Cardiothoracic Radiology

Course Director:

Dr. Elizabeth Lee

WELCOME to Thoracic Radiology! Details of your elective are listed below. Please contact either myself, or the elective coordinator, Kim Desbrough at 615-9016, or if questions arise.

Additional thoracic radiology educational materials.

Daily Clinical Activities

8:00 a.m. to 5:00 p.m. All activities take place in the Inpatient Chest Radiology Reading Room (B1D242 UH) behind the film loan desk on B1.

Week 1: Inpatient/Outpatient Chest Radiology Chest radiographs of all inpatients and outpatients including Taubman Center and University of Michigan Satellite clinics are interpreted on this rotation. Please introduce yourself to the radiology house officer assigned to Inpatient/Outpatient Chest. In general, the same resident will be there all week. The attending radiologists rotate on a daily basis. When two medical students are on the service, one should start on Inpatient and the other on ICU.

Week 2: ICU Radiology This includes chest radiographs of all ICU patients (TICU, NICU, BICU, CCU, CCMU, SICU). Again, please introduce yourself to the radiology house officer who will be on the rotation all week. Films are previewed by the resident and then reviewed with the attending. After the ICU reading is completed, you may wish to attend Inpatient/Outpatient Chest Reading to see if more cases are being interpreted.

Week 3: Chest CT Chest CT examinations are interpreted on this assignment, including standard chest CT, HRCT, thoracic aorta, pulmonary embolus, cardiac CT and airway examinations. Please introduce yourself to the house officers and attending radiologists on CT. CT-guided percutaneous lung biopsies, if scheduled, will be performed in the morning, typically between 8 a.m. and 12 p.m. You should check the schedule for the day or ask the resident/fellow you are working with on CT if there is a lung biopsy you can watch.

Week 4: Repeat Inpatient, ICU or Chest CT as desired


Attendance at the following conferences is expected during your Chest Radiology elective. If you have any questions regarding the time or location of any conference, please ask the radiology resident or attending you are working with.

Thursday, 7:45 a.m. - 8:30 a.m. Chest Interesting Case Conference, Room B1D246. (Not held every week. Please check schedule or ask resident/fellow/staff)

Wednesday 5:00 p.m. – 6:00 p.m. Radiology Grand Rounds, MCHC Auditorium


Four Chest Teaching File Cases

These may be cases you have seen during your rotation on Chest Radiology or while on any other rotation. Bear in mind that these cases will be used to create a student teaching file to be used by third and fourth year medical students in the future; your questions and discussion should therefore be aimed at a level your fellow students can understand and learn from. At the end of your rotation you should present your cases to Dr. Agarwal in power point format. Dr. Agarwal will review the cases with you at that time. After the presentation, please email an electronic copy of your presentation to Amy Spencer and Dr. Agarwal. This is a good learning experience and opportunity more for you than others, so please take this seriously.

Each case should include the following:

  1. Brief clinical history (you may wish to review the medical record for this) page 1
  2. Select 2-4 films for presentation.
  3. 1-4 questions regarding the films presented, such as.....What is the finding?...What is the differential diagnosis of this finding?...What is the best diagnosis? page 1
  4. Answers to the questions asked in #3. page 2
  5. A brief discussion of the finding, disease and/or the films as pertinent to the case. page 2

Note: You can get the relevant images directly from the careweb image viewer to create your powerpoint file.


Recommended Reading: These may be signed out from Amy, and must be returned at the end of your rotation, or your grade will be withheld.

  1. Clinical Radiology: The Essentials. Richard H. Daffner. (Williams & Wilkins, 1993)
  2. Fundamentals of Radiology (4th edition). Lucy Frank Squire & Robert A. Novelline

Additional Reading (can be checked out at the Taubman Library):

  1. Chest Roentgenology. Benjamin Felson. (W.B. Saunders, 1973) a timeless text
  2. A Radiologic Approach to Diseases of the Chest. IM Freundlich & DG Bragg. (Williams & Wilkins, 1992)
  3. Critical Care Imaging. Lawrence R. Goodman & Charles E. Putnam. (W.B. Saunders, 1992)
  4. Computed Tomography and Magnetic Resonance of the Thorax. Naidich, Zerhouni & Siegelman. (Raven Press 1991)
  5. High Resolution CT of the Lung. Richard Webb, Nestor Muller & David Naidich. (Raven Press, 1992)


Daily attendance and compiling the four (4) teaching file cases are required to pass the elective. A grade of high pass or honors can be achieved by completing additional work under the supervision of one of the chest radiology faculty. This may include additional teaching file cases, preparation of a case report, participation in or contribution to a research project, etc. The quality and intensity of the additional work completed will be evaluated in determining your grade. Bear in mind that extra work of poor quality may not merit a grade of high pass or honors. Similarly, a grade of high pass or honors may be achieved on the basis of an outstanding performance during the required daily clinical activities, attendance and the required teaching files.