This program reviews fundamental MRI safety information and meets the annual training recommendations from the American College of Radiology. Importantly, MRI facilities must now comply with the revised requirements for diagnostic imaging from The Joint Commission and document that MRI technologists participate in ongoing education that includes annual training on safe MRI practices in the MRI environment. Notably, Advanced MRI Safety Training for Healthcare Professionals, Level 2 MR Personnel covers each MRI safety topic specified by The Joint Commission, as well as many additional subjects that will expand the knowledge-base of healthcare professionals involved with MRI technology.

With 35 years of experience in the field of MRI, the author of the best-selling textbook series, the Reference Manual for Magnetic Resonance Safety, Implants and Devices, and the creator of the internationally popular website, MRIsafety.com, Dr. Frank G. Shellock is uniquely qualified to present the information in this program.

Advanced MRI Safety Training for Healthcare Professionals (4th Edition), Level 2 MR Personnel is a 2 hour and 45 minute program that is divided into three different sections.

Educational Objectives

• Understand the safety issues related to MRI.
• Describe the bioeffects associated with the static magnetic field, time-varying magnetic fields, and radiofrequency fields.
• Present guidelines that prevent projectile-related accidents.
• Describe polices that avoid issues related to acoustic noise.
• Review procedures that prevent burns associated with MRI.
• Explain and demonstrate appropriate pre-MRI screening procedures.
• Identify techniques to manage patients with claustrophobia, anxiety, or emotional distress.
• Describe guidelines to handle medical emergencies in the MRI setting.
• Understand the safety considerations for gadolinium-based contrast agents.

This is a Pay-To-View program. Purchase is required for full program access.

Applied Radiology and William Faulkner & Associates are pleased to introduce “The Online Course for MR Safety Officers (MRSO) and MR Medical Directors (MRMD)”. This comprehensive program, focusing on MR Safety, covers many aspects relating to the safety practices of the Magnetic Resonance Imaging (MRI) environment. It is designed for those individuals who are either currently serving as their facility’s MRSO and/or MRMD, or those who are preparing to assume these responsibilities. The content of this course will be helpful for those preparing for the American Board of Magnetic Resonance Safety MRSO and MRMD examinations.

The content of The Online Course for MR Safety Officers and MR Medical Directors is based upon current FDA and ACR guidelines, including the ACR Guidance Document for MR Safe Practices, as well as those promulgated by industry regulatory bodies such as the International Electrotechnical Commission.

The complete online program has been approved for up to 10 AMA PRA Category 1 credits™ (CME) and 10 Category A ARRT continuing educational credits (CE).

The Online Course for MR Safety Officers (MRSO) and MR Medical Directors (MRMD) is not affiliated with, nor endorsed by the American Board of Magnetic Resonance Safety (ABMRS)
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This is a Pay-To-View program. Purchase is required for full program access.

Jessica J. De Sabato, MD; James Kim, BS; Saadiya Sehareen, DO; Nina Vincoff, MD; Sofya Kalantarova, MD

Until recently, wire-guided localization was the gold standard for preoperative localization of nonpalpable breast cancers, a technique prone to unique complications and challenges, including wire dislodgement or migration, interference with the dissection route, and the need for coupling radiology and surgery services. Wireless localization devices such as radioactive seed localization, Scout, LOCalizer, EnVisio navigation system, and Magseed can help avoid these limitations. This activity is designed to educate radiologists about wireless localization devices, including their techniques, advantages, and limitations.

Available for CME Credit. To receive CME credit, you must complete the post exam and review the discussion and references provided with the exam results.

Lisa Singer, MD, PhD; Benjamin H. Kann, MD; Daniel N. Cagney, MD; Jonathan E. Leeman, MD; Sue S. Yom, MD, PhD; David Kozono, MD, PhD

While traditionally CT- and x-ray based, lung stereotactic body radiation therapy (SBRT) practices will likely be impacted by the emerging availability of MR guidance. This review provides an overview of the role of MR guidance in SBRT for the treatment of lung cancers. Limitations, data, and future directions for treatments are reviewed with a focus on peripheral, central, and ultracentral lung cancers.

