Job Description Part 2:
Sub-Specialist Training in Neuroradiology
Institute of Neurological Sciences, Southern General Hospital, Glasgow
Introduction
This is an exciting opportunity to train in neuroradiology at one of the largest neurosciences centres in
the UK. The Institute of Neurological Sciences (INS) has, for many years, been a centre for
subspecialty training in neuroradiology with one or two specialist trainees in neuroradiology at any
one time. It offers specialist training in all core aspects of diagnostic neuroradiology as well as
offering possible further training in interventional neuroradiology, head and neck imaging and
paediatric neuroradiology. This centre of academic excellence also provides ample opportunity for,
and encourages participation in, neuroradiological research.
Background
The Institute of Neurological Sciences
The Institute of Neurological Sciences (INS) is located on the Southern General Hospital (SGH)
campus, in the southwest of Glasgow. The INS is a tertiary and quarternary referral centre providing
neurosurgical, neurological, neuroradiological, neuropathology and clinical neurophysiology. services
for the 2.7 million people in Glasgow and the West of Scotland. Oral and maxillofacial surgery are also
based here, providing trauma and elective surgery and specialist provision for head and neck cancer and
cervicofacial vascular malformations. Acute stroke services for the south of Glasgow have recently been
amalgamated at the INS. The Queen Elizabeth National Spinal Injuries Unit for Scotland at the SGH
provides acute and rehabilitation care for the whole of Scotland, replacing former facilities in
Edinburgh and Glasgow. Glasgow forms the Northern axis of the two-centre UK vein of Galen National
Service (in partnership with Great Ormond Street Hospital in London) taking referrals from the 25-30
million population of the Northern half of the UK and beyond. The large number and variety of
patients seen at the INS provides an extensive training opportunity for specialist registrars in
radiology wishing to sub-specialise in neuroradiology.
Department of Neuroradiology
Our department is dedicated to excellence in clinical neuroradiology, as well as education and
research.
Medical Staff
Consultants
Our current complement is 9 consultant neuroradiologists, one post being vacant, with the following
main areas of interest:
Dr K Forbes
Diagnostic neuroradiology/ MRI/paediatric
(Lead Clinician)
Dr E Teasdale
Diagnostic neuroradiology/CT/ trauma/stroke/SPECT
Professor D Hadley
Diagnostic neuroradiology/ MRI/SPECT/ paediatric/ functional
Dr D Kean
Diagnostic neuroradiology/ MRI
Dr JJ Bhattacharya
Interventional neuroradiology/ vascular lesions/ Diagnostic
Dr C Santosh
Diagnostic neuroradiology/ MRI/ SPECT/stroke
Dr S Jenkins
Interventional neuroradiology/ Head and Neck /Diagnostic
Dr A Siddiqui
Interventional neuroradiology/ Head and Neck /Diagnostic
(Plus vacant post for diagnostic neuroradiologist)
Specialist Registrars in Neuroradiology
There are 2 posts for Specialist Registrars to acquire sub-specialist training in neuroradiology.
Specialist Registrars in Radiology
Trainees from the West of Scotland Training Scheme rotate through the INS. There are between 2
and 4 trainees from years 1-3 at any one time for 3 month rotations. 4th/ 5th year trainees can return
to INS if they select the neuroradiology module.
Departmental equipment
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1.5T GE Signa Horizon MRI scanner
3.0T GE MRI scanner installed
Phillips 64-slice MDCT Scanner
Phillips MX 8000 4-slice MDCT Scanner
Phillips 20-10 Allura biplane, flat panel neuroangiography unit
IOS mobile digital C-arm (backup angio)
Nova SPECT scanner dedicated for brain imaging
Orbix skull radiography unit
Transcranial Doppler unit
Specialist Registrar in Neuroradiology
The post is designed to fulfil the training curriculum for consultant neuroradiologists as outlined in the
RCR documents ‘Structured training in clinical radiology’ and its’ appendix, ‘Curricula for subspecialty
training’. As stated in the above documents, a minimum of one year of full-time training in
neuroradiology is essential, but two years are recommended. A trainee would normally spend years 5
and 6 of training in post. Trainees entering the post would have completed normal rotations through
neuroradiology as part of their core training in clinical radiology.
