Applied Radiology
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Available Programs and Courses FOR Physician

A complete listing of currently available online programs is provided below. To view course materials click an available viewing format provided with each listing (PDF, HTML, Interactive). To access online exams and claim credit you must be registered and logged in.  To add courses to your "MyAR Archives" user account select the "Add To Cart" button provided with each course title and follow the prompts. 

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* The Online Course for MR Safety Officers (MRSO) and MR Medical Directors (MRMD)
Released: September 23, 2019 Expires: September 30, 2022 CE credits: 10.0 Cost: $975.00
Faculty: William Faulkner, B.S.,R.T.(R)(MR)(CT), FSMRT | Kristan Harrington, MBA, R.T.(R)(MR), ARRT, MRSO
17958

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).

Module 1: Basic MRI Physics Relevant to MRI Safety
Module 2: Static Field: Bioeffects and Access Control
Module 3: Gradient Magnetic Fields: Bioeffects and Safety
Module 4: Radio Frequency Field: Bioeffects and Safety
Module 5: Implants and Devices
Module 6: Gadolinium-Based MR Contrast Agents
Module 7: MR Safety Screening
Module 8: Managing Emergent Situations and Patient Considerations: Quench and Patient Anxiety & Patient Monitoring

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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* Advanced MRI Safety Training For Healthcare Professionals:
Level 2 MR Personnel - Updated Edition
Released: April 05, 2017 Expires: April 30, 2020 CE credits: 2.5 Cost: $50.00
Faculty: Frank G. Shellock, PhD, FACC, FACR, FACSM
16626

This program reviews fundamental MRI safety protocols 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. As such, 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.

With more than 30 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.

Advanced MRI Safety Training for Healthcare Professionals, Level 2 MR Personnel is a 150-minute program that is divided into three sections.

Educational Objectives

  • Understand the safety issues related to MRI.
  • Describe the bioeffects associated with the static magnetic field, time-varying magnetic, and radiofrequency fields.
  • Present guidelines that prevent projectile-related accdents.
  • 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.
  • Identify safety considerations for gadolinium-based contrast agents.

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

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* Basic MRI Safety Training:
Level 1 MR Personnel - Updated Edition
Released: April 04, 2017 Expires: April 30, 2020 CE credits: 1.0 Cost: $30.00
Faculty: Frank G. Shellock, PhD, FACC, FACR, FACSM
16950

Anyone who enters 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 desiring preparation for safety training as, Level 2 MR Personnel.

With more than 30 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. 

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* The Joint Commission: Understanding and Complying With The Latest Requirements For MRI Safety
Released: July 01, 2018 Expires: June 30, 2020 CE credits: 1.5 Cost: $30.00
Faculty: Frank G. Shellock, PhD, FACC, FACR, FACSM
17314

This program describes the Joint Commission’s requirements for annual training on specific MRI safety practices. In addition, it covers procedures to manage patients undergoing MRI with recommendations to prevent ferromagnetic objects from entering the MRI environment; claustrophobia, anxiety, or emotional distress; guidelines to screen patients with medical implants and devices; procedures to prevent thermal injuries; methods to handle patients requiring urgent or emergent medical care; contrast agent safety including information for nephrogenic systemic fibrosis, and techniques to avoid problems related to acoustic noise.

Educational Objectives

  1. Describe the latest requirements from The Joint Commission for MRI with an emphasis on safety and training.
  2. Present procedures for managing claustrophobic patients, screening prior to MRI, preventing ferromagnetic accidents, avoiding MRI-related thermal injuries, handling emergencies, and preventing acoustic noise issues.
  3. Define methods to ensure compliance with the latest requirements from The Joint Commission for MRI safety.
  4. Summarize The Joint Commission’s requirements for annual training on specific MRI safety practices.

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

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A Clinical Review: Benefits of Tomosynthesis in Daily Practice
Released: December 15, 2019 Expires: December 14, 2021 CE credits: 1.0 Cost: $0.00
Faculty: Dean J. Phillips, DO
18257

Annual mammography screening can save lives because breast cancer is a progressive disease and early detection enables improved prognosis due to appropriate treatment of small nonpalpable node-negative cancers. Multiple randomized controlled trials and observational studies have shown that mammography can reduce breast cancer mortality by 30% or more.

Digital breast tomosynthesis (DBT) first entered the breast imaging clinical arena when the Food and Drug Administration (FDA) approved DBT in 2011. Multiple studies have shown that DBT is effective in both mammography screening and diagnostic settings. Tomosynthesis has quickly emerged as a practice-changing standard that improves the clinical accuracy of a mammogram by increasing both sensitivity and specificity; thus, reducing the masking effect of overlapping fibroglandular tissue, thereby improving breast cancer detection. The improved accuracy and overall efficiency that DBT provides, will enhance radiologists’ performance and improve the patient experience.

Learning Objectives

  • Discuss the importance of breast screening mammography.
  • Incorporate the differences between, and benefits of 2D and 3D mammography into routine clinical practice.
  • Apply 3D tomosynthesis to improve patient care, particularly in the management of patients with dense breasts.

