PET/CT Imaging

Fellowship Director: Munir Ghesani, MD, FACNM

Overview

The NYU Department of Radiology PET/CT fellowship is an exciting educational pathway for board eligible radiologists and nuclear medicine physicians. The objective of our fellowship program is to enrich your basic training with detailed knowledge of all facets of PET/CT. We aim to culture a well-rounded fellow whose knowledge spans the width and breadth of the most current up-to-date clinical PET/CT applications while cultivating a solid understanding of research. Over the course of one year, the fellow is expected to progress from reading and interpreting PET/CTs under complete supervision with the ultimate goal of establishing complete reader independence. We tailor our program at NYU to the fellow’s specific intellectual goals combined with a basic training blueprint that can be adjusted to fit individual needs. When the fellow completes their PET/CT fellowship, they will be well rounded in all aspects of clinical and research applications of PET/CT. They will also gain valuable communication skills required to work with referring clinicians.

Facilities

We are equipped with some of the most technologically advanced equipment including a Siemens Biograph 6 PET/CT scanner, a state-of-the art Philips iSite PACS and Siemens RIS, and a digital voice dictation system. The Division of Nuclear Medicine of the Department of Radiology is also equipped with a wide variety of dedicated PET/CT review and analysis workstations with advanced oncology and neurology processing packages from Siemens, MIMvista, Aycan Medical Systems and others. We utilize a large selection top-of-the-line workstations and a new ergonomic reading room for easy and comfortable reading. Additionally, the fellow has a designated workspace and high-end computer system to be used for research in a dedicated office at our affiliate Bellevue Hospital.

Clinical PET/CT operations are located in a freestanding Cancer Center which allows us to work very closely with the entire oncological team. We develop close relationships with our referrers and derive the benefit of continuous medical education which is a natural outcome of the daily information exchange among multidisciplinary teams.

Oncological PET/CT Training

Oncological FDG PET/CT studies are a core component in evaluating a patient with cancer with respect to initial diagnosis, staging, re-staging, evaluating response to therapy and assessing disease recurrence. We are fortunate to have a high volume of PET/CT studies - fellows will see a mix of both typical cases as well as more unusual and complex scans. We most commonly evaluate neoplasms of the lung, skin, head and neck, breast, blood, genitourinary system, bones and gastro-intestinal tract. The daily reading sessions with our fellowship-trained experts coupled with multiple weekly educational conferences contribute to a well-rounded fellowship. The continuous and dynamic daily interaction between the oncologists and nuclear radiologists is also a tremendous growth opportunity. Fellows will leave training with an extensive knowledge base coupled with confidence which is essential for exceptional performance in day-to-day clinical practice.

Neurological PET/CT Training

FDG PET/CT is a valuable tool in evaluation of both dementia and seizure disorders. The fellow will learn the typical (and atypical) findings in order to distinguish between diseases such as Alzheimer’s dementia, Parkinson’s Disease, Pick’s disease, Dementia with Lewy bodies and vascular dementia amongst other pathological disease states. We are fortunate to see a high volume of neurological cases as we are part of a large and dynamic institution.

Cardiac PET/CT Training

During their training, the PET/CT fellow will be exposed to cardiac viability imaging and myocardial sarcoidosis imaging. The principles and practices of PET perfusion imaging will be taught. Elective time may be used to obtain experience in myocardial perfusion SPECT imaging in the Tisch Hospital Nuclear Medicine Department if desired.

Schedule & Responsibilities

General Schedule

The general schedule of the fellow is 4 clinical days and 1 academic day per week with works hours starting at 8 am and finishing between 5 and 6 pm. During the course of a clinical day, the fellow works with a close-knit group of board certified attendings with the balanced objective of education and quality patient care. The day typically includes 1-2 morning and 1-2 afternoon PET/CT reading sessions. The fellow may start reading 6 – 8 cases/day and will work up to 12 or more cases/day or more at the end of their training. The fellow will be responsible for daily protocols and IV contrast decisions with a gradually increasing level of responsibility as appropriate. The fellow may also participate several times a year in didactic and case conference for the NYU radiology residents as desired. Opportunities to learn about radioimmunotherapy at the Cancer Center are available if the fellow is interested.

Academic Research Day

Some of our current research efforts include evaluating the accuracy of PET amyloid imaging in Alzheimer’s disease, the role of 3D rendering of PET/CT data sets in preoperative/intraoperative localization of nonpalpable malignant melanoma, and using PET/CT as a marker of treatment response (comparing SUV verses anatomic CT changes) and as a prognostic indicator in patients undergoing a variety of novel cancer therapies. We are also participating in numerous ongoing multi-institutional clinical trials that use RECIST and International Workgroup Criteria response as study endpoints that will allow the fellow to develop exceptional research analysis skills. The fellow will be expected to complete at least one research project during the year with the goal of submission of an abstract to the annual SNM and/or RSNA meetings.

