Departments

The Body Imaging division at Yale consists of two cohesive sections (Abdominal Imaging and Ultrasound) whose faculty members provide world-class subspecialty clinical care across a wide range of diseases. Our commitment to clinical excellence, compassion for our patients, and reputation for progressive innovation has allowed us to remain on the forefront of clinical medicine. Equipped with cutting-edge technology, the section of Abdominal Imaging provides comprehensive Body MR, Body CT, and fluoroscopy imaging services that encompass a full range of diseases involving the abdomen and pelvis with a focus on high-end oncology imaging. The Ultrasound section offers a comprehensive range of imaging exams that encompass a wide-range of both vascular and non-vascular pathology. Our state-of-the-art equipment, coupled with our world-class facilities at both the Smilow Cancer Center and our various outpatient sites provide an unparalleled experience for all our patients.

The Center for Breast Cancer at Smilow Cancer Hospital and Yale Cancer Center provides coordinated, state-of-the-art care for patients with benign and malignant diseases of the breast. For patients diagnosed with breast cancer , we offer dedicated care, innovative treatment options, and cutting-edge research. A great deal of progress in the detection and treatment of breast cancer has been made in recent years, and our physicians are on the leading edge of finding even better solutions. Women with a diagnosis of breast cancer are cared for by a multidisciplinary team of physician specialists, including radiologists, breast surgeons, medical oncologists, radiation oncologists, pathologists, and plastic surgeons. From the tranquility of the building, to our complementary therapy services, to the most sophisticated personalized therapies and equipment available, Yale is committed to tailoring treatment to our patients to ensure they have the best experiences possible during their time in our care. Breast Surgery Although many general surgeons perform breast surgery, dedicated breast surgeons have the experience and knowledge to handle difficult or unusual cases, and are generally more likely to understand the complexities of breast diagnosis and treatment. The surgeons at the Center for Breast Cancer at Smilow Cancer Hospital and Yale Cancer Center perform breast surgery exclusively, and are nationally known as leaders in their field. Yale surgeons were among the first to perform a lumpectomy instead of a mastectomy, and were instrumental in the development of noninvasive procedures like sentinel lymph node biopsy, intraoperative guidance by ultrasound, and advanced oncoplastic procedures. Our surgeons are experienced in cutting-edge techniques, such as skin-sparing and nipple-sparing mastectomy, and often work hand-in-hand with our plastic surgeons to offer women a variety of options for breast reconstruction. Medical Oncology Many patients with breast cancer also need medical therapy, such as chemotherapy and/or endocrine therapy. Our team of experts utilizes both standard chemotherapies and novel targeted therapies to attack the cancer precisely while minimizing harm to normal tissues. Our medical oncologists are nationally recognized for their contributions to breast cancer research. For example, investigators at Yale helped to elucidate the biology of a cellular receptor called HER2. As a result, our medical oncologists have been successful in developing treatment strategies for HER2-positive breast cancer, and have extended this expertise to provide effective therapies for triple-negative/basal-like and hormone receptor-positive breast cancer. They continue to study new treatments, and patients at Smilow Cancer Hospital have the opportunity to receive such novel therapies through clinical trials, many of which are not available elsewhere in Connecticut. New and complicated patient cases are discussed weekly by the entire team so that

The dedicated pediatric hematologists and oncologists of the Yale Pediatric Hematology and Oncology Program provide comprehensive and compassionate care for children with all forms of cancer and blood diseases, including leukemia, malignant tumors and lymphomas, as well as sickle cell disease, hemophilia, coagulation abnormalities, and platelet disorders. Our program utilizes a team approach to care, and is active in research that seeks to advance the diagnosis and treatment of pediatric cancer and blood diseases. Cure rates continue to rise for children with cancer. At Yale, we are determined that more and more children will survive, and that they will thrive. We work to design treatments that cause less discomfort to patients in the short term and fewer serious complications in the long term. Smilow Cancer Hospital and Yale New Haven Children’s Hospital’s care team works with patients and their families to design individual treatment plans. In addition to an oncologist, our multidisciplinary team includes advanced practice providers, registered nurses, social workers, a psychologist, psychiatrist, neuropsychologist, nutritionist, and child life specialists, all who have expertise in the medical, social, emotional and educational needs of children and teens. Understanding that children with cancer and blood disorders need more than medical care, we work with patients and their families to help them meet their social, emotional, educational, and behavioral needs. Our support services include: Routine psychosocial evaluations for newly diagnosed patients and their families. Home visits for the most gravely ill or psychiatrically symptomatic children and their families. A school integration program that includes counseling for families and children about their rights to have special services. We work with school districts to make appropriate accommodations for students returning to school, including providing special education services, if necessary. Psychoeducation and neuropsychological testing for patients at risk for neurocognitive problems. Support groups for siblings and parents. End-of-life support team for children and families. HEROS Survivorship Program The HEROS (Health, Education, Research & Outcomes for Survivors of Childhood Cancer) Survivorship Program at Smilow promotes the lifelong health of pediatric cancer patients after their cancer treatment has ended.It was the first childhood cancer survivorship program in Connecticut to offer comprehensive care for adults and children who had survived pediatric cancer. In our specialty clinic, patients receive detailed cancer treatment summaries and an individualized schedule for future screening for chronic conditions related to their original cancer treatment. Our multidisciplinary team that includes a pediatric oncologist, nurse practitioner, psychologist, registered dietician, and nurse educator are committed to caring for each patient as a whole person and empowering survivors

