Imaging Sciences and Intervention Radiology Department

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Faculty
Facilities
256 SLICE CT SCANER (Philips Brilliance 256 slice)

The multi slice CT has revolutionized cross sectional imaging with exquisitely detailed multiplanar depiction of human anatomy and functional details. 256-slice is one of the most advanced CT systems in the world. It delivers high image quality, dose efficiency and rapid reconstruction times and can carryout a full body scan in less than a minute.

Features and applications

Expand clinical boundaries in neuro, cardiac, pulmonary, trauma and pediatric imaging
Acquire 80mm of coverage in every rotation with sub millimeter isotropic accuracy.
Best-in-class reconstruction speeds using 3-D cone beam reconstruction.
Efficient X-ray tube eliminates waiting times between scanning sequences and enhances workflow.
Advanced whole brain perfusion creates instant blood volume and blood flow maps to guide timely treatment of ischaemic stroke.
Comprehensive cardiac analysis with coronary CT angiogram and cardiac function analysis for more complete care.
Non invasive cardiac perfusion assessment.
Advanced 3D imaging
Carotid, cerebral, aortic and peripheral angiograms.
Lung emphysema quantification for pre-surgical assessment.
Lung nodule protocol to improve nodule detection sensitivity.
Virtual endoscopy to perform and interpret exams more quickly.
Bone mineral densitometry for quantitative analysis of osteoporosis.
Body perfusion scan to asses the nature of the mass lesion.
Dental CT and 3D face for enhancing surgery.
DUAL SLICE CT Scanner (GE)

Dual slice (multislice) CT provides speed, resolution, image quality, reduced dose, and coverage optimal for an emergency CT study. Sub millimeter slice thickness provides the high spatial resolution required for the visualization of small anatomy. Speed is sufficient to perform more aggressive studies like CT angiograms.

MAGNETIC RESONANCE IMAGING (Siements Avanto 1.5T)

High end award winning 1.5T MR system, capable of performing one of the most comprehensive applications ranges available today. The unique combination of leading magnet and gradient technology together with revolutionary image acquisition techniques provides unsurpassed clinical benefits. Excellent and efficient parallel imaging technique enhances the flexibility, accuracy and speed of imaging examinations.

Features and applications

The revolutionary parallel imaging (Tim - Total image matrix) technology.
Equipped with strongest gradient in the industry - SQ-engine.
Ultra lightweight coils and low to the floor assures high level of comfort for even very ill patients
Advanced neuro imaging: Multi nuclear MR Spectroscopy, diffusion tensor imaging, tractography, susceptibility weighted imaging, dynamic perfusion, functional MRI
Non contrast (ASL - Arterial Spin Labeling) high spatial resolution perfusion imaging for evaluation of stroke, tumors, degenerative diseases, epilepsy.
4D MRA in all body parts with low contrast dose.
Comprehensive advanced cardiac imaging covering morphology, function, dynamic imaging, tissue characterization, coronary imaging, plaque characterization, myocardial viability study and more.
Free breathing high resolution body imaging.
Fast comprehensive whole body imaging and central nervous system survey.
DIGITAL SUBTRACTION ANGIOGRAPHY (GE Innova 4100 biplane)

The DSA system equipped with biplane detectors give breathtaking fluoroscopy and outstanding angiography and is one of the most advanced DSA systems in the world. This dedicated neuro vascular DSA system with large 40 x 40cms size flat panel tremendously decrease procedure time and radiation to the patient.

The superb image quality and advanced 3D tools help in confident decision making during all kinds of endovascular procedures. High resolution imaging by the fixed X-ray system provides crisp, virtually distortion-free visualization of small details and objects to support endovascular interventions, including intracranial aneurysm coiling and carotid stenting procedures.

