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Course Overview and Educational Objectives

Data regarding gadolinium deposition in patients who have undergone contrast-enhanced MRI is rapidly evolving. Further research is needed to evaluate the clinical significance, if any, of these findings. In the meantime, radiologists, pharmacists, and referring physicians must ensure informed decision-making about the benefits and potential risks to patients undergoing a contrast-enhanced MRI examination.

This lecture will discuss the relevant physicochemical properties and classification of gadolinium-based contrast agents, review recent literature on the deposition of gadolinium, and discuss recent changes to the ACR recommendations for screening patients undergoing GBCA examinations.

After completing this activity, the participant should be better able to:

• Describe how physicochemical properties and classification of GBCAs may affect patient safety
• Discuss recent studies reporting the discovery of gadolinium deposits in patients who have undergone contrast-enhanced MRI exams
• Summarize what is known and not known regarding the clinical significance of gadolinium deposition in patients
• Implement new ACR guidelines for screening patients receiving a GBCA-enhanced procedure

Joint Accreditation Statement

In support of improving patient care, this activity has been planned and implemented by the Postgraduate Institute for Medicine and ICPME. Postgraduate Institute for Medicine is jointly accredited by the American Council for Continuing Medical Education (ACCME), the Accreditation Council for Pharmacy Education (ACPE), and the American Nurses Credentialing Center (ANCC), to provide continuing education for the healthcare team.

Pharmacy Continuing Education
Postgraduate Institute for Medicine designates this continuing education activity for 1.0 contact hour(s) (0.1 CEUs) of the Accreditation Council for Pharmacy Education. (Universal Activity Number – 0809-9999-18-252-H01-P).

To view this program and receive ACPE credit, please click here: http://www.powerpak.com/course/content/116101

Physician Continuing Medical Education
This activity has 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 Postgraduate Institute for Medicine and International Center for Postgraduate Medical Education. The Postgraduate Institute for Medicine is accredited by the ACCME to provide continuing medical education for physicians.

The Postgraduate Institute for Medicine designates this enduring material for a maximum of 1.0 AMA PRA Category 1 Credit(s)™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

SA-CME: This activity meets the criteria for self-assessment toward the purpose of fulfilling requirements in the American Board of Radiology (ABR) Maintenance of Certification Program.

To view this program and obtain credit for AMA PRA Category 1 Credit(s) please click here: http://courses.icpme.us/class_learn?course=603

The European Accreditation Council for CME (EACCME^®)
The UEMS-EACCME^® has mutual recognition agreements with the American Medical Association (AMA) for live event and e-learning materials. For more information go to http://www.uems.eu/uems-activities/accreditation/eaccme.

Radiologic Technologist Continuing Education
This program has been approved by the American Society of Radiologic Technologists (ASRT) for 1.0 hour of ARRT Category A continuing education credit.

To view this program and ARRT Category A continuing education credit, please click here: http://courses.icpme.us/class_learn?course=603

Faculty

Robert E. Lenkinski, PhD
Professor of Radiology and Vice Chair of Radiology Research
UT Southwestern
Dallas, TX

Robert E. Lenkinski, PhD, is Professor of Radiology and Vice Chair of Radiology Research at UT Southwestern. He holds the Charles A. and Elizabeth Ann Sanders Chair in Translational Research, and the Jan and Bob Pickens Distinguished Professorship in Medical Science, in memory of Jerry Knight Rymer and Annette Brannon Rymer and Mr. and Mrs. W.L. Pickens.

Before joining the faculty at UT Southwestern in 2011, Dr. Lenkinski served as Professor of Radiology at Harvard Medical School. Earlier academic appointments include Visiting Assistant Professor of Chemistry at the University of Houston, Research Assistant Professor of Psychology and Biophysics at the University of Illinois College of Medicine in Chicago, Assistant Professor of Biochemistry at the University of Alabama in Birmingham, Visiting Assistant Professor of Chemistry at the Weizmann Institute of Science, Associate Professor of Chemistry at the University of Guelph in Canada, and Associate Professor of Radiological Science at the University of Pennsylvania School of Medicine, where he received his first appointment in Radiology.

Dr. Lenkinski is a lanthanide chemist by training. A major focus of Dr. Lenkinski's research involves developing, validating, and applying magnetic resonance spectroscopic and multinuclear imaging methods for the study of human disease. He wants to understand how the metabolic information derived from these methods can aid in the diagnosis, staging, and treatment of a variety of pathologies. Current applications involve brain tumors, breast cancer, prostate cancer, and renal function.

