Clinical Care

Chang Yeuh Ho, Division Chief

The Neuroradiology subspecialty team at Indiana University School of Medicine is comprised of 13 fellowship-trained neuroradiologists, who provide a complete range of safe and efficient diagnostic neuroimaging services. Together, and in collaboration with healthcare providers in other IU School of Medicine academic departments, the Neuroradiology subspecialty team strives to identify the most accurate diagnoses and provide the highest quality patient care available.

Faculty educators on this team use leading-edge imaging applications and techniques, including functional Magnetic Resonance Imaging (fMRI), a specialized imaging technique used prior to neurosurgery to map brain function non-invasively—often in combination with intra-operative MRI. This enables imaging acquisition and real-time review with neurosurgery during operations rather than relying solely on images obtained before or after surgery. This means immediate modifications can be made to the surgical plan if needed, often reducing the necessity of additional or repeat surgeries.

Katherine Patterson, Division Chief

Through breast imaging partnerships with IU Health, Eskenazi Health, Eli Lilly and HealthNet at Barrington, this subspecialty team continues to push the boundaries of excellence in breast cancer detection, thereby improving population health in Indiana.

The addition of 3D mammography, also known as tomosynthesis, at most of the diagnostic sites has enhaced the team’s leadership in breast imaging in Central Indiana. Tomosynthesis, by seeing through overlapping tissue, improves cancer detection and reduces unnecessary recalls. The breast imaging Division maintains a Breast Imaging Center of Excellence certification, the hallmark of quality for breast imaging. The team is also preparing to expand its high risk screening program by launching Hughes RiskApps, a risk-assessment software for identifying high-risk patients for MRI screening and prevention, in order to improve patient care and outcomes. Many faculty members volunteer for the Komen Tissue Bank Collection Event to help find a cure for breast cancer.

Kumar Sandrasegaran, MD, Division Chief

The Abdominal Imaging group collaborates closely with IU Health clinical divisions to perform and interpret a range of imaging studies, integrated with ongoing research and education. The group focuses its expertise in the areas of ultrasound and imaging intervention, CT and MR imaging, and GI and GU fluoroscopy.

Diagnostic ultrasound of solid organ transplant patients supports one of the largest surgical transplant programs in the U.S., while image-guided biopsy and intervention plays an essential role for patients of the Simon Cancer Center. We are engaged in perfecting newer CT imaging techniques such as low radiation dose CT using 128- and 256-slice CT scanners. Low iodine dose CT using less than a quarter of standard contrast dose is being performed on patients with borderline renal function. Integrated with the centers of excellence for pancreatic and hepatobiliary disease, our group is at the forefront in development of novel imaging techniques— secretin-enhanced MRCP (S-MRCP), dynamic contrast-enhanced perfusion MRI (DCE-MR), diffusion-weighted MR imaging of the abdomen (DWI-MR), MR elastography, and T1-mapping of patients with pancreatic disease, chronic liver disease and cancers. Expertise in GI fluoroscopy, offering unique evaluation of small bowel diseases by CT enteroclysis, and assessment of female pelvic organ prolapse by dynamic colpocystoproctography (DCP).

Stacy Rissing, MD, Division Chief

As the cost of healthcare escalates, the value of screening exams for early detection and treatment becomes essential. The cardiothoracic, or chest imaging, team at IU School of Medicine remains committed to patient screening exams and have made tremendous strides in the lung cancer screening program. This program is expected to reduce lung cancer-specific mortality by 20 percent.

The seven radiologists on this team work closely with their thoracic surgery colleagues to ensure the quality and accessibility of this program at IU School of Medicine clinical facilities. The team also offers coronary calcium score screening CT scans, which have received attention in the popular press and continue to be valued by patients and referring clinicians. Many lives are saved by early cancer detection, early diagnosis of coronary artery disease, and early treatment for these pathologies, and the teams is motivated to continue to offer and improve these services.

Trenton D. Roth, MD, Division Chief

The musculoskeletal radiology team includes six musculoskeletal fellowship-trained radiologists and one physician assistant as well as two musculoskeletal imaging fellows per year and three to four diagnostic radiology residents rotating each month on the musculoskeletal service. The team’s clinical service base is IU Health Methodist Hospital but also provides musculoskeletal imaging expertise for multiple hospitals and outpatient facilities throughout the IU Health system as well as Eskenazi Health, Center for Orthopedic Surgery and Sports Medicine, and Central Indiana Orthopedics.

