Neuro-Radiology/Interventional Neuro-Radiology

Hoag offers five dedicated neuro-radiologists, and the latest advances in imaging. These resources are shared by our various programs. Its latest generation multidetector CT scanners are capable not onlyof routine anatomic imaging but also techniques important for measuring blood volume and perfusion imaging, permeability imaging (to address blood brain barrier breakdown issues), and all forms of 3-dimensional reconstruction. Dynamic angiographic data can also be obtained regarding sites of blood vessel blockage, tumor blood supply and its changes with treatment. Hoag’s multiple MRI scanners include two high field 3-Tesla instruments capable of advanced high resolution routine brain imaging, functional brain MRI, diffusion tensor imaging which allows analysis of white matter pathways through which tumors can spread, chemical analysis of brain tissue using MRI spectroscopy, as well as additional forms of brain perfusion imaging, all with 3-dimensional capabilities.

Recently, Hoag added the PET/MR scanner, one of only two such instruments available for clinical use in California. Also, the addition of the 3D Lab, which allows dedicated staff to reconstruct images in preparation for surgical procedures as well as allow neurologists to immediately diagnose neuro perfusion imaging so the physicians can make immediate decisions regarding the need to invasively treat patients.

After reconstruction, CT and MR images can be fed into a computer, which guides stereotactic vascular intervention, radiosurgery or conventional brain surgery during the procedure. All these techniques are vitally useful to the interventional radiologists to assess results post intervention and the surgeon in the precise resection of a tumor, and overall diagnostic expertise.

The latest 3-dimensional conventional angiographic techniques greatly facilitate minimally invasive threading of tiny catheter tubing through the blood stream to the brain, injecting dye, and reconstructing fine anatomic detail of the vascular tree, permitting delivery of focused chemotherapy to small segments of abnormal brain tissue, extracting clots, or placing microcoils to seal ruptured vessels.

Hoag’s neuro-interventional radiologists collectively have the greatest amount of experience in Orange County with treatment of strokes, aneurysms, and AVMs using non-invasive image-guided endovascular techniques. Hoag’s advanced imaging team supports the image-guided stereotactic and functional neurosurgery teams in their approach to brain tumors and epilepsy surgery.

Hoag continues to be recognized since 2008 as #1 in Orange County for Stroke and the treatment of stroke using state-of-the art imaging equipment while using the least amount of radiation to obtain the most precise results.

Clinical Research

Wallace Peck (IR): Penumbra CLP 4853.A: A randomized, concurrent controlled trial to assess the safety and effectiveness of the Separator 3D as a component of the Penumbra System in the revascularization of large vessel occlusion in acute ischemic stroke.

Michael Brant-Zawadzki: Penumbra, Inc: ACE “An Aneurysm Coiling Efficiency Study of the Penumbra Coil 400 System.”

Richard Rhee (Radiology): Clinical Development and Evaluation of the Nociscan™ Diagnostic Software Suite for Post- Processing MRI and MR Spectroscopy (MRS) of Lumbar Intervertebral Discs to Diagnose Disc Pain and Degeneration