Division of Cardiothoracic Imaging
The Division of Cardiothoracic Imaging provides comprehensive, integrative services for pulmonary and cardiac diseases in the emergency, inpatient and outpatient settings. Our board certified, specialty-trained radiologists work closely with referring clinicians from various clinical services, including Montefiore Einstein Center for Heart and Vascular Care, Montefiore Einstein Center for Cancer Care, Children's Hospital at Montefiore, the Departments of Surgery and Radiation Oncology, and the Divisions of Pulmonary Medicine and Critical Care Medicine.
Each diagnostic study and interventional procedure is individually tailored to optimize diagnostic accuracy, procedural planning, medical therapy and patient follow-up. The modalities utilized are radiography, computed tomography (CT) and angiography (CTA), and magnetic resonance imaging (MRI).
The Division of Cardiothoracic Imaging at Montefiore plays a key role in teaching students of Albert Einstein College of Medicine during their required third-year clerkship and during their fourth-year clinical and research electives. All radiology residents spend a significant portion of their time learning both cardiac and thoracic cross-sectional imaging modalities as well as radiography in the intensive care and emergency settings. The division is also actively involved in interdisciplinary education.
The Division of Cardiothoracic Imaging is active in many diverse areas involving the screening, diagnosis and treatment of a wide variety of conditions.
Using primarily radiography and CT, we evaluate a wide variety of disease processes within the chest, including pneumonia, lung cancer, interstitial lung disease, chronic obstructive pulmonary disease (COPD), sarcoidosis, pulmonary embolism and aortic aneurysm, in addition to dissection and imaging in the intensive care and emergency room settings. Our Division is working closely with the lung transplantation team.
Cardiac CT and MR are widely utilized to evaluate both acquired and congenital heart disease. Our cardiac imaging team uses state-of-the-art workstations to perform sophisticated clinical analyses that guide therapy and to pursue an active research agenda.
CT coronary angiography uses leading-edge, noninvasive technology to assess coronary artery disease by taking three-dimensional images of the arteries. The approach reduces the number of patients who need conventional angiography, and it is used to determine whether the patient is safe to be discharged from our emergency department. Additionally, cardiac CT-calculated calcium scores help clinicians risk-stratify patients, even in the emergency setting.
Before and after repair, cardiac MR is used widely to evaluate ischemic and nonischemic cardiomyopathy and congenital cardiac anomalies. Imaging techniques are used extensively as planning tools for interventional and minimally invasive cardiac procedures, including transcatheter aortic valve replacement (TAVR) for the treatment of aortic stenosis and pulmonary vein ablation in the setting of atrial fibrillation.
Lung Cancer Screening
Montefiore's lung cancer screening program for high-risk patients uses low-dose CT to help detect the disease at its earliest, most treatable stage, before the patient has become symptomatic. The program is coordinated by a team of experts from multiple specialties. Patients can be referred for a biopsy and, if cancer is discovered, to the Lung Cancer Program at Montefiore Einstein Center for Cancer Care. Our screening program is accredited by the American College of Radiology and participates in the national registry.
Using state-of-the-art technologies, we perform image-guided biopsies of lesions of the lung, pleura, mediastinum and chest wall. These procedures—often performed on an outpatient, ambulatory basis—combine careful attention to patient safety with diagnostic efficacy to provide percutaneous access to tissue diagnosis.
The Cardiothoracic Radiology Section is actively involved in multidisciplinary, collaborative clinical research in the various aspects of cardiac and pulmonary disease, and it recently was awarded a grant from the American Heart Association.
The Cardiothoracic Imaging Fellowship at Montefiore Medical Center and Albert Einstein College of Medicine offers two positions each year with comprehensive training in plain film and cross-sectional imaging of the thorax and cardiovascular system as well as image-guided interventional procedures.