Call Responsibilities

Call responsibilities include covering the PET/CT clinic on Saturdays every 3 – 4 weeks with a day off to be used the following week or at a later time point at the discretion of the Fellowship Director. There will also be once monthly responsibility to cover IV contrast injections at an NYU satellite office in Brooklyn. A transportation and lunch stipend is provided for the remote call days and an office with a full-featured PACS workstation will be available for research, learning or clinical work.

Tumor Boards

We review and discuss PET/CT cases at multiple multidisciplinary conferences; these include Thoracic Tumor Board, Hematological Tumor Board, Gynecological Malignancies Tumor Board, Head and Neck Tumor Board and a weekly General Oncology conference. The PET/CT fellow will participate in these conferences once they develop the necessary skills to present and discuss cases. There are also weekly interdepartmental conferences such as journal club and interesting case conference specifically geared for the rotating radiology residents and the PET/CT fellow. Our fellow also has access to Radiology Grand Rounds.

Electives and Vacation

The fellow is entitled to 6 weeks of scheduled radiology electives, which is taken in the form of two-week blocks. The individual section chiefs for each section of the Radiology Department approve rotations on a case-by-case basis. The fellow may choose elective rotations based on their particular goals and needs. The fellow also has access to training from a dedicated nuclear physicist. The fellow receives 4 weeks of vacation. Time is provided to attend away conferences if an abstract is presented.

Other Benefits

Fellows receive complete medical and dental coverage which is active immediately upon the start date. The Fellow is also entitled to a $600 yearly book stipend and a $1500 conference allotment which is detailed in our fellow policy guidelines. Sick days, maternity and paternity benefits are also available, set by the universal hospital guidelines.

Location

We are located in one of the most intellectually stimulating, dynamic and culturally diverse cities of the world, with our Cancer Center in Midtown Manhattan at 160 E 34th St (corner of 3rd Avenue). There are many opportunities enriching experiences just outside of the hospital once the daily work is completed. World renowned museums, fantastic dining, Broadway shows, beautiful parks, music and culture are just blocks away. It is a once in a lifetime experience to live and work in NYC. If you so choose, there are innumerable suburbs located just outside NYC that may be more suitable for family style living.

Application

How to Apply:

Prospective applicants should email Munir Ghesani, MD, the PET/CT Fellowship Program Director (munir.ghesani@nyumc.org), expressing their interest in PET/CT fellowship at NYU and then follow the steps delineated below.

The new online application for our 2019-2020 academic year fellowship programs can be found at https://informatics.med.nyu.edu/apps/fellowship/app.

Here is information to guide you through the online application process.

  1. First, sign up to get a username and password to log onto the application program.
  2. Once you are logged in, you will need to enter basic information about yourself (ex. Name, residency, fellowship you are applying for, etc).
  3. You will then be able to directly load the following documents into your application file:
    1. CV
    2. Personal Statement
    3. Board Scores
    4. Dean’s letter
  4. Three letters of recommendation (including one from your program director) are required. Letters must come directly from their authors; they can directly load their letters online. All that is needed is their names and email addresses. Once this information is submitted by the applicant, a recommendation request email will be sent out to their listed recommenders detailing how to submit it. This is the preferred method for letter submission. Alternatively, they can mail their letter to the below address.
  5. Letters of Recommendation must be on department letterhead, scanned in, and signed by the letter writers.
  6. Documents (dean’s letters, letters of recommendation) that cannot be uploaded can be mailed to:

    Nati Mejias
    Fellowship Coordinator
    NYU Langone Department of Radiology
    462 First Avenue
    H Building - 3W36
    New York, NY 10016

  7. You can check the status of your application by logging onto the application program at https://informatics.med.nyu.edu/apps/fellowship/app.
  8. If you are having technical issues with the online application, please call our radiology IT department at 212 263-3433 and ask for Chandan Prithiani or contact Chandan at Chandan.Prithiani@nyumc.org.
  9. Those who have trained in non US institutions may encounter a challenge uploading related documents due to a glitch in our system, reflecting the lack of a US state. We are correcting this. However, our temporary ‘work around’ is to select a bogus state for your application. If you encounter this problem, please select Alabama as your state, which will allow you to continue the application process.
  10. Mailing or emailing your application materials is not recommended as it can lead to a delayed review. We strongly advise using the online application program.
  11. Recommendation request emails will be sent out to your listed recommenders AFTER you submit your application. Please check in with your listed recommenders after you submit your application to confirm that they have received this email.”
  12. To check the status of your application after the initial submission, please log onto https://informatics.med.nyu.edu/apps/fellowship/app with your username and password.”