Diagnostic Neuroradiology
The training program offers the opportunity for specialist registrars to consult, perform and interpret,
under close supervision, invasive as well as noninvasive procedures in neuroradiology. These
procedures include CT, MR imaging, cerebral angiography, myelography and plain film radiography
related to the brain, head, neck, and spine. Non-invasive angiographic techniques for arterial and
venous disease will be taught. There will be exposure to MR spectroscopy, functional MRI, CT and MR
perfusion, diffusion-weighted imaging and SPECT.
Previous experience of cerebral angiography is not necessary although all trainees should have
developed basic angiographic skills during their core training. We will give full training in the principles
and practise of neuroangiography. Registrars will be given graduated responsibility in the
performance of the procedures as competence increases. Selective external carotid and spinal
angiography as well as petrosal venous sampling for investigation of Cushing’s disease will be taught.
There will be opportunity to perform spinal biopsies.
Interventional Neuroradiology
All neuro-trainees will be exposed to, and assist in some interventional procedures both scheduled
and emergencies. Areas of interest include treatment of cerebral aneurysms. INS was involved in the
ISAT trial (endovascular v surgical treatment) and we have one of the largest experiences in the UK
of treating complex wide-neck aneurysms by the balloon remodelling technique and intracranial
stenting. There is a large AVM programme, and this is one of the few centres in the UK specialising in
treatment of superficial vascular malformations. In conjunction with the Royal Hospital for Sick
Children & Queen Mothers Maternity Hospital, Yorkhill we provide UK-wide quarternary care for
neonates and children with cerebral vascular malformations, mainly vein of Galen aneurismal
malformations as part of the nationally funded Vein of Galen National Service.
Trainees who are specifically interested in, and show aptitude for Interventional Neuroradiology, will
be encouraged to become more fully involved in the Interventional Programme initially assisting in
and eventually performing endovascular procedures under supervision. We normally accommodate
one trainee at a time in full interventional training. We have recently established a triangular
neurointervention meeting with Edinburgh and Newcastle and are exploring the possibilities of
exchanges between these centres to broaden the training experience.
Timetable
This will be flexible and can be adjusted to accommodate a trainee’s needs and interests. A typical
example would consist of:
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CT - equivalent of two sessions per week
MRI - equivalent of two sessions per week
Angiography - equivalent of two sessions per week
Study/ meetings - equivalent of one session per week
Research - equivalent of one session per week:
Sample timetable:
am
meeting
pm
Monday
Tuesday
CT
neurosurgery
/spinal injuries
Angio
Intervention
Research
Wednesda
y
Academic
neuropath/
audit
MRI
Thursday
Friday
Study
neurology/
stroke
Angio
MRI
CT
Clinical & academic meetings
Weekly neurosurgical, neurological, stroke, spinal injury, neuropathology and Head & Neck meetings
are held. The trainee will be encouraged to participate actively and subsequently chair meetings.
Active involvement in the weekly departmental audit meeting is an important part of the post.
Wednesday morning is set aside as an academic session in the INS. There is a regular programme of
visiting speakers and case presentations in University term time. Weekly departmental teaching
seminars and tutorials are held on Wednesday mornings and the trainee will be expected to give
presentations on selected topics.
Teaching Duties
The SGH has a long tradition of teaching medical students from Glasgow University, and the INS is
the teaching centre for clinical neurosciences in the University with Academic Departments of
Neurosurgery, Neurology and Neuropathology. The Trainee will be expected to take part in the
teaching duties of the department. This may involve teaching radiology and other SpRs, and medical
students. Other tutorials may include radiography and nursing staff.
