Aurela Clark, MD; Xiaoqin Wang, MD; Riham El Khouli, MD; Margaret Szabunio, MD

Imaging the pregnant patient is challenging as it involves both the parent and the fetus and, consequently, several medical, ethical, or legal considerations. Theoretically, all available imaging modalities may be used to evaluate the pregnant patient; however, in practice, confusion regarding the safety of the fetus often results in unnecessary avoidance of useful diagnostic tests, especially those involving ionizing radiation. This review is part 2 of a 2-part series and focuses on specific clinical scenarios (nonobstetric and obstetric) in pregnant patients and the recommended imaging modalities to answer clinical questions while focusing on fetal and parental safety.

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.

Individuals entering the magnetic resonance imaging (MRI) environment, whether on a regular or infrequent basis, must be properly trained to ensure their safety, the protection of patients, and the security of other facility staff members. This program, Basic MRI Safety Training, Level 1 MR Personnel accomplishes the initial training that is necessary to ensure safety in the unique setting associated with the MRI system. It includes information pertaining to MRI technology, describes common hazards and unique dangers associated with the MRI setting, and presents vital recommendations and guidelines to prevent accidents and injuries. Importantly, this program provides the fundamental MRI safety information for Level I MR Personnel recommended by the American College of Radiology and may be utilized by individuals preparing for safety training as Level 2 MR Personnel.

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 the information in this program.

Educational Objectives

• Appreciate the importance of MRI
• Identify the hazards associated with MRI
• Understand the screening process
• Describe steps to prevent accidents and injuries

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.

Zachary K. Englander, MD, MS; Christopher Troy, MD; Masih Tazhibi, BA; Nina Yoh, MD; Hong-Jian Wei, PhD; Neil Feldstein, MD; Elisa Konofagou, PhD; Luca Szalontay, MD; Cheng-Chia Wu, MD, PhD,

The blood-brain barrier (BBB) remains a significant blockade for effective drug delivery in treating diffuse intrinsic pontine glioma (DIPG). Low-frequency focused ultrasound (FUS) therapy in conjunction with intravenous microbubbles can transiently disrupt the BBB in a localized manner to facilitate drug delivery. This review examines recent preclinical studies evaluating the safety and feasibility of FUS-mediated BBB opening in the brainstem. The authors also discuss the published phase 0-2 clinical trials of low-frequency FUS therapy in the adult glioma population, and phase 1 clinical trials in DIPG that are underway.

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.

One technique for reducing this exposure is to use a high relaxivity GBCA that can be administered at a lower dose than a conventional GBCA, without any impact on image quality. GBCA selection for interventional procedures such as radiosurgery is one such example, where the selection of a GBCA can play a role in patient management and outcomes.

In this program, an experienced neuroradiologist and neuro oncologist will present their clinical experiences with the use of stereotactic localization radiosurgery, following the administration of a high relaxivity GBCA. Through case study examples, the clinical impact of contrast selection will be demonstrated. Following the presentation, questions from the audience will be addressed during a live Q&A.

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

• Review the role of stereotactic radiosurgery (SRS) for brain metastases and the role of pre-operative localization MRI exams for stereotactic radiosurgery.
• Outline the differences between gadopiclenol and other group II gadolinium-based contrast agents.
• Discuss the use of gadopiclenol in specific case-based scenarios for stereotactic localization exams and its impact on patient management.

This program is made possible through an unrestricted educational grant from Guerbet.

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.

Jonathan R Wood, MD; Ghazal Shadmani, MD; Marilyn J Siegel, MD

Pediatric upper-extremity sports injuries are common. However, the diagnosis can be challenging for radiologists who have limited experience in imaging children. Increased awareness of the imaging findings is critical in establishing the correct diagnosis and ensuring optimal patient management and outcomes. This activity is designed to educate radiologists about the radiographic findings of common acute and chronic sports injuries of the upper extremities in the pediatric population. Mechanisms of injury are also reviewed, as they impact the type of fracture that occurs. Additionally, the role of magnetic resonance imaging in complementing plain radiography is discussed.

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 including the radiologist's responsibilities and liabilities, MRI staff education and patient safety. It is designed specifically for practicing radiologists, fellows, residents, and healthcare professionals who oversee MRI services and will provide practical guidance from two respected MRI safety educators who present information on accepted safety standards of care based on the 2020 ACR Manual on MR Safety, the 2021 FDA Guidance Document, and a review of the literature.

Program Considerations: It is critical to have established MRI safety protocols and to have a clear understanding of the basics of MRI Safety. 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. These MRI safety policies should be reviewed and updated annually in order to prevent patient injury.

Educational Objectives

• Describe the difference between Level 1 & Level 2 MR personnel.
• Differentiate and identify the ACR-designated Safety Zones.
• Implement safety considerations for the static magnetic field, time-varying gradient magnetic fields, and radiofrequency fields.
• Employ procedures and protocols to prevent RF-related burns and methods to manage SAR levels.
• Manage acute and chronic gadolinium-based contrast agent adverse events.

Program support provided by Bracco Diagnostics, Inc.

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

This CME and CE accredited program aims to provide a comprehensive overview of new artificial intelligence applications supporting cardiac CT. Through clinical case study reviews, Dr. Dinesh Kalra will share his clinical knowledge and insights into cardiovascular imaging and provide examples of super-resolution, deep-learning reconstructive technologies that are improving cardiac CT image quality and the overall diagnostic confidence in cardiovascular case interpretations.

Dr. Kalra stated, “I'm able to better see the same segments that were difficult to see with older generation scanners. The image sharpness, the resolution, and the low-contrast detection rates have all improved and there's no trade-off, so one doesn’t sacrifice resolution for radiation dose. This allows us to deliver less radiation, see less noise, while obtaining superb image quality.” 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:

• Describe the various reconstruction techniques and their clinical utility in coronary CT.
• Incorporate advanced AI processing solutions that achieve higher resolutions into cardiac CT imaging protocols in order to improve clinical outcomes.
• Increase diagnostic confidence in the interpretation of stenosis and plaque characterization.

This program has been sponsored by Canon Medical Systems, USA

Sudha R. Amarnath, MD

This review article describes specific considerations for pelvic radiation therapy in the adolescent and young adult (AYA) cancer population, including fertility and premature ovarian insufficiency, sexual health, financial toxicity, and psychological impact. Awareness of these effects and available resources can help radiation oncologists to better communicate and counsel patients, set clear and realistic expectations, and proactively manage late side effects that can impair quality of life and long-term survivorship.

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.