Features and applications

Neuro vascular cath lab dedicated for all intra cranial and extra cranial interventional procedures.
Very high detector efficiency lowers the radiation dose for patients and staff.
State of the art 3D-rotational angiogram (3D RA)
Biplane configuration and 3D RA reduces procedure time significantly.
CT like image acquisition (3D-CT) facilitates in aggressive emergency management.
Peripheral angiogram with bolus chasing significantly reduces examination time, radiation and contrast doses.
Ultrasound system - Philips iU22

The premium performance ultrasound system captures crisp, high-resolution images even in technically challenging situations. It makes easy to add 3D imaging to any exam by removing the barriers to volume imaging and a host of workflow enhancers facilitate faster exams, enabling perfect image optimization.

Features

Obtain exceptional 2D and 3D image quality from a single transducer.
Real-time, simultaneous imaging in two planes.
Volume viewing on any PACS.
Multi planar reconstruction of volume data.
Enhancements in superficial soft tissue imaging.
Whole body contrast-enhanced ultrasound.
State of the art strain based elastography and sono CT.
Dedicated medical instrument navigation system guiding soft tissue biopsy and ablation procedures.
Appreciable reduction in examination time, pain and fatigue related to exam.
PACS (Picture archiving and communication system) - Agfa IMPAX

Makes the department more efficient, enables increased productivity, and allows department to more effectively serve hospital staff, patients, and referring physicians. It forms a comprehensive, fully-integrated solution that meets all digital needs. In addition to RIS, the system features state of the art Picture Archiving and Communication System (PACS), medical reporting, solution monitoring & management services (SMMS), and audit services. Integrated with other hospital systems, such as hospital information systems (HIS) and Electronic Patient Records (EPR), the benefits of RIS extend well beyond radiology.

Features

Powerful and flexible electronic order handling and scheduling.
Scanning of Paper Forms.
Easy and efficient patient registration.
Comprehensive work list generation.
Full integration of PACS and RIS related information with speech recognition.
Powerful transcription functions.
Shorter report turnaround times with flexible results distribution.
Automatic billing data transmission.
Delivery of professional-quality reports with Business Intelligence Module.
Integrated image processing tools to enhance the workflow.
Advanced security system enabling compliance with HIPAA and other security standards.
Efficient radiation management.
Support of international finding codes such as ICD, SNOMED and ACR.
Multi-lingual capabilities.
Highly flexible and modular system, easy to add modules, allow the addition of functional extensions for other specialties.
Results distribution to clinicians via EPR integration, web portals or wireless devices.
Radiofrequency Ablation - Celon POWER

Radiofrequency ablation system provides the latest innovative radiofrequency technology for the precise and efficient ablation of tumors, varicose veins, inter vertebral disc diseases, denervation and other diseases using bipolar radiofrequency. Main benefit of the bipolar technology is the restriction of radiofrequency current flow to the volume under treatment (e.g. tumour), as a result of which undesirable side-effects are avoided. In addition to the above, no neutral electrodes are required, which means simplification of the patient's preparation, cost reduction and increased safety.

Features

Latest and most promising non surgical treatment for patients with tumors.
Very high level of patient acceptability with no evidence of significant complications.
Effective treatment for small tumors and other specified diseases.
Minimally invasive, with no skin incision.
Typically little or no pain.
Minimal hospital stay.
Can be repeated if needed.
Computed and Digital Radiography (CR and DR) - Agfa and Cura

Flexible, high quality digital imaging solution enables seamless integration of the X-ray generator with the hospital or radiology information system. Innovative high end advanced flat panel detectors provide outstanding image quality, optimal workflow and operability.

Features

Virtually unlimited positioning freedom.
Auto-positioning.
Software to enhance image quality and workflow.
Appreciable reduction in examination time.
Superb image quality and potential for dose reduction.
Supports general radiology, including full leg, full spine, extremities, neonatal and pediatric applications.
Optimizes cassette based workflow with drop-and-go buffer.
High throughput and fast preview of images.
Small footprint - better management of available space.
DICOM connectivity and integration.
Mentors

Prof. Mahadevan Pillai was born in Kayamkulam (Kerala) in 1908. He took his medical training at Vizag Medical college. After completing a Diploma in Medical Radiology from UK, he worked in the Dept of Radiology at Madras Medical College (Barnard Institute). It is here that he popularized the use of neuroradiological investigations, in association with Dr.Ramamurthi. After short stints as professor of radiology at NIMHANS and Medical College Trivandrum, he joined the institute as the head of the department of radiology. He retained the position from 1975 to 1979. During his tenure at this department, he set high standards of quality for radiological investigations.

