Malick Bio Idrissou, PhD; Anusha Muralidhar, PhD; Reinier Hernandez, PhD; Quaovi H. Sodji, MD, PhD

Radiopharmaceutical therapy (RPT) and immune checkpoint inhibitors (ICIs) represent transformative approaches to treating metastatic cancers. This review article discusses how RPT delivers targeted radiation to primary and metastatic tumors and the therapeutic advantages of combining RPT with ICIs while focusing on outcomes and challenges such as toxicity, immunosuppressive tumor microenvironment, and logistical barriers.

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.

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.

This educational program featuring Dr. Shreyas Vasanawala will cover pediatric MR imaging applications using Gadopiclenol, a recently approved gadolinium-based contrast agent (GBCAs).

Following a brief review of the literature and the currently available GBCAs, Dr. Vasanawala will discuss practice considerations as they relate to MRI contrast media selection and dose administration. Additionally, Dr. Vasanawala will share several case studies demonstrating the clinical value and benefits of Gadopiclenol for patients who may present with complex pathology and/or who may be subject to repeat contrast-enhanced MRI exams over their lifetime.

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

• Explain the properties that distinguish gadopiclenol injection from the other high relaxivity gadolinium-based contrast agents (GBCAs).
• Employ the FDA-approved indications and clinical applications for gadopiclenol injection in pediatric patients.
• Apply clinical considerations and dosing options for gadopiclenol administered to vulnerable patient populations who may experience repeat, lifetime dosing of a GBCA.

This program is made possible through an unrestricted educational grant from Bracco Diagnostics Inc.

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.

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.

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.

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

The techniques described in this article will aid the radiologist in performing and interpreting a US exam for appendicitis. The article details assessment criteria pertaining to the normal appendix and acute appendicitis, differential diagnosis and potential pitfalls, and considerations for the reporting of right lower quadrant US findings.

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

Nikhil G. Thaker, MD, MHA, MBA; Brian De, MD; Chirag Shah, MD; Sudhir Manda, MD; Trevor J. Royce, MD, MS, MPH; Sushil Beriwal, MD, MBA

As health care systems transform from traditional care delivery models to digital health models, IoT will enable integration of electronic health records and nonhealth care data with therapeutic augmented reality, wearable technologies, smart voice assistants, digital medicines, robots with artificial intelligence capabilities, continuous and Bluetooth-enabled monitors, and smart cameras. This review discusses the digital transformation of health care systems, IoT technology in cancer care, its practical applications in radiation oncology, and ongoing opportunities and challenges.

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.

Laura E Minton; Renu Pandit; WR Willoughby, PhD; Kristin K Porter, MD, PhD

Gadolinium (Gd)-based contrast agents (GBCAs) dominate the current contrast-enhanced magnetic resonance imaging (CE-MRI) market and are proven to increase the efficacy of diagnostic magnetic resonance imaging (MRI) scans. However, in the future it is likely that a personalized combination of contrast enhancement and image processing techniques will be used to optimize diagnosis and treatment planning while minimizing risk and cost. This activity is designed to educate radiologists about the future of MRI contrasts agents, including high relaxivity macrocyclic GBCAs, alternatives to GBCAs, and imaging processing techniques.

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.

Chipo Raranje, MS; Ryan Mueller, MD; Alex T. Price, PhD; Lauren E. Henke, MD; Xiaodong Zhao, PhD; Hyun Kim, MD; Eric Laugeman, MS; Joshua P. Schiff, MD

The authors describe practical treatment planning considerations for implementing a cone-beam CT-guided adaptive radiation therapy (CTgART) program with a specific focus on a template-based treatment planning methodology. The article discusses diseasesite- specific treatment planning considerations for the delivery of CTgART to the thorax, abdomen, prostate, and bladder, and examines future directions for this technology, which is becoming increasingly accessible and utilized in radiation oncology.

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.