The Yale Gamma Knife Center is the only stereotactic radiosurgery unit in Connecticut dedicated to treating head and neck conditions. Gamma Knife radiosurgery is a type of focused radiation therapy used to treat certain types of tumors or abnormalities in the brain, its covering, and nerves and blood vessels. It is an effective, noninvasive alternative to brain surgery. Gamma Knife offers similar precision to open surgery with general anesthesia but with fewer risks and discomfort.Gamma Knife radiosurgery requires no incision and is done under local anesthesia.It is a one-day outpatient procedure and rarely requires hospitalization. Most patients return to their normal activities within 24 hours of the procedure. The experts in our Gamma Knife Center have more than 30 years of combined experience in radiosurgery. Our team works together to deliver a strong dose of precisely focused radiation. Gamma Knife can be used for both children and adults who meet the criteria for treatment with this advanced technology. Conditions we treat include: Brain metastases, most commonly from lung cancer, melanoma, breast cancer, colon cancer, renal cell cancer, and gynecological and genitourinary cancers Benign brain tumors such as meningiomas, acoustic neuromas (i.e., vestibular schwannomas), and pituitary adenomas Arteriovenous malformations Trigeminal neuralgia Intraocular melanoma Head and neck cancers, such as nasopharyngeal carcinoma Recurrent malignant primary brain tumors Glomus jugulare tumors Essential tremor (thalamotomy with Gamma Knife)

Urologic cancers include prostate, bladder, kidney, urothelial upper tract, testicular, penile, and urethral cancer. The Smilow Cancer Hospital Prostate and Urologic Cancers Program at Yale Medicine is uniquely qualified to treat these cancers. Our program utilizes the most advanced technology and techniques available to diagnose, manage, and treat urologic cancers. We are leaders in the use of MRI/US Fusion prostate biopsy (which blends MRI and ultrasound for increased accuracy), utilizing the ExactVu and Artemis systems across the region. This technology allows us to detect the cancer early and closely monitor it. When surgery is needed, our urologists provide extensive expertise in nerve-sparing laparoscopic and robotic surgery, traditional open surgery, and novel targeted or “focal“ treatments. Our patients also benefit from the expertise of a collaborative approach to cancer care, which personalizes treatment. We engage experts who specialize in medical oncology, radiation oncology, surgical oncology, pathology, and diagnostic imaging. Patients also have access to caregivers who can help with the physical, emotional, and psychological issues related to these cancers. The extended team includes health educators, social workers, dieticians, and complementary therapists. Our goal is to ensure the highest standard of care to support our patients and their families. Imaging and Interventional Radiology Our radiologists are experts in magnetic resonance imaging (MRI), ultrasound, computed tomography (CT), and fluoroscopy, and combine their clinical expertise with advances in technology including MR-US fusion for prostate imaging, as well as positron emission tomography (PET) scans and advanced nuclear medicine scans. In addition, Blue Light™ Cystoscopy, an advanced endoscopic technology, is employed to improve bladder cancer detection and reduce risk of cancer recurrence. Surgery Our experienced urologic surgeons are committed to achieving optimal cancer outcomes, emphasizing organ preservation and the safeguarding of sexual and urinary function as much as possible. Through advanced techniques including minimally invasive and robotic surgery, our urologists are able to optimize both cancer care and surgical recovery. Cryoablation (tumor freezing) may be a good option for some patients with prostate or kidney tumors. Focal therapy is also available for appropriate patients with prostate cancer, as it is able to treat the cancer without the use of radiation or surgery, preserving the prostate, as well as urinary and sexual function. Similarly, for some patients with cancers of the ureter or upper urinary tract, a laser can be used to treat the tumor and preserve kidney function. Medical Oncology Chemotherapy is an important component of cancer care for many patients, as it can delay or prevent tumors from recurring when used before surgery. It can also help patients with advanced or metastatic disease. As a major national

Our physicians play a critical role in the timely diagnosis and management of acutely ill patients. As an integral part of a Level I trauma center, we provide comprehensive imaging services for our inpatients and outpatients. We provide highly specialized care in all areas of acute care imaging, and are pioneers in developing emergency radiology standards of care.