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

Supported through an unrestricted educational grant from FUJIFILM Medical Systems U.S.A., Inc.

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A Multimodality Approach to Imaging the Mediastinum and Pleura: Pearls and Pitfalls
Released: March 01, 2020 Expires: February 28, 2022 CE credits: 1.0 Cost: $0.00
Faculty: Applied Radiology
18596

Leonid Roshkovan, MD; Sharyn I. Katz, MD, MTR

Diagnostic interpretation of cross-sectional imaging of the mediastinum and pleura presents unique and significant challenges even to the experienced radiologist. The mediastinum is anatomically complex, comprising numerous structures ar-ranged into multiple anatomic compartments that can give rise to a wide range of pathologies. The pleural space is thin and multi-planar, which can confound evaluation and quantification of pleural abnormalities.

In this article, we will review imaging approaches to the mediastinum and pleura and present imaging pearls and pitfalls that can assist radiologic interpretation. This will include common masses that present in routine imaging of the chest and key imaging features that help to distinguish them using CT, MRI and FDG-PET/CT.

The knowledge of common mediastinal and pleural pa-thologies present on cross-sectional imaging will enable the radiologist to make informed diagnostic radiologic interpreta-tions and guide appropriate intervention and surveillance.

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.

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A Multimodality Review Of Solid and Cystic Pancreatic Masses
Released: August 01, 2018 Expires: July 31, 2020 CE credits: 1.0 Cost: $0.00
Faculty: Applied Radiology
17371

Samir Mehta, MD, and Jonathan Dorff, MD

The discovery of incidental asymptomatic pancreatic masses has gone up dramatically with the advent and increasing accessibility of CT and MRI.

It is imperative to understand the different imaging features and behaviors of these masses on CT and MRI to construct an appropriate differential diagnosis, as recommendations based on these masses are very different. Knowledge of the relevant clinical history and patient populations affected is also important to formulate an accurate diagnosis. It is also important to recognized pitfalls in diagnosing the masses, as there are both typical and atypical appearances.

There are also mimics of pancreatic masses that lead to unnecessary follow-up and workup, for which the radiologist should be aware. A multimodality approach is frequently needed to narrow the differential diagnosis, though tissue sampling is usually required for a definitive diagnosis.

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.

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A review of strategies for optimizing workflow, quality improvement, and patient safety within radiation oncology departments
Released: December 01, 2018 Expires: November 30, 2020 CE credits: 1.0 Cost: $0.00
Faculty: Applied Radiology
17614

Bindu V. Manyam, MD; Naichang Yu, PhD; Tim Meier, RTT; John H. Suh, MD; Samuel T. Chao, MD

With increases in complexity of radiation delivery and patient volume, vulnerable sources for errors may exist within radiation oncology workflow. Patterns of care recommendations are outlined by the American College of Radiology and the National Comprehensive Cancer Network guidelines; however, departmental and institutional policies and standards for quality and patient safety may vary. This article examines initiatives to mitigate errors and enhance safety, and describes efforts to incorporate quality improvement and patient safety into resident education.

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.

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Adrenal imaging: Using A Three-category Approach To Managing The Adrenal “Incidentaloma”
Released: October 01, 2018 Expires: September 30, 2020 CE credits: .75 Cost: $0.00
Faculty: Applied Radiology
17528

Lisa M. Ho, MD

Imaging plays a critical role in the work-up and clinical management of adrenal disease. Because masses in the adrenal glands are one of the most commonly encountered incidentalomas, the American College of Radiology (ACR) has developed specific recommendations on how to manage incidentally discovered adrenal masses in the adult population. The purpose of this article is to review the imaging appearance of common adrenal diseases and provide a diagnostic imaging algorithm for work-up of the “adrenal incidentalomas.”

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.

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Advances in MR and CT Imaging: Emphasis on Artificial Intelligence:
RSNA 2019 Archived Program
Released: January 01, 2020 Expires: January 01, 2022 CE credits: 1.0 Cost: $0.00
Faculty: Mathias Prokop, MD, Ph.D. | Garry E. Gold, MD
18369
RSNA 2019 Archived Program

This Expert Forum Symposium features two respected radiologists who share their clinical experience applying advanced artificial intelligence techniques in both MR and CT imaging.

MR and CT imaging are advancing at a rapid rate with new scanner and software technology finding its way into advanced imaging scanners each year. Artificial Intelligence is proving to play a major role in this expansion. In this one-hour accredited CME symposium, Dr. Gold and Dr. Prokop will provide insight into how they are putting new AI tools into everyday practice at their facilities and explain how these tools are providing better patient care and throughput. Following the presentations, the faculty will take question from the audience.

Advances in CT Imaging
Presented by: Mathias Prokop, MD

Advances in MSK MR Imaging
Presented by: Garry E. Gold, MD

Educational Objectives

At the completion of this program, participants will be able to:

  1. Practice two new novel approaches for advanced joint imaging with MR
  2. Describe the clinical value of deep learning reconstruction techniques in CT
  3. Discuss and implement Artificial Intelligence into clinical practice today

This program was originally presented live at RSNA 2019 and sponsored by the Institute for Advanced Medical Education (IAME) and supported through an unrestricted educational grant from Canon Medical Systems.

