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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* 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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* 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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* 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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* 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 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 MSK & Sports Medicine Imaging
Released: January 16, 2018 Expires: January 15, 2020 CE credits: 2.0 Cost: $0.00
Faculty: Jon Jacobson, MD, Christine Chung, MD
17062
RSNA 2017 Archived Program

As new technological advances in Magnetic Resonance & Ultrasound continue to impact how healthcare professionals diagnose and treat sports related injuries; this program from RSNA 2017 features:

The Future of MR in MSK
by Dr. Christine Chung
Unique Ultrasound Solutions in MSK and Sports Medicine

by Dr. Jon Jacobson

Each provides insight into how these modalities are transforming patient care. Also included is a live USD scanning session with Dr. Jacobson, where he provides a detailed description of his scanning techniques.

Educational Objectives

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

  • Describe imaging techniques that can reduce scan time without decreasing image quality.
  • Describe how the infrastructure of MSK tissue provides a rationale for the development of a qualitative pulse sequence.
  • Be familiar with the normal appears of tendons under USD
  • Recognize the common MSK pathology seen on USD
  • Describe applications where dynamic USD is used in MSK imaging.

This program was originally presented live at RSNA 2017 and sponsored by the Institute for Advanced Medical Education (IAME) and supported through an unrestricted educational grant from Toshiba America Medical Systems (now Canon Medical Systems USA, Inc.).

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Augmented and Virtual Reality:
Exploring A Future Role In Radiation Oncology Education and Training
Released: December 01, 2017 Expires: December 01, 2019 CE credits: 1.0 Cost: $0.00
Faculty: Applied Radiation Oncology
17034

William Jin, Brandon Birckhead, MD; Bradford Perez, MD; Sarah Hoffe, MD

The range of differences on the augmented/virtual reality AR/VR spectrum are mainly attributed to its depth of immersion. AR/VR technology is being used, through all spectrums of their devices, in surgery, imaging, medical student/resident/fellow education. The utility of AR/VR lies in its advantage to be massively scalable, reproducible, and realistic in simulating clinical environments. This article discusses how AR/VR technologies can cost-effectively enhance radiation oncology training.

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, 2020 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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Can New Imaging Technologies Improve Patient Outcomes?
Released: January 16, 2018 Expires: January 15, 2020 CE credits: 2.0 Cost: $0.00
Faculty: Junsung Choi, MD, Kenneth Snyder, MD, PhD, Miyuki Sone, MD
17061
RSNA 2017 Archived Program

As new technological advances in Computed Tomography continue to impact how healthcare professionals diagnose and treat patients with stroke, pancreatic and biliary cancer and other oncological disease; this program from RSNA 2017 features the following presentations. Each will provide insight into how advanced imaging is improving patient outcomes.

Saving Brain and Improving Patient Outcomes with a Better Acute Stroke Protocol
by Dr. Kenneth Snyder
Can UHR CT Improve Outcomes with Better Detection, Diagnosis and Staging of Pancreatic and Biliary Cancer

by Dr. Miyuki Sone
I
mproving Oncologic Outcomes Using a Unique 4DCT Solution
by Dr. Junsung Choi.

Educational Objectives

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

  • Describe how advanced physiologic imaging is transforming the treatment of acute ischemic stroke.
  • Describe the limitations of conventional CT in the diagnosis of pancreatic and biliary disease.
  • Be familiar with the clinical utility of Ultra High Resolution CT Imaging.
  • Describe how hybrid Angio/CT systems are providing clinical utility in interventional oncologic imaging.

This program was originally presented live at RSNA 2017 and sponsored by the Institute for Advanced Medical Education (IAME) and supported through an unrestricted educational grant from Toshiba America Medical Systems (now Canon Medical Systems USA, Inc.).

