Departments

We are committed to providing patient-focused, evidence-based care to all of our patients, pairing clinical expertise with the latest advances in technology. We offer a comprehensive range of imaging services, and tailor each exam to meet each patient’s specific needs. Our board-certified doctors are national and international leaders in diagnostic imaging and advanced image-guided therapies, and they are dedicated to maintaining the highest standards of care in patient safety, quality, and satisfaction. We employ a multidisciplinary approach to care, and collaborate with physicians from all medical specialties to make the most accurate diagnosis and determine the best treatment options. Yale patients have access to highly advanced imaging equipment, including an intraoperative MRI/IR/OR suite, and 3D tomosynthesis. Our radiologists conduct advanced research in MRI, MRS, PET, interventional oncology, and image processing. Specialized care is offered in the following areas: Abdominal imaging Breast imaging Cardiovascular imaging Emergency and trauma radiology Neuroradiology Nuclear medicine and molecular imaging (including PET/CT) Pediatric radiology Thoracic imaging Vascular/interventional radiology Rapid, in-house subspecialist imaging interpretations Overnight coverage by three in-house attending radiologists at Yale New Haven Hospital Leader in 3D tomosynthesis mammography imaging and research Leader in screening breast ultrasound Comprehensive multidisciplinary lung cancer screening program with ultra-low-dose CT scanning Cardiac CoreValue planning service, providing a minimally invasive transcatheter aortic valve implantation option for patients with severe aortic stenosis MRI for pacemaker patients Ultrasound contrast and elastography imaging Dedicated peripheral vascular ultrasound Integrated musculoskeletal ultrasound device Subspecialized pediatric interventional radiology expertise Recognized expertise in management of primary and secondary liver cancer Molecular imaging for recurrent prostate cancer and the diagnosis of Alzheimer’s disease Advanced tumor imaging for optimizing best treatment outcomes DaTscan, a diagnostic test for Parkinson’s Disease Portable neuro Intensive Care Unit (ICU) computed tomography (CT) scanning Interventional radiology with state-of-the-art minimally invasive image-guided therapy, including targeted and precision cancer treatments, back pain treatment, and biliary stone laser treatment, among others

The breadth of experience among our doctors is reflected in their unique approach to patient care, management of complex medical cases, expertise in imaging guidelines and unwavering commitment to clinical excellence. Magnetic resonance imaging (MRI) is a noninvasive medical test that physicians use to diagnose and treat medical conditions. It uses a powerful magnetic field, radio frequency pulses and a computer to produce detailed pictures of organs, soft tissues, bone and virtually all other internal body structures. An MRI does not use radiation. A computed tomography scan, more commonly known as a CT scan, is a diagnostic medical test that produces multiple images of the inside of the body. The cross-sectional images generated during a CT scan can be reformatted in multiple planes, and can even generate three-dimensional images of internal body structures. We also specialize in fluoroscopic imaging—real-time moving pictures displayed on a monitor. This specialized technology helps us detect conditions that affect the gastrointestinal as well as the urinary and reproductive (genitourinary) tracts. Our experts perform esophagrams, upper GI series and barium enemas to look for swallowing and digestion conditions. In addition, we do a variety of other imaging tests, including cystograms to detect voiding issues and hysterosalpingograms, which help us see if a woman’s fallopian tubes are open or blocked.

Covering every aspect of health care for adults, Internal Medicine is the largest department in the Yale School of Medicine, and the largest clinical service at Yale New Haven Hospital. We provide comprehensive and specialized services in all areas in a variety of outpatient settings as well as the Veterans Affairs (VA) Connecticut Health Care System campus in West Haven. Our culture of collaboration and research gives patients access to expert opinions from nearly 1,000 doctors, as well as opportunities to get tomorrow’s health care today through more than 100 clinical trials. Most importantly, we attend to our diverse community of patients with compassionate, thorough care. Specialized care is offered in the following areas: Allergy & clinical immunology Cardiovascular medicine Digestive diseases Endocrinology General internal medicine Geriatrics Hematology Infectious diseases Medical oncology Occupational health & environmental medicine Nephrology Pulmonology, critical care & sleep medicine Rheumatology International reputation for work in understanding function, independence, and quality of life in older persons Key research breakthroughs of the past decade that include the development of a protective Lyme bacillus disease vaccine, exploration of the underlying causes of allergic disease, and the discovery of novel inherited immunological diseases Largest interventional cardiology program in Connecticut Major referral center for patients with type 1 and type 2 diabetes, as well as other metabolic conditions Nationally ranked program in kidney diseases and the largest kidney transplant program in New England, with multidisciplinary care clinics One of the largest peripheral vascular programs in the country, with leadership and participation in multiple new percutaneous device trials Once of only a few motility centers in Connecticut to provide all motility procedures and services Unique medical forensic exams for individuals with claims of torture who are seeking asylum in the U.S.