Prof.Sashidharan who graduated from Banaras Hindu University and also completed his postgraduate training in radiology at the same institute and joined the institute as an assistant professor in 1976. He was later promoted to the post of associate professor and then headed the department from 1981 - 1983.

Prof.V.R.K.Rao (Vedula Rajani Kanth Rao) was born at Anakapalle in Andhra Pradesh in 1948. He graduated from Andhra Medical College, Visakhapatnam in 1970 and pursued his postgraduate program in Radiology at Safdarjang Hospital, Delhi University and at Banaras Hindu University. He joined the department as Assistant Professor in Radiology in early 1977 and later was in charge of the department from 1986 till 1993 as Professor and Head. He contributed to the birth and growth of Interventional Radiology at this Institute with recognition of the Institute at the national level. Simultaneously useful efforts were made by him to develop biomaterials for Therapeutic Endovascular Neurointervention.

Prof. Kolathu Ravi Mandalam was born in New Delhi in 1954. He graduated from Maulana Azad Medical College, New Delhi and completed his post graduation in radiology from the same institute. After a short period of residency at Safdarjung Hospital, New Delhi, he joined the Department of radiology at SCTIMST. As a team with Prof.V.R.K. Rao and later as the head of the department, he has guided the department to national fame in the field of diagnostic and interventional cardiovascular radiology.

Services

The department of Imaging Sciences & interventional Radiology as the name suggests, caters to all the diagnostic & interventional needs of the institute. The department has - Xray machines. X-ray of all body parts as needed can be taken. There are also 4 mobile units which are used to take x-rays of patients who cannot be moved to the x-ray unit. For these patients, X-ray can be taken in the bed itself.

ULTRASOUND/ COLOUR DOPPLER:

Ultrasound scanning for all body parts can be carried out at the department when necessary. Doppler imaging can be carried out for the neck & peripheral arteries & veins as also for the visceral vessels. Transcranial arterial doppler can also be done. Ultrasound guided intervnetional procedures performed in the department include aspiration, biopsies, pseudoaneurysm occlusion to name a few.

CT:

With the state of art CT scanner, the department caters to all types of CT studies such as non contrast & contrast studies of the brain, abdomen, lung. Cardiac CT, coronary CT, CT angiography for the vessels of the brain, abdomen, lung and peripheral arteries can also be performed.

Entire range of CT guided interventional procedures like aspiration / biopsy and therapeutic procedures like CT guided drainage procedures, ablation of tumors, CT guided alcohol injection into vertebral tumors, CT guided laser ablation of osteoid osteoma ( a bone tumor ) etc are performed.

MRI:

MR offers a vide range of diagnostic options. This includes routine imaging as also advanced imaging protocols. These include Cardiac MRI, MR angiography, diffusion weighted imaging, perfusion weighted imaging, MR spectroscopy, Diffusion tensor imaging, functional MRI.

DIGITAL SUBSTRACTION ANGIOGRAHY UNIT:

The department offers services for a wide variety of vascular lesions - intracranial as also extracranial. This includes peripheral arterial angioplasty, intracranial aneurysm coiling, intracranial arteriovenous malformation embolisation, embolisation of spinal vascular malformations, tumour embolisation, vertebroplasty to name a few. A detailed list of these procedures can be obtained from the website.

