Breast MRI with Gadopiclenol

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

Credits: 1.0 Category A, ARRT credit | 1.0 AHRA CRA credit • Effective Date: July 18, 2024 • Expiration Date: July 31, 2027

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.

Learning Objectives

At the conclusion of this activity, participants should be able to:

Commercial Support

This program has been supported by Guerbet LLC.

To view the program and complete the Post-Exam and claim credits select Profession below.

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Clinical Applications of MR Imaging in Stereotactic Localization Radiosurgery Procedures

Jenny WU, MD  and Glen Stevens, DO, PhD

Estimated time for completion: 1.5 hours   •   Date of Release: January 2, 2024  •   Expiration Date: January 31, 2027

Gadolinium-based contrast agents (GBCAs) are essential for enhancing the quality of MRI scans to make it easier for radiologists to identify pathology. The US Food and Drug Administration (FDA) and the American College of Radiology (ACR) recommend limiting patient exposure to gadolinium where possible. 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 CME/CE accredited Expert Forum webinar, 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.

Learning Objectives

At the conclusion of this activity, participants should be able to:

Accreditations

This activity has been planned and implemented in accordance with the accreditation requirements and policies of the Accreditation Council for Continuing Medical Education (ACCME) through the joint providership of IAME and Anderson Publishing. IAME is accredited by the ACCME to provide continuing medical education for physicians. IAME designates this internet live activity for a maximum of one and a half (1.5) AMA PRA Category 1 Credits™.

This course meets all criteria and has been approved by the AHRA, The Association for Medical Imaging Management and the CRA for one and a half (1.5) ARRT Category A CE Credit.

Commercial Support

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

To view the program and complete the Post-Exam and claim credits select Profession below.

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Clinical Applications & Imaging Considerations of Gadopiclenol Injection

Lawrence Tanenbaum, MD, FACR

Estimated time for completion: 1.0 hour   •   Date of Release: May 10, 2023  •   Expiration Date: March 31, 2023

In September 2022, Gadopiclenol injection, which is both macrocyclic (stable) and has high relaxivity properties received FDA marketing approval and may provide dosing options that can decrease gadolinium exposure, particularly in vulnerable patients

In this accredited Expert Forum webinar, the assessment of Gadopiclenol injection in neuro, body, and pediatric MR imaging will be presented by a panel of MR imaging experts and will include commentary from Lawrence N. Tanenbaum, MD. To encourage audience participation, a live Q & A session will follow the discussion.

Learning Objectives

At the conclusion of this activity, participants should be able to:

Accreditation

This course is approved by the The Association for Medical Imaging Management (AHRA) for 1.0 "Category A" ARRT and CRA continuing education credit.

Commercial Support

This program has been supported by Guerbet LLC.

To view the program and complete the Post-Exam and claim credits select Profession below.

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Development and Use of Elucirem (gadopiclenol) injection, a Macrocyclic, High-Relaxibity GBCA for CE-MRI

Lawrence Tanenbaum, MD, FACR; Laurie A. Loevner, MD; Donna Roberts, MD; Jeffrey Weinreb, MD; Ahmed Abdelal, PharmD

Estimated time for completion: 1.0 hour   •   Date of Release: February 24, 2023  •   Expiration Date: March 31, 2026

After decades of administrations, substantial evidence has accumulated for the efficacy and safety of gadolinium-based contrast agents (GBCAs) in magnetic resonance imaging (MRI). However, their excellent performance has led to increased use and dosing for many neuro and cardiovascular applications in adults and children.

As a result, concern has been growing in the radiology community, particularly with respect to use of the less stable agents, which are generally linear and, therefore, bind less tightly to the gadolinium (Gd) ion. While recognizing the value of these agents, the US Food and Drug Administration (FDA) and the American College of Radiology (ACR) now recommend limiting patient Gd exposure where possible. One technique for reducing Gd exposure is to use a high-relaxivity

One technique for reducing Gd exposure is to use a high-relaxivity GBCA that can be used at a lower dose than a conventional GBCA without impact on image quality. Until recently, however, the GBCA with the highest relaxivity was a linear agent. Consequently, it has been widely recognized for some time that it would be preferable if a GBCA was both macrocyclic in structure and high relaxivity, and that such an agent could be used to reduce Gd exposure by decreasing the amount of Gd injected.

A new GBCA that is both macrocyclic and high relaxivity has been developed and received FDA marketing approval in September 2022. A group of radiologists with extensive experience in contrast-enhanced (CE)-MRI convened to discuss this new GBCA, Elucirem™ (gadopiclenol) injection, and this monograph presents a summary of this expert panel forum.

Learning Objectives

At the conclusion of this activity, participants should be able to:

Accreditation

This course is approved by the The Association for Medical Imaging Management (AHRA) for 1.0 "Category A" ARRT continuing education credit.

Commercial Support

This program has been supported by Guerbet LLC.

To view the program and complete the Post-Exam and claim credits select Profession below.

(Site Registration/Login Required)