Applied Radiology is pleased to offer you a selection of free Journal-CME accredited courses to choose from, as part of your free subscription to AR.
Accreditation/Designation Statement
These activities have been planned and implemented in accordance with the accreditation requirements and policies of the Accreditation Council for Continuing Medical Education (ACCME) through the joint providership of IAME and Anderson Publishing.
The Institute for Advanced Medical Education (IAME) designates these Journal-based activities for a maximum of 1 AMA PRA Category 1 Credit™ each. Physicians should only claim credit commensurate with the extent of their participation in the activity.
Please Note: Prior to January 1, 2023 these activities qualified for SA-CME credits.
Untangling the Postoperative Upper GI Tract: Imaging Appearance of Altered Anatomy and Its Complications
Thomas Seykora, MD; Charles M. Vollmer, MD; Melkamu Adeb, MD
Estimated time for completion: 1 hour • Date of release and review: CME: February 5, 2025 | CE: March 5, 2025 • Expiration Date: CME: February 5, 2026 | CE: March 31, 2026
The authors discuss how an understanding of typical postsurgical anatomy of the upper gastrointestinal tract is fundamental for identifying and classifying postoperative complications on imaging. This review illustrates the expected imaging appearance of various bariatric, anti-reflux, gastric, and hepatopancreatobiliary surgeries and discusses associated complications along with their multi-modality evaluation where appropriate.
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Pediatric Appendicitis US: Practical Considerations
Artineh Hayrapetian, MD; Mathurika Jeyasingam, MD; Michael Francavilla, MD
Estimated time for completion: 1 hour • Date of release and review: November 2024 • CME Expiration Date: October 31, 2025
The techniques described in this article will aid the radiologist in performing and interpreting a US exam for appendicitis. The article details assessment criteria pertaining to the normal appendix and acute appendicitis, differential diagnosis and potential pitfalls, and considerations for the reporting of right lower quadrant US findings.
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Quality and Safety in Medical Imaging During Pregnancy and Lactation — Part 2
Aurela Clark, MD; Xiaoqin Wang, MD; Riham El Khouli, MD; Margaret Szabunio, MD
Estimated time for completion: 1 hour • Date of release and review: September 1, 2024 • Expiration Date: August 31, 2025
Imaging the pregnant patient is challenging as it involves both the parent and the fetus and, consequently, several medical, ethical, or legal considerations. Theoretically, all available imaging modalities may be used to evaluate the pregnant patient; however, in practice, confusion regarding the safety of the fetus often results in unnecessary avoidance of useful diagnostic tests, especially those involving ionizing radiation. This review is part 2 of a 2-part series and focuses on specific clinical scenarios (nonobstetric and obstetric) in pregnant patients and the recommended imaging modalities to answer clinical questions while focusing on fetal and parental safety.
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A Practical Guide to Wireless Breast Localization Devices
Jessica J. De Sabato, MD; James Kim, BS; Saadiya Sehareen, DO; Nina Vincoff, MD; Sofya Kalantarova, MD
Estimated time for completion: 1 hour • Date of release and review: July 1, 2024 • Expiration Date: June 30, 2025
Until recently, wire-guided localization was the gold standard for preoperative localization of nonpalpable breast cancers, a technique prone to unique complications and challenges, including wire dislodgement or migration, interference with the dissection route, and the need for coupling radiology and surgery services. Wireless localization devices such as radioactive seed localization, Scout, LOCalizer, EnVisio navigation system, and Magseed can help avoid these limitations. This activity is designed to educate radiologists about wireless localization devices, including their techniques, advantages, and limitations.
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Next Top Model: An Overview of Breast Cancer Risk Assessment Models
Pooja Agrawal, MD; Carolyn M. Audet, PhD; Laura L. Ernst, BA; Katie Lang, MS; Sonya A. Reid, MD, MPH; Katie M. Davis, DO; Rebecca Selove, PhD, MPH; Maureen Sanderson, PhD; Lucy B. Spalluto, MD, MPH
Estimated time for completion: 1 hour • Date of release and review: January 1, 2024 • Date of review: December 31, 2024 • Expiration Date: December 31, 2025
Numerous risk assessment models are available to calculate a woman’s lifetime risk of developing and/or carrying a gene mutation that may predispose her to developing breast cancer. Knowledge of risk may help to inform individual screening practices. Further understanding and evaluation of risk assessment models are needed to increase their utilization.
