5300-203A
The Role of Hepatobiliary Phase
Imaging in Liver MRI

An online lecture recorded Wednesday, January 23 | 2019

Target Audience
This educational activity is intended for radiologists, radiologist technologists, and nurses

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This course expires March 1, 2021

If you want credit, this course must be completed (i.e. view course content (PDF file), pass the posttest, AND print the certificate) by no later than February 28, 2021

Please note, after this course has expired, no aspect of the course will be accessible, including the course link.

Course Overview
In 2018, it is estimated that 42,220 new cases of liver cancer will be diagnosed, and about 30,200 people will die of liver cancer.¹  Hepatocellular carcinoma (HCC) is the 6^th most common cancer worldwide, leading to the third mostly likely cause of cancer-related deaths.² While extracellular gadolinium-based contrast agents have been heavily relied upon for diagnosing HCC, the emergence of gadolinium-based liver-specific agents have been found especially useful for detection of HCC, as the uptake of the contrast agent by functioning hepatocytes provides increased signal intensity of the liver parenchyma.²

Dr. Daniele Marin from Duke University Medical Center will address advances in liver MRI, with a focus on the role of hepatobiliary contrast agents in the optimization of liver imaging. Included will be a discussion of the similarities and differences between extracellular and liver-specific agents; technical considerations; and the pearls and pitfalls of administering hepatobiliary contrast agents in the acquisition and interpretation of liver MRI.

1. Key Statistics about Liver Cancer. American Cancer Society website. https://www.cancer.org/cancer/liver-cancer/about/what-is-key-statistics.html.  Accessed August 29. 2018.
2. Niendorf  E, Spilseth B, Wang X, Taylor A. Contrast Enhanced MRI in the Diagnosis of HCC. Diagnostics (Basel). 2015;5(3):383-398.

Educational Objectives
At the conclusion of this activity, participants should be better able to:

• Compare the mechanism of action of both extracellular and liver-specific gadolinium-based agents, and the benefits of each
• Explain the value that hepatobiliary phase imaging brings to lesion identification and image interpretation, especially in cases of hepatocellular carcinoma
• Describe the technical considerations of administering liver-specific agents and how to optimize imaging protocols
• Compare and contrast standard LMRI interpretation to hepatobiliary phase interpretation

Joint Accreditation Statement

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

Physician Continuing Medical Education
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.

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 https://www.uems.eu/areas-of-expertise/cme-cpd/eaccme/mutual-recognition-with-the-united-states

Nurse Continuing Medical Education
The maximum number of hours awarded for this Continuing Nursing Education activity is 1.0 contact hours.

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

How to Enroll and Participate

There are no fees or prerequisites to participate in this program. Estimated time to complete this activity is one hour.

Click ENROLL NOW, CONTINUE, CONFIRM ORDER, and ACCESS COURSE NOW.

• Click on the blue link. Complete the precourse questions and SUBMIT.
• Click on the blue link again to view the recording.

How to Receive a Certificate of Credit

• Log-in to your account at www.icpme.us
• View the entire educational activity session. At the conclusion of the lecture, close the Vimeo window.
• Return to the course in your account at www.icpme.us.
• From the COURSE HOME page, click the button for POSTTEST and for EVALUATION.
• A passing grade of at least 75% is required to receive credit. You may take the test up to three times.
• Upon receipt of a passing grade, you will be able to print a certificate of credit from your account at www.icpme.us

Your certificate of credit will remain in your account at www.icpme.us as a permanent record of your participation.

Faculty
Daniele Marin, MD, FSCBTMR

Dr. Marin is an Associate Professor of Radiology at Duke University, where he serves as the Medical Director of the Multi-D Lab. Dr. Marin’s clinical and research interests focus on medical imaging with specific emphasis on quantitative imaging, clinical applications of dual energy CT, and new strategies for radiation dose reduction at CT.

Dr. Marin received his medical degree in 2003 from the University of Rome Sapienza, Italy. After a residency at the University of Rome Sapienza, he completed a four-year research and clinical fellowship in Abdominal and Cardiovascular Imaging at Duke University and joined the Duke University faculty in July 2012 as an Assistant Professor. In 2010, Dr. Marin also completed his doctorate in Translational Medicine at the University of Rome Sapienza.

Dr. Marin has contributed over 70 original articles and reviews to medical literature and numerous book chapters. He has provided many invited lectures nationally and internationally. In addition, Dr. Marin was the recipient of 2015 RSNA Research Scholar Grant for a project on imaging-based quantification of tumor heterogeneity. Dr. Marin was also the recipient of 2015 SAR Dodd Research Award for work on accurate assessment of radiation dose reduction at CT using iterative reconstruction algorithms.

Dr. Marin is a member of numerous scientific societies and international radiological committees, including the Quantitative Imaging Biomarkers Alliance (QIBA) and the Education Exhibits Committee for the Radiological Society of North America. He also serves on the Editorial Board of the journal Radiology.

Dr. Marin is a well-respected educator and has recently received the Reed P. Rice, M.D. Memorial Award for excellence in residents’ education at Duke University.

Disclosure Information
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.

Daniele Marin, MD, has nothing to disclose.

The PIM and ICPME planners and managers have nothing to disclose.

Disclosure of Unlabeled Use
This educational activity may contain discussion of published and/or investigational uses of agents that are not indicated by the FDA. The planners of this activity do not recommend the use of any agent 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.

Questions?
For questions regarding this program, please contact ICPME:
Email: information@icpmed.com

Jointly Provided by

This activity is supported by an independent educational grant from
Bayer HealthCare Pharmaceuticals

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.

Course image attribution:  Nephron [CC BY-SA 3.0 (https://creativecommons.org/licenses/by-sa/3.0) or GFDL (http://www.gnu.org/copyleft/fdl.html)], from Wikimedia Commons