Top 10 Questions for Radiology Resident Interview

1. Describe the key factors you consider when evaluating a chest X-ray for a patient with shortness of breath?

When evaluating a chest X-ray for a patient with shortness of breath, I consider the following key factors:

• Cardiac size and shape: Cardiomegaly or an abnormal cardiac silhouette may indicate heart failure or pericardial effusion.
• Pulmonary vascularity: Increased or decreased pulmonary vascularity can suggest pulmonary edema, interstitial lung disease, or pulmonary embolism, respectively.
• Lung parenchyma: Infiltrates, consolidation, or nodules may indicate pneumonia, pulmonary edema, or lung cancer.
• Pleural space: Pleural effusions, pneumothorax, or pleural thickening may cause shortness of breath.
• Diaphragm and mediastinum: A high or low diaphragm, mediastinal widening, or masses can indicate diaphragmatic dysfunction, aortic dissection, or other mediastinal pathology.

2. How do you approach interpreting a CT scan of the abdomen and pelvis in a patient with suspected appendicitis?

Window settings

• Use abdominal and pelvic windows to optimize visualization of different structures.

Appendiceal anatomy

• Identify the location of the appendix, usually in the right lower quadrant.
• Note its size, shape, and relationship to surrounding structures.

Signs of appendicitis

• Look for thickening and enhancement of the appendix wall.
• Check for obliteration of the appendiceal lumen.
• Evaluate for surrounding inflammation, such as peri-appendiceal fat stranding or abscess formation.

Differential diagnoses

• Consider other conditions that can mimic appendicitis, such as Meckel’s diverticulitis or right-sided colonic diverticulitis.

3. What are the imaging findings suggestive of a brain tumor in a patient presenting with seizures?

• Mass lesion: A focal area of abnormal tissue density, typically iso- or hyperintense on T2 and heterogeneously enhancing on gadolinium.
• Edema: Surrounding edema, causing mass effect and distortion of normal brain structures.
• Abnormal enhancement: Irregular or nodular enhancement, often with a central necrotic core.
• Contrast enhancement: Peripheral or ring-like enhancement on post-contrast images.
• Diffusion restriction: Reduced diffusion of water molecules within the tumor, indicating cellularity or high grade.
• Spectroscopy: Metabolic changes, such as elevated choline or reduced NAA, can suggest malignancy.

4. How do you evaluate a patient with suspected pancreatitis on an abdominal MRI?

• T1-weighted images: Look for pancreatic enlargement, edema, and fluid collections.
• T2-weighted images: Assess for increased pancreatic and peripancreatic signal, which may indicate inflammation and edema.
• Fat-suppressed T2-weighted images: Improve visualization of the pancreas and surrounding structures.
• Contrast-enhanced images: Evaluate for pancreatic ductal dilatation, pseudocyst formation, and areas of delayed enhancement, which can suggest necrosis.
• MR cholangiopancreatography (MRCP): Visualize the pancreatic and biliary ducts to assess for stones, strictures, or other abnormalities.

5. Describe the imaging features of a vertebral compression fracture on plain radiographs?

• Loss of vertebral height: Reduction in the vertical dimension of the affected vertebra.
• Increased vertebral density: Condensation of the trabecular bone, resulting in a brighter appearance.
• Angular deformity: A wedge-shaped appearance of the vertebral body, with the anterior height being less than the posterior height.
• Posterior vertebral body margin irregularity: A smooth or step-like deformity of the posterior vertebral body margin, known as the “posterior vertebral body depression” sign.
• Paravertebral soft tissue swelling: Associated edema or hematoma may be visible in acute fractures.

6. How do you use ultrasound to evaluate the thyroid gland?

• Transverse and longitudinal views: Visualize the size, shape, and echo-texture of the thyroid lobes.
• Nodule evaluation: Assess the size, shape, margins, and echogenicity of thyroid nodules.
• Blood flow: Use color Doppler ultrasound to evaluate intrathyroidal blood flow, which can help differentiate benign from malignant nodules.
• Lymph node assessment: Examine the cervical lymph nodes for enlargement or abnormal echogenicity.

7. Describe the role of nuclear medicine in evaluating a patient with suspected myocardial infarction?

• Myocardial perfusion imaging: Assess for regional myocardial ischemia or infarction by injecting a radioactive tracer and imaging the heart at rest and during stress.
• SPECT (single-photon emission computed tomography): Provides three-dimensional images of myocardial perfusion, allowing for better localization and quantification of ischemic areas.
• PET (positron emission tomography): Uses a radioactive tracer that emits positrons, allowing for more specific imaging of myocardial viability and metabolism.