Dr. Lenkinski is also investigating targeted molecular imaging agents, including lanthanide-based MRI relaxation and shift reagents and their conjugation to low-molecular weight ligands and their analogous PET tracers. He wants to develop targeted agents for imaging of micro-calcifications in human breast cancer.

Additional research involves the development and validation of a number of quantitative MRI methods, including arterial spin labeling, dynamic contrast-enhanced MRI, and diffusion weighted MRI for the study of human disease.

Jeffrey C. Weinreb, MD, FACR, FISMRM, FSCBT/MR
Professor of Radiology and Biomedical Imaging
Vice Chair for Strategic Planning and Innovation
Yale School of Medicine
Director, MRI Services
Yale New-Haven Hospital
New Haven, CT

After graduating Phi Beta Kappa from the Massachusetts Institute of Technology, Dr. Weinreb received his medical degree from the Mount Sinai School of Medicine. He has held faculty positions at University of Texas Southwestern Medical School, Columbia College for Physicians and Surgeons, and New York University School of Medicine, where he was Director of MRI for 15 years and led a group that pioneered the development of Body MRI, Breast MRI, and MRA. Yale has been his home since 2002.

Dr. Weinreb is currently Professor of Radiology and Biomedical Imaging at the Yale School of Medicine and Chief of MRI at Yale-New Haven Hospital. He is a leading authority on MRI contrast agents, MRI safety, and the use of MRI for the abdomen (focusing on the liver), and pelvis (focusing on the prostate). A noted educator and lecturer, he has presented more than 900 invited lectures and has been a frequent Visiting Professor throughout the world. Dr. Weinreb has authored/co-authored more than 200 published manuscripts and 3 textbooks, and he has been on the editorial boards of numerous medical journals. As Chairman of the American College of Radiology Commission on Quality and Safety, Dr. Weinreb spearheaded efforts to improve the quality of medical imaging in the USA. Recently, he led an international effort to develop PI-RADS v2 (Prostate Imaging Reporting and Data System Version 2) to standardize the acquisition, interpretation, and reporting of prostate MRI, and the manuscript was recognized as the Best Clinical Research Paper published in European Urology for 2016. He has served as President of the SCBT/MR, President of the New York Roentgen Society, and Vice President of the ACR, and he currently chairs ACR RADS Steering Committee. He is the recipient of the 2017 ACR Gold Medal Award.

Disclosure of Conflicts of Interest

Postgraduate Institute for Medicine (PIM) requires instructors, planners, managers and other individuals who are in a position to control the content of this activity to disclose any real or apparent conflict of interest (COI) they may have as related to the content of this activity. All identified COI are thoroughly vetted and resolved according to PIM policy.  The existence or absence of COI for everyone in a position to control content will be disclosed to participants prior to the start of each activity.

The faculty has reported the following financial relationships or relationships to products or devices they or their spouse/life partner have with commercial interests related to the content of this CME activity:

Robert E. Lenkinski, PhD has received consulting fees from Aspect Medical Imaging and has received a research grant from Philips Healthcare.

Jeffrey C. Weinreb, MD, FACR, FISMRM, FSCBT/MR has received consulting fees from Bracco.

The following planners and managers have reported NO financial relationships or relationships to products or devices they or their spouse/life partner have with commercial interests related to the content of this CME activity:

Disclosure of Unlabeled Use

This educational activity may contain discussion of published and/or investigational uses of products and devices that are not indicated by the FDA. The planners of this activity do not recommend the use of any products and devices outside of the labeled indications.

The opinions expressed in the educational activity are those of the faculty and do not necessarily represent the views of the planners. Please refer to the official prescribing information for each product for discussion of approved indications, contraindications, and warnings.

Disclaimer

Participants have an implied responsibility to use the newly acquired information to enhance patient outcomes and their own professional development. The information presented in this activity is not meant to serve as a guideline for patient management. Any procedures, medications, or other courses of diagnosis or treatment discussed or suggested in this activity should not be used by clinicians without evaluation of their patient's conditions and possible contraindications on dangers in use, review of any applicable manufacturer's product information, and comparison with recommendations of other authorities.

What you are about to see is a previously recorded live symposium. Please note that only "home study" credit will be awarded for participating in this archived presentation. No "live" credits are available.