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An Emergent Role For Radiomic Decision Support In Lung Cancer
Released: December 01, 2019 Expires: November 30, 2021 CE credits: 1.0 Cost: $0.00
Faculty: Applied Radiology
18367

Gleb A. Kuzmin, PhD;* Mishka Gidwani, BS;* Tianjun Ma, PhD;* Tingliang Zhuang, PhD; Mohamed E. Abazeed, MD, PhD

This review article discusses recent developments in radiomics—a computational image evaluation technique that integrates medical images, clinical data, and machine learning—its applications to lung cancer treatments, and the challenges associated with radiomics as a tool for precision diagnostics and theranostics.

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Anterior Cruciate Ligament and Meniscal Tears: A Multi-modality Review
Released: January 01, 2020 Expires: December 31, 2022 CE credits: 1.0 Cost: $0.00
Faculty: Applied Radiology
18417

Matthew Schwenke, MD; Manu Singh, MD; and Bernard Chow, MD

Injuries to the anterior cruciate ligament (ACL) are increasing over time, with younger women at elevated risk. Meniscal tears are also a significant source of morbidity in both the younger and older populations. Surgical repair of both conditions may alleviate symptoms and allow resumption of athletic activities. Understanding of the pathogenesis, associated findings, and appearance of these injuries on all imaging modalities is critical to their accurate diagnosis and timely treatment. Radiographs may show indirect signs of ACL and meniscal injuries. Ultrasonography is being utilized more often in the workup of these conditions as an adjunct to physical exam and as an initial screening tool. Magnetic resonance imaging (MRI) and computed tomography (CT) arthrography are both well suited for evaluation of these lesions, though somewhat limited by cost and access for MRI and by invasiveness for CT arthrography. ACL and meniscal tears can also be graded and classified according to their appearance on imaging which helps guide the surgeon during arthroscopy.

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.

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Augmenting Cancer Control Efforts In A Limited Resource Setting By Leveraging International Collaborations In Radiation Oncology
Released: July 01, 2019 Expires: June 30, 2020 CE credits: 1.0 Cost: $0.00
Faculty: Applied Radiology
17915

Joel Yarney, MD; Hannah Ayettey Anie, MD; Verna Vanderpuye, MD; Francis Adumata Asamoah, MD; Baffuor Awuah, MD; Clement Edusa, MD; Samuel Tagoe, PhD; Samuel Denyo, BTech; Pearl Aba Scott, MD; Francis Doughan, MPhil; Kofi Adesi Kyei, PhD; Charles Aidoo, HND; Bismark Dwobeng, MD; Rebecca Wong, MD; Horia Vulpe, MD; Shivanshu Awasthi, MPH, PharmD; Angelina Fink, MPH; Stuart Wasserman, MS; Peter Johnstone, MD; Louis Harrison, MD; Kosj Yamoah, MD, PhD

Oncologists may not be familiar with the utilization and operation of radiation therapy facilities in limited-resource settings. Additionally, oncologists interested in global radiation oncology need to understand the challenges and opportunities pertinent to the field. This article describes innovative international efforts regarding quality assurance, capacity building, and research and training that address unmet needs and improve radiation treatment for patients in Ghana, a major hub for radiation treatment in Africa.

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Biliary Tract Emergencies: What the Radiologist Should Know
Released: July 01, 2019 Expires: June 30, 2021 CE credits: 1.0 Cost: $0.00
Faculty: Applied Radiology
17918

Sarah D. Fenerty, MD; Sudhir Kunchala, MD; and Matthew A. Morgan, MD

Acute biliary conditions are a common occurrence in the emergency department, but may be underappreciated on diagnostic imaging, particularly since these injuries may occur in complex patients or be a secondary injury in a patient presenting with a more obvious primary injury. The potential for delayed diagnosis could result in significant morbidity.

Since findings may be subtle, radiologists need to be comfortable with common presentations of acute biliary disease to maintain an adequate level of suspicion and detect early signs of injury. The radiologist should also be familiar with other imaging modalities that may be useful in confirming biliary injury and tailor effective follow up imaging to a patient’s clinical situation.

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Chemoradiation Treatment of Glioblastoma Multiforme: Treatment Guidelines and Considerations
Released: September 01, 2019 Expires: August 31, 2021 CE credits: 1.0 Cost: $0.00
Faculty: Applied Radiology
17995

Krissia Margarita Rivera Perla, ScB; Ollin Gomez Venegas, BA; Steven A. Toms, MD, MPH

Authors review the North American and European guidelines for chemoradiation of GBM created as a result of the new 2016 WHO classification system, focusing specifically on age, performance status, molecular markers, and disease recurrence. They also discuss factors such as socioeconomic and insurance status that impact radiation treatment compliance and GBM outcomes.