8. How do you interpret a bone scan in a patient with suspected metastatic disease?

• Increased uptake: Focal areas of increased tracer uptake can indicate metastatic lesions or other bone abnormalities.
• Multiple lesions: Widespread involvement of multiple bones suggests disseminated metastatic disease.
• Pattern of uptake: Different patterns, such as lytic, sclerotic, or mixed, can provide clues to the underlying etiology.
• Correlation with other imaging: Combine bone scan findings with plain radiographs, CT, or MRI for a comprehensive assessment.

9. What are the key imaging features that differentiate acute from chronic renal failure on ultrasound?

Acute renal failure

• Increased renal parenchymal echogenicity: Swollen and edematous kidneys appear brighter than normal.
• Loss of corticomedullary differentiation: The normal distinction between the cortex and medulla becomes less clear.
• Increased renal size: The kidneys may be enlarged due to edema.

Chronic renal failure

• Small, contracted kidneys: Shrunken kidneys with decreased size and increased echogenicity.
• Loss of renal contour: Smooth and rounded kidney outlines.
• Increased parenchymal heterogeneity: Patchy areas of increased and decreased echogenicity throughout the kidneys.

10. Discuss the role of contrast-enhanced CT in evaluating a patient with suspected pulmonary embolism?

• Pulmonary artery visualization: Intravenous contrast injection allows for clear visualization of the pulmonary arteries, enabling detection of emboli.
• Filling defects: Pulmonary emboli appear as filling defects within the enlarged pulmonary arteries.
• Central vs. peripheral embolism: CT can differentiate between central (main pulmonary artery or lobar branches) and peripheral (segmental or subsegmental branches) emboli.
• Collateral vessels: Contrast-enhanced CT can reveal collateral vessels that develop in response to chronic emboli.
• Alternative diagnoses: CT also allows for evaluation of other potential causes of dyspnea, such as pneumonia, lung masses, or pleural effusions.

Radiology Residents are responsible for providing comprehensive radiological care to patients under the supervision of attending radiologists. They perform a wide range of diagnostic imaging procedures, including X-rays, CT scans, MRIs, and ultrasound exams. Residents also interpret medical images and provide written reports to referring physicians. Additionally, they may participate in research projects and teaching activities.

1. Diagnostic Imaging

Residents perform a variety of diagnostic imaging procedures, including:

• X-rays
• CT scans
• MRIs
• Ultrasound exams

2. Image Interpretation

Residents interpret medical images and provide written reports to referring physicians. These reports describe the findings of the imaging examination and may include recommendations for further evaluation or treatment.

• Reviewing and interpreting images from various imaging modalities
• Identifying and describing abnormalities and findings
• Correlating findings with clinical history and physical examination

3. Patient Care

Residents provide patient care under the supervision of attending radiologists. This includes:

• Explaining procedures to patients
• Positioning patients for exams
• Monitoring patients during exams

4. Education and Research

Residents may participate in research projects and teaching activities. This may include:

• Conducting clinical research studies
• Presenting research findings at conferences
• Teaching medical students and other healthcare professionals

Preparing for a Radiology Residency interview can be a daunting task, but following certain tips and strategies can help you put your best foot forward and increase your chances of success.

1. Research the Program

Before the interview, take some time to research the Radiology Residency program you are applying to. This will help you understand the program’s history, mission, and goals. You should also familiarize yourself with the faculty and their research interests. This will help you demonstrate your interest in the program and ask informed questions during the interview.

• Visit the program’s website
• Read the program’s mission statement
• Review the faculty’s profiles
• Attend a program information session

2. Practice Your Answers

It is likely that you will be asked a number of common interview questions. Take some time to practice your answers to these questions. This will help you feel more confident and prepared during the interview. Common interview questions include:

• “Tell me about yourself.”
• “Why are you interested in this program?”
• “What are your strengths and weaknesses?”
• “What are your research interests?”
• “What are your career goals?”

3. Dress Professionally

First impressions matter, so it is important to dress professionally for your interview. This means wearing a suit or business casual attire. You should also make sure that your clothes are clean and pressed. Avoid wearing clothes that are too revealing or too casual.

4. Be Yourself

It is important to be yourself during your interview. The interviewers want to get to know the real you. So be honest and genuine in your answers. Don’t try to be someone you’re not. The interviewers will be able to tell if you’re being fake.

5. Follow Up

After the interview, be sure to follow up with a thank-you note. This is a simple way to show your appreciation for the interviewers’ time and to reiterate your interest in the program. In your note, you can also mention any specific aspects of the program or the interview that you found particularly interesting.