Research
The neuroradiology department has a long tradition of research and regularly presents at
neuroradiology meetings, national and international. Recent trainees have presented at BSNR in Hull
and London (winning the oral paper prize), ASNR in Washington DC and New Orleans, USA, at the
WFITN in Venice and at the Symposium Neuroradiologicum in Paris. The trainee will be encouraged
and guided in research projects and be expected to present findings at meetings, and develop them
for publication. The department has a regular output of publications in major journals (a list of recent
publications is attached as an appendix). The 3.0T MRI scanner has allocated research sessions. The
University of Glasgow also maintains a 7.0T high-field MRI unit for animal studies providing exciting
opportunities for basic research in which INS neuroradiologists are actively involved.
Conferences/ Courses
The trainee will be encouraged and given the opportunity to attend appropriate national meetings.
We may also contribute some financial support for trainees in attending international meetings and
courses (recent trainees have attended the European Courses in Neuroradiology, and in Head and
Neck Radiology, and taken the MSc in Neurovascular Diseases of the Universities of Paris and Mahidol
University, Bangkok. We will also assist trainees in seeking sponsorship to attend such courses.
On-call service
The trainee will participate in the neuroradiology on-call rota 1 in 5 with appropriate banding. There
will always be consultant cover.
Library/ teaching facilities
Departmental library has a good range of neuroradiology and neuroscience textbooks. Departmental
funds are available for new and replacement books. A full set of ASNR teaching curriculum videos is
kept and a growing departmental film library is well maintained and catalogued. The trainee will help
in the development of the film library. A computer (PC) is provided for the use of trainees with
internet access and medline facilities. An extensive list of E-journals is also available through the
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Medical Library including most of the relevant neuroscience and radiology titles A departmental digital
camera and digital projector are available for teaching/presentations etc.
Office space etc.
The trainee will share the registrars’ room with the rotating trainees. There is a Staff Common Room.
For further information contact:
Dr Sarah Jenkins
Consultant Neuroradiologist (College tutor)
Sarah.Jenkins@ggc.scot.nhs.uk
Dr Kirsten Forbes
Consultant Neuroradiologist (Lead Clinician)
Kirsten.Forbes@ggc.scot.nhs.uk
Department of Neuroradiology
Institute of Neurological Sciences
Southern General Hospital
1345 Govan Road
Glasgow
G51 4TF
0141 201 1100 (ext 2040)
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Appendix: Selected Publications, Department of Neuroradiology, INS 2005-2008
Santosh C, Brennan D, McCabe C, Macrae IM, Holmes WM, I Graham D, Gallagher L, Condon B,
Hadley DM, Muir KW, Gsell W.
Potential use of oxygen as a metabolic biosensor in combination with T2(*)-weighted MRI to define
the ischemic penumbra.
J Cereb Blood Flow Metab. 2008 Jun 11. [Epub ahead of print]
Bhattacharya JJ, Siddiqui MA, Zampakis P, Jenkins S.
MRA artefacts with Nexus coils.
Neuroradiology. 2008 Jul 18. [Epub ahead of print]
Simpson GC, Teasdale E.
Cause of false-positive when using arterialization of cerebral veins as a diagnostic feature of dural
arteriovenous fistula.
AJR Am J Roentgenol. 2008 Aug;191(2):W76
Fagan AJ, Mullin JM, Gallagher L, Hadley DM, Macrae IM, Condon B.
Serial postmortem relaxometry in the normal rat brain and following stroke.
J Magn Reson Imaging. 2008 Mar;27(3):469-75.
Wedderburn CJ, van Beijnum J, Bhattacharya JJ, Counsell CE, Papanastassiou V, Ritchie V, Roberts
RC, Sellar RJ, Warlow CP, Al-Shahi Salman R; SIVMS Collaborators.
Outcome after interventional or conservative management of unruptured brain arteriovenous
malformations: a prospective, population-based cohort study.
Lancet Neurol. 2008 Mar;7(3):223-30..
Annamalai G, Lindsay KW, Bhattacharya JJ.
