FELLOWSHIP IN INTERVENTIONAL RADIOLOGY OF UNIVERSITY OF NAIROBI (Fell.Interv.Rad)

Introduction/ Program background

Interventional Radiology is a well-established minimally invasive clinical sub-specialty in radiology. It encompasses diagnostic and therapeutic procedures done under image guidance utilizing the latest of medical technologies. Procedures done cut across all medical disciplines and are integral in the day to day care of most patients. The performance of these procedures has associated responsibilities, impacts patient outcomes and has medico-legal consequences. As such they require appropriately trained interventional radiology physicians to offer these services.

Philosophy

Born out of the field of Diagnostic Radiology, IR requires a more clinical focus on initial consultation and post-procedural management, rather than its previous role of performing image-guided procedures. Interventional Radiology.

Rationale

Interventional radiology (IR) is a medical specialty that performs various minimally-invasive procedures.  IR performs both diagnostic and therapeutic procedures through very small incisions or body orifices. Diagnostic IR procedures are those intended to help make a diagnosis or guide further medical treatment, and include image-guided biopsy of a tumor or injection of an imaging contrast agent into a hollow structure, such as a blood vessel or a duct. By contrast, therapeutic IR procedures provide direct treatment—they include catheter-based medicine delivery, medical device placement (e.g., stents), and angioplasty of narrowed structures.

The main benefits of interventional radiology techniques are that they can reach the deep structures of the body through a body orifice or tiny incision using small needles and wires. That decreases risks, pain, and recovery compared to open procedures. Real-time visualization also allows precision guidance to the abnormality, making the procedure or diagnosis more accurate. These benefits are weighed against the additional risks of lack of immediate access to internal structures (should bleeding or a perforation occur), and the risks of radiation exposure such as cataracts and cancer.

Objectives

Our program is organized to provide comprehensive training and experience in both diagnostic and interventional radiology. Our goal is to produce graduates who are comfortable practicing independently in any field of radiology. From an IR perspective, our goal is to provide thorough training in the evaluation and management of patients requiring image-guided diagnostic vascular and interventional procedures and a supervised experience in the performance of imaging-guided treatment. Interventional procedures are guided by a number of imaging modalities including fluoroscopy, angiography, ultrasound and computed tomography. Our program is structured to ensure our graduates have the ability to interpret all forms of diagnostic imaging and to perform a broad range of vascular and interventional procedures.

In addition, the program is structured to enhance the trainee's knowledge of the signs and symptoms of disorders amenable to diagnosis and/or treatment by image-guided techniques. An understanding of the symptoms, as well as the pathophysiology and natural history of the disorders is fostered. The trainee will know the indications and contraindications to vascular and interventional procedures, as well as understand the medical and surgical alternatives to those procedures. The trainee will become skilled in the technical aspects of percutaneous procedures and will develop a complete understanding of the imaging methods used to guide the percutaneous procedures.