Individuals entering the magnetic resonance imaging (MRI) environment, whether on a regular or infrequent basis, must be properly trained to ensure their safety, the protection of patients, and the security of other facility staff members. This program, Basic MRI Safety Training, Level 1 MR Personnel accomplishes the initial training that is necessary to ensure safety in the unique setting associated with the MRI system. It includes information pertaining to MRI technology, describes common hazards and unique dangers associated with the MRI setting, and presents vital recommendations and guidelines to prevent accidents and injuries. Importantly, this program provides the fundamental MRI safety information for Level I MR Personnel recommended by the American College of Radiology and may be utilized by individuals preparing for safety training as Level 2 MR Personnel.

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

Educational Objectives

• Appreciate the importance of MRI
• Identify the hazards associated with MRI
• Understand the screening process
• Describe steps to prevent accidents and injuries

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

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).

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

CT Technology continues to evolve with modern platforms now being designed with improved patient comfort, increased workflow, and advanced applications supporting comprehensive diagnoses, precise treatment plans and better patient outcomes.

In this CE accredited Expert Forum Webinar, Rick Banner, RT (R), Senior Director of Marketing, Fujifilm Medical Systems U.S.A., Inc. shares insights into the design of advanced CT platforms that are addressing today’s clinical challenges while reducing the total cost of ownership. These advanced features will be supported by Dr. Lawrence N. Tanenbaum’s personal experience on how these advanced features are making a clinical difference in the day-to-day operations in busy imaging departments.

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

• Implement advanced CT applications
• Effectively manage obese and claustrophobic patients
• Implement workflow considerations with improved CT service and reliability

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

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.

Depending on its intended application in Fluoroscopy or CT, Barium Sulfate (BaSO4) contains specific combinations of additional ingredients that support the diagnosis of disease, define treatment options, and improve patient outcomes. When used for the anatomical evaluation of the GI tract or the physiology of swallowing, a comprehensive understanding of the clinical utility of Barium products and their additives, is needed. This accredited program explains the differences and the benefits of each additive and is designed to increase knowledge about the clinical applications of Barium.

Dr. Sireci will provide a comprehensive overview of each Barium product, its indication and intended use. Following the presentation, the audience is invited to join Dr. Sireci for lively Q & A session.

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

• Explain the role that BaSO4 plays in barium-containing contrast media.
• Review the purpose of each ingredient/additive found in BaSO4 contrast media products currently available for fluoroscopic and radiographic examinations.
• Describe the formulation of barium products that are appropriate for single and double contrast anatomic radiographic evaluation of the gastrointestinal (GI) tract.
• Summarize qualities of the barium-containing contrast media used in evaluation of swallowing that make them most appropriate for that application.
• State the properties of barium-containing contrast media used in computed tomography (CT) applications

Educational Credits
One (1) AHRA CRA Credit

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

In this Expert Forum, Lawrence Tanenbaum, MD, FACR and Suzie Bash, MD review considerations for optimizing contrast-enhanced MRI in neuroimaging, extending from patient tolerance to standardizing procedures. Following the presentation questions from the audience were addressed in a moderated Q&A session.

Educational Objectives:

• Manage issues related to patient tolerability and acute adverse events.
• Implement standardized and optimized MR contrast-enhanced protocols.
• Identify clinical indications for contrast-enhanced MRI for brain and spine imaging

Supported by GE Healthcare

Catriona M. Steele, PhD, Bonnie Martin-Harris, PhD, Memorie Gosa, PhD, Stephanie Edwards Allen, BSRT, MBA

The MBSS, also known as a video fluoroscopic swallow study (VFSS), is a barium-sulfate–enhanced fluoroscopic motion study used to evaluate anatomy and swallowing physiology si­multaneously in real time. Varibar, an FDA-approved barium sulfate product for evaluation of dysphagia, together with The Modified Barium Swallow Impairment Profile (MBSImP), are used to ensure standardization and reproducibility in the MBSS. This monograph explains the relationship between Varibar, the MBSImP, and the International Dysphagia Diet Standardisation (IDDSI) framework in evaluation of swallowing in clinical practice.

At the conclusion of this activity, participants will be able to:

• Explain how the modified barium swallow study (MBSS), The Modified Barium Swallow Impairment Profile (MBSImP), and barium sulfate products are used to evaluate dysphagia
• Describe the development of FDA-approved barium sulfate products used to assess dysphagia
• Review the International Dysphagia Diet Standardisation (IDDSI) framework: what it is and how it was developed
• Define the relationship between the MBSS, the MBSImP, barium sulfate, and IDDSI, and how they are used in clinical practice
• Summarize pediatric and clinical-practice considerations in performing the MBSS

This program has been supported through an educational grant from Bracco Diagnostics, Inc.