The purpose of this activity is to 1) introduce breast cancer risk assessment models for estimating an individual’s risk of developing breast cancer or risk for carrying a gene mutation that may predispose to developing breast cancer, 2) review the strengths and limitations of each model and the model’s applicability to underrepresented populations, and 3) provide an example that demonstrates the use of risk assessment models.
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Radiological Detection of Cardiac Amyloid: MRI with Pathological Correlation
Navpreet Kaur Khurana, MBBS; Saurabh Jha, MD
Estimated time for completion: 1 hour • Date of release and review: November 1, 2023 • Date of review: October 9, 2024 • Expiration Date: October 31, 2025
Cardiac involvement in light chain and transthyretin amyloidosis is commonly encountered by radiologists. Cardiac MRI is the primary imaging modality for cardiac amyloid (CA) with high sensitivity and specificity. However, other cardiac conditions can mimic CA, potentially affecting the accuracy of diagnosis. Knowledge of these mimics will help improve diagnosis and management of CA.
This activity is designed to educate trainees and radiologists on the typical and atypical findings of cardiac amyloidosis on cardiac MRI and nuclear medicine. This will reduce positive and false negative interpretations and lead to improved diagnosis.
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Percutaneous and Transvenous Liver Biopsy
Amir Hossein Mostafavi Sterabadi, BS; Hassan Anbari, MBChB; Minhaj S. Khaja, MD, MBA; Baljendra S. Kapoor, MD
Estimated time for completion: 1 hour • Date of release and review: September 1, 2023 • Date of Review: August 12, 2024 • Expiration Date: August 31, 2025
Liver biopsy is an invaluable adjunct to laboratory findings in diagnosing and treating varioius liver diseases. However, the various methods of obtaining liver samples, their indications and contraindications, as well as the nuances and rationale behind choosing one method over another are not all well understood by interventional radiologists.
This activity is designed to explain different ways of performing liver biopsy and some other ancillary interventions to obtain liver tissue samples. We aim to explain the indications, contraindications, efficacy, patient selection, and potential complications associated with these procedures.
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Multimodality Evaluation of Fetal Congenital Diaphragmatic Hernia and its Mimics
Ana Mitchell, MD; Simran Sekhon, MD; Kriti Gwal, MD; John McGahan, MD
Estimated time for completion: 1 hour • Date of original release: November 1, 2022 • Date of review: October 9, 2024 • Expiration Date: October 31, 2025
A variety of intrathoracic masses may present in the fetus and present as a mimic to congenital diaphragmatic hernia. Knowledge of their locations, ultrasound characteristics, and MRI findings helps limiting the differential diagnosis and guiding treatment. Jointly provided by IAME and Anderson Publishing Inc., this activity is designed to educate radiologists about fetal intrathoracic masses and distinguishing imaging features that will help in guiding management. Knowledge of the ultrasound and MRI features of these masses will help in differentiate these masses from congenital diaphragmatic hernia. Once this diagnosis can be made ultrasound and MRI may also be used to predict residual pulmonary tissue and other findings, such as liver herniating into the thorax, which will help guide fetal and neonatal therapy.
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Lung Ultrasound: A Practical Review for Radiologists
Samuel J. Tate, MD; Jeffrey Lin, DO, MPH; John P. McGahan, MD
Estimated time for completion: 1 hour • Date of original release: May 1, 2023 • Date of review: May 23, 2024 • Expiration Date: May 30, 2025
Lung ultrasound (LUS) has become a powerful bedside tool in diagnosing pathology, guiding procedures, and directing management. Knowledge and interpretation of artifactual patterns, true parenchymal structures, and signs unique to LUS will allow providers to utilize this modality in their care of patients. This activity is designed to educate radiologists about basic findings of lung ultrasound to help interpret images and refine differentials with this modality.
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Non-neoplastic Cystic Lesions of the Central Nervous System
Part 2: Idiopathic and Acquired Cysts
Orest Kayder, MD; Hamed Kordbacheh, MD; Sai Srikar Kilaru, MD; Imad Zak, MD, FACR
Estimated time for completion: 1 hour • Date of release and review: September 1, 2022 • Date of review: August 12, 2024 • Expiration Date: August 31, 2025
A variety of non-neoplastic intracranial cystic lesions are frequently encountered on brain imaging. Knowledge of their locations, imaging characteristics, and clinical behavior helps limit the differential diagnosis and guiding treatment. Jointly provided by IAME and Anderson Publishing Inc, this activity is designed to educate radiologists about idiopathic and acquired intracranial cystic lesions encountered on imaging, including their frequency, clinical presentation, and distinguishing imaging features that will help in guiding management.