The musculoskeletal radiology team cares for patients with trauma, sports- and work-related injuries, arthritis, metabolic bones diseases, tumors, infections and other problems. With advanced equipment, the team offers interpretive expertise in musculoskeletal radiography, computed tomography, magnetic resonance imaging, ultrasonography, and fluoroscopy as well as procedural expertise in arthrography, bone and soft tissue biopsy, and image-guided joint or tissue aspiration and injection.

The musculoskeletal radiology team serves as sub-specialty consultants for orthopedic trauma, joint replacement, rheumatology, bone endocrinology, musculoskeletal oncology, and sports medicine clinical providers. This includes regular participation in multidisciplinary conferences that promote collaborative interactions between subspecialists. Members of this radiology department Division at IU School of Medicine are also involved in imaging and interpretation for athletes at Ball State, IUPUI, Anderson and Taylor universities as well as Indiana high schools.

Thomas Casciani, MD, Division Chief

The Interventional Radiology group at IU School of Medicine is one of the top three programs in the country performing Yttrium-90 radioembolizations for treatment of primary and secondary liver cancers. The liver tumor working group includes physician specialists from interventional radiology, oncologic surgery, transplant surgery, hepatology, medical oncology and radiation oncology, providing an outstanding example of the power of interspecialty collaboration in treatment for this challenging area of medicine. Faculty physicians in this specialty area now offer advanced therapy for liver cancers that promises to significantly improve quality and length of life.

By working closely with colleagues at Northwestern University, the IU School of Medicine’s Department of Radiology Interventional Radiology team has doubled procedure volume for radioembolization every year since its introduction at IU School of Medicine in 2006.

James W. Fletcher, MD, Division Chief

The faculty of this Radiology Department subspecialty area provides professional supervision, interpretation and reporting of nuclear medicine imaging procedures performed at University Hospital, Methodist, Riley Hospital for Children, Eskenazi, and IU Health North, West, Tipton, and Saxony. The physician educators provide supervision, interpretation and reporting of PET/CT exams from Methodist, Simon Cancer Center, Goodman Hall and a number of mobile PET/CT units for Ball, Margaret Mary and Central Indiana Cancer Center physician staff. The team also provide radionuclide therapy for hyperthyroidism, thyroid cancer (131I), radio immunotherapy for lymphoma (131I-rituximab) and castrate resistant recurrent prostate cancer (223Ra-dichloride). New therapy for patients with progressive neuroendocrine neoplasia (NEN) using a novel radiolabeled peptide 177Lu DOTA-TATE will be introduced. The physicians in this subspecialty unit continue to provide access to 11C-acetate for management of recurrent prostatic cancer, 68Ga-DOTA-NOC for NEN and will initiate 68Ga-PSMA for recurrent prostatic cancer management—all under FDA-authorized, physician-sponsored Expanded Access INDs.

Matthew Cooper, MD, Division Co-Chief

The Pediatric Radiology subspecialty team is working to improve the quality of skeletal surveys performed for child abuse around the State of Indiana. With the help of physicians on the child abuse team at Riley Hospital for Children, hospitals and imaging centers who do not follow the ACR–SPR Practice Parameter for Skeletal Surveys in Children are identified and receive a phone call and follow-up email from one of the pediatric radiologists at IU School of Medicine. The radiologist provides information which includes an informational poster that that reviews the required views and proper patient positioning and can be hung up in technologist for easy reference.

The Department of Radiology’s pediatric radiology team includes eight general pediatric radiologists. Most of the general pediatric radiologists have an area of specialized interest:

• pediatric musculoskeletal imaging
• child abuse
• fetal magnetic resonance imaging
• cardiac imaging
• thoracic imaging
• urologic imaging
• oncologicimaging

Each member of this team is board-certified by the American Board of Radiology and meets all ACR accreditation requirements. All of the pediatric radiologists are fellowship-trained and five of the eight radiologists have achieved their Certificate of Added Qualification in Pediatric Radiology from the American Board of Radiology. The other three will become eligible to receive this certification within the next several years. The radiologists are supported by tremendous physician assistants, sonographers, flouro and X-ray techs, and support staff who work together to provide care to some of the sickest patients in Indiana.