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Combining Immunotherapy with Radiation Therapy to Induce the Abscopal Response:
Released: March 01, 2019 Expires: February 29, 2020 CE credits: 1.0 Cost: $0.00
Faculty: Applied Radiology
17775

Jason Liu, BS; Heath B. Mackley MD, FACRO

This review article identifies demographic, clinical, and treatment variables associated with the abscopal effect— the phenomenon in which radiation induces a regression of tumor cells outside the field of irradiation. Authors describe the current state of knowledge regarding these variables and examine research on the influence of tumor type, patient’s immune system, overall tumor burden, and radiation therapy parameters on the abscopal effect.

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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Common Applications of Time of Flight (TOF) Imaging: PET/CT Beyond FDG
Released: March 20, 2018 Expires: March 19, 2020 CE credits: 1.0 Cost: $0.00
Faculty: Bital Savir, MD
17146

PET/CT using Fluorodeoxyglucose (FDG) has been used for many years as an adjunct modality to conventional imaging. Until recently, PET/CT’s main utility was in oncology and to a lesser degree cardiology and neurology. However, new radiotracers were approved by the FDA; increasing the application of PET/CT in clinical practice. This Expert Forum aims to educate medical imaging professionals about the common indications of Time of Flight (TOF) PET/CT scans using various radiotracers that include: F18- FDG, F18-Fluciclovine, GA68-DOTA-TATE, and F18-Florbetapir.

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

Educational Objectives

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

  • Describe the importance of PET/CT quality.
  • Describe common FDG applications.
  • Describe the legacy and new FDA-approved radiotracers, their indications and cost.

This program was originally broadcast live as part of a webinar sponsored by IAME and supported through an unrestricted educational grant from Philips Healthcare.

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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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Emotional-intelligence-centric Leadership Training for Radiation Oncologists
Released: December 01, 2017 Expires: December 01, 2019 CE credits: 1.0 Cost: $0.00
Faculty: Applied Radiology
17035

Sarah E. Hoffe, MD; Joanne Quinn, PhD, MBA; Jessica Frakes, MD; Thomas J. Dilling, MD; Nadia A. Saeed, BA; Louis B. Harrison, MD

Current residency training in radiation oncology does not incorporate leadership competency skills. Additionally, increasing administrative burdens in healthcare correlate with growing physician burnout and stress, but residency training has no systematic strategy to increase resiliency. Although simulation-based medical education (SBME) can incorporate teamwork, communication, and collaboration exercises at the undergraduate medical level, it has not been studied/incorporated at the national graduate level in radiation oncology. This article addresses the role of an emotional-intelligence (EI)-based leadership curriculum during such training.

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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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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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 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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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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PE or no PE? Alternative diagnoses on CTA
Released: March 01, 2018 Expires: February 29, 2020 CE credits: 1.0 Cost: $0.00
Faculty: Applied Radiology
17137

Kelly W. Capel, MD, and Lynn S. Broderick, MD, FACR

Given that pulmonary embolism (PE) is the third-leading cause of cardiovascular death and that the signs and symptoms of PE are often nonspecific, many care providers obtain CTA in the acute-care setting to evaluate for any life-threatening or urgent pathology.

While most of these patients will likely not have an underlying PE, this article showcases several alternative potential pathologies, ranging from common intrathoracic conditions such as pneumonia, to acute aortic syndrome and intra-abdominal pathology, which may be partially captured via subtle clues on CTA examinations.

In the acute-care setting, the radiologist’s ability to recognize other potential sources of pain and shortness of breath as well as coexisting pathology in patients being evaluated for PE with CTA is critical.

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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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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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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Spectral CT: Adding Value in the Emergency Department
Released: November 09, 2017 Expires: November 08, 2019 CE credits: 1.0 Cost: $0.00
Faculty: Gopal Punjabi, MD
17006

Computed Tomography (CT) continues to be the modality of choice in most emergency departments and is respected for its ability to quickly capture cross sectional images of the body, allowing ED physicians to quickly assess patients.

In recent years, several manufacturers have developed scanners with the ability acquire images at varying energy levels, which allow imaging professionals to differentiate the various elements of the body based on their material density and atomic numbers.