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Trauma Imaging in Pregnancy: A Review of the Evolving Appearance of the Placenta on CT and Mimics of Placental Injury
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
Estimated time for completion: 1 hour • Date of original release: June 1, 2022 • Date of review: April 25, 2024 • Expiration Date: April 30, 2025
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.
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Imaging Upper Extremity Injuries in Pediatric Athletes
Jonathan R Wood, MD; Ghazal Shadmani, MD; Marilyn J Siegel, MD
Estimated time for completion: 1 hour • Date of original release: March 1, 2022 • Date of review: February 13, 2024 • Expiration Date: February 28, 2025
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.
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The Future of Magnetic Resonance Imaging Contrast Agents
Laura E Minton; Renu Pandit; WR Willoughby, PhD; Kristin K Porter, MD, PhD
Estimated time for completion: 1 hour • Date of original release: January 1, 2022 • Date of review: December 31, 2024 • Expiration Date: December 31, 2025
Gadolinium (Gd)-based contrast agents (GBCAs) dominate the current contrast-enhanced magnetic resonance imaging (CE-MRI) market and are proven to increase the efficacy of diagnostic magnetic resonance imaging (MRI) scans. However, in the future it is likely that a personalized combination of contrast enhancement and image processing techniques will be used to optimize diagnosis and treatment planning while minimizing risk and cost. This activity is designed to educate radiologists about the future of MRI contrasts agents, including high relaxivity macrocyclic GBCAs, alternatives to GBCAs, and imaging processing techniques.
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Interventional Stroke Management: An Update
Ryan Holland, MD; Steven Benitez, MD; Addison Fortunel, MD; Andrew Brook, BA, MS; Deepak Khatri, MD; Allan Brook, MD
Estimated time for completion: 1 hour • Date of release and review: November 1, 2021 • Date of review: December 31, 2024 • Expiration Date: December 31, 2025
As thrombectomy has become the standard of care for large vessel/arterial occlusions, the indications are initiated by proper imaging and understanding of the brain blood flow physiology. This two-part series examines the standard of care for acute stroke imaging and the latest techniques. The second part of this activity on stroke intervention will appear in the November-December issue of Applied Radiology.
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Imaging in Stroke Diagnosis and Treatment: An Update
Steven Benitez, MD; Ryan Holland, MD; Richard Zampolin, MD; Andrew Brook, BA, MS; Joshua Hirsch, MD; Allan L Brook, MD, Deepak Khatri, MD
Estimated time for completion: 1 hour • Date of original release: September 1, 2021 • Date of review: August 12, 2024 • Expiration Date: August 31, 2025
As thrombectomy has become the standard of care for large vessel/arterial occlusions, the indications are initiated by proper imaging and understanding of the brain blood flow physiology. This two-part series examines the standard of care for acute stroke imaging and the latest techniques. The second part of this activity on stroke intervention will appear in the November-December issue of Applied Radiology.
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An Overview of Acute Mesenteric Ischemia
Arash Mirrahimi, MD, MSc; Charlotte Gallienne, MD; Hournaz Ghandehari, MD, FRCPC
Estimated time for completion: 1 hour • Date of original release: January 1, 2021 • Date of review: December 31, 2024 • Expiration Date: December 31, 2025
Acute mesenteric ischemia (AMI) is a true surgical emergency and a rare life-threatening condition, accounting for 0.01% of hospital admissions, with extremely high mortality rates (up to 69%). Poor outcomes remain prevalent despite advances in both diagnostic and treatment options over the last two decades
Early diagnosis and management are particularly important given that the highest incidence of AMI occurs in the elderly population, who often have multiple comorbidities leading to a worse prognosis. Biphasic contrast enhanced multidetector computed tomography (MDCT) images have become the mainstay and standard of care for investigation and timely diagnosis of AMI.
As such, the importance of recognizing imaging features of AMI and timely communication of findings with the referring physicians is of utmost importance for diagnostic radiologists and always a worthwhile topic for review. We have therefore endeavored to provide a brief summary of the presentation of AMI, its causes, relevant anatomy, and most importantly, illustrated review of CT findings that delineate ischemic changes of the bowel and mesentery.
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