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Comprehensive Care For The Child Or Adolescent Diagnosed With A Childhood Malignancy Requiring Palliative Radiation Therapy: A Review
Released: June 01, 2018 Expires: May 31, 2020 CE credits: 1.0 Cost: $0.00
Faculty: Applied Radiation Oncology
17303

Tamara Vern-Gross, DO, FAAP

Because of the low incidence of pediatric malignancies, no consensus has been reached on the best practices for the delivery of pediatric palliative radiation therapy. As a result, current practice is extrapolated from adult literature and single institutional series. In addition to the technologies for palliation of pediatric patients are essential components of communication for meeting medical and psychosocial needs of the families and patients; these needs are not always addressed. A multidisciplinary approach with appropriate care and communication addressing patient questions and needs provides meaning and improved quality of life during this phase of treatment.

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.

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Controversies In The Preoperative Radiotherapeutic Management of Resectable Esophageal Cancer
Released: September 01, 2018 Expires: August 31, 2020 CE credits: 1.0 Cost: $0.00
Faculty: Applied Radiology
17462

Stephanie R. Rice, MD; Adeel Kaiser, MD; Elizabeth Nichols, MD

This review examines the role of trimodality therapy in the management of esophageal cancer, focusing on controversies surrounding the optimal total neoadjuvant RT dose employed. Current and past technologies for radiation treatment delivery and their impact on overall survival and toxicity are discussed. The authors also detail the data driving the management of resectable esophageal carcinoma, reviewing studies comparing neoadjuvant CRT followed by surgery to definitive CRT, neoadjuvant CRT followed by surgery to surgery alone, and controversies in radiation dose and planning considerations for preoperative resectable esophageal cancer.

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.

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Digital Technologies to Advance Clinical PET for Oncology and Beyond
Released: June 05, 2019 Expires: June 04, 2021 CE credits: 1.0 Cost: $0.00
Faculty: Michael V. Knopp, MD, PhD
17860
Recent technological advances challenge traditional PET acquisition procedures in order to leverage the benefits of digital technology to improve diagnostic capabilities, patient experience, quantification and new indications. Precision medicine is a call to action to radically advance capabilities in the era of molecular targeted medicine.

In this Expert Forum Webcast, Michael V. Knopp, MD, PhD will provide an overview of current digital PET technologies and how leveraging these digital advances improves PET imaging using clinical cases. He will demonstrate how new concepts result in acceleration of acquisition time, dose reduction and dynamic imaging to help improve quality and the patient and staff experience. These new applications apply to the clinical practice for oncology, neurology and orthopedics / sports medicine.

Learning Objectives

  • Describe current PET technologies.
  • Describe the benefits of digital photon counting.
  • Understand the benefit of improved time of flight timing.
  • Understand the benefit of reduced voxel size and higher matrix reconstruction.
  • Describe ultra-fast whole-body imaging.
  • Describe the benefits of imaging at lower tracer doses.
  • Describe the benefits of dynamic PET imaging.
  • Describe the use of Y-90 for post-therapy assessment.

Supported through an unrestricted educational grant from Philips Healthcare.

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Evidence-based Approach to Minimizing IV Contrast Extravasations
Released: July 10, 2019 Expires: July 09, 2021 CE credits: 1.0 Cost: $0.00
Faculty: Ryan K Lee, MD, MBA
17889

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.

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Experiences with Multi-Energy CT: Applications in a Community Hospital Setting
Released: October 09, 2018 Expires: October 08, 2020 CE credits: 1.0 Cost: $0.00
Faculty: Kevin Smith, MD
17520
In recent years, several manufacturers have developed CT scanners with the ability to acquire images at varying energy levels, thereby allowing imaging professionals to differentiate the various elements of the body based on their material density and atomic numbers.

This technique, known as Multi-Energy CT, Dual Energy CT or Spectral CT, to name a few, has the potential to revolutionize the way we depict and interpret CT scans. In this Expert Forum Webcast, Dr. Kevin Smith will share his clinical experiences with the use of Multi-Energy CT in a community hospital setting.

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

Learning Objectives

  • Understand how Dual Energy CT compares to conventional imaging.
  • Review common dual energy reformats and post-processing at our institution.
  • Review clinical cases in which DECT has been deployed and added value in a community setting.
  • Review the radiologists workflow for handling extra series and images.

This program is supported through an unrestricted educational grant from Philips Healthcare

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Genomics and Radiomics: Tools To See The Unseen To Personalize Radiation Therapy
Released: December 01, 2019 Expires: November 30, 2021 CE credits: 1.0 Cost: $0.00
Faculty: Applied Radiology
18368

G. Daniel Grass, MD, PhD; Matthew N. Mills, MD; Jacob G. Scott, MD, DPhil; Steven A. Eschrich, PhD; Javier Torres-Roca, MD

Genomics and radiomics provide an opportunity to increase the precision of radiation delivery in selection of dose and spatial delivery. Further understanding of host and tumor differences with interrogative approaches may provide opportunity to precisely deliver radiotherapy beyond spatial and anatomic features to one guided by intrinsic tumor biology. This article addresses how tumor genomic blueprints can be exploited for radiation therapy; radiomics as a noninvasive means to assessing tumor biology; clinical applications regarding treatment response, treatment planning, and toxicity; and radiogenomics utility.

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.