This technique has the potential to revolutionize the way we depict and interpret CT scans. In this Expert Forum Webcast, Dr. Gopal Punjabi will share his clinical experiences with the use of Spectral CT in the Emergency Department with a focus on body imaging.

Educational Objectives

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

  • Describe scenarios where spectral CT can enhance diagnosis.
  • Describe the types of images that can be obtained with spectral CT.
  • Understand how to interpret the additional data acquired in spectral CT imaging.

Supported through an unrestricted educational grant from Philips Healthcare.

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Stereotactic Ablative Radiation Therapy In The Treatment of Liver Tumors
Released: March 01, 2018 Expires: February 29, 2020 CE credits: 1.0 Cost: $0.00
Faculty: Applied Radiation Oncology
17143

Benjamin O. Spieler, MD; Lorraine Portelance, MD; Eric A. Mellon, MD, PhD

This review article discusses the major indications for stereotactic ablative radiation therapy for liver cancer, as well as the technologies available and/or necessary for safe treatment delivery. Specific areas discussed include hepatocellular carcinoma, intrahepatic cholangiocarcinoma, dose, image guidance and respiratory management, emerging techniques, and radiation-induced liver disease.

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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Stereotactic Body Radiation Therapy In Early Stage Non-small Cell Lung Cancer:
A Brief Primer For The Multidisciplinary Tumor Board
Released: March 01, 2018 Expires: February 29, 2020 CE credits: 1.0 Cost: $0.00
Faculty: Applied Radiation Oncology
17144

Andrew Kennedy, MD; Susan Garwood, MD; Allison Grow, MD, PhD; Ryan Lipscomb, MS

Multidisciplinary team members treating lung cancers may not be aware of the complexity and coordination required for delivery of stereotactic body radiation therapy (SBRT) to lung masses. Shifts in practice have occurred in management of early stage non-small cell lung cancer (NSCLC), particularly with regard to the role of the specialized pulmonologist (interventional pulmonology), which involves different staging techniques than traditional mediastinoscopy. This review provides key information to foster a deeper understanding and appreciation for patient selection, work up, behind-the-scenes critical quality assurance tasks, and clinical pearls for stereotactic radiation therapy for lung 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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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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The Role of Prostate MR in Detection & Management of Prostatic Neoplasia
Released: January 01, 2017 Expires: December 31, 2019 CE credits: 1.0 Cost: $0.00
Faculty: Stephen J. Pomeranz, MD
16571

Prostate MRI can be an effective tool in preventive as well as diagnostic and ongoing patient care for patients with statistical likelihood and/or risk factors predisposing them to the diagnosis of prostatic neoplasia. Used efficiently, MR contributes to early detection, accurate staging and localization, and reduction in unnecessary biopsies and treatment.

Skilled reporting provides allied health professionals with critical results to serve patients optimally, allocate resources effectively and improve treatment and surgical outcomes for their patients. This Expert Forum webcast will include a series of case reviews that incorporate and elucidate these concepts.

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

Educational Objectives

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

  • Identify the clinical indications for effective utilization of MR of the prostate.
  • Be familiar with signal characteristics of prostate neoplasia on MRI, and understand the application of ACR standard PI-RADS scale to this type of imaging pathology.
  • Describe MRI's key role as a diagnostic tool for screening, active surveilance, staging, recurrence, identification, treatment planning and treatment response evaluation.

Supported through an unrestricted educational grant from Hitachi Medical Systems.

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The Safety and Efficacy of Combined Immunotherapy and Radiation Therapy
Released: March 01, 2019 Expires: February 29, 2020 CE credits: 1.0 Cost: $0.00
Faculty: Applied Radiology
17776

Shwetha Manjunath, MD; Jacob E. Shabason, MD, MTR

To date, there is little consensus on how to best combine radiation and immune checkpoint blockade (ICB) to maximize therapeutic gains while minimizing the potential for serious overlapping toxicities. This review summarizes relevant clinical data related to both safety and efficacy of the combination of ICB and radiation. 

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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