Institute of Neurological Sciences

neuoinstiute

 

Introduction


 

The Institute of Neurological Sciences (INS) is located on the Southern General Hospital campus, in the southwest of Glasgow.  The INS is a tertiary and quaternary referral centre providing both regional and national clinical services.  Regional services comprise clinical neurosciences (neurology, neurosurgery, neurophysiology, neuropathology and neuroanaesthesia) to the 2.7 million people in Glasgow and the West of Scotland.  There are currently 10 consultant neurosurgeons (90 beds) and 25 consultant neurologists (36 beds).  Associated specialties such as neuro-oncology, neuro-otology, neuro-ophthalmology also attend.  Oral and maxillofacial surgery (12 consultants) is 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 are amalgamated at the INS.  National services comprise the Queen Elizabeth National Spinal Injuries Unit for Scotland at the SGH, which provides acute and rehabilitation care for the whole of Scotland, replacing former facilities in Edinburgh and Glasgow.  Glasgow shares the national coiling service for ruptured cerebral aneurysms (with Edinburgh) and forms the Northern axis of the two-centre UK vein of Galen National Service (in partnership with Great Ormond Street Hospital in London).

The large number and variety of patients seen at the INS provides an unrivalled training opportunity for specialist registrars in radiology, particularly those planning a career in a District General Hospital.

Department of Neuroradiology


 

Our department is dedicated to excellence in Clinical Neuroradiology, as well as education and research.

Medical Staff

Consultants

We currently comprise 10 consultant neuroradiologists, with the following main areas of interest:

  •  Dr J Bhattacharya – Interventional / Paediatric vascular lesions & Diagnostic neuroradiology
  • Dr J Dervin –  Diagnostic & Interventional Neuroradiology
  • Dr J Duplessis – Interventional  & Diagnostic Neuroradiology
  • Dr K Forbes  – Diagnostic & Paediatric neuroradiology/Research
  • Dr A Iqbal – Diagnostic Neuroradiology
  • Dr R Jampana – (Educational Supervisor)  Diagnostic Neuro & Head and Neck Radiology /SPECT
  • Dr S Jenkins – Interventional  & Diagnostic Neuroradiology
  • Dr R Joseph – Diagnostic Neuroradiology
  • Dr C Santosh – Diagnostic Neuroradiology/ SPECT/Research
  • Dr A Siddiqui – Diagnostic & Interventional Neuroradiology

Specialist Registrars in Neuroradiology

  • There are currently 2 posts for Specialist Registrars to acquire sub-specialist training in neuroradiology with extension of the CCT.

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 one of two neuroradiology modules. There are currently 2 Specialist Registrars to acquire sub-specialist training in neuroradiology with extension of their CCT. In addition we regularly have overseas Radiologists and other specialty trainees attending the department for various durations.

Departmental Equipment

  • 1.5T GE Signa Horizon MRI scanner installed 2001
  • 3.0T GE MRI scanner installed 2004
  • Phillips MX 8000 Multislice CT scanner installed 2001
  • Phillips 64 slice CT scanner installed 2007
  • Phillips 20-10 Allura biplane, flat panel neuroangiography unit with rotational facilities was installed in 2007
  • IOS mobile digital C-arm (backup angio)
  • Nova SPECT scanner dedicated for brain imaging
  • Orbix skull radiography unit
  • Transcranial Doppler unit
  • Portable Ultrasound scanner

Annual Workload of the Department (2009-10) 

  • CT : 9450 including 1750 CT angiograms
  • MRI : 9900 including MR angiograms
  • Diagnostic Cerebral Angiography: 440
  • Interventional procedures: 220
  • SPECT: 1110
  • Transcranial Doppler: 400
  • Tertiary referral second opinion reporting (CT, MRI) : 1200

Clinical & Academic Meeting

You can attend the following meetings:

  •  Monday: 12.15pm Spinal Injuries meeting Dr Duplessis
  • Tuesday: 1.15pm Neurosurgical meeting Dr Dervin
  • Wednesday:  8.00am Oncology MDT Dr Forbes/ Dr Joseph ,  9.00 am Epilepsy MDT  Dr Santosh/ Jampana
  • Thursday:   9am Stroke Meeting Dr Santosh/ Iqbal ,  12.15 Neurology meeting Dr Joseph/ Bhattacharya
  • Friday: 8 am Head & Neck MDT Dr Jampana

In addition, other meetings such as Pituitary MDT, Neuroophthalomology, Neurology and surgical handover meetings provide an opportunity to expand knowledge and clinical experience. The trainee will be expected to participate actively in such meetings.  Trainees will be involved in the MDT preparation and may also lead some of the MDT meetings.  Involvement in the weekly Wednesday morning clinical governance activity is an important part of the rotation.

Wednesday morning is set aside as an academic session in the INS.  There is a rolling programme of meetings as shown below.

  • 1st Wednesday of month: Discrepancy meeting
  • 2nd Wednesday of month: Interesting Cases meeting
  • 3rd Wednesday of month: Departmental meeting
  • 4th Wednesday of month: Consultant’s meeting
  • During University Term: 11am Neurosciences academic meeting, Ground floor Conference room

Regular Film Viewing Teaching Session

  • In addition to teaching during the reportinfg sessions, we have formal teaching every Week: Wed (Dr Iqbal) Fri (Dr Joseph).

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 may be expected to give presentations on selected topics and participate in regular tutorials.

Research


The neuroradiology department has a long tradition of research and regularly presents at neuroradiology meetings.  Many trainees have participated in research projects, presenting findings at meetings, and developed them for publication in peer-reviewed journals

On-call


4th and 5th year registrars who choose either Module 1 or 2 will participate in the neuroradiology on call on a 1 in 6 basis.  They will be first on call with a Consultant as 2nd on call.