Available for SA-CME Credit. To receive SA–CME credit, you must complete the post exam and review the discussion and references provided with the exam results.

Arash Mirrahimi, MD, MSc; Charlotte Gallienne, MD; Hournaz Ghandehari, MD, FRCPC

Acute mesenteric ischemia (AMI) is a true surgical emergency and a rare life-threatening condition, accounting for 0.01% of hospital admissions, with extremely high mortality rates (up to 69%). Poor outcomes remain prevalent despite advances in both diagnostic and treatment options over the last two decades

Early diagnosis and management are particularly important given that the highest incidence of AMI occurs in the elderly population, who often have multiple comorbidities leading to a worse prognosis. Biphasic contrast enhanced multidetector computed tomography (MDCT) images have become the mainstay and standard of care for investigation and timely diagnosis of AMI.

As such, the importance of recognizing imaging features of AMI and timely communication of findings with the referring physicians is of utmost importance for diagnostic radiologists and always a worthwhile topic for review. We have therefore endeavored to provide a brief summary of the presentation of AMI, its causes, relevant anatomy, and most importantly, illustrated review of CT findings that delineate ischemic changes of the bowel and mesentery.

Available for SA-CME Credit. To receive SA–CME credit, you must complete the post exam and review the discussion and references provided with the exam results.

Often there is lack of knowledge amongst imaging professionals regarding IV contrast dynamics and the relationship between contrast injection, observed enhancement, and scan acquisition timing. The design of appropriate imaging protocols leads to effective and consistent cardiovascular exams; especially when applied to complex clinical scenarios.

This CME/CE accredited program will review contrast-saline dynamics and discuss rational protocol design for cardiac and vascular CT angiography. Effective cardiovascular imaging protocols, utilizing multiple CT injector platforms to achieve optimal imaging, will be reviewed. We invite you to join Dr. Richard Hallett for a comprehensive discussion and case study review of this important topic.

Following the presentation questions from the audience were addressed in a moderated Q&A session.

Educational Objectives:
At the completion of this activity, participants should be able to:

• Understand the relationship between bolus contrast media injection and observed enhancement.
• Implement methods to design rational contrast injection / scan acquisition protocols.
• Review various models of CT contrast injectors and discuss benefits, limitations, and injection protocol adjustments for each.
• Apply customized contrast-saline injection / scan principles to complex cardiovascular disease cases.

Made possible through an unrestricted educational grant from Bracco Diagnostics, Inc.

IV contrast extravasation is a not uncommon complication in the performance IV contrast enhanced CT examinations. In this accredited Expert Forum Webcast, we will review the different complications related to IV contrast administration. This will be followed by analysis of different factors that contribute to IV contrast-extravasation and subsequent discussion of best practices that can reduce the incidence of IV contrast extravasation. A novel method which reduced contrast extravasation by over 50% will also be presented.

Following the presentation questions from the audience were addressed in a moderated Q&A session.

Learning Objectives

• Discuss the different types of complications associated with IV contrast extravasation.
• Describe the various factors that can contribute to IV contrast extravasation.
• Apply best practices to reduce the incidence of IV contrast extravasation.

No special educational preparation is required for this CME/CE Activity!

Supported through an unrestricted educational grant from Bracco Diagnostics, Inc.

Anurag Saraf, MD; Graham Boyd, MD; Alexandra De Leo, MD; Phylicia D. Gawu, DO; Chelsea C. Pinnix, MD, PhD; Steve Braunstein, MD, PhD; Rachel Jimenez, MD; Idalid Franco, MD, MPH; Lisa Singer, MD, PhD

Medical education must develop and adapt through robust education scholarship, applying novel teaching with evidence-based best practices to optimally convey new concepts. Continued growth in undergraduate, graduate and continuing medical education as well as in diversity, equity, and inclusion efforts, are critical for the future of radiation oncology. This review article explores how education scholarship can facilitate these advances in areas from artificial intelligence to technology-oriented teaching.

