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Claiming CE Credit

To receive credits, participants must review the program materials in their entirety and complete the online post examination and evaluation. CE credits require a post examination score of 80% or higher.

Program Summary

Dynamic contrast-enhanced breast MR imaging using gadolinium-based contrast agents (GBCAs) offers superior cancer detection to mammography and breast ultrasound due to the visualization of tumor neovascularity as a tumor-specific feature. Despite the clear advantages of breast MR imaging, it is currently recommended only for patients with a high lifetime risk of breast cancer, but recent data shows that there is also a benefit for women at a greater than average risk

While GBCAs are essential to performing breast MR imaging, guidance from the US Food and Drug Administration (FDA) and the American College of Radiology (ACR) includes the recommendation of limiting a patient's gadolinium exposure where possible. One technique for reducing gadolinium exposure is to use a high-relaxivity GBCA that can be administered at a lower dose than a conventional GBCA without deteriorating image quality. Gadopiclenol recently received FDA approval and is a high-relaxivity GBCA that decreases gadolinium exposure.

This educational program provides a clinical rationale for lowering the administered gadolinium dose when performing breast MRI on patients who may receive repeat MR contrasted exams throughout their lifetime for breast cancer screening. Through a review of case studies, Dr. Pinker-Domenig will provide insight on how to achieve optimal imaging while lowering the gadolinium dose with Gadopiclenol for breast MRI.

Effective Date: July 18, 2024
Expiration Date: July 31.2027
Format: Self Instructional - Audio Visual with Slides
Educational Credits:
One (1.0) ARRT Category A CE Credits
One (1.0) AHRA CRA Credits
Estimated Completion Time: 60 minutes

This webinar is an educational activity sponsored by Guerbet, LLC.

Target Audience & Cost

This program is intended for: Radiologic Technologists, Radiology Administrators and related Imaging Professionals.

There is no cost to participate in this program.

Educational Objectives

Upon completion of this CE activity the healthcare provider should be able to:

• Understand and employ the clinical indications for dynamic-contrast enhanced breast MRI.
• Access clinical considerations and apply lower gadolinium dosing options for patients who may experience repeat, lifetime dosing of a GBCA for breast MRI.
• Implement breast MR imaging protocols to achieve the most accurate breast cancer diagnosis.

Presented by

Katja Pinker-Domenig, MD, PhD, EBBI, FISMRM, FSBI

Dept. of Radiology, Breast Imaging Service
Memorial Sloan Kettering Cancer Center

Katja Pinker-Domenig, MD, PhD, recently named Division Chief of Breast Imaging at the Department of Radiology at Columbia University Vagelos College of Physicians and Surgeons (VP&S) (May 2024), is an internationally renowned physician-scientist and board-certified radiologist with extensive expertise in all aspects of state-of-the-art breast imaging, including mammography, digital breast tomosynthesis, ultrasound, MRI, and breast interventions.

She has special training in the use of imaging to diagnose and treat disease with a focus on research and advanced medical imaging. Her top clinical accomplishments include the successful use of multiparametric MRIs in routine patient care; a concept that she developed, investigated, and implemented in Vienna and further refined at Memorial Sloan Kettering Cancer Center (MSK) to achieve the most accurate breast cancer detection.

Before joining MSK, Dr. Pinker-Domenig trained and practiced at the Medical University of Vienna in Austria. With a strong interest in cancer research that uses advanced imaging, she joined MSK in 2014 as a researcher, and has been a member of the radiology team at Memorial Hospital since November 2017, as well as a professor of radiology at Weill Medical College of Cornell University since November 2020. Until September, Dr. Pinker-Domenig will serve as the Director of Research and the Director of Breast MRI for the Breast Imaging Service in MSK’s Department of Radiology. She is an Executive Board Member of the nonprofit European Society of Breast Imaging and has co-authored several guidelines addressing all aspects of breast cancer imaging.

Accreditation

Radiologic Technologists:
This course meets all criteria and has been approved by the AHRA, The Association for Medical Imaging Management for one (1.0) ARRT Category A CE Credit.