The Center for Thoracic Cancers at Smilow Cancer Hospital consists of a multidisciplinary team of experts dedicated to providing evaluation of and treatment for patients with a thoracic malignancy, including lung cancer, esophageal cancer, thymoma, or chest wall tumors. Patients in Connecticut and beyond have access to nationally recognized expert clinicians, who provide an organized, collaborative approach to cancer care, as well as the latest technologies and treatments. Our team consists of a collaboration of specialty physicians, including medical oncology, radiation oncology, thoracic surgery, pulmonary medicine, digestive diseases, pathology, diagnostic imaging, and nursing. In addition to our expert clinicians, patients also receive comprehensive care to help with the physical, emotional, and psychological issues that are part of confronting cancer. Patients also benefit from the attention of the team's care coordinators, who make management of even the most detailed multidisciplinary treatment plan less complicated. Our team is active in clinical research, and focuses on developing advances to care in areas of thoracic oncology where the standard treatment needs improvement and where the optimal treatment approach remains unclear. To provide the best care, most of our patients are enrolled in a clinical trial where they can receive innovative therapy for their advanced disease, including immunotherapy, which was first used in clinical trials at Smilow Cancer Hospital. The Center for Thoracic Cancers offers second opinions that are easy, convenient, and all done remotely. Call (203) 200-LUNG for more information and learn how to schedule a second opinion appointment with one of our providers. Medical Oncology Our medical oncologists are nationally recognized for their leadership and expertise in lung cancer treatment and research, and are dedicated to offering personalized treatment options. Biomarker testing is often performed on the tumor to look for specific mutations that can be targeted by medication. There are currently FDA-approved lung cancer treatments for tumors showing abnormalities in EGFR, KRAS, ALK, ROS1, BRAF V600E, MET, RET , and NTRK genes. Recent studies conducted at Yale have led to FDA approval of drugs for the treatment of lung cancer, such as the immunotherapy drug Tecentriq (atezolizumab), which has been proven to improve patient survival for newly diagnosed NSCLC. This drug is designed to block PD-L1, a protein that was discovered by scientists at Yale and that has been instrumental in improving survival for lung cancer patients. Another FDA-approved drug, osimertinib, which stemmed from Yale Cancer Center and Smilow Cancer Hospital researchers, was approved for the treatment of adults with early-stage NSCLC with EGFR gene mutations. Surgery Many patients in need of surgery are referred for a minimally invasive surgery known as a video-assisted thoracoscopi

Yale Cancer Center is Connecticut's only cancer center designated as a Comprehensive Cancer Center by the National Cancer Institute—and one of only 57 in the nation. The significance of this designation has profound implications for those who choose Smilow Cancer Hospital as the place where they will be cared for and receive treatment for their cancer. National Cancer Institute cancer centers are national leaders in cancer research, prevention, detection, and treatment. This provides patients at Smilow Cancer Hospital with novel treatment options and expert care.

Radiation is a critical part of treatment for almost all advanced head and neck cancers, and can be delivered alone or combined with chemotherapy before or after surgery. Precise radiation techniques are vital for patients with head and neck tumors, since crucial structures that are often very close to tumors must be avoided.Intensity modulated radiotherapy (IMRT) accurately targets tumors while minimizing damage to normal surrounding tissue.

