This program reviews fundamental MRI safety information 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. Notably, 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 involved with MRI technology.

With 35 years of experience in the field of MRI, the author of the best-selling textbook series, the Reference Manual for Magnetic Resonance Safety, Implants and Devices, and the creator of the internationally popular website, MRIsafety.com, Dr. Frank G. Shellock is uniquely qualified to present the information in this program.

Advanced MRI Safety Training for Healthcare Professionals (4th Edition), Level 2 MR Personnel is a 2 hour and 45 minute program that is divided into three different sections.

Educational Objectives

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

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

In this CME/CE accredited program Dr. Howard Rowley reviews important efficacy considerations of the FDA approved gadolinium-based contrast agents (GBCAs), including clinical utility, safety issues, and practical approaches for selecting a GBCA when considering patient history, pathology and related risks.

Following Dr. Rowley's presentation, Dr. Rowley joins a panel of MR imaging experts in discussion about this important topic, followed by a moderated Q & A session with audience participation.

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

• List the key considerations in the choice of GBCAs, while balancing safety and efficacy.
• Describe the transient effects of T1 and T2 relaxation during a GBCA bolus.
• Understand the impact of high relaxivity gadolinium agents vs macrocyclic agents.
• Design MRI protocols to optimize exam efficiency and enhanced lesion detection.
• Implement GBCA protocols for special patient populations after considering risk assessment.

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

Elainea N Smith, MD; Mohammad Ghosheh, MBBS; Kristin K Porter, MD, PhD

The abdominal radiologist plays an important role in providing care for transgender and gender-diverse patients, regardless of whether these patients choose to pursue gender-affirming hormone therapy or surgery. Radiologists must be aware of the various treatment options and associated anatomic and pathologic changes in transgender patients to ensure accurate imaging interpretation. This activity is designed to educate radiologists about caring for transgender patients by reviewing relevant imaging findings of hormonal therapies, nonoperative procedures, and gender-affirming surgeries with a focus on abdominal and pelvic imaging. Creating an inclusive environment for transgender patients is also discussed.

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.

Lisa Singer, MD, PhD; Benjamin H. Kann, MD; Daniel N. Cagney, MD; Jonathan E. Leeman, MD; Sue S. Yom, MD, PhD; David Kozono, MD, PhD

While traditionally CT- and x-ray based, lung stereotactic body radiation therapy (SBRT) practices will likely be impacted by the emerging availability of MR guidance. This review provides an overview of the role of MR guidance in SBRT for the treatment of lung cancers. Limitations, data, and future directions for treatments are reviewed with a focus on peripheral, central, and ultracentral lung cancers.

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.

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.

Often there is lack of knowledge amongst imaging professionals regarding IV contrast dynamics and the relationship between contrast injection, observed enhancement, and scan acquisition timing. The design of appropriate imaging protocols leads to effective and consistent cardiovascular exams; especially when applied to complex clinical scenarios.

This CME/CE accredited program will review contrast-saline dynamics and discuss rational protocol design for cardiac and vascular CT angiography. Effective cardiovascular imaging protocols, utilizing multiple CT injector platforms to achieve optimal imaging, will be reviewed. We invite you to join Dr. Richard Hallett for a comprehensive discussion and case study review of this important topic.

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

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

• Understand the relationship between bolus contrast media injection and observed enhancement.
• Implement methods to design rational contrast injection / scan acquisition protocols.
• Review various models of CT contrast injectors and discuss benefits, limitations, and injection protocol adjustments for each.
• Apply customized contrast-saline injection / scan principles to complex cardiovascular disease cases.

Made possible through an unrestricted educational grant from Bracco Diagnostics, Inc.

CT Technology continues to evolve with modern platforms designed for radiation therapy (XRT) with advanced applications supporting comprehensive diagnoses, precise treatment plans and better patient outcomes. XRT is guided by CT Simulation which can be obstructed due to metal implants beam hardening artifacts. Metal Artifact Reduction (MAR) is a projection-based reconstruction technique that restores anatomical details obscured by metal during conventional image reconstruction and automatically improves images for increased clinical confidence.