Available for SA-CME Credit. To receive SA–CME credit, you must complete the post exam and review the discussion and references provided with the exam results.

With the recent FDA approval of gadopiclenol injection, radiologists now have the choice of a macrocyclic gadolinium-based contrast agent (GBCA) with 2 – 3 times higher relaxivity at a lower standard dose as compared to other gadolinium-based contrast agents on the marke

Therefore, and because gadopiclenlol is different than other currently available GBCAs, a review of the clinical benefits of using a higher relaxivity GBCA at a lower administered dose is important. A clear understanding of relaxivity and calculation of the volume to be administered based on dosing considerations, is necessary

In this accredited webinar, Mr. Faulkner will provide insights into the differences of the current FDA-approved GBCAs and how these differences apply to MR imaging. Following the presentation, questions from the audience were addressed during a live Q&A.

Educational Objectives:
At the completion of this activity, participants should be able to:

• Identify the properties that distinguish gadopiclenol injection from the other high relaxivity and conventional gadolinium-based contrast agents (GBCAs).
• Employ the FDA-approved indications and clinical applications for gadopiclenol injection.
• Calculate and administer the proper volume dose of gadopiclenol, as compared to other conventional GBCAs.
• Apply clinical considerations and dosing options for gadopiclenol to vulnerable patient populations who may experience repeat dosing of GBCA.

Made possible through an unrestricted educational grant from Bracco Diagnostics, Inc.

Steven Benitez, MD; Ryan Holland, MD; Richard Zampolin, MD; Andrew Brook, BA, MS; Joshua Hirsch, MD; Allan L Brook, MD, Deepak Khatri, MD

As thrombectomy has become the standard of care for large vessel/arterial occlusions, the indications are initiated by proper imaging and understanding of the brain blood flow physiology. This two-part series examines the standard of care for acute stroke imaging and the latest techniques. The second part of this activity on stroke intervention will appear in the November-December issue of Applied Radiology.

Available for CME Credit. To receive CME credit, you must complete the post exam and review the discussion and references provided with the exam results.

In this Expert Forum, Dr. Matthew Covington shares his understanding of the benefits and limitations of contrast-enhanced mammography, as compared to contrast-enhanced breast MRI, and how this imaging technique can be incorporated into clinical practice. Following the presentation questions from the audience were addressed in a moderated Q&A session.

Learning Objectives

• Dictate the strengths and limitations of contrast-enhanced mammography compared to contrast-enhanced breast MRI.
• Recognize indications for the appropriate use of contrast-enhanced mammography.
• Implement a contrast-enhanced mammography program.

This program is made possible through an unrestricted educational grant from FUJIFILM Healthcare Americas Corporation.

Leila T. Tchelebi, MD; Nicholas G. Zaorsky, MD, MS; Jennifer Rosenberg, MD; Kujtim Latifi, PhD; Sarah Hoffe, MD

While MR-guided radiation therapy (MRgRT) offers many benefits, it is a costly and resource-intensive investment that can strain radiation oncology clinics not adequately prepared to incorporate this treatment. This work reviews clinical advantages and practical limitations of MRgRT, and suggests ideal patients for this technology. The authors also provide a practical guide for centers acquiring MRI-based linear accelerators to foster seamless integration.

Available for SA-CME Credit. To receive SA–CME credit, you must complete the post exam and review the discussion and references provided with the exam results.

Samuel J. Tate, MD; Jeffrey Lin, DO, MPH; John P. McGahan, MD

Lung ultrasound (LUS) has become a powerful bedside tool in diagnosing pathology, guiding procedures, and directing management. Knowledge and interpretation of artifactual patterns, true parenchymal structures, and signs unique to LUS will allow providers to utilize this modality in their care of patients. This activity is designed to educate radiologists about basic findings of lung ultrasound to help interpret images and refine differentials with this modality.

Available for SA-CME Credit. To receive SA–CME credit, you must complete the post exam and review the discussion and references provided with the exam results.

