The imaging department at Harefield Hospital is a progressive and modern department specialising in whole sprectrum of cardiac, thoracic and non-invasive vascular imaging. It provides specialist imaging service to support cardiology, thoracic medicine, cardiac and thoracic surgery respiratory including heart and lung transplantation.
The department provides secondary and tertiary services to local as well as wider population. It is one of the largest cardiac imaging department in UK in clinical activity and also has active research programmes.
The department performs chest radiography (including some general radiography), fluoroscopic procedures, ultrasound (US) and Doppler scans, echocardiography, nuclear medicine (both cardiac and non-cardiac), multi-slice computed tomography (MSCT) and magnetic resonance imaging (MRI) scanning related to above specialities. We also perform US and MSCT-guided thoracic and other invasive procedures.
Radiofrequency ablation of lung tumours is performed under CT guidance.
Catheter laboratories are located within and managed by the imaging department with most of the procedures being performed by the cardiologists. PET-CT service is provided for Harefield patients at an external site.
The department is equipped with Agfa Impax system with access to all imaging from anywhere within the Trust.
The department undertakes both NHS and private work.
Meet the team
Imaging services manager
- Juliette Tenant
Consultants
- Dr Simon Padley, director of radiology
- Dr Paras Dalal MRCP FRCR, lead for thoracic and oncology imaging
- Dr Tarun K Mittal MD FRCR, lead for cardiac CT
- Dr Evangelos Skondras consultant cardiothoracic radiologist
- Professor Dudley Pennell, head of heart assessment
- Professor Richard Underwood, lead for nuclear medicine
- Dr Joyce Wong MRCP, lead for cardiac MRI
- Dr Georgia Keramida, consultant in nuclear medicine
- Dr Shelley Rahman Haley MRCP, lead for echocardiography
PACS manager
Mr Adam Bell
Featured in the press
As part of the Channel 4 primetime documentary ‘How to Lose Weight Well’, presenter Dr Alexander van Tulleken visited Harefield to speak with consultant cardiothoracic radiologist Dr Paras Dalal, ‘an expert in radiofrequency’, to understand how radio waves can be used to reduce tumours in patients.
With thanks to Channel 4.
Facilities and procedures
The department specialises in cardiothoracic and non-invasive vascular imaging. US and CT-guided interventional procedures are also performed. The following imaging modalities are provided for:
The department provides excellent training facilities in all aspects of cardio-thoracic imaging. Harefield Hospital is a leading tertiary centre for whole range of cardiac and thoracic medicine and surgery and is the only centre for heart and lung transplantation for the whole of south England and Wales (one of the largest centre in UK for this purpose and also one the world’s best known). This provides exciting opportunities for training and research in this specialised field as the department works as an essential part of all the clinical teams.
Chest imaging
Training is provided in the interpretation of chest radiographs, diagnostic and interventional ultrasounds of the chest, computed tomography (CT scanning) for all pulmonary diseases (including high resolution CT for interstitial lung diseases, lung tumour staging, assessment of end stage lung disease for transplantation and complications after transplantation) and nuclear ventilation-perfusion scans. Routing CT guided interventions such as biopsies etc are also performed. Thoracic MRI is also undertaken.
Cardiac and non-invasive vascular imaging
Whole spectrum of cardiac imaging are performed including plain radiography, echocardiograms, nuclear cardiology, ECG gated computed tomography and magnetic resonance imaging. Training can also be arranged for diagnostic coronary angiography where required.
Training can be undertaken
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As part of the UK specialist registrar rotation in consultation with the candidate’s training director and post-graduate dean. This can be at any level of training, although SPRs in their fourth or fifth year of training are preferred for sub-speciality training.
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After CCST as a clinical fellowship. However appropriate funding for this will have to arranged through the respective post-graduate deanery.
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Research fellowship, subject to availability of suitable funding.
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Short period training at other levels.
For information regarding the cardiac CT course, please contact:
Dr Tarun K Mittal on telephone +44 (0)1895 828609 or email: t.mittal@rbht.nhs.uk
Harefield Hospital offers several unique advantages for carrying out research in cardiac and thoracic imaging:
- Location of the CT scanner unit in same department as the cardiac catheter labs allowing comparative studies to be performed. The hospital is a regional centre for interventional cardiology and has a rapidly expanding primary angioplasty service.