Yale’s Department of Neurology has been at the forefront of cutting-edge clinical care and scientific discovery since it began in 1952. It was Yale scientists who discovered the genes that cause Multiple Sclerosis. Yale housed one of the first epilepsy monitoring units in the country, and one of the first stroke centers at its partner, the Veterans Affairs (VA) Center in West Haven. Today, our team of experienced doctors are committed to understanding and treating the entire spectrum of nervous system diseases. Expert physicians specialize in brain and nerve health for both children and adults. Specialized care is offered in the following areas: Amyotrophic lateral sclerosis (ALS), myasthenia gravis, peripheral neuropathy, neuromuscular disorders Alzheimer’s disease/cognitive disorders Epilepsy and neurophysiology General neurology, headache, pain Multiple sclerosis and neuroimmunology Neurodegenerative disorders Neurocritical care Neurological infections Neuro-oncology Parkinson’s disease and movement disorders Stroke and vascular neurology

Yale’s section of neuroradiology is one of the largest in the country. Advanced neuroradiology imaging techniques, especially in MRI and CT, have shown vast new ways of understanding, evaluating, and diagnosing diseases of the central nervous system. This understanding is crucial in concerns regarding the prevalence of traumatic brain injury in high-level sports and the military. Radiologists have also made strides in enhancing imaging for other diseases ranging from tumors, to multiple sclerosis, to strokes. The new imaging techniques available at Yale allow for insight into many areas of medicine. They make possible greater knowledge of a variety of diseases, including those for which there is currently a wealth of understanding, such as tumors and demyelinating diseases, and those that have been difficult to understand, particularly neurodegenerative diseases such as Alzheimer’s disease and Parkinson’s disease, as well as neuropsychiatric disorders.

The Yale Multiple Sclerosis Center is a multidisciplinary service that evaluates and treats patients with suspected or diagnosed multiple sclerosis (MS). MS is a chronic central nervous system disease that causes symptoms ranging from numbness to weakness. Up to 10% of MS patients are diagnosed before the age of 18. The disease has different effects in these younger patients whose brains are still developing. The Yale Multiple Sclerosis Center offers streamlined resources including sophisticated brain imaging, pharmacy, an infusion center, and phlebotomy. A specialized nurse is available to answer questions about disease-modifying therapies. Social work and nutrition consultants are available. In addition, there are opportunities to participate in MS clinical trials, research studies, and regularly scheduled clinical care conferences. Pediatric neurologist, Naila Makhani, MD, MPH, evaluates and treats these younger patients. She has significant experience in MS, receives funding from Race to Erase MS and participates in clinical trials for MS therapies in children. Dr. Makhani sees children under 12 years of age at the Long Wharf Medical Center (1 Long Wharf Drive, New Haven) and children 13 and older at the Yale Multiple Schlerosis Center (6 Devine St. in North Haven)—a 10-minute drive from the main Yale Medical Center campus.

At the Yale Multiple Sclerosis Center, patients may receive all of their care in one easy-to-access location. Our team provides comprehensive care to patients at a state-of-the-art facility in North Haven featuring advanced MRI scanners, a clinical laboratory, and dedicated infusion center. Our expert neurologists collaborate with experienced nurses, therapists, and social workers to care for patients at all stages of disease. In addition to patients with multiple sclerosis, we treat patients with neuromyelitis optica, transverse myelitis, optic neuritis, and other neuroimmune disorders. MS Access is a program designed to expedite the diagnosis and treatment of multiple sclerosis (MS). For patients with multiple sclerosis, we believe an accurate, timely diagnosis and early treatment are crucial to a patient's overall well-being. We also understand that a potential diagnosis of MS can be overwhelming, and a long wait to see a specialist can cause needless anxiety and frustration. We developed MS Access to address these issues. The physicians at the Yale Multiple Sclerosis Center will expedite initial visits for individuals about whom another doctor (e.g. primary care doctor, general neurologist, or ophthalmologist) is concerned regarding a new diagnosis of MS or optic neuritis. We will work to see these patients urgently, arrange for any necessary diagnostic imaging or lab work, and address treatment options early. To take advantage of this program, referring physicians can call our MS Clinic in North Haven, CT, at 203-287-6100 and let staff know that the referral is for MS Access. Patients who have been recently diagnosed with MS or who suspect that they might have it can ask their physician to refer them to the Yale Multiple Sclerosis Center.

