to become board eligible.
- xi. To become Level III in cardiovascular MRI and to independently acquire and interpret CMR imaging.
Clinical/Academic Expectations for CCT/MRI program
Objectives
- 1. Must read and learn about the basic principles of computed tomography and magnetic resonance imaging physics.
- 2. Must remain up to date on the studies and clinical applications of cardiac CT imaging.
- 3. All clinical work will be performed under the direct supervision of the PHI faculty.
- 4. Set number of assigned days will be given to the fellow in order to prepare and acquire images in CT or MRI under the direct supervision of the nurses, techs, and faculty.
- 5. Goal number of contrasted and noncontrasted CT studies will need to be physically acquired by the fellow prior to graduation of the program. Each study will have to be signed off as completed by the lead technologist.
- 6. Goal number of defined sequences will need to be set up and acquired for cardiac MRI as dictated by the fellowship director and will need to be signed off as completed by the lead technologist.
- 7. Fellow will be assigned weekly rotations in either CT or cardiac MRI and will be responsible for the performance and interpretation of the studies done on that particular day with supervision based on the assigned faculty of that corresponding day.
- 8. Attendance at monthly lectures by attendings will be done for the fellow in the topics of either CT/ MRI.
- 9. Perform 10 lectures/academic year (~1 monthly) in topics as determined by fellow and attending primarily for board preparation.
- 10. Attendance at all structural clinical meeting which primarily occur on the Thursdays and/or Fridays of every week.
- 11. In the last 9 months of the academic year, fellow will be responsible to help and guide through transcatheter valve cases at the structural meetings usually performed on Thursday/Friday mornings.
- 12. Fellow will be required to publish either 2 abstracts or 1 peer reviewed article in the academic year.
- 13. Fellow must submit an abstract and attend at least 1 national meeting for either SCMR or SCCT.
- 14. Feedback will be given to the fellow and vice versa to ensure the fellow and program our meeting desired expectations throughout the year.