Spontaneous resolution of a colloid cyst of the third ventricle.
Br J Radiol. 2008 Jan;81(961):e20-2.
Mathew MR, Teasdale E, McFadzean RM.
Multidetector computed tomographic angiography in isolated third nerve palsy.
Ophthalmology. 2008 Aug;115(8):1411-5.
Cordonnier C, Al-Shahi Salman R, Bhattacharya JJ, Counsell CE, Papanastassiou V, Ritchie V, Roberts
RC, Sellar RJ, Warlow C; SIVMS Collaborators.
Differences between intracranial vascular malformation types in the characteristics of their presenting
haemorrhages: prospective, population-based study.
J Neurol Neurosurg Psychiatry. 2008 Jan;79(1):47-51.
Krings T, Geibprasert S, Luo CB, Bhattacharya JJ, Alvarez H, Lasjaunias P.
Segmental neurovascular syndromes in children.
Neuroimaging Clin N Am. 2007 May;17(2):245-58.
Carrim ZI, Reeks GA, Chohan AW, Dunn LT, Hadley DM.
Predicting impairment of central vision from dimensions of the optic chiasm in patients with pituitary
adenoma.
Acta Neurochir (Wien). 2007 Mar;149(3):255-60.
Zampakis P, Santosh C, Taylor W, Teasdale E.
The role of non-invasive computed tomography in patients with suspected dural fistulas with spinal
drainage.
Neurosurgery. 2006 Apr;58(4):686-94
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Dempsey MF, Wyper D, Owens J, Pimlott S, Papanastassiou V, Patterson J, Hadley DM, Nicol A,
Rampling R, Brown SM.
Assessment of 123I-FIAU imaging of herpes simplex viral gene expression in the treatment of glioma.
Nucl Med Commun. 2006 Aug;27(8):611-7.
Razvi SS, Walker L, Teasdale E, Tyagi A, Muir KW.
Cluster headache due to internal carotid artery dissection.
J Neurol. 2006 May;253(5):661-3
Muir KW, Halbert HM, Baird TA, McCormick M, Teasdale E.
Visual evaluation of perfusion computed tomography in acute stroke accurately estimates infarct
volume and tissue viability.
J Neurol Neurosurg Psychiatry. 2006 Mar;77(3):334-9
Dempsey MF, Wyper D, Owens J, Pimlott S, Papanastassiou V, Patterson J, Hadley DM, Nicol A,
Rampling R, Brown SM.
Assessment of 123I-FIAU imaging of herpes simplex viral gene expression in the treatment of glioma.
Nucl Med Commun. 2006 Aug;27(8):611-7.
Thammaroj J, Subramaniam V, Bhattacharya JJ.
Stroke in Asia.
Neuroimaging Clin N Am. 2005 May;15(2):273-82, ix-x.
Dempsey MF, Condon BR, Hadley DM.
Measurement of tumor "size" in recurrent malignant glioma: 1D, 2D, or 3D?
AJNR Am J Neuroradiol. 2005 Apr;26(4):770-6.
Teasdale E.
The neurologist in the DGH: how to survive without on site neuroradiolgy.
J Neurol Neurosurg Psychiatry. 2005 Sep;76 Suppl 3:iii39-iii47
Teasdale GM, Wardlaw JM, White PM, Murray G, Teasdale EM, Easton V; Davie Cooper Scottish
Aneurysm Study Group.
The familial risk of subarachnoid haemorrhage.
Brain. 2005 Jul;128(Pt 7):1677-85
Bone I, Hadley DM.
Syndromes of the orbital fissure, cavernous sinus, cerebello- pontine angle, and skull base.
J Neurol Neurosurg Psychiatry. 2005 Sep;76 Suppl 3:iii29-iii38
Muir KW, Santosh C.
Imaging of acute stroke and transient ischaemic attack.
J Neurol Neurosurg Psychiatry. 2005 Sep;76 Suppl 3:iii19-iii28
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