Resources

Equipment

The MMC Dept. of Radiology has five 64-slice CT scanners with dose reduction technology, one of which has CT fluoroscopy. The two newest scanners, which were installed in 2015 and 2016, have dual-kV scanning capability. There are five MRI scanners - one 3T and four 1.5T. A total of 13 ultrasound units include 10 Philips iU22 units, two Zonare Medical Systems units, and one SonoSite. The latter three devices are dedicated to the IR suites. Nuclear medicine equipment includes two Siemens Symbia S SPECT and two Siemens Symbia Intevo 2 SPECT/CT units. There is also a Siemens Biograph 6 PET/CT. IR has two single-plane Siemens suites that were installed in 2011 and one biplane Siemens suite that was installed in 2012, all of which include the most recent software such as cone beam CT. Fluoroscopy has three conventional, low-dose Philips fluoroscopic units with pulsed fluoroscopy and video imaging capability, which are ideal for all applications including pediatrics. A remotely operated fluoroscopic unit is well suited for special studies such as bariatrics, speech swallows, and defacography. The general radiology rooms are all equipped for DR. There are five ACR-accredited mammography units, one of which is equipped for upright stereo biopsies, and one prone stereotactic mammographic biopsy unit.

Procedures

The MMC Dept. of Radiology performs over 200,000 diagnostic imaging studies per year, which include approximately 35,000 CT scans, 23,000 ultrasounds, and 13,000 MRI exams. Vascular diagnosis procedures include approximately 6,000 CT and MR angiograms and noninvasive arterial segmental physiologic studies.

IR residents also rotate at St. Mary’s Regional Medical Center in Lewiston, ME, and Southern Maine Health Care – Biddeford Medical Center in Biddeford, ME. Every year, these institutions together perform approximately 2,800 CT and MR angiograms and noninvasive arterial segmental physiologic studies, 30 diagnostic angiograms and venograms, 10 dialysis access evaluations, 200 angiopasty/stent/TIPS procedures (arterial and venous), 20 dialysis access interventions, 35 embolization procedures (hemorrhage, ischemia, UFE, etc.), 10 thrombolysis/thrombectomy procedures, 20 IVC filter placements, 75 venous access procedures, 500 biopsies/abscess drainages/paracenteses/chest tubes/thoracenteses, 50 GI/GU interventions, 5 tumor ablations, and 30 vertebroplasty/kyphoplasty procedures. In addition, IR founded the Venous Care Center at St. Mary’s, where every year approximately 100 endovenous laser treatments, 150 sclerotherapies, and 10 phlebectomies are performed. Meanwhile, at the SMHC Vascular Center, which was also founded by IR, about 40 EVLTs, 60 sclerotherapies, and 5 phlebectomies are performed every year.

Clinical Activities

IR residents rotate at three dedicated outpatient clinics. The first clinic, which is located at MMC, is resident-run, and receives referrals from other such clinics within the institution. This clinic is the first IR resident clinic that was established in the United States. The second clinic, which is located only 1.5 miles from MMC, is a private clinic that is staffed by the faculty of the IR residency program. The third clinic is located at St. Mary’s Regional Medical Center in Lewiston, ME. Outpatient clinical activities include 900 new patient visits and 1,000 follow-up visits every year. In addition, varicose vein procedures are performed at both the private clinic and the clinic at St. Mary’s.

Inpatient clinical activities at MMC include approximately 200 hospital admissions and 1,500 inpatient consultations every year. Three IR advanced practice providers at MMC help to manage the inpatient clinical service.

Resident Run Interventional Radiology Clinic Resources

The following documents are presented by programs with established resident run IR clinics to assist in establishing or improving new resident clinics.

Clinical Justification

This is a column published in JACR in 2010 describing the benefits to clinical training of a resident-run VIR clinic.

Consult Documentation Presentation

This is a very helpful presentation by a medical coding professional that serves as a refresher course in what to include in your clinic documentation.

Handbooks

Resident Clinic Handbook
This is the handbook established and used at Maine Medical Center. It contains some computer program specific information but the remainder can be used as a guideline.

Wake Forest Resident Clinic Manual
This is the handbook developed by Heath McCullough for the clinic he started at Wake Forest. He encourages interested parties to edit and use the manual as you see fit.