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MRI


ROTATION

Faculty representative: Dr. Alex Somwaru

Hours:         

  • 8:00a – until attending dismissal (approximately 5:00 pm)
  • When you arrive: 
    • Sit at designated MR locations [23-4226 (SL), 23-7058 (West), 44-8895 (PACC)]
    • Please sign into radiology locator so that technicians/other residents may locate you. 
    • Please call technicians at all sites to let them know when you arrive and provide them with the reading room number they should call to reach you. 
      • SL:  23-3493 / 23-3485
      • West:  23-8420 / 36-3372
      • BI:  20-2563
      • PACC:  44-8872
      • Brodsky: 23-8951, 23-8707
      • Kingsway: 

Location: Follow the attending who is covering that day. Please call attending the day before for where the next day's reading site will be. 

  • SL reading room (23-4226)
  • West reading room corner (23-7058)
  • PACC (44-8859 or 44-6082)

What to Read:    

  • MR Abdomen/Pelvis 
  • With Dr. Kagen only:
    • Surgical planning for tram flaps
    • Lymphedema studies
  • Inpatients cases should be read first
  • Leave Dr. Kagen’s MRA’s unless otherwise instructed (let Dr. Kagen protocol these cases)
  • MR prostates are usually but not always to be signed off by Dr. Kagen
  • Resident can/should prelim, especially when Dr. Kagen is on site
End of rotation presentation: Residents are expected to give a short 20-30 minute talk on a body MRI topic of choice.

Protocoling: 

Residents should protocol 1 week ahead of time. If there is no resident on MR, the attending will arrive by 9 am and protocol studies.
  • Senior resident protocols all sites in IDX. 
    • When junior resident is more experienced on the rotation, they should begin to protocol too
  • If you do not know the right protocol, ask or leave it blank. Guessing is not acceptable
  • If the script is not available and there is any question, write “Call radiologist with script”
  • If study is obvious (ie Prostate, Enterography) then leave it blank.

WORKLIST

Work group
  • BI Petrie
  • PACC
  • West
  • SL
  • BI Cancer Center
  • Kings Highway
  • Kingsway Diagnostic
Body region: Abdomen, Pelvis 
Modality: MR

CONTACTS

Reading Rooms
  • SL:  23-4226
  • West:  23-7058
  • BI PACC:  44-6082

MR Techs
  • SL:  23-3493 / 23-3485
  • West:  23-8420 / 36-3372
  • BI:  20-2563
  • PACC:  44-8872

INTERDISCIPLINARY CONFERENCES

  • MSH Body conference: Wednesday at 4 pm, MSW webinar 4th floor conf room
  • GI Multidisciplinary Tumor Board: Monday at 5 pm, MSH Rm# L3-94, PACC Rm# 4A-18, MSW Rm# LLA-37, BI Rm # Baird 16, Chelsea Rad Onc Rm# D-18
  • General Multidisciplinary Tumor Board: Thursday at 5 pm, MSW Conf room #2C or SL Surgery Conf room Clark #10

GOTO MEETING

The reading room with the attending logs into the webinar and shares their screen with the other side
  • To access the SLR webinar, go to www.gotomeeting.com
  • Click join meeting
  • Ask SLR residents for their access code (159.803.383)

RESOURCES

Recommended Books  

  • Body MRI by Evan Siegelman
  • Additional Reading:
    • Primer on MR Imaging of the Abdomen and Pelvis by Diego R. Martin, Michele A. Brown and Richard C. Semelka
    • Liver MRI: Correlation with other Imaging Modalities and Histopathology by Shahid M. Hussain, J.L. Gollan and R.C. Semelka)
  • H-drive Rotation Files
    • My computer - (H:) drive - Dept  - Rad1  Rad  Body MRI
Resources
  • YouTube Videos on Dr. Michael Lipton's MRI course
    • Dr. Lipton is an associate professor of radiology at Albert Einstein College of Medicine and associate director of its Gruss Magnetic Resonance Research Center

LIVER - Fat assessment

1.5T Fat Fraction (IDEAL IQ sequence) 
  • 3 point Dixon 7th series FP = Fat Percentage 
  • ROI divided by 10 
    • < 5: Normal 
    • 5-33: Mild 
    • 33-66: Moderate 
    • > 66: Severe 
Fat Fraction (In/Out of Phase)
  • IN – OUT x 100 
                2(IN)

LIVER - OPTN classification


Table 3 describes the mandatory diagnostic criteria for HCC classification in patients with chronic liver disease 

UNOS/OPTN system 
  • Standardizes the language that radiology reports must include to qualify for exception points 
  • Hepatic nodules must be classified according to OPTN criteria 
  • Nodules < 1 cm are too small to characterized and are NOT considered for additional priority on the transplant waiting list 
  • All HCC are categorized as class 5 lesions 
  • Non-diagnostic study is class 0 (images not of sufficient quality to confidently apply the criteria) à repeat study with same or alternative acceptable modality

LIVER - Iron assessment

1.5T Iron - 3 point Dixon 4th series (opp T2s) 
  • ROI divided by 10 
    • < 14: Severe 
    • 14-24: Mild-Moderate 
    • > 24: Normal 
T2* 
  • <14: Severe 
  • 14-20: Mild-Moderate 
R2* 
  • ROI divided by 10 
    • < 50: Normal 
    • > 71: Severe 
3T Iron T2* 
  • < 14: Significant iron present 

PROSTATE

  • Likert scoring criteria 


Ċ
RadRez Administrator,
Mar 27, 2018, 4:57 PM
ĉ
RadRez Administrator,
Apr 8, 2017, 6:42 AM