Oncologic Imaging and Image Guided Cancer Therapeutics

Fellowship (Interventional Oncology):

Background:  An explosion has occurred in the imaging-related technologies that support cancer diagnosis and image guided tumor therapy.  Increasing imaging sensitivity is allowing earlier detection of most solid neoplasms, and more precise assessment of therapeutic response.  Strategies for determining tumor volume, capabilities for functional and molecular imaging, and improved databases utilization are impacting our understanding of tumor biology while contributing to optimized patient care.  In support of these advances, novel imaging technologies, such as the breast CT, are being developed at this institution.  From a therapeutic perspective, a growing number of minimally-invasive image-guided cancer therapeutics are being shown to be efficacious for an increasing number of solid neoplasms.  Approaches being investigated at UC Davis include chemoembolization, radiofrequency ablation, microwave ablation, cryo-ablation, MRI guided high frequency ultrasound ablation, and the use of persistent hepatic artery and portal vein infusion ports. 

In response to these opportunities, a Fellowship in Oncologic Imaging and Image Guided Cancer Therapeutics has been implemented.  Its purpose will be to provide post-residency training that will more effectively translate advances in imaging technology to patient management. 

The UC Davis Medical Center and the Department of Radiology offer a unique setting for this effort.  Our Cancer Center is one of 60 that has gained designation by the National Cancer Institute.  It has one of the nation’s largest clinical trials programs with approximately 150 adult and 50 pediatric clinical trials currently in effect.  An established and funded Image Response Assessment Team currently provides imaging expertise and consultation to members of the Cancer Center.  It does this in support of the development and performance of clinical trials and translational research.  Similar effort is provided by the Department of Radiology in support of the California Cancer Consortium, a multi-center project conducting translational cancer research.  Collaborations with Lawrence Livermore National Laboratories have been developed relating to interventional neuroradiology.  The UC Davis Genome Project and the Center for Biophotonics provide additional research and translational synergies. The proposed Fellowship Training Program in Oncologic Imaging and Image Guided Cancer Therapeutics will incorporate and expand upon each of these collaborations while providing a route for subspeciality training and early career development in Diagnostic Radiology. 

Program Content:  During this Fellowship a trainee will gain practical expertise, and will become proficient in conventional and developing technologies of cross sectional imaging and nuclear medicine as they relate to detecting, to staging, and to evaluating therapeutic efficacy.  The Fellow will also be trained in image guided diagnostic and therapeutic procedures.  Expertise in image-guided biopsies of all neoplasms will be gained. The fellow will learn the interventional techniques of abdominal and thoracic radiofrequency ablations, chemoembolization, and venous and arterial infusion port placement.  Experience may also be gained with the use of MRI guided high frequency ultrasound ablation, cryotherapy ablation, microwave ablation, radiotherapy, and yitrium microbead embolization therapy for the management of mass lesions. 

There will be a great deal of flexibility in prospectively defining each individual's program of training, with effort made to match the interests, capabilities and career aspirations of the selected candidate.  Areas of Program emphasis are outlined on the following page.  There will be a potential for a second year of fellowship, which may include a year of research or of concentrated clinical focus.  There is also the possibility of Interventional Radiology training with subsequent CAQ eligibility during the second year. 

Program Leadership:  The Fellowship will be within the Department of Radiology under the direction of Wayne Monsky, MD, PhD, Assistant Professor of Radiology.  The Section Chief is Daniel P. Link, M.D., Professor.
Program content:

A.  Required Research: One research project with preparation of a manuscript for submission.

B.  Reading:             “Oncology Imaging” Bragg, Rubin, Hricak

“Nuclear Oncology – Diagnosis and Therapy” Khalkhali, Maublant, Goldsmith

C.  UCDMC Conference Participation:

Presenting at tumor boards

Imaging response assessment team participation

D.  Separate Areas of Potential Program Emphasis: 

1.  Oncologic Imaging Emphasis:

• One to two months of Clinical Cross Sectional Oncology Imaging using CT and MR; including Chest, MSK, Neuroradiology, and Pediatric Radiology.
• One to two months of Advanced CT imaging, including Image processing volumetrics, PET Fusion CT, and exposure to breast CT.
• One month of Advanced MRI, including dynamic enhanced MRI and breast MRI.
• Two months on PET and Nuclear Medicine with Radionuclide based therapies.
• Two months of Interventional Radiology with an emphasis on Interventional Oncology (chemoemblization, Oncology related bland embolization, central venous/hepatic artery/portal vein infusion ports, billiary interventions, uterine artery embolization).
• Body/Thoracic Interventions (biopsies, RF ablation).
• One month Research.
• One month elective, potentially including Surgical Oncology or Hematology Oncology Rotation.

2.  Interventional Oncology Emphasis:

• Four months IR. 
• Three months body interventions including biopsies and therapies.
• One month PET.

• Two months in imaging rotating through all services as above based on focus of interest.

• One month research.
• One month elective on Surgical Oncology.

3.  Research Emphasis:

• 6 months clinical imaging and or intervention
• 6 months research.  Research faculty mentors might include John Boone, John McGahan, Wayne Monsky, Ramsey Badawi, Kit Lam, Simon Cherry, Kathy Ferrara, Erik Wisner, Frank Chen (or other Berkely/Livermore).

Number of Fellowships: 1 per year

Duration of Fellowship: 1 year—with the possibility of an additional year as a Clinical Instructor

Vacation: 24 days per year

Competitive Benefits

1. Completion of four-year residency in the United States or Canada.
   
   
2. California Medical License before starting fellowship. Please visit the California Medical Board Web site or contact them directly for more information: http://www.medbd.ca.gov/ or (916) 263-2344.
   
   
3. Requirement for Acceptance of International Medical Graduates at UC Davis for Postgraduate Training.

To apply, please submitt the following materials to the fellowship coordinator at the address below.

1. A completed UC Davis application form.
2. Current CV.
3. A letter of recommendation from the director of your radiology residency program.
4. Two additional letters of recommendation from physicians of your choice.
5. A letter from the dean of your medical school (optional).
6. Medical school transcripts and USMLE scores (optional).
7. Personal statement.

If you have questions or would like to submit your application materials, please contact:

Tracey Brown
tracey.brown@ucdmc.ucdavis.edu
Phone: (916) 734-6533
Fax: (916) 734-6548

UC Davis Health System
Department of Radiology
4860 Y Street Suite 3100
Sacramento, CA 95817