Since the 1990’s, multi-patient contrast administration has been available in the form of the Pharmacy Bulk Package (PBP), which is still offered by several contrast vendors. The FDA required that all related Prescribing Information (PI) sheets for the PBP include specific directions for the dispensing of the contrast from the PBP container. The PI language describes withdrawing the contrast from the bottle in a suitable work area, specifically “a laminar flow hood, using aseptic techniques”. However, this method is not possible in most CT Suites, as laminar flow hoods are generally located in the Pharmacy, not the CT suite.

Therefore, during the last decade, regulators have begun to have concerns about the use of PBP. In 2009, The Joint Commission began citing imaging providers who were using PBP to fill power injector syringes in what they considered an unsuitable work area, as described in the manufacturer’s PBP guidelines for the dispensing of contrast.

This Expert Forum will review the steps taken by the contrast media industry and the FDA to develop a safe and compliant solution for multi-patent contrast administration in CT. This solution is now available as the Imaging Bulk Package (IBP) which is approved for use in the CT Suite. This panel will also share their comprehensive process for incorporating IBP into their clinical practice.

Supported through an unrestricted educational grant from Bracco Diagnostics Inc.

Ryan Lee, MD, MBA • Daniel Karolyi, MD • Matthew Kuhn, MD, FACR • Mahmud Mossa-Basha, MD • Joseph Cavallo, MD, MBA

This CE accredited program will provide an educational resource that addresses current and future iodinated contrast media shortages and its clinical impact.

By bringing together a group of radiologists with expertise in CT, MRI, NM/PET, US & AI, who have experienced this crisis in their imaging departments and who have established ‘best practices and procedures’ designed to address clinical and operational alternatives in order to deliver safe and effective patient care throughout Radiology; this comprehensive program will cover the following topics:

• The operational impact of contrast media waste.
• The use of saline supporting contrast optimization with improved image quality.
• Patient safety considerations & imaging challenges when moving to alternative imaging methods.
• When and how to implement emergency protocols, based on iodinated contrast availability.
• The use of AI to provide improved outcomes without the use of contrast.

Clinical scenarios that include IV and oral contrast administration, patient management, non-contrast imaging options, and the use of Barium and other contrast media will be discussed.

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

• Identify which imaging exams may be affected by a shortage of iodinated contrast media.
• Implement emergency protocols to continue providing safe and effective patient care.
• Manage clinical challenges associated with moving from one preferred imaging modality to another (i.e., CT vs MRI vs NM vs US)
• Employ the use of AI solutions to support imaging capabilities and address patient specific imaging outcomes.

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

In this Expert Forum, Dr. Lawrence Tanenbaum, MD, FACR, will review the classification of Gadolinium MR contrast agents according to their molecular structure, ionicity, and stability. The impact of these properties and supporting clinical data for safety considerations in choosing an agent will be discussed with the goal of providing insight that can be applied in everyday clinical practice. Following the presentation questions from the audience were addressed in a moderated Q&A session.

Educational Objectives:

• To review the current landscape of Gadolinium-based contrast agents and their classification according to their molecular structure, ionicity, and stability.
• To understand how these properties impact the safety and efficacy of GBCAs.
• To review the important clinical data that impact safety considerations in choosing an MR contrast agent and how that applies to everyday clinical practice.

Supported by GE Healthcare

Howard Rowley, MD, FACR; Lorna P. Browne, MD; Kevin J. Chang, MD, FACR; Christopher Comstock, MD, FACR; J. Paul Finn, MD; Scott Reeder, MD, PhD; Max Wintermark, MD

Currently, 6 general-use gadolinium-based contrast agents (GBCA) are available and approved for a variety of MRI indications, including brain, body, and breast imaging, in adults and children. Gadolinium-based contrast agents comprise a gadolinium (Gd) ion bound to an organic ligand to form a chelate. Whether the chelate is linear or macrocyclic and ionic or nonionic impacts the size and stability of the Gd-chelate complex, as well as its distribution and elimination. In addition, the chelate structure also impacts the relaxivity, or r value, of the GBCA, which dictates the ability to provide contrast enhancement relative to background. Understanding the different safety and efficacy profiles of GBCAs can be valuable when selecting a GBCA. Here, we present discussions from a recent Expert Panel Forum focused on the safety and efficacy of GBCAs, as well as specific considerations related to their selection for neuroimaging, pediatric imaging, body imaging, and breast imaging applications.