We cover all of the components critical to successfully managing patients with brain tumors. This includes comprehensive evaluation and diagnosis, genomic profiling of the tumor, leading-edge treatment options, follow-up, and psychosocial support. We welcome newly diagnosed patients as well as those who have already received extensive treatment elsewhere, along with patients in need of second surgeries or follow-up biopsies. We work closely with other Yale Medicine brain tumor doctors to provide a comprehensive, multidisciplinary approach that is patient-focused. Using advanced microsurgical techniques, including intraoperative neurophysiological monitoring and awake craniotomy (when appropriate), our brain tumor surgeons strive to achieve the maximum extent of tumor removal while preserving neurological function. Often, what is often deemed "inoperable" by some surgeons is considered operable at Yale with successful outcomes. We are the only hospital in the region to have MRI and angiography capabilities in our operating room. Yale New Haven Hospital also banks all tumor samples and performs genomic profiling to better understand tumor mutations. We use this information to help direct postsurgical therapy. Our state-of-the-art neurosurgical operating rooms in Smilow Cancer Hospital are the only in the regionto offer intraoperative MRI, intraoperative angiography, stereotactic surgical guidance, and operative brain mapping to precisely pinpoint brain tumors during surgery.These technologies, combined with our surgical expertise allow for the best in surgical care for patients. A team of experts dedicated to caring for patients with brain tumors, including specialized brain tumor surgeons, radiation oncologists, neuroradiologists, medical neuro-oncologists, neuropathologists, and other specialists meets weekly to arrive at the most advanced and appropriate treatment plan for each individual. Yale is one of the few centers capable of offering even more personalized and precise oncologic care, when appropriate, based on the genetic makeup of the individual’s tumor. Inquiries from referring physicians or directly from patients or their families are welcome. All inquiries are handled expeditiously by our team of experienced patient coordinators. Their role includes ensuring that appropriate appointments are made in a timely fashion, and coordinating with the various medical specialists involved in each treatment plan. New patients with brain tumors are usually seen within two or three days. Our patient coordinators also act as patient advocates, communicating with the various medical specialists contributing to the treatment plan. Through Yale’s strong tradition of and commitment to research, practitioners are well acquainted with the most advanced treatment methods and have access to clinical trials. Patients also benefit from the specialized resources at Smilow Cancer Hospital and Yale New Haven Hospital, such as an advance

Lung cancer is the third most common cancer in the U.S., but it is the leading cause of cancer-related deaths. The reason is that most lung cancers are diagnosed in late stages of the disease. Hence, early detection is a key for longer survival when lung cancer is only limited to one area of the lung. A diagnosis of lung cancer often begins when a chest X-ray or computed tomography (CT) scan shows a nodule—an area of abnormal tissue—in the lungs. Lung cancer screening is one way to catch cancer early, when it is still a lung nodule. The other way, which is more common, of finding a lung nodule is incidental, while patients are getting lung imaging for other medical problems. Lung nodules that are suspicious or show signs of growth over time often need to be biopsied. Biopsy of lung nodule with bronchoscopy is preferred as risk of complications is very low and lymph node staging can be performed concurrently. However, traditional bronchoscopy has lower success for lung nodule biopsy. At the Yale Robotic Bronchoscopy Program, Yale interventional pulmonologists and thoracic surgeons will perform a next-generation bronchoscopy—robotic-assisted bronchoscopy with novel shape-sensing technology—that will allow them to visualize and biopsy remote parts of the lung that were previously inaccessible, significantly improving the success of lung nodule biopsy. The Yale Robotic Bronchoscopy Program takes a multidisciplinary approach to patient care; it is a joint program between Yale Interventional Pulmonology and Yale Thoracic Surgery, part of the Thoracic Oncology Program, which takes care of more than 40% of lung cancer patients in Connecticut while attracting patients from New England and beyond. The goal of the program is to diagnose potentially cancerous lung nodules in the periphery and hard-to-read parts of the lungs. The robotic bronchoscopy technology will help to biopsy and diagnose those nodules with significantly improved accuracy and safety. Yale New Haven Hospital offers this new technology, which has greater dexterity, reach, vision, and shape-sensing technology that offers greater stability when compared with traditional bronchoscopy. A regular bronchoscope has a camera on one end. The other end is held by a doctor who manually performs the procedure. With a robotic bronchoscopy, the endoscope is attached to a robotic arm, which the doctor operates from an independent console. The Yale doctors will be using robotic bronchoscopy concurrently with 3D fluoroscopy for real time imaging to further improve the accuracy of the procedure. Furthermore, doctors will also perform a procedure called EBUS—endobronchial ultrasound, which allows biopsy of the lymph nodes around the lungs and airways. This helps not just with the diagnosis but with the staging of lung cancer. Performing robotic-assisted bronchoscopy and EBUS under single anesthesia will help reduce the unnecessary waiting times and anxiety that patients may traditionally experience.

Yale’s Department of Surgery is a premier center for adult and pediatric surgical treatment, providing comprehensive care for a full range of conditions and diseases. To ensure that our patients experience shorter hospital stays and less postoperative discomfort, we employ the latest technologies and surgical techniques, and perform minimally invasive surgery whenever possible. Our renowned surgeons and faculty continue to push the frontiers of surgical science through innovative treatment and leading-edge research, with the ability to offer treatment options that can be difficult to find elsewhere. More state-of-the-art surgical suites at Yale New Haven Hospital than in any other hospital in the region Collaboration with the Yale Department of Biomedical Engineering and with industry to develop 3-D bioprinting for the regeneration, repair, and replacement of human tissue and vessels Nationally recognized Center of Excellence and designated training center for transcatheter aortic valve replacement (TAVR) Yale’s Endocrine Neoplasia Laboratory is an internationally renowned multidisciplinary research group in which surgeons work with endocrine geneticists to decipher the molecular genetics of endocrine tumor disease First program in Connecticut to offer three different minimally invasive bariatric surgical techniques: Roux-en-Y gastric bypass, LAP-Band® surgery, and laparoscopic sleeve gastrectomy

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

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