Neuro endovascular and Interventional Radiological Procedures

Endovascular Angioplasty (PTA & STENTING)
Endovascular Thrombolysis
Endovascular Embolization
Aneurysms
AVMs
VOGM
Non Galenic AV Fistulas
Dural arteriovenous fistula (DAVF)
Carotid-cavernous fistula (CCF)
Spinal vascular malformation.
Craniofacial vascular malformation.
HNF Tumours
Spinal tumours.
Epistaxis
Post traumatic arteriovenous fistula
Traumatic arterial Injuries
Endovascular Treatment of Vasospasm
Papavarine infusion
Balloon Angioplasty
Endovascular Blood sampling from
Inferior Petrosal sinus and cavernous sinus
Miscellaneous endovascular Procedure
Superselective Chemotherapy of brain tumours
Temporary balloon occlusion test of the internal carotid artery
Wada's test
Direct percutaneous glue injection in tumours.

Peripheral Endovascular and Intervention Radiological Procedures

Arterial Endovascular Percutaneous Tranluminal non-coronary angioplasty and /or stenting of
Endovascular Thrombolysis
Peripheral vascular occlusion
Acute thromboembolism
Vascular graft occlusion
Endovascular Embolization
Peripheral aneurysm embolization
Peripheral AVM embolization
Pulmonary AVM/AVF embolization
Hemoptysis
Gastro intestinal bleeding
Epistaxis
Uterine artery embolization
Testicular vein embolization vericoceles
Ovarian Vein embolization
Acute haematuria due to disease process or post nephrostomy
Aortopulmonary collaterals before or after surgery for congenital heart disease
Endovascular Peripheral AVF Closure
Stent Graft placements
Endovascular Venous Procedures
Superior Vena caval venoplasty and stenting
Inferior Vena cava venoplasty and stenting
Inferior Vena cava filter placement for deep vein thrombosis
Varicose vein ablation using laser or radio frequency.

Non- Vascular Intervention

Musculoskeletal procedure and Backache Management
Percutaneous vertebroplasty
Steroid injection for painful facet joint
Epidural injection of steroid / xylocaine.
Laser Assisted nonvascular intervention
Percutaneous laser disc decompression.
Laser ablation of osteoid osteoma.
Trachea Bronchial Procedures
Tracheal stenting
Laser ablation of bronchial tumours.
Biopsy of lung, mediastinum and chest wall
Miscellaneous Procedures
Laser of RF ablation of tumours of liver, bone, lung and other organs.
Abscess drainage
Retrieval of foreign bodies
Biopsy of abdominal lesion
CT/US guided aspiration
CT/US guided needle biopsy
Emergency Procedures
Thrombolysis of Acute stroke syndrome
Acute tumour bleeding
Acute epistaxis
Intracranial Aneurysmal Bleed
Treatment of cerebral Vasospasm
Angioplasty of vasospasm
Posttraumatic facial or nasal bleeding
Carotid and vertebral injury embolization
Acute Gastrointestinal bleeding
Embolization of acute hematuria
Embolization of Primary or secondary Postpartum bleeding
Embolization Acute bleeding from gynecological Malignancy
Embolization Acute Mesentric Ischemia
Embolization Acute bleeding from Nasopharyngeal Angiofibroma
Embolization of Aortopulmonary collaterals in emergency for congenital heart disease