The Pituitary Program is a destination center for the clinical management of pituitary, parasellar, and anterior skull base disease delivering state-of-the-art, multidisciplinary care. It is the referral center for the state of Connecticut for treatment of complex pituitary and sellar-parasellar pathology using the expertise of minimally invasive endoscopic skull base surgery jointly performed by neurosurgery and ENT. Patient cases are reviewed by a multidisciplinary pituitary tumor board, with intraoperative hormone monitoring, intraoperative MRI, and whole exome sequencing of tumors for potential genomic-based diagnosis and treatment. The Yale endocrinology team and other supporting subspecialties follow each patient during the hospitalization for uninterrupted endocrine care. We aim to maximize the quality of care and the ultimate outcome of each patient. To ensure the best care possible, we co-manage the pituitary disorder with each patient’s primary care physician, and actively seek second opinions, exploring dynamic testing and pituitary hormone replacement therapy options. Yale New Haven Hospital is a regional center for pituitary surgery, and our physicians have specific expertise in treating a variety of neuroendocrine diseases, including Cushing's disease and adult growth hormone deficiency syndrome. We also evaluate and treat reproductive disorders in collaboration with the sections of Reproductive Endocrinology and Infertility. Additionally, we work closely with colleagues in neurosurgery, surgical endocrinology, therapeutic radiology, and other departments to make sure patients benefit from our patient-centered, team-based approach. Combined with first-rate technology at Yale New Haven Hospital, the Yale Cancer Center and the Department of Neurosurgery’s Gamma Knife Center, the Pituitary Program is uniquely positioned to offer every diagnostic and treatment option available, including: Dynamic pituitary magnetic resonance imaging (MRI), an enhanced diagnostic imaging technique Inferior petrosal sinus sampling to sample hormones from the veins that drain the pituitary gland 3-D conformal radiotherapy to better target tumors Intensity-modulated radiation therapy, an advanced high-precision technique Transphenoidal surgery performed through the nose and sphenoid sinus Gamma Knife surgery (stereotactic radiosurgery) performed at the Gamma Knife Center, the only dedicated Gamma Knife facility in Connecticut. At Yale New Haven Children's Hospital, our longstanding pediatric endocrinology clinic provides the same services and excellence of care that adults receive.

An ultrasound is a high-frequency soundwave that can create images from inside the body. It is a commonly ordered diagnostic imaging tool used for screening and examining organs and tissues. It is often used to assist and guide doctors performing other medical procedures, such as biopsies. An ultrasound is painless and does not expose patients to any radiation. We specialize in both screening and diagnostic vascular ultrasound, including aortic aneurysm screening and follow-up post-aneurysm repair, evaluation of vascular access complications, arterial bypass graft surveillance, renal artery stenosis, venous thrombosis, and venous reflux.We also provide evaluation of dialysis fistulas and grafts, native peripheral arteries, and peripheral arterial disease. We have recently introduced two new ultrasound clinical applications that incorporate the latest advancements in technology: Elastography to assess liver fibrosis, and contrast-enhanced ultrasound of liver masses. Elastography to assess liver fibrosis This technique allows doctors to evaluate fibrosis in the liver while simultaneously assessing the liver with regular ultrasound to check for masses and other abnormalities. Noninvasive, image-guided elastography of the liver can accurately detect liver fibrosis, allowing patients with chronic liver disease to be safely monitored and avoid the risks associated with liver biopsy. We are also investigating elastography of lesions to determine if this technique can be used to differentiate between benign and malignant lesions. Contrast-enhanced ultrasound of liver masses The intravenous injection of microbubbles (tiny bubbles of gas), in combination with ultrasound, allows physicians to determine if a liver lesion is benign or malignant. This method can determine the risk of developing cancer or recurrence of a tumor in at-risk patients with cirrhosis, or those who have been treated with chemo or radiofrequency ablation for liver tumors. A relatively noninvasive procedure, this provides an alternative to the more invasive and costly computed tomography (CT) or magnetic resonance imaging (MRI) exams. We also perform many other services, such as: Fine-needle aspiration of the thyroid, parathyroid, and soft tissue masses Thyroid and parathyroid imaging Lymph node mapping prior to thyroidectomy, and screening for metastatic disease after a thyroidectomy Musculoskeletal ultrasound for ligament and tendon tears and joint abnormalities Evaluation of the anal sphincter and rectal cancer staging with transrectal ultrasound using the 360° Endorectal Probe Gynecological ultrasound, including first-trimester imaging, ovarian cancer screening, sonohysterography (ultrasound of the uterus), HyCoSy (ultrasound of the fallopian tubes), and other gynecologic imaging exams

Children’s safety is our top priority. Our dedicated radiologists are trained in pediatric radiology and provide compassionate and personalized care to each of our patients. We use advanced imaging techniques and work closely with pediatric providers to determine the best way to diagnose a specific problem. We maintain the highest standards of care and patient safety. For exams that require radiation, special attention is given to minimize the radiation dose during a child’s exam without affecting image quality. We offer the latest in technology and equipment, and utilize a variety of imaging techniques, such as fluoroscopy, ultrasound, computed tomography (CT), magnetic resonance imaging (MRI), and X-rays to accurately detect and diagnose disease.