2020 Joint AAPM | COMP Virtual Meeting
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Session Title: Hot Topics in Breast MRI
Question 1: 1. Women with triple-negative breast cancer pose a major challenge to the oncology community as many are young, and a significant proportion have which mutation?
Reference:Reference: Olufunmiayo I. Olopade, Tatyana A. Grushko, Rita Nanda, Dezheng Huo. Advances in Breast Cancer: Pathways to Personalized Medicine. Clin Cancer Res. 2008 Dec 15; 14(24): 7988–7999.
Choice A:BRCA1
Choice B:BRCA2
Choice C:CHEK2
Choice D:PTEM
Question 2: Which MRI protocols shorten image acquisition and interpretation time, allow higher volume patient throughput, thus being more cost-effective, while maintaining a high diagnostic accuracy.
Reference:Doris Leithner, Linda Moy, Elizabeth Morris, Maria A Marino, Katja Pinker. Abbreviated MRI of the breast: Does it Provide Value? J Magn Reson Imaging. 2019 Jun; 49(7): e85–e100.
Choice A:Ultrafast MRI
Choice B:Abbreviated MRI
Choice C:Multiparametric MRI
Question 3: Which of the following statements with regard to the clinical significance of gadolinium deposition in patients with normal renal function is FALSE?
Reference:1. Gadolinium retention after GBCA use, FDA Briefing Document, Medical Imaging and Drugs Advisory Committee, September 8, 2017. 2. Welk B, McArthur E, Morrow SA, MacDonald P, Hayward J, Leung A, Lum A. Association Between Gadolinium Contrast Exposure and the Risk of Parkinsonism. JAMA. 2016 Jul 5;316(1):96-8. 3. Gulani V, Calamante F, Shellock FG, Kanal E, Reeder SB; International Society for Magnetic Resonance in Medicine. Gadolinium deposition in the brain: summary of evidence and recommendations. Lancet Neurol. 2017 Jul;16(7):564-570.
Choice A:The FDA has determined that there is no convincing current evidence for gadolinium deposition disease.
Choice B:There is clear evidence of harm from gadolinium tissue deposition in humans
Choice C:There is no evidence of tissue injury in the brain from gadolinium deposits.
Choice D:Early data suggest gadolinium tissue deposition is not associated with adverse neurological outcomes.
Question 4: Based upon available evidence on gadolinium deposition, which of the following is TRUE?
Reference:1. Gulani V, Calamante F, Shellock FG, Kanal E, Reeder SB; International Society for Magnetic Resonance in Medicine. Gadolinium deposition in the brain: summary of evidence and recommendations. Lancet Neurol. 2017 Jul;16(7):564-570. 2. McDonald RJ, McDonald JS, Dai D; Comparison of Gadolinium Concentrations within Multiple Rat Organs after Intravenous Administration of Linear versus Macrocyclic Gadolinium Chelates; Radiology. 2017 Dec. Ahead of Print. 3. Tweedle MF, Kanal E, Muller R. Considerations in the Selection of a New Gadolinium-Based Contrast Agent. Supp Appl Radiol. 45(5); 2014. 1-11.
Choice A:Macrocyclic GBCAs have overall higher chemical stability and deposit more than linear agents
Choice B:Linear GBCAs have overall higher chemical stability and deposit more than macrocyclic agents
Choice C:Macrocyclic and linear agents have similar chemical stability and deposit equally.
Choice D:Linear GBCAs have overall lower chemical stability and deposit more than macrocyclic agents
Choice E:Macrocyclic GBCAs have overall lower chemical stability and deposit more than linear agents
Question 5: When imaging at higher field strengths (i.e. 3T vs 1.5T), why can a lower dose of GCBA be used in the DCE acquisition?
Reference:Rohrer M, Bauer H, Mintorovitch J, Requardt M, Weinmann HJ. Comparison of magnetic properties of MRI contrast media solutions at different magnetic field strengths. Invest Radiol. 2005;40(11):715‐724. doi:10.1097/01.rli.0000184756.66360.d3 Diakova, G., Korb, J.‐P. and Bryant, R.G. (2012), The magnetic field dependence of water T 1 in tissues. Magn. Reson. Med., 68: 272-277. doi:10.1002/mrm.23229
Choice A:Because the native T1 of tissues decreases at higher field strengths
Choice B:Because the native T1 of tissues increases at higher field strengths
Choice C:Because the relaxivity of contrast agents increases at higher field strengths
Choice D:Because the relaxivity of contrast agents decreases at higher field strengths
Question 6: Which of the following results in a more accurate lesion ADC measurement?
Reference:Iima, M., Partridge, S.C. & Le Bihan, D. Six DWI questions you always wanted to know but were afraid to ask: clinical relevance for breast diffusion MRI. Eur Radiol 30, 2561–2570 (2020). https://doi.org/10.1007/s00330-019-06648-0
Choice A:Calculating the ADC in each voxel and averaging over the ROI in the ADC map
Choice B:Averaging the signal from the ROI in each DW image and calculating the ADC from these averages
Choice C:Utilizing synthetic DWI high b-value images
Choice D:Decreasing the acquisition voxel size
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