In MR Imaging, a careful review of the safety criteria for the selection of a Gadolinium-based Contrast Agents (GBCAs) should be considered for pediatric and neonatal patients. The program will provide a comprehensive review of the supporting research that addresses Gadolinium selection in this special patient population. Both chronic and long-term effects of GBCAs will be discussed.

As a Pediatric Neuroradiologist, Dr. Shah is uniquely qualified to share his experience which includes a discussion of risk vs benefits, supported by practical protocols for the administration of MR contrast; including limiting the amount of contrast given to patients that may receive several lifetime doses. Following the presentation, the audience is invited to join Dr. Shah for an interactive Q & A session.

Educational Objectives:
At the completion of this activity, participants should be able to:

• Explain the differences between available MR contrast agents and any associated adverse events
• Improve clinical management decisions about when to administer MR contrast (risk vs benefit)
• Apply FDA guidelines regarding MRI contrast agents to clinical practice.

Made possible through an unrestricted educational grant from Bracco Diagnostics, Inc.

This accredited program provides a comprehensive overview of MRI safety considerations for passive / active implants, and devices.

When considering patient safety during MR imaging, it is critical to assess the patient’s history and have a clear understanding of any passive and or active implants and/or devices. The ACR Manual on MR Safety states that the Radiologist is responsible for the safety of the patient undergoing the MRI Exam. They are also responsible for implementing MR Safety policies and procedures and ensuring that the facilities’ personnel adhere to them at all time. Regarding implants and devices, regular reviews and updates to the MRI safety policy should be completed.

With more than 35 years of experience in the field of MRI, the author of the best-selling textbook series, the Reference Manual for Magnetic Resonance Safety, Implants and Devices, and the creator of the internationally popular website, www.MRIsafety.com, Dr. Frank G. Shellock is uniquely qualified to present this important MRI Safety information designed for MRI Imaging professionals.

Educational Objectives

• Name and describe the current labeling terminology for implants & devices.
• Safely image patients with passive and active, MR Conditional implants and devices.
• Establish a comprehensive MRI Safety protocol for imaging implants & devices.

Program support provided by Bracco Diagnostics, Inc.

This is a Pay-To-View program. Purchase is required for full program access.

Ana Mitchell, MD; Simran Sekhon, MD; Kriti Gwal, MD; John McGahan, MD

A variety of intrathoracic masses may present in the fetus and present as a mimic to congenital diaphragmatic hernia. Knowledge of their locations, ultrasound characteristics, and MRI findings helps limiting the differential diagnosis and guiding treatment. Jointly provided by IAME and Anderson Publishing Inc., this activity is designed to educate radiologists about fetal intrathoracic masses and distinguishing imaging features that will help in guiding management. Knowledge of the ultrasound and MRI features of these masses will help in differentiate these masses from congenital diaphragmatic hernia. Once this diagnosis can be made ultrasound and MRI may also be used to predict residual pulmonary tissue and other findings, such as liver herniating into the thorax, which will help guide fetal and neonatal therapy.

Available for CME Credit. To receive CME credit, you must complete the post exam and review the discussion and references provided with the exam results.

Pooja Agrawal, MD; Carolyn M. Audet, PhD; Laura L. Ernst, BA; Katie Lang, MS; Sonya A. Reid, MD, MPH; Katie M. Davis, DO; Rebecca Selove, PhD, MPH; Maureen Sanderson, PhD; Lucy B. Spalluto, MD, MPH

Numerous risk assessment models are available to calculate a woman’s lifetime risk of developing and/or carrying a gene mutation that may predispose her to developing breast cancer. Knowledge of risk may help to inform individual screening practices. Further understanding and evaluation of risk assessment models are needed to increase their utilization.

The purpose of this activity is to 1) introduce breast cancer risk assessment models for estimating an individual’s risk of developing breast cancer or risk for carrying a gene mutation that may predispose to developing breast cancer, 2) review the strengths and limitations of each model and the model’s applicability to underrepresented populations, and 3) provide an example that demonstrates the use of risk assessment models.

Available for CME Credit. To receive CME credit, you must complete the post exam and review the discussion and references provided with the exam results.