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Hand Masses: An Essential MRI Review
Released: May 01, 2019 Expires: April 30, 2021 CE credits: 1.0 Cost: $0.00
Faculty: Applied Radiology
17859

Nicholas Hardin, DO; Shaked Laks, MD; Carola Mullins, MD; Osvaldo Padilla, MD; Lisa Kafchinski, MD; and Crysela Smith, MD

Hand masses are commonly encountered entities that often cause clinical and diagnostic dilemmas due to their nonspecific clinical presentation and overlapping imaging findings. This article systematically reviews the most commonly encountered hand masses in clinical practice in order to help the radiologist gain a structured diagnostic approach and familiarity with typical clinical presentations. Furthermore, this review will strengthen the radiologist’s ability to recognize pertinent MR imaging findings and gain knowledge of the underlying pathology on a cellular level.

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.

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Imaging Brachial Plexus Pathology
Released: November 01, 2019 Expires: October 31, 2021 CE credits: 1.0 Cost: $0.00
Faculty: Applied Radiology
18104

James Thomas Patrick Decourcy Hallinan, MBChB; Mini N. Pathria, MD; and Brady K. Huang, MD

Brachial plexus disorders are a diagnostic challenge due to the complex anatomy and nonspecific symptomatology. MRI remains the best modality for assessing the brachial plexus (BP), due to its superior soft-tissue contrast compared to CT or ultrasound. Traumatic lesions are the most common cause of BP dysfunction, closely followed by neoplastic infiltration. Infection, inflammation and iatrogenic causes are less common.

This review article will provide an overview of anatomy and practical, up-to-date BP imaging techniques for general radiologists, followed by a step-wise discussion of common pathology. Clinically relevant advances such as dynamic tho-racic outlet MRI will also be discussed.

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Imaging of Hydrocephalus
Released: May 01, 2018 Expires: April 30, 2020 CE credits: 1.0 Cost: $0.00
Faculty: Lawrence N. Tanenbuam, MD, FACR | Wende N. Gibbs, MD,MA
17245

Wende N. Gibbs, MD, MA, and Lawrence N. Tanenbaum, MD, FACR

Hydrocephalus is a a mechanical complication of different pathologic conditions and a disease process itself.  The morphologic features are easily recognizable, but the patho-physiology remains incompletely understood.  Nearly all hydrocephalus is due to cerebrospinal fluid (CSF) obstruction at some point between the ventricles and the systemic venous circulation.  Classification is important as it informs optimal treatment. 

Optimized imaging is vital to the success of flow diversion.  Current treatments are limited and invasive: CSF diversion via catheter or endoscopic third ventriculostomy.  Decision making relies upon high resolution imaging to determine the site of obstruction and anatomic features that may complicate the procedure.

Morphologic and physiologic imaging are used to evaluate suspected normal pressure hydrocephalus (NPH).  Several morphologic measures individually and in combination have shown high positive predictive value in identifying individuals who will respond to treatment with ventricular shunting and in differentiating NPH from Alzheimer disease, which can have a similar imaging appearance.

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.

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Imaging of Postoperative Internal Hernias
Released: November 01, 2018 Expires: October 31, 2020 CE credits: 1.0 Cost: $0.00
Faculty: Applied Radiology
17560

Douglas H. Sheafor, MD, FSAR

In postoperative bariatric patients, internal hernias are one of the most common, and dreaded postoperative complications; unfortunately, these hernias are also challenging to diagnosis clinically and radiographically. This article highlights several keys to correct diagnosis of the postoperative internal hernia, including understanding the common postoperative anatomy, optimizing CT imaging using oral contrast and multiplanar reformats, and combining findings such as swirling of the mesentery, bowel obstruction and other CT abnormalities to increase the specificity of diagnosis. In the acute-care setting, radiologists should have a high index of suspicion for internal hernias in the setting of prior RYGB surgery and signs of obstruction, particularly given their association with closed loop obstruction and bowel ischemia mandating prompt surgical intervention.

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Improving Access To Radiation Therapy In Indonesia
Released: July 01, 2019 Expires: June 30, 2020 CE credits: 1.0 Cost: $0.00
Faculty: Applied Radiology
17916

Soehartati Gondhowiardjo, MD, PhD; Sri Mutya Sekarutami, MD, PhD; Angela Giselvania, MD; Steven Octavianus, MD; Muhamad Iqbal Assegab

To date, the exponential rates of population growth and cancer incidence often outpace the linear rate of radiation therapy services growth, especially in developing countries such as Indonesia. There are many challenges faced in closing this gap and improving radiation therapy facilities and services. This review article summarizes the challenges and the efforts to overcome them.

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Improving The Therapeutic Index For Nonoperable Esophageal Cancer Patients With Modern Radiation Technologies
Released: September 01, 2018 Expires: August 31, 2020 CE credits: 1.0 Cost: $0.00
Faculty: Applied Radiology
17464

Michael D. Chuong, MD; Shahed Badiyan, MD; Matthew Hall, MD, MBA; Smith Apisarnthanarx, MD

Although there is general awareness that modern radiation technologies both reduce normal organ dose while permitting safe dose escalation in nonoperable EC patients, there is lack of consensus about how these technologies should be routinely employed in the clinic. There clearly is need for well-designed clinical trials to guide clinical decision making in this regard, several of which are being planned (NCT01102088) or already underway (NCT01512589). This course examines how contemporary radiation technologies can improve the therapeutic index, including both reduced cardiopulmonary and hematologic toxicity and higher tumor control, for nonoperable esophageal cancer patients receiving definitive chemoradiation.