Radiology Administrators:
This course meets all CRA renewal credit criteria and has been approved for one (1.0) continuing education credit in the following CRA domain: Operations Management (OM).

For information on applicability and acceptance of continuing education credit for this activity, please consult your professional licensing board or other credentialing organization.

Method of Participation/Criteria for Success

CE Credits
To receive CE credits for participating in this CE activity you must successfully complete the online post examination with a passing score of 80% or higher.

Online examinations return an immediate grade report. Upon receiving a passing score click Continue and complete the evaluation form. To view and print your Statement of Credit click the Print/View Certificate button displayed from within your MyAR Archives page.

Disclaimer

Participants have an implied responsibility to use the newly acquired information to enhance patient outcomes and their own professional development. The information presented in this activity is not meant to serve as a guideline for patient management. Any procedures, medications, or other courses of diagnosis or treatment discussed or suggested in this activity should not be used by clinicians without evaluation of their patient’s conditions and possible contraindications on dangers in use, review of any applicable manufacturer’s product information, and comparison with recommendations of other authorities.

• Risk Associated with Intrathecal Use: Intrathecal administration of GBCAs can cause serious adverse reactions including death, coma, encephalopathy, and seizures. The safety and effectiveness of ELUCIREM have not been established with intrathecal use. ELUCIREM is not approved for intrathecal use.
• Nephrogenic Systemic Fibrosis: GBCAs increase the risk for NSF among patients with impaired elimination of the drugs. Avoid use of ELUCIREM among these patients unless the diagnostic information is essential and not available with non-contrast MRI or other modalities.
• Hypersensitivity Reactions: With GBCAs, serious hypersensitivity reactions have occurred. Before ELUCIREM administration, assess all patients for any history of a reaction to contrast media, bronchial asthma and/or allergic disorders. These patients may have an increased risk for a hypersensitivity reaction to ELUCIREM.
• Gadolinium Retention: Gadolinium is retained for months or years in several organs. The highest concentrations have been identified in the bone, followed by other organs (e.g. brain, skin, kidney, liver, and spleen). While clinical consequences of gadolinium retention have not been established in patients with normal renal function, certain patients might be at higher risk. These include patients requiring multiple lifetime doses, pregnant and pediatric patients, and patients with inflammatory conditions. Minimize repetitive GBCA imaging studies, particularly closely spaced studies when possible.
• Acute Kidney Injury: In patients with chronically reduced renal function, acute kidney injury requiring dialysis has occurred with the use of GBCAs. The risk of acute kidney injury may increase with increasing dose of the contrast agent.
• Extravasation and Injection Site Reactions: Injection site reactions such as injection site pain have been reported in the clinical studies with ELUCIREM. Extravasation during ELUCIREM administration may result in tissue irritation. Ensure catheter and venous patency before the injection of ELUCIREM.
• Interference with Visualization of Lesions Visible with Non-Contrast MRI: As with any GBCA, ELUCIREM may impair the visualization of lesions seen on non-contrast MRI.

• Pregnancy: GBCAs cross the human placenta and result in fetal exposure and gadolinium retention. There are no available data on ELUCIREM use in pregnant women to evaluate for a drug-associated risk of major birth defects, miscarriage or other adverse maternal or fetal outcomes.
• Lactation: There are no data on the presence of ELUCIREM in human milk, the effects on the breastfed infant, or the effects on milk production. However, published lactation data on other GBCAs indicate that 0.01 to 0.04% of the maternal gadolinium dose is excreted in breast milk.
• Pediatric Use: The safety and effectiveness of ELUCIREM have not been established in pediatric patients younger than 2 years of age.
• Geriatric Use: This drug is known to be substantially excreted by the kidney, and the risk of adverse reactions to this drug may be greater in patients with impaired renal function.
• Renal Impairment: In patients with renal impairment, the exposure of gadopiclenol is increased compared to patients with normal renal function. This may increase the risk of adverse reactions such as NSF. No dose adjustment of ELUCIREM is recommended for patients with renal impairment.