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

Hydrocephalus is a a mechanical complication of differ-ent 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) obstruc-tion 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 diver-sion.  Current treatments are limited and invasive: CSF di-version 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.

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. 

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.).

As technology continues to impact how healthcare is practiced, this presentation on Computed Tomography - What's Next & Why? | New Hardware & Software Transformations will highlight through the clinical experiences of an Expert Faculty; how they are maximizing the latest advances to increase patient care, satisfaction and throughput.

This program was originally presented live at RSNA 2016 and sponsored by the Institute for Advanced Medical Education (IAME) and supported through an unrestricted educational grant from Toshiba America Medical Systems.

The Medicare Access and CHIP Reauthorization Act of 2015 (MACRA) ended the Sustainable Growth Rate formula, which has determined Medicare Part B reimbursement rates for physicians and replaces it with new ways of paying for care. Under MACRA, participating providers will be paid based on the quality and effectiveness (value) of care they provide rather than the volume of care they provide under the current system.

This Expert Forum webcast features a panel of experts who will review the importance of MACRA and what it means to the radiology community. They will provide an overview of what MACRA involves and define which providers must begin planning immediately. In addition, the program will describe the Merit-based Incentive Payment System (MIPS) and the four performance categories, which will ultimately determine how radiologists and other physicians are reimbursed for their services.

The panel is moderated by Dr. Gregory N. Nicola, Vice President, Hackensack Radiology Group and will answer questions from the online audience.

Educational Objectives

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

• Describe what MACRA is and how it will affect radiologists.
• Understand the performance category measurements.
• Describe the necessary steps to be MACRA Ready by 2019. ​

Supported Through An Unrestricted Educational Grant from Bracco Diagnostics, Inc.

A review of the literature indicates an increased incidence of gadolinium deposition in the brain as a result of repeated contrast-enhanced MR imaging procedures. With a wide selection of gadolinium-based contrast agents available; imaging professionals must be aware of their chemical make-up when selecting the best agent for a particular study.

In this third of a four-part CME/CE Accredited Expert Forum Webcast Series, Dr. Richard Semelka shares his clinical experiences and best practices as it relates to the use of Gadolinium Based Contrast Agents (GBCAs) in body MR imaging.

Following Dr. Semelka's presentation, a panel discussion was moderated by Dr. Lawrence Tanenbaum; where questions from the audience were addressed.

Educational Objectives

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

• Discuss the role of GBCAs in body MR imaging.
• Understand how stability of a GBCA plays a role in body MR imaging.
• Evaluate choice of GBCA based on age of patient and likelihood of patient undergoing multiple studies.

Supported Through An Unrestricted Educational Grant from Guerbet, LLC.

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.

Uncertainty still exists regarding the appropriate and effective routine assessment of myocardial disease with contrast-enhanced MRI. Today more recent and novel MRI myocardial characterization techniques exist, such as T1 and T2 mapping. However, insufficient awareness of the pitfalls in cardiac MRI diagnosis frequently contribute to missed diagnosis in the workup of patients with myocardial infarction and other diseases of the heart muscle.

This Expert Forum featuring Dr. Joseph Schoepf will address these issues and provide a review of the basic principles and recent advances in contrast-enhanced Cardiac MR imaging. Particular emphasis will be placed on the MR assessment of diseases of the myocardium and novel methods for their granular characterization. Following Dr. Schoepf's presentation, a short Q&A will be conducted where your questions can be answered.

Educational Objectives

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

• Select suitable approaches for the routine assessment of myocardial disease with contrast-enhanced MRI.
• Discuss current developments in the MR characterization of the myocardium.
• Implement methods to improve accuracy of Cardiac MRI for the granular, comprehensive diagnosis of myocardium infarction and fibrosis.

Supported through an unrestricted educational grant from Guerbet, LLC.

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.

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.

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.

Ultrasound and MR elastography are relatively new, clinically validated, and highly reliable and reproducible imaging techniques to non-invasively, rapidly, and cost-effectively evaluate chronic liver disease in children and adults.

These techniques have widespread applicability in the pediatric population, not only in patients with non-alcoholic fatty liver disease (NAFLD), a leading cause of chronic liver disease in U.S. children, but in a variety of other pediatric chronic liver diseases. By measuring tissue stiffness, the radiologist can assist the clinician in identifying the presence of fibrosis within the liver parenchyma.

Histopathologic examination of liver biopsy specimens has long been considered the gold standard for the evaluation of hepatic fibrosis. However, liver biopsy is invasive, costly, not without complications, samples only a fraction of the liver parenchyma, and requires sedation/anesthesia in young children.

In this CME/CE Accredited Expert Forum, Dr. Podberesky will provide a brief overview of ultrasound and MR elastography techniques, review the current literature, applications, and provide imaging examples.

Following Dr. Podberesky's presentation questions from the audience were taken and answered in a moderated Q&A.

Educational Objectives

• To understand the basic principles of ultrasound and MR elastography.
• To understand how to apply liver ultrasound and MR elastography techniques to the pediatric population.
• To review the role that liver ultrasound and MR elastography play in the clinical evaluation and surveillance of liver fibrosis and inflammation in children.

Supported Through An Unrestricted Educational Grant from Philips Healthcare.

Open MRI Systems have evolved enormously since their inception in the 1980’s and today, true high-field systems offer an excellent, patient centric alternative to closed, cylindrical bore systems for imaging of basic and advanced applications throughout the body.

In this first webcast of a 2-Part Series, Dr. Lawrence N. Tanenbaum discusses the advantages of High Field Open MRI in Neuro imaging.

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 how market forces including patient centric imaging are impacting today’s radiology departments.
• Describe how modern Open MRI Systems align with value-based care and are changing the way that imaging facilities do business.
• Understand the technical specifications of High-Field Open MRI Systems.
• Understand the concept of isotropic imaging and new fat suppression technologies.
• Describe the increased image quality and range of applications in Neuro imaging.

Supported through an unrestricted educational grant from Hitachi Healthcare Americas