Physicians Optimization of Contrast Use How to Make the Most of What You Have-
#DOCTORISMRM2015 Physicians Optimization of Contrast Use How to Make the Most of What You Have

Program Description / Statement of Need:

Gadolinium-based contrast agents (GBCAs) are routinely used in a wide variety of MRI protocols, particularly for exams of the central nervous system (CNS), breast, prostate and liver. The role of newer, GBCAs has not been critically evaluated in many clinical practices. Furthermore, details of the MRI protocol, including the timing of post-contrast imaging, the exact type of MRI pulse sequence and the prescribed order of sequences are all important but often overlooked considerations in the design of MRI protocols. This program aims to refresh knowledge regarding the mechanisms of GBCAs and optimal post-contrast MRI protocol design. The need to understand the agents utilized for Neuroradiology MR, perfusion MR and Prostate Imaging will be assessed, evaluated and discussed. The available literature suggests that the sensitivity of contrast-enhanced breast MRI in detection of cancer is considerably higher than that of either radiographic mammography or ultrasound. In addition, MRI is not limited by breast density, which is a major advantage in comparison with mammography, and is effective even in women who have breast implants or have undergone previous breast surgery. Thus, Contrast Enhancement administered with Breast MRI is vital and necessary for us to understand. Gadolinium agents are not all the same with respect to relaxivity. We need to understand which Gadolinium agents on the US market are best for our patients based on crossover studies and other peer review literature.

Target Audience:

The content of this MRI Program is intended for healthcare professionals who work in and with the MRI system and MRI environment. These individuals include Radiologists and Other Physicians, MRI Technologists, Radiologic and Imaging Nurses, MRI Facility Managers, MRI Researchers, and Others.  

Program Objectives:

1. Study Brain Tumor Imaging--Clinical crossover studies: high relaxivity vs traditional agents Role of post-Gad T2 FLAIR, 3D techniques, perfusion/permeability 

2. Identify and Optimize protocols for Neuro applications.

3. Describe the role of dynamic contrast-enhanced sequences in CNS MRI and review data showing the value of high relaxivity agents in brain tumors.

4. Describe the current paradigm of prostate cancer diagnosis with its shortcomings and explain how prostate MRI can fill the gap.

5. Review the essential aspects of image acquisition and interpretation of multi-parametric prostate MRI with an emphasis on DCE-MRI.

6. Illustrate the MR features of typical prostate cancer and its mimics at the setting of screening, diagnosis, staging , active surveillance and focal therapy.

7. Understand efficacy, safety, and indications, hardware, fundamentals, and safety considerations associated with MR imaging of the breast.

8. Review the up-and-coming clinical applications for Magnetic Resonance Imaging, particularly for Breast MR.  

Accreditation and CME Credit Statements

This CME activity has been planned and implemented in accordance with the Essential Areas and Policies of the Accreditation Council for Continuing Medical Education thru the joint providership of The Institute for Medical Studies (IMS) and Northwest Imaging Forums, Inc. IMS is accredited by the ACCME to provide continuing medical education for physicians.  

The Institute for Medical Studies designates this educational activity for a maximum of 1.5 AMA PRA Category 1 Credits™. Physicians should only claim credit commensurate with the extent of their participation in the activity.  

Nurses may claim credit for activities approved for AMA PRA Category 1 Credits ™ in most states, for up to 50% of the nursing requirement for recertification. This activity is designated for up to 1.5 AMA PRA Category1 Credits ™
Release Date: 07/28/2015 Expiration Date: 7/28/2017

Faculty and planner Disclosures:

Matt Wilson (CME activity planner) has no commercial relationships to disclose.

As an accredited provider of continuing medical education, it is the policy of The Institute for Medical Studies (IMS) to ensure balance, independence, objectivity, and scientific rigor in all of its educational activities. In accordance with this policy, faculty must disclose any financial relationships with commercial interests germane to their presentation. Additionally, in the event a conflict of interest (COI) does exist, it is the policy of IMS to ensure that the COI is resolved in order to ensure the integrity of the CME activity. For this CME activity, any COI has been resolved thru content review by IMS.


For this CME activity, any COI has been resolved thru content review by IMS.

Howard Rowley, MD has the following commercial relationships to disclose

Honoraria / consulting / agreements

· GE Healthcare à contrast

· Bayer à contrast

· Guerbet à contrast

· Trial consulting:

o Lundbeck – DIAS

o Gore – REDUCE


o Genentech – PRISMS

· Off-label use of contrast

o Perfusion, MRA, peds


Haydee Ojeda Fournier, MD has no commercial relationships to disclose

Aytek Oto, MD
has the following commercial relationships to disclose:

Philips Health Care - Primary Investigator - Research Grant
Bracco Diagnostics - Honorarium - Speaking engagements
Profound - Medical Advisory Board


Acknowledgement of commercial support:

This CME activity supported by an unrestricted educational grant from Bracco Diagnostics Inc

The CME REGISTRATION, EVALUATION FORM, and POST TEST (a score of 75% or greater must be obtained), will need to be completed and returned to the following address to earn the 1.5 PRA Category 1 AMA credit.
The system will record your score and present it at the end

Northwest Imaging Forums, Inc.
P.O. Box 25909
Eugene Oregon 97402 or Fax to 541-683-8499



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