At the conclusion of this activity, participants will be able to:

• Describe the distinguishing properties of the available gadolinium-based contrast agents (GBCAs) currently used for magnetic resonance imaging (MRI);
• Review how the structure of the gadolinium (Gd)-chelate complex determines the stability of a GBCA, and how stability relates to both Gd retention and nephrogenic systemic fibrosis (NSF);
• Explain what a “high-relaxivity” GBCA is and summarize results of crossover studies comparing standard- and high-relaxivity GBCAs for MRI; and,
• State the key considerations when selecting a GBCA for neuro MRI, pediatric MRI, body MRI, and breast MRI.

This program was supported through an educational grant from Bracco Diagnostics, Inc..

This accredited program provides a comprehensive overview of MRI safety including the radiologist's responsibilities and liabilities, MRI staff education and patient safety. It is designed specifically for practicing radiologists, fellows, residents, and healthcare professionals who oversee MRI services and will provide practical guidance from two respected MRI safety educators who present information on accepted safety standards of care based on the 2020 ACR Manual on MR Safety, the 2021 FDA Guidance Document, and a review of the literature.

Program Considerations: It is critical to have established MRI safety protocols and to have a clear understanding of the basics of MRI Safety. The ACR Manual on MR Safety states that the Radiologist is responsible for the safety of the patient undergoing the MRI Exam. They are also responsible for implementing MR Safety policies and procedures and ensuring that the facilities’ personnel adhere to them at all time. These MRI safety policies should be reviewed and updated annually in order to prevent patient injury.

Educational Objectives

• Describe the difference between Level 1 & Level 2 MR personnel.
• Differentiate and identify the ACR-designated Safety Zones.
• Implement safety considerations for the static magnetic field, time-varying gradient magnetic fields, and radiofrequency fields.
• Employ procedures and protocols to prevent RF-related burns and methods to manage SAR levels.
• Manage acute and chronic gadolinium-based contrast agent adverse events.

Program support provided by Bracco Diagnostics, Inc.

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

Margaret M. Fynes, MD; Christine Smith, MS; and Martin B. Brodsky, PhD, ScM

Dysphagia is a common clinical challenge, particularly in the elderly. The modified barium swallow study (MBSS), initially developed by radiologists and speech-language pathologists (SLPs) at The Johns Hopkins Hospital, is critically important for evaluation and treatment of dysphagia. In this article, the authors, radiologist Margaret M. Fynes, MD, and two SLPs, Christine Smith, MS, and Martin B. Brodsky, PhD, ScM, review the technical and patient considerations for optimal performance of the MBSS according to The Johns Hopkins protocol. Because both perspectives, radiologist and SLP, are included, the article is able to highlight the importance of the role of each, as well as how they work together. Elements of the MBSS that have become more standardized over time, specifically the barium sulfate contrast agent products used, and the scoring and reporting of the examination with the Modified Barium Swallowing Impairment Profile (MBSImP), are described, and the contribution of this standardization to the overall accuracy and reliability of the MBSS is discussed.

At the conclusion of this activity, participants will be able to:

• Review the causes and incidence of dysphagia
• Describe technical and patient considerations associated with performing a fluoroscopic modified barium swallow study (MBSS) to evaluate dysphagia
• Explain how the MBSS contributes to the evaluation and treatment of patients with dysphagia by assessing the cause of dysphagia and allowing implementation of compensatory strategies in real-time
• Explain the importance of the relationship between the radiologist and speech-language pathologist (SLP) during performance of the MBSS >
• Explain how use of a standardized series of barium sulfate contrast agent products, as well as use of the Modified Barium Swallowing Impairment Profile (MBSImP), have contributed to standardization of the MBSS examination
• Detail the benefits of MBSS standardization on the robustness and consistency of the examination

This Program Has Been Supported Through An Unrestricted Educational Grant from Bracco Diagnostics, Inc.

Gadolinium-based contrast agents (GBCAs) differ in structure and ionicity which, in turn affects their stability and safety profiles. The more stableagents are associated with a lower risk of nephrogenic systemic fibrosis (NSF) and less Gd deposition in brain, bone, and other tissues. Several patient populations are considered vulnerable to Gd exposure, including children, the elderly, the renally impaired, and those that require repeat MRI exams.

In these cases, GBCA utilization should be limited to studies where the results contribute significantly to the diagnosis and/or patient management.

In the following webinar and corresponding monograph, Lawrence N. Tanenbaum, MD, FACR and Donna Roberts, MD share case examples including MRI applications and considerations for understanding at risk adult and pediatric patient populations when performing Neuro MRI.

• Identify patient populations at increased risk of experiencing an adverse event following administration of a GBCA.
• Understand and discuss risk factors related to the use of GBCA's in specific patient populations.
• Implement alternative approaches for the clinical management of at risk patients.

Supported through an educational grant from GE Healthcare