In this accredited Expert Forum Webinar, Yashbir Mehta,MD, shares insights into the advanced CT Simulation techniques supporting the improvement of XRT treatment planning accuracy and specificity of tumor volumes. These advanced features are supported by a clinical review of cases demonstrating improved treatment plans, thus impacting patient management and care.

Learning Objectives

• Implement advanced CT applications.
• Effectively manage obese and claustrophobic patient.
• Implement workflow considerations for improved service and reliability.

This program is made possible through an unrestricted educational grant from FUJIFILM Healthcare Americas Corporation.

Victor E. Chen, MD; Joseph F. Lombardo, DO, PharmD; Serguei A. Castaneda, MD; Karen M. Winkfield, MD, PhD; Scot A. Fisher, DO; Eric L. Gressen, MD; Shari B. Rudoler, MD; Weisi Yan, MD, PhD; Shefali R. Gajjar, MD

This review article describes key factors that contribute to lung cancer disparities for Black patients and discusses strategies and future directions for radiation oncologists to bridge the gap. Topics discussed are contributing factors for disparities in lung cancer incidence, disparities in lung cancer prevention, disparities in lung cancer treatment and outcomes, and potential strategies to overcome barriers.

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.

Ronald Chow, MS; Minglei Kang, PhD; Shouyi Wei, PhD; J. Isabelle Choi, MD; Robert H. Press, MD; Shaakir Hasan, DO; Arpit M. Chhabra, MD; Keith A. Cengel, MD, PhD; Haibo Lin, PhD; Charles B. Simone, II, MD

In this manuscript, the authors review the proposed mechanisms of action for FLASH radiation therapy (FLASH RT), summarize early preclinical results, discuss the first-in-human treatments with a focus on proton FLASH, and highlight challenges and future considerations of FLASH RT.

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.

Jonathan R Wood, MD; Ghazal Shadmani, MD; Marilyn J Siegel, MD

Pediatric upper-extremity sports injuries are common. However, the diagnosis can be challenging for radiologists who have limited experience in imaging children. Increased awareness of the imaging findings is critical in establishing the correct diagnosis and ensuring optimal patient management and outcomes. This activity is designed to educate radiologists about the radiographic findings of common acute and chronic sports injuries of the upper extremities in the pediatric population. Mechanisms of injury are also reviewed, as they impact the type of fracture that occurs. Additionally, the role of magnetic resonance imaging in complementing plain radiography is discussed.

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.

Leila T. Tchelebi, MD; Nicholas G. Zaorsky, MD, MS; Jennifer Rosenberg, MD; Kujtim Latifi, PhD; Sarah Hoffe, MD

While MR-guided radiation therapy (MRgRT) offers many benefits, it is a costly and resource-intensive investment that can strain radiation oncology clinics not adequately prepared to incorporate this treatment. This work reviews clinical advantages and practical limitations of MRgRT, and suggests ideal patients for this technology. The authors also provide a practical guide for centers acquiring MRI-based linear accelerators to foster seamless integration.

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

Nathaniel Goldman, BA*; Matthew Gallitto, MD*; Cheng-Chia Wu, MD, PhD

This review article provides a thorough outline of various modalities to help guide implementation of strategies to reduce anxiety in treatment facilities. Categories include interventions before treatment (psychoeducational interventions, play therapy) and during treatment (specialized staff, environmental modifications, distraction, reward/incentive systems).

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.

Today, with such a wide selection of gadolinium-based contrast agents available to choose from; imaging professionals must be aware of the chemical make-up when selecting a MR agent for a particular exam.

This CME/CE accredited webinar with Lawrence N. Tanenbaum, MD, FACR,  provides a review of the currently available FDA-approved MR contrast agents and their safety profiles. Following Dr. Tanenbaum's presentation questions from the audience were addressed in a moderated Q&A session.

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

• Discuss the available FDA-approved contrast agents in the US market.
• Review the chemical structure, indications, and safety profile of these agents.
• Develop a better understanding of how selection of contrast can affect patient outcomes.

Supported through an unrestricted educational grant from GE Healthcare

Brittany R. Derynda, BA; *Casey L. Liveringhouse, MD; John M. Bryant, MD; Stephen A. Rosenberg, MD, MS

This review article describes technical advantages for MR-guided radiation therapy (MRgRT) that lead to the rationale for use in the oligometastatic setting. The authors summarize existing data demonstrating the feasibility, safety, and efficacy of MRgRT for various disease sites. Finally, the authors discuss ongoing clinical trials utilizing MRgRT, which will continue to define and expand its role.

