ROTATIONS‎ > ‎

BODY 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 (M), 23-7058 (West)]
    • 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. 
      • M:  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. Morningside (3rd Floor - Clark Building) or West ballroom (4th Floor), depends on the site Body MRI attending covers Fluoro "RF" (check QGenda)

  • Morningside reading room (23-4226)
  • West reading room corner (23-7058)
CONFERENCES:
  • Body ICC Conference, Thursdays 4 PM
    • 1st Thursday of Month: Systemwide, MSH presents
    • 2nd Thursday of Month: Systemwide, MSW presents (Moderated by Dr. Gnerre)
    • 3rd Thursday of Month: No Conference
    • 4th Thursday of Month: Not Systemwide, MSW only (Moderated by Dr. Roudenko)


Goals & Expectations

Curriculum:

Refer to LINK

First Day:

PACS Worklist

  • MR Abd/Pelvis
    • Prioritize Inpatient Cases
    • MRAs for preoperative planning of flap surgeries (Read wtih Dr Kagen only)
    • Lymphedema studies (Read with Dr Kagen only)
  • Vascular 
Protocol: 

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.

Use the following Body MRI RIS Filter
  • Senior resident protocols all sites in RIS. 
    • 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.
  • Dr. Kagen will protocol MRAs & Lymphedema studies
Supplementary reading material and cases:
  • Review and read supplementary articles organized by R level
  • Resident prepared teaching cases
  • Shared Body MRI Folder
End of rotation presentation: Residents are expected to give a short 20-30 minute talk on a body MRI topic of choice.



WORKLIST

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

CONTACTS

Reading Rooms
  • M:  23-4226
  • West:  23-7058

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

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)
  • G-drive Rotation Files
    • My computer - (G:) 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) 
  • Put ROI on Liver in FatFrac IDEAL IQ sequence, get Avg Fat %
    • < 5: Normal 
    • 5-33: Mild 
    • 33-66: Moderate 
    • > 66: Severe 
Fat Fraction (In/Out of Phase)
  • IN – OUT x 100
        2(IN) 

LIVER - Iron assessment

Columbia University calculator


Iron Deposition Calculations:

1.       Put ROI on Liver in R2* sequence, get Avg R2*

2.       Use Avg R2* to calculate T2* = (1/R2*) x 1000

3.       In 1.5 T magnet:

a.       T2*< 21 ms means mild iron deposition

b.      T2*< 14 ms means severe iron deposition

4.       Go to http://www.columbia.edu/~sj2532/t2_star.html and put T2* value to get Liver Iron Concentration mg/g (Normal Range: 0.17-1.8)



R2*  
  • < 50: Normal 
  • > 71: Severe 
T2* 
  • <14: Severe 
  • 14-20: Mild-Moderate 
3T Iron T2* 
  • < 14: Significant iron present 

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

PROSTATE

  • Likert scoring criteria 


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