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.

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Indications, Barriers and Paths To Advancement In Palliative Radiation Oncology
Released: June 01, 2018 Expires: May 31, 2020 CE credits: 1.0 Cost: $0.00
Faculty: Assorted Faculty
17304

Muhammed M. Fareed, MD; Monica Krishnan, MD; Tracy A. Balboni, MD, MPH; Hsiang-Hsuan Michael Yu, MD

Palliative radiation oncology is an integral part of radiation oncology practice with practical implications in common clinical scenarios including bone metastases, brain metastases, malignant spinal cord and cauda equina compression, tumor related bleeding, fungation, obstruction and visceral metastases. Further education and research is needed as part of residency training and beyond to enhance the spectrum of care for advanced cancer patients delivered by radiation oncologists. Supportive and palliative care skills must expand beyond the technical aspects of radiation therapy delivery to generalist palliative care competencies, including symptom management basics, communication and goals of care, advance care planning, psychosocial issues, cultural considerations, spiritual needs and ethical/legal issues.

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.

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Innovation in High Resolution Imaging:
RSNA Nov. 26, 2018 OnDemand
Released: January 01, 2019 Expires: January 01, 2021 CE credits: 1.5 Cost: $0.00
Faculty: Applied Radiology
17643
RSNA 2018 Archived Program

As technological advances in MR, CT, USD, and Combined Angiography/CT systems continue to impact how healthcare is practiced, this Expert Forum Symposium Series, featuring two (2) individual presentations from experts in their respective fields; will highlight through their clinical experiences, how they are maximizing the latest advances in imaging, and assess the growing impact that artificial intelligence is having on improved patient outcomes, satisfaction and throughput.

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

Deep Learning Reconstruction
by Mathias Prokop, MD
Enhanced Value of Neuro MR Imaging Using Deep Learning Reconstruction Denoising Methods
by Vincent Dousset, MD, PhD

Educational Objectives

At the completion of this program, participants will be able to:

  • Discuss the clinical value of new deep learning reconstruction techniques in CT.
  • Implement new de-noising methods in neuro MR imaging.

This program was originally presented live at RSNA 2018 and sponsored by the Institute for Advanced Medical Education (IAME) and supported through an unrestricted educational grant from Canon Medical Systems.

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Magnetic Resonance Enterography In Inlammatory Bowel Disease
Released: February 01, 2019 Expires: January 31, 2021 CE credits: 1.0 Cost: $0.00
Faculty: Applied Radiology
17699

Hina Arif-Tiwari, MBBS, MD, DNB; Philip Taylor, DO; Bobby T. Kalb, MD; and Diego R. Martin MD, PhD, FRCPC

Inflammatory bowel disease (IBD), including Crohn’s disease (CD) and ulcerative colitis (UC) is a chronic debilitating inflammatory disease that currently lacks a single gold standard diagnostic test. Magnetic resonance enterography (MRE) is an excellent modality for assessing IBD because it demonstrates a greater ability to depict submucosal pathology in comparison to other diagnostic modalities.

Although patient preparation for MRE often involves ingestion of various osmotic agents, recent research suggests that this may be unnecessary, as the high level of bowel wall contrast is sufficient even without bowel distention.

The ability to distinguish between acute forms of IBD and non-acute forms of IBD is an important role for MRI imaging. Acute flares will demonstrate mural increased T2 signal, best appreciated on fat saturation T2-weighted sequences. MRE also plays a role in the diagnosis of extra-enteric complications of IBD such as perirectal abscess or sclerosing cholangitis.

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.

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MRI of Endometriosis: A Comprehensive Review
Released: September 01, 2019 Expires: August 31, 2021 CE credits: 1.0 Cost: $0.00
Faculty: Applied Radiology
18048

Naziya Samreen, MD; Candice A. Bookwalter, MD, PhD; Tatnai L. Burnett, MD; Myra Feldman, MD; Shannon P. Sheedy, MD; Christine Menias, MD; and Wendaline M. VanBuren, MD

Endometriosis affects a significant number of reproductive age women and can continue to be present after menopause. The disease is much more complex than ovarian endometriomas, and understanding histology, disease location, and the limitations and benefits of imaging can aid in the diagnosis and management of these patients.