Ongoing Projects
  1. Indo - Italian Collaborative project: "Brain MRI studies of motor and behavioral function in health and disease, with particular emphasis on stroke" Indian Collaborator : Prof. A.K. Gupta, Italian Collaborator:Prof. Marco Fiorelli
  2. Development of iron oxide nanoparticle probes for organ specific molecular MR imaging" funded by BRNS was started. PI: Dr.Jayasree
  3. Multimodality neuroimaging in presurgical work up of patients with temporal lobe epilepsy (TLE) -Principal Investigator, funded by Kerala State Council for Science, Technology and Environment PI: Dr.C.Kesavadas
  4. A post-marketing safety study in patients with moderate renal insufficiency who receive OMNISCAN (Gadodiamide Injection) for contrast-enhanced magnetic resonance imaging (MRI) PI : Dr.C.Kesavadas, Multicenter trial
  5. Development of Neurofeedback system using EEG and realtime fMRI Collaborative Project with Scientists & Technologists of Indian Origin Abroad Programme of Department of Science & Technology, Govt. of India
  6. Self-Regulation of Broca's Area ((right inferior frontal gyrus) using Real time fMRI in Post Stroke Aphasia patients - Dr,C.Kesavadas, Department of Biotechnology, Govt. of India
  7. Improving epilepsy localisation in lesion negative focal epilepsy using EEG-fMRI - Dr.Kesavadas, funded by DBT, Govt. of India
  8. Collaborating with the Center of Excellence in Magnetic Resonance Imaging: SWI imaging with Prof.Mark E Haacke, The Magnetic Resonance Institute for Biomedical Research, Detroit, MI, USA PI: Dr. B Thomas
  9. Development and evaluation of a non- rebreathing sequential gas delivery circuit to maintain constant end tidal Carbon dioxide (ETCO2), to be used for Cerebro Vascular Reactivity (CVR) assessment using fMRI and allied techniques. PI; Dr. B.Thomas ( Institute funding for faculty)
  10. Multimodality Plaque Imaging: Comparison of contrast enhanced USG, CT and MRI. PI. Dr. Divyata Hingwala, (Institute funding for residents)
Publications
(Peer reviewed & indexed articles since the last 5 years 2005 to 2010)
(Only articles with the first author from radiology department is included)
  1. Suboptimal Contrast Opacification of Dynamic Head and Neck MR Angiography due to Venous Stasis and Reflux: Technical Considerations for Optimization. Hingwala DR, Thomas B, Kesavadas C, Kapilamoorthy TR. AJNR Am J Neuroradiol. 2010 Dec 2 [Epub ahead of print]
  2. Susceptibility weighted imaging in cerebral hypoperfusion-can we predict increased oxygen extraction fraction? Kesavadas C, Santhosh K, Thomas B. Neuroradiology. 2010 Nov;52(11):1047-54.
  3. Leukoencephalopathy with brainstem and spinal cord involvement and lactate elevation: A rare white matter disease with characteristic magnetic resonance imaging findings. Sen A, Wattamwar PR, Thomas B, Nair M. Neurol India. 2010 Nov-Dec;58(6):958-60.
  4. Advanced magnetic resonance imaging with histopathological correlation in papillary tumor of pineal region: Report of a case and review of literature. Vaghela V, Radhakrishnan N, Radhakrishnan VV, Menon G, Kesavadas C, Thomas B. Neurol India. 2010 Nov-Dec;58(6):928-32
  5. Pendharkar HS, Thomas B, Gupta AK. Susceptibility-weighted imaging incapillary telangiectasia. Neurol India. 2010 Jul-Aug;58(4):618-9.
  6. Thomas B. Diffusion tensor imaging: A colorful collage or a clinical tool? Neurol India. 2010 Nov-Dec;58(6):877-8. PubMed PMID: 21150053.
  7. Jayasree.R.S, Gupta.A.K, Vivek.V and Nayar.V.U, Spectroscopic and thermal analysis of a Submandibular Sialolith of Wharton's Duct resected using Nd:YAG laser, Lasers Med Sci. 23, 125-129, 2009
  8. Ariya Saraswathy, Jayasree.R.S, Baiju.K.V, Gupta.A.K, Mahadevan Pillai.V.P, Optimum wavelength for the demarcation of brain tumour using autofluorescence spectroscopy, Photo medicine and Laser Surgery, 27(3):425-33, 2009.
  9. Jayasree.R.S, Gupta A.K, Mira Mohanty, Narendra. K.B., Effect of 980 nm diode laser and 1064 nm Nd:YAG laser on the inter vertebral disc-in vitro and in vivo studies, Photo medicine and Laser Surgery, 27(4):547-52, 2009
  10. R.S.Jayasree,V.U.Nayar and V.Jordanovska Vibrational Spectra of Mono, Di and Tri Methyl Ammonium Double Sulphates of Rare Earths Pr, Nd, Ho and Eu, Spectrochim Acta, 65A, 278-284, 2006
Patents
Research
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