WOMEN’S IMAGING AT NYU MEDICAL CENTER
Women’s Imaging was established as a section in the Department of Radiology at NYU in 2002 by Department Chairman Robert I. Grossman, M.D., with the goal of providing comprehensive, superb clinical care, in addition to promoting research and teaching in Women’s Imaging. The breast imaging section, headed by Hildegard Toth, M.D., provides all aspects of breast imaging. The body imaging section, headed by Genevieve Bennett, M.D., includes all aspects of abdominal and pelvic imaging related to Women’s Imaging, including ultrasound, CT, and MRI. Dr. Bennett and Joseph Yee, M.D., an ultrasonographer in the Radiology Department, also provide ultrasound expertise in the Obstetric and Gynecologic (OB/GYN) Ultrasound Unit at Bellevue Hospital. This collaboration between the Radiology and OB/GYN Departments is unique, and has promoted better training of both radiology and OB/GYN residents in OB/GYN ultrasound.
FELLOWSHIP TRAINING IN WOMEN’S IMAGING AT NYU
A Women’s Imaging Fellowship has been offered in the Department of Radiology at NYU since July 2004. This fellowship includes six months devoted to breast imaging and six months devoted to body imaging. The Women’s Imaging fellows spend a month in the Obstetric and Gynecologic Ultrasound Unit at Bellevue. This exposure allows interactions not only with the Radiology faculty but also with the Obstetrician/Gynecologists, thereby broadening their experience to include a clinical perspective. Two of the three upcoming Women’s Imaging fellows for the 2006–2007 academic year are currently fourth-year radiology residents at NYU: Allison Levy, M.D., and Cathleen Heffernan, M.D.
CME IN WOMEN’S IMAGING AT NYU
In December of this past year, a dedicated Women’s Imaging session was offered at our twenty-fourth annual CT/MRI Head-to- Toe Imaging conference. In addition to lectures by members of the Radiology Department, Ilan Timor, M.D., from the NYU Department of Obstetrics and Gynecology participated. Two guest lecturers from Harvard Medical School, Beryl Benacerraf, M.D., of the High Risk Obstetrical Ultrasound unit at the Brigham and Women’s Hospital, and Elizabeth Rafferty, M.D., Associate Director for Breast Imaging at the Massachusetts General Hospital, spoke on obstetric ultrasound, and breast imaging and digital tomosynthesis, respectively. These well-received lectures assured Women’s Imaging a spot in future Head-to-Toe Courses. A dedicated Women’s Imaging CME course is in the planning stages for the fall of 2007.
WOMEN’S IMAGING: BEYOND ULTRASOUND
Ultrasound, in large part because of its widespread availability, low cost, and lack of radiation, is well established as the primary modality for imaging assessment of the pregnant patient as well as first-line imaging for most gynecologic disorders. Obstetric and gynecologic ultrasound in the Department of Radiology at NYU is available for inpatient and emergency room patients at both Tisch Hospital and Bellevue Hospital, and outpatients at Faculty Practice Radiology and Bellevue Hospital. CT is also well established as an important diagnostic tool for the evaluation of disorders of the female pelvis, including neoplastic and inflammatory conditions. Fusion imaging with positron emission tomography (PET) promises to be particularly helpful for both initial staging and detecting recurrences in gynecologic malignancies.
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Figure 3. Adenomyosis at US and MRI. (A) Transabdominal pelvic ultrasound in a 35-year-old patient with dysmenorrhea demonstrates an enlarged, globular uterus (u) with diffusely heterogeneous echotexture of the myometrium. (B) Sagittal T2W TSE MR image in the same patient demonstrates the enlarged uterus with a markedly thickened junctional zone (j), consistent with adenomyosis.
Figure 4. Adnexal Mass at US Clarified by MRI. (A) Transvaginal pelvic ultrasound in a postmenopausal patient demonstrates a solid left adnexal mass (arrow). A normal left ovary could not be identified. (B) T2W TSE coronal MR image of the pelvis obtained in the same patient demonstrates that this is a pedunculated fibroid (arrow) arising from the uterus which contains additional fibroids(f). A normal left ovary was also identified (not shown).