- Easy assess of the CT scanner to all the in-patient wards, ITU and the out-patient departments.
- Access to both 1.5 and 3T MRI scanner with high field strengths and cardiac software.
- World-class heart and lung transplant unit and ventricular assist device program, which are able to utilize and are much dependent on a good CT scanner for assessment of their patients.
- Performance of whole range of cardiac and thoracic surgical and medical procedures at Harefield Hospital.
- Excellent relationships between various clinical teams and imaging department.
- World class reputation of the Hospital and the Trust in diagnosis and treatment of heart and lung diseases.
Research projects currently underway
Coronary calcification in acute coronary syndromes with multislice computed tomography and its prognostic significance". This multi-centric project involves prospectively evaluating the presence and extent of coronary calcification (using multislice CT) in 600 patients with clinical diagnosis of acute coronary syndrome with a view to correlate with angiographic findings and determine the prognostic significance of calcification in these patients. Since the approval from the Ethics Committee in April 2004, the project has already enrolled 249 patients to date (April 2006).
"Predictive value of delayed contrast-enhanced magnetic resonance imaging (CE-MRI) in patients with chronic ischaemic cardiomyopathy for recovery of function after revascularization". This prospective study has recruited 60 patients with chronic heart failure (LV ejection fraction <35% as measured with MRI) with or without angina undergoing revascularization. This study has enrolled 35 patients since its approval.
‘Role of Coronary Calcification in assessment of patients presenting to Rapid Chest pain clinic’. This study has enrolled 350 patients over 2 year period. It proposes to evaluate the usefulness of CT coronary calcification as a fast non-invasive tool in assessment of these patients and its relationship with other existing methods like exercise stress test.
- Haj-Yahia S, Mittal T, Birks E, Carby M, Petrou M, Pepper J, Dreyfus G, Amrani M. Lung fibrosis as a potential complication of the hemostatic tissue sealant, biologic glue (Bioglue). J Thorac Cardiovasc Surg. 2007 May;133(5):1387-8.
- Griffin N, Mansfield L, Redmond KC, Dusmet M, Goldstraw P, Mittal TK, Padley S. Imaging features of isolated unilateral pulmonary artery agenesis presenting in adulthood: a review of four cases. Clin Radiol. 2007 Mar;62(3):238-44.
- Iqbal MB, Stavri G, Mittal T, Khaghani A. A calcified cardiac mass. Int J Cardiol. 2007 Feb 14;115(3):e126-8
- Mittal TK, Barbir M and Rubens M. ‘Role of computed tomography in risk assessment for coronary heart disease’ Postgrad. Med. J. 2006;82: 664-671.
- Mittal TK and Rubens M. Chapter entitled “Cardiac CT – Techniques and Principles” in Noninvasive Imaging of Myocardial Ischaemia. Published by Springer-Verlag.
- Asherson A, Mittal TK, Ilsley C. An unusual cause of chest pain and ST-segment elevation. Heart 2006; 92: 100.
- Hamour IM, Mittal TK, Bell AD, Banner NR. Reversible Sirolimus-associated pneumonitis after heart transplantation. J Heart Lung Transplant. 2006;25: 241-4.
- Partridge JB, Mittal TK, Chambers RJ. Arterial coronary artery bypass grafts: revised criteria for patency on multidetector computed tomography. Proceedings of UK Radiological Congress 2004, BJR congress series. 2004:56
- Thompson GR, Partridge J. Coronary calcification score: the coronary-risk impact factor. Lancet 2004;363:557-559
- Raipancholia R, AlBustami M, Chambers RJ, Partridge J, Mitchell AG, Amrani M, Ilsley C. Multislice computed tomographic contrast enhanced imaging of arterial and venous coronary artery bypass grafts.. European Heart Journal Vol 4, Abstr. Suppl. 2002;145
- Partridge JB, Chambers RJ, Kent D & Griffiths K. Multislice CT in Congenital Heart Disease. Radiology 2002 – Joint RCR/BIR/CR national meeting- poster- citation awaited.