Library and Teaching Facilities


There is access to an up to date library of textbooks.  A full set of ASNR teaching curriculum videos is kept and a departmental film library is well maintained and catalogued.  There are a large number of teaching cases available for review on the Teaching Archive of the INS PACS server.  A computer (PC) is provided for the use of trainees, with internet access and full medline facilities. A Mac computer is also available

Office Space etc.


A registrars’ room/ library is provided with the facilities listed above.  There are two departmental Common Rooms.

Modules


 

Diagnostic Neuroradiology including Oral and Maxillofacial Radiology

Clinical Supervisor: Dr R Jampana

This module provides Core and Level 1 Neuroradiology Training.

The ‘duty radiology’ sessions provide exposure a wide variety of in patient and outpatient imaging including acute stroke imaging with CTA and perfusion imaging, CTA vascular studies of acute SAH and other intracranial haemorrhage, acute head trauma and all other types of acute CT imaging for neurology, neurosurgery and neuro-ophthalmology.  We also provide CT scanning for GPs for the investigation of chronic headache and of course OP CT scanning for non-acute work in neuroimaging.  The duty radiology sessions also provide the opportunity to see and report on a huge variety of abnormal CT/ MRI scans performed at our referring hospitals, when a neuroradiology second opinion report has been requested by our clinical colleagues at the INS.  The use of National PACS and Glasgow wide RIS means that such studies can now be very easily accessed and reviewed often with access to the original report.

MRI sessions allow the trainee to supervise and report on imaging from both a 1.5 and 3 Tesla Magnet. (1.5T GE Signa Horizon MRI scanner installed 2001, 3.0T GE MRI scanner installed 2004).  We have the ability to perform a wide variety of MR imaging, including Time resolved contrast MRA, MR spectroscopy, functional MRI and high resolution 3T imaging for epilepsy and MR angiography.

Regarding maxillofacial and skull base imaging, there are three afternoon lists for Head and Neck CT.  We perform high quality dual phase contrast imaging for suprahyoid head and neck cancer cases as our routine staging (520 scans per annum 09/10 figures i.e. approximately 10 per week) performed on Monday, Wednesday and Friday afternoons using the 64 slice scanner.  Trainees with a specific interest in H&N radiology can tailor their rota to these sessions (Supervisor: Dr Jampana) and take part in the Friday MDT. MRI is used as a problems solving tool in more complex cases and routinely for TMJ.  There is the opportunity for exposure to lots of cross-sectional imaging of maxillofacial trauma, TMJ pathology, salivary gland imaging and other craniofacial disease.

Regarding neuroangiography and neurointerventional work, trainees will have the opportunity follow patients with acute neurovascular pathology from their non-invasive imaging assessment with CT/CTA to their assessment with diagnostic digital subtraction angiography and subsequent neurointerventional management.

Trainees can assist with DSA and interventional procedures dependant on their previous experience and future interests.

Sample Rota

 Monday  Tuesday  Wednesday  Thursday  Friday
 AM  Duty Radiologist  CTA Processing/ Reporting  Clinical Governance/ Teaching  Angiography/ CT  Study
 PM  MRI  Duty Radiologist  MRI  MRI  CT

 Radiological Research

Clinical Supervisors: Dr C Santosh / K Forbes

This module provides Core and Level 1 academic training

This module has been designed for specialist registrars who wish to gain further experience in radiological research.  The Royal College of Radiologists expects all specialist registrars in clinical radiology to develop research skills through participation in one or more research projects.  This 3-month module would allow you to undertake a more concentrated period of research than is currently possible, with the aim of culminating in a presentation at a radiological conference and a publication in a peer-reviewed journal.  This module should be of interest to all specialist radiology registrars, whatever their final job plans, as a strong grounding in research methodology is crucial to understanding and implementing new radiological developments.  Specialist registrars with a particular interest in research may wish to consider taking back-to-back modules (6 months) or undertaking an externally funded higher research degree e.g. MD and advice and supervision could be offered for this within the INS.

The INS offers a strong research setting for undertaking this module.  The majority of current consultants are actively involved in ongoing research, with several having higher research degrees and University of Glasgow academic appointments.  A number are principal investigators on external funded grants.  Further, the department has previously supervised MD students from within radiology.  It is well placed for offering training in research methodology including study planning, data analysis, manuscript preparation and conference presentation.  Specialist registrars could either become involved in an ongoing research study or could initiate their own project.  Advice will be offered as to suitable studies that could be performed within the department.

Research studies could be focused either on diagnostic imaging modalities such as MRI, CT, DSA or SPECT, allowing the trainee to gain a more detailed understanding of this technology, or on neurointerventional practice.  The recent installation of a 3T MRI, the only such magnet in Scotland, offers a unique opportunity for MR research, with a wide range of capabilities including MR spectroscopy, angiography and diffusion tensor imaging.  Further, trainees can access the 7T University of Glasgow magnet, for in vitro or animal studies.  Our department has a long history and wide experience of CT research, including CT angiography and perfusion and has a strong academic neurointerventional interest.

  • Sample Rota
 Monday  Tuesday  Wednesday  Thursday  Friday
 AM  Research  Duty Radiologist  Clinical Governance/ Teaching  Research Duty Radiologist
 PM  Research  Study Session  MRI  Research  MRI

 


 

If you are interested in finding out more about either module, please contact Dr Jampana as the Educational Supervisor.  Potential weekly rotations and research studies can then be discussed with the relevant consultants.  It would be recommended that such discussions happen as far as possible in advance of the proposed module, to ensure adequate prior planning.

We look forward to welcoming you to the Institute.

Dr Ravi Jampana

(On behalf of all the staff in Dept of Clinical Neuroradiology)

 

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