A dedicated MRI protocol and key imaging features are used to optimize disease detection. Comprehensive cases will broaden the capacity for pattern recognition of pelvic morphologic changes, secondary associations, and features of malignant degeneration

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Multimodality Management of Colorectal Liver Oligometastases
Released: September 01, 2019 Expires: August 31, 2021 CE credits: 1.0 Cost: $0.00
Faculty: Applied Radiology
17994

Shauna R. Campbell, DO; Ehsan H. Balagamwala, MD; Neil M. Woody, MD, MS; Kevin L. Stephans, MD

Authors examine modern treatment approaches to limited liver metastases from colorectal cancer, discussing the intent and sequencing of treatment, chemotherapy, surgical resection, radiofrequency ablation/cryoablation, chemoembolization, radioembolization, external-beam radiation therapy, stereotactic body radiation therapy (SBRT), and proton therapy and the indication for each modality. The review also describes circumstances in which SBRT is preferred over other liver-directed therapies.

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Musculoskeletal Imaging In Children: What The General Radiologist Should Know
Released: March 01, 2019 Expires: February 28, 2021 CE credits: 1.0 Cost: $0.00
Faculty: Applied Radiology
17793

Jennifer Shaffer Ngo, MD, and Gary R. Schooler, MD,

Pediatric musculoskeletal injuries often manifest differently from adult injuries and similar mechanisms may present differently depending on the degree of skeletal maturity. This article outlines many of the common pediatric injuries that the general radiologist may encounter in practice. Select topics include physeal injuries, elbow fractures, developmental dysplasia of the hip, slipped capital femoral epiphysis, and Blount disease. Knowledge of these unique pathologies and anatomic variants will help the radiologist recognize these entities sooner, ultimately helping facilitate the most expeditious and appropriate care.

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.

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Novel Techniques for Liver Assessment:
RSNA Nov. 27, 2018 OnDemand
Released: January 01, 2019 Expires: January 01, 2021 CE credits: 1.5 Cost: $0.00
Faculty: Applied Radiology
17644
RSNA 2018 Archived Program

As technological advances in MR, CT, USD, and Combined Angiography/CT systems continue to impact how healthcare is practiced, this Expert Forum Symposium Series, featuring three (3) individual presentations from experts in their respective fields; will highlight through their clinical experiences, how they are maximizing the latest advances in imaging, and assess the growing impact that artificial intelligence is having on improved patient outcomes, satisfaction and throughput.

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

Advanced and Emerging Ultrasound Technologies for Assessment of Liver Disease
by Andrew Trout, MD
Ultrasound Fusion Technology with Auto-Registration
by Nami Azar, MD, MBA
Advancements in Interventional Radiology Using A Combined CT & Angiography System
by Bela Kis, MD. PhD

Educational Objectives

At the completion of this program, participants will be able to:

  • Identify clinical scenarios where ultrasound fusion imaging can be implemented.
  • Review the role of shearwave elastography in the assessment of diffuse liver disease.
  • Describe the value of the hybrid CT/angiography system in liver tumor embolization cases.

This program was originally presented live at RSNA 2018 and sponsored by the Institute for Advanced Medical Education (IAME) and supported through an unrestricted educational grant from Canon Medical Systems.

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Optimizing Contrast-Enhanced CT with the Use of Saline
Released: November 01, 2018 Expires: October 31, 2020 CE credits: 1.0 Cost: $0.00
Faculty: Dominik Fleischmann, MD | Lior Molvin, RT, CT, MBA
17582
Advances in technology have led computed tomography (CT) to become one of the main diagnostic tools utilized today in modern healthcare, as it provides a safe and low risk anatomical visualization of the human body. However, these advances have also introduced new challenges related to the administration of contrast, which is a fundamental component of many CT imaging exams, particularly in cardiac CT.

This Expert Forum aims to help a wider audience of radiology professionals understand how to use iodine contrast safely, by using a weight-based contrast strategy, which allows technologists and radiologists to image safely while obtaining optimal results. In addition, we will discuss the value of including saline in your protocols, which can result in contrast savings, but also provides the ability to optimize the contrast injection process to improve image quality and patient safety.

Learning Objectives

  • Gain insight into weight-based imaging strategies and how to implement them in clinical practice.
  • Identify when saline may be a helpful addition to an injection strategy.

Supported through an unrestricted educational grant from Bracco Diagnostics Inc.

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Patient Education In Radiation Oncology: Evolution and Innovation
Released: August 01, 2019 Expires: July 31, 2021 CE credits: 1.0 Cost: $0.00
Faculty: Nadia Saeed, BA
17942

Nadia Saeed, BA

Radiation therapy remains one of the more misunderstood treatment modalities in cancer care. This article discusses the evolution of patient education in radiation oncology, discussing current education tools and practices as well as new innovations and future directions, including virtual reality, social media, apps and more.

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Pediatric Bone Imaging: Differentiating Benign Lesions From Malignant
Released: July 01, 2018 Expires: June 30, 2020 CE credits: 1.0 Cost: $0.00
Faculty: Applied Radiology
17305

Alysha Vartevan, DO; Crystal May, DO; and Craig E. Barnes, MD

Bone tumors are one of the most common lesions encountered by radiologists. Fortunately, most pediatric bone tumors are benign. Although cross sectional imaging such as CT or MRI can be useful, the most important imaging modality in the initial workup of a bone tumor is the plain radiograph.