Amir Hossein Mostafavi Sterabadi, BS; Hassan Anbari, MBChB; Minhaj S. Khaja, MD, MBA; Baljendra S. Kapoor, MD

Liver biopsy is an invaluable adjunct to laboratory findings in diagnosing and treating varioius liver diseases. However, the various methods of obtaining liver samples, their indications and contraindications, as well as the nuances and rationale behind choosing one method over another are not all well understood by interventional radiologists.

This activity is designed to explain different ways of performing liver biopsy and some other ancillary interventions to obtain liver tissue samples. We aim to explain the indications, contraindications, efficacy, patient selection, and potential complications associated with these procedures.

Available for CME Credit. To receive CME credit, you must complete the post exam and review the discussion and references provided with the exam results.

Navpreet Kaur Khurana, MBBS; Saurabh Jha, MD

Cardiac involvement in light chain and transthyretin amyloidosis is commonly encountered by radiologists. Cardiac MRI is the primary imaging modality for cardiac amyloid (CA) with high sensitivity and specificity. However, other cardiac conditions can mimic CA, potentially affecting the accuracy of diagnosis. Knowledge of these mimics will help improve diagnosis and management of CA.

This activity is designed to educate trainees and radiologists on the typical and atypical findings of cardiac amyloidosis on cardiac MRI and nuclear medicine. This will reduce positive and false negative interpretations and lead to improved diagnosis.

Available for CME Credit. To receive CME credit, you must complete the post exam and review the discussion and references provided with the exam results.

Kaitlyn Lapen, MD; Noah J. Mathis, BS; C. Jillian Tsai, MD, PhD; Jonathan T. Yang, MD, PhD; Erin F. Gillespie, MD

The authors review published prospective trials and protocols on stereotactic radiation therapies for metastatic disease to determine whether the terms SBRT and SABR are being used differentially based on intent of treatment, defined by primary study outcome, and propose a distinct definition of each.

Available for SA-CME Credit. To receive SA–CME credit, you must complete the post exam and review the discussion and references provided with the exam results.

Dr. Laurie Fajardo will share her understanding of the benefits of synthetic 2D images with digital breast tomosynthesis (DBT) for diagnosing breast cancer along with considerations for implementing Synthetic 2D breast imaging protocols into your practice. Following the presentation questions from the audience were addressed in a moderated Q&A session.

Learning Objectives

• Implement digital breast tomosynthesis protocols in clinical practice.
• Differentiate characteristics of synthetic 2D mammography by manufacturer.
• Discuss differences between wide vs narrow angle DBT acquisition and its effect of angular range on synthetic-2D image generation.

This program is made possible through an unrestricted educational grant from FUJIFILM Healthcare Americas Corporation.

Will Jin, MD;1* Santosh Mohan, MMCi, COPHIMS;2 Matt Adams, BS;3 Sarah Hoffe, MD;4 Edmondo Robinson, MD, MBA2

Recent studies have shown the emergence of digital therapeutics (DTx) as potential solutions in the cancer care continuum to improve medication adherence, chemotherapy tolerance, and overall survival, while potentially reducing financial toxicity. In this review, the authors examine these new modalities and possible future benefits for cancer patients.

Available for SA-CME Credit. To receive SA–CME credit, you must complete the post exam and review the discussion and references provided with the exam results.

Kaitlin M Zaki-Metias, MD; Mehrvaan Kaur, MD; Huijuan Wang, MD; Bilal Turfe; Nicholas Mills, MD; Yanruo Lu, MD; Bashir H Hakim, MD; Leslie S Allen, MD

Pregnant patients infrequently undergo CT given the risk of radiation to the developing fetus. As such, when CT is performed on pregnant patients in emergent situations, radiologists may be unfamiliar with the appearance of the placenta on CT and its normal evolution throughout gestation. This activity is designed to educate radiologists about the normal appearance of the placenta on CT and its evolution throughout pregnancy, as well as differentiation of these findings from placental abruption.

Available for SA-CME Credit. To receive SA–CME credit, you must complete the post exam and review the discussion and references provided with the exam results.