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.

Ana Mitchell, MD; Austin Kwong, MD; Simran Sekhon, MD; John P McGahan, MD, FACR

Given that ovarian and adnexal masses are commonly encountered in daily clinical practice, it is important to be able to recognize worrisome features on MRI. Once these are identified, it is important to accurately classify ovarian masses according to criteria ranging from low-risk to high-risk lesions. Recognizing and categorizing ovarian masses is important for determining that no further treatment or imaging is required for benign or low-risk lesions. Similarly, recognition of a worrisome feature and proper classification of high-risk masses are necessary to permit appropriate referral of these patients to a surgical oncologist.

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

In this second of a 3 Part Series, Dr. Laurie Fajardo discusses the benefits of digital breast tomosynthesis (DBT) for detecting and diagnosing breast cancer and things to consider when planning or implementing DBT into breast imaging practices.

Dr. Fajardo discusses the importance of radiation dose reduction with synthetic 2D, reviews the published literature on the performance of synthetic 2D mammography, and shares how DBT can impact data storage and network data transmission across your PACS and enterprise system.

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

• Describe the efficacy of synthetic 2D from DBT.
• Implement procedures for managing DBT data volumes and workflow.
• Develop an approach to interpreting DBT images.

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

This educational webinar features a panel of experts from Nuclear Medicine, Urology and Oncology, who are involved in the diagnosis and management of Prostate Cancer. By understanding the benefits of PSMA imaging, a Urologist’s timely referral can positively impact the patient’s journey and ultimately their quality of life. The clinical benefits of a prompt and accurate diagnosis of Prostate CA, using PSMA-11 PET/CT, will be reviewed by the faculty.

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

1. Discuss the clinical benefits of PSMA Imaging for the diagnosis and management of prostate cancer
2. Describe patient considerations for ⁶⁸GA PSMA-11 PET/CT
3. Articulate the clinical implications supporting the timely diagnosis of prostate cancer
4. Implement guidelines of when to order ⁶⁸GA PSMA-11 vs other imaging modalities (Bone scan, CT, MRI)
5. Implement PSMA Imaging practice considerations to improve outcomes and patient management

This program is made possible through an unrestricted educational grant from Telix Pharmaceuticals

Dr. Laurie Fajardo will share her understanding of the benefits of synthetic 2D images with digital breast tomosynthesis (DBT) for diagnosing breast cancer along with considerations for implementing Synthetic 2D breast imaging protocols into your practice. Following the presentation questions from the audience were addressed in a moderated Q&A session.

Learning Objectives

• Implement digital breast tomosynthesis protocols in clinical practice.
• Differentiate characteristics of synthetic 2D mammography by manufacturer.
• Discuss differences between wide vs narrow angle DBT acquisition and its effect of angular range on synthetic-2D image generation.

This program is made possible through an unrestricted educational grant from FUJIFILM Healthcare Americas Corporation.

Will Jin, MD;1* Santosh Mohan, MMCi, COPHIMS;2 Matt Adams, BS;3 Sarah Hoffe, MD;4 Edmondo Robinson, MD, MBA2

Recent studies have shown the emergence of digital therapeutics (DTx) as potential solutions in the cancer care continuum to improve medication adherence, chemotherapy tolerance, and overall survival, while potentially reducing financial toxicity. In this review, the authors examine these new modalities and possible future benefits for cancer patients.

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.

Kaitlin M Zaki-Metias, MD; Mehrvaan Kaur, MD; Huijuan Wang, MD; Bilal Turfe; Nicholas Mills, MD; Yanruo Lu, MD; Bashir H Hakim, MD; Leslie S Allen, MD

Pregnant patients infrequently undergo CT given the risk of radiation to the developing fetus. As such, when CT is performed on pregnant patients in emergent situations, radiologists may be unfamiliar with the appearance of the placenta on CT and its normal evolution throughout gestation. This activity is designed to educate radiologists about the normal appearance of the placenta on CT and its evolution throughout pregnancy, as well as differentiation of these findings from placental abruption.

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.