Differentiating between benign and malignant bone tumors is not always straightforward; however, it is possible to distinguish between them by carefully evaluating charac-teristics such as the lesion’s type of margin, pattern of bone destruction, type of periosteal reaction and presence of an associated soft tissue mass. In addition, matrix type and tumor location can help narrow the differential diagnosis.

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.

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Proton Therapy for Colorectal Cancer
Released: September 01, 2019 Expires: August 31, 2021 CE credits: 1.0 Cost: $0.00
Faculty: Applied Radiology
17993

Saira E. Alex, BS; Eric D. Brooks, MD; Emma B. Holliday, MD

Based on current standards, colon cancer is treated with surgical resection and chemotherapy, and rectal cancer is treated with preoperative radiotherapy. This review of the literature suggests the potential for improved local control and reduced toxicity when treating colorectal cancer with proton therapy compared to the current treatment paradigms. Additionally, surgery and ablative techniques have traditionally been used to treat metastatic colorectal cancer. This review discusses how proton therapy could offer an alternative approach to reduce toxicity and act in lieu of surgery in the metastatic setting.

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Quality And Safety Education In Medical School
Released: August 01, 2019 Expires: July 31, 2021 CE credits: 1.0 Cost: $0.00
Faculty: Nadia Saeed, BA
17943

Nadia Saeed, BA

Compared to many other fields, quality and safety is a relatively new discipline within medicine. Many efforts to improve quality and safety in healthcare are aimed at training practicing physicians and residents through efforts such as safety courses, quality improvement project participation, and continuing medical education sessions. However, there has been increasing interest in beginning quality and safety education earlier in physicians’ training. Upstream interventions during medical education can introduce future physicians to this crucial aspect of medical practice early in their careers and have the potential to significantly improve patient safety and quality of healthcare delivery. This article discusses the considerations and dimensions of quality and safety training in medical education.

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The Global Radiation Oncology Workforce In 2030: Estimating Physician Training Needs And Proposing Solutions To Scale Up Capacity In LMICS
Released: July 01, 2019 Expires: June 30, 2020 CE credits: 1.0 Cost: $0.00
Faculty: Applied Radiology
17917

Shekinah Nefreteri Cluff Elmore, MD, MPH, is at Harvard Medical School, Boston. Gregorius Ben Prajogi, MD; Jose Alfredo Polo Rubio, MD; Eduardo Zubizarreta, MD, are at the International Atomic Energy Agency, Vienna.

This review examines the capacity gap in RT through the lens of human resource needs. The authors model radiation oncologist training needs, investigate the disparity between HMICs vs LMICs, and explore solutions for training/licensure and regional collaboration.

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The impact of cybersecurity in radiation oncology: Logistics and challenges
Released: December 01, 2018 Expires: November 30, 2020 CE credits: 1.0 Cost: $0.00
Faculty: Applied Radiology
17613

Elizabeth M. Nichols, MD; Shafiq Ur Rahman, MBA, MS; Byongyong Yi, PhD

On the rise, health-related cyberattacks are generally categorized into four groups: data loss, monetary theft, attacks on medical devices and infrastructure attacks. Breaches in cybersecurity can levy drastic consequences in radiation treatment delivery and health care overall. This review article describes experiences and unique needs and strategies pertaining to radiation oncology IT infrastructure, electronic medical records, automatic time outs, treatment planning and delivery, plan verification, screen locking and more to help prevent and overcome a cyber disaster.

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.

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Undergraduate Medical Education and Radiation Oncology: Current Concerns and Effective Initiatives
Released: August 01, 2019 Expires: July 31, 2021 CE credits: 1.0 Cost: $0.00
Faculty: Nadia Saeed, BA
17944

Nadia Saeed, BA

There is a critical role for integrating radiation concepts in medical school education, with the goal of continuing to attract students to the specialty. However, several medical schools lack formal teaching of radiation, and many students receive little exposure to the field. The question of how to improve integration of radiation oncology into medical education remains up for debate. This article examines the current limitations to and the various methods of implementing radiation education in medical school curricula.

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Vascular Anomalies: Description, Classification and Nomenclature
Released: September 01, 2018 Expires: August 31, 2020 CE credits: 1.0 Cost: $0.00
Faculty: Applied Radiology
17465

Deborah R. Shatzkes, MD

“Nomenclature has been the major obstacle to our understanding and management of vascular anomalies.” These words were written by John Mulliken over 30 years after publishing his seminal paper on the biologic basis of vascular anomalies in 1982. The intervening decades have brought tremendous progress in classification, diagnosis and therapy of this diverse group of lesions. Still, much confusion exists in the medical community, in no small part because of inaccurate and inconsistent use of nomenclature both in the liter-ature and in clinical practice.

The multidisciplinary International Society for the Study of Vascular Anomalies (ISSVA) was formed in 1992 to promote research in the field of vascular anomalies and to create a uniform nomenclature that would facilitate research and clinical practice. ISSVA created a comprehensive classi-fication scheme based on Mulliken’s work on the biologic basis of disease, updated most recently in 2014 and available at issva.org/classification. The ISSVA classification and its associated nomenclature are widely accepted as the gold standard by the numerous medical specialties involved in clinical care and research related to vascular anomalies.

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.

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