Dr Chandra with a stent retriever |
The field of radiology has come a long way since Wilhelm
Conrad Roentgen’s discovery of X-rays in 1895. Ultrasound and nuclear medicine,
computerised tomography (CT) and magnetic resonance imaging (MRI) are all
commonplace techniques that aid in the diagnosis of disease.
What is not commonly known is that radiologists now do far
more than sit in a dark room interpreting images and writing reports for other
doctors.
Many of the Monash Imaging radiologists (Prof Stuckey front, centre) |
Monash University’s Dr Ronil Chandra is an interventional
radiologist at Monash Imaging, the largest academic imaging department in
Australia. Monash Imaging is also unique
with its own university department, at Monash University’s School of Clinical
Sciences at Monash Health.
Dr Chandra did his medical training in Melbourne, before
specialising in radiology at Massachusetts General Hospital, Boston and Harvard
Medical School. Having trained and worked with some of the world’s
best radiologists, Dr Chandra believes the imaging services provided at Monash
Health are as good as anywhere in the world.
“We do amazing work
here but very few people know about it,” says Director, Monash Imaging at
Monash Health and Head of Department of Imaging at Monash University, Professor
Stephen Stuckey.
“We have more than 430 staff including radiologists, imaging
technologists, nurses and support staff who support, perform or interpret over
325,000 imaging examinations every year at Monash Imaging—and we also publish
over 50 peer-reviewed papers annually, making us one of the most academically
productive imaging departments in the country.”
“More than half of all Monash Health Emergency Department
patients and almost all patients admitted to our hospitals are serviced by our
Department of Imaging,” says Professor Stuckey.
There are a number of sub-specialists in the Monash Imaging
team, including nine specialist interventional radiologists. When not interpreting an image,
interventional radiologists may be found inserting a stent into a patient’s
brain to remove a blood clot or to treat a brain aneurysm.
Professor Stuckey says interventional radiologists use
minimally invasive techniques to treat patients for a range of conditions
including cancer, stroke, brain aneurysms and spinal injuries.
”We navigate the body’s natural highways to stop a bleed in
the brain, remove a blood clot or to deliver chemotherapeutic agents directly
to a cancer site,” says Dr Chandra. “Recent advances in imaging technology are
driving this rapid change in clinical practice.”
“Five years ago, a standard CT scan for an emergency patient
with acute stroke had fewer than 100 images—now standard CT imaging contains
3000 images,” says Dr Chandra.
“Radiologists need to analyse those images extremely fast to determine
the best treatments.”
Radiologists are critical members of the medical team,
facilitating rapid diagnosis of cause of illness with imaging techniques, and
are increasingly integrated into treatment paradigms using minimally invasive
interventional radiology techniques,” he says.
“Our team has become so clinical we see patients in clinic,
do ward rounds in ICU and run infusions in the ICU.”
“The reality these days is patients don’t always have a
surgeon—they have an interventional radiologist.”
In recognition of their expertise, Monash Medical Centre has
recently been designated the second endovascular clot retrieval site in
Victoria, with the largest patient catchment area.
“Stroke patients arriving at Monash Medical Centre are met
by a multidisciplinary team of specialists including interventional
radiologists and stroke physicians, who aim to remove a clot from a patient’s
brain in under 60 minutes,” says Dr Chandra.
“We remove clots by inserting a stent retriever into the
femoral artery in the patient’s groin and navigating up the neck and into the
head.”
“Patients come in unable to speak or move, and as soon as we
pull out the clot, they’ve recovered.
Their paralysis is gone.”
“The bottom line is we convert these patients from severe
stroke to no stroke or mild stroke, and then they recover,” says Dr Chandra.
Before these techniques were available, patients either died
or were left significantly disabled— these minimally invasive techniques not
only save lives but patients are usually eligible to go home after 24-48 hours.
Dr Chandra says that while the procedures are costly, the
economic benefit to the community is enormous.
“We’re saving on rehabilitation costs and reducing nursing
home admissions. Most importantly, we’re returning people back to their
families and back to normal life—that is priceless.”
International Day of Radiology is 8 November, the
anniversary of Wilhelm
Conrad Roentgen’s discovery of X-rays in 1895.
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