PET/MRI in Abdominopelvic Oncology

Targeted CE per ARRT’s Discipline, Category, and Subcategory classification:
[Note: Discipline-specific Targeted CE credits may be less than the total Category A credits approved for this course.]

Magnetic Resonance Imaging: 0.25
Procedures: 0.25
Body: 0.25

Nuclear Medicine Technology: 0.25
Procedures: 0.25
Endocrine and Oncology Procedures: 0.25

Registered Radiologist Assistant: 0.25
Procedures: 0.25
Abdominal Section: 0.25

Radiation Therapy: 0.25
Patient Care: 0.25
Patient and Medical Record Management: 0.25

Outline

1. Introduction
2. Technical and Workflow Considerations for PET/MRI
3. PET/MRI versus PET/CT
4. Pearls and Pitfalls of PET/MRI
5. Prostate Cancer
6. Neuroendocrine Tumors
7. Rectal Cancer
8. Pancreatic Cancer
9. Hepatobiliary Cancer
10. Gynecologic Cancers
11. Other Tumors
12. Conclusion

Objectives

Upon completion of this course, students will:

1. list limitations in the acquisition and interpretation of PET/CT data
2. identify the date that PET/MRI was first approved for clinical use in the Unites States
3. list the imaging vendors that sell commercial PET/MRI systems in the Unites States
4. describe the hardware components of current PET/MRI systems
5. list the tissue types that are identified by Dixon MRI sequences used for attenuation correction
6. describe the general guidelines for PET/MRI acquisitions
7. list practical challenges that have limited widespread adoption of PET/MRI into clinical practice
8. list the benefits of PET/MRI over PET/CT
9. compare the sensitivity of PET/MRI and PET/CT
10. identify tissue types that are not accounted for by MRAC images
11. list common causes of dephasing on MRAC images that can result in PET signal loss
12. identify the most common noncutaneous malignancy in men
13. describe the current NCCN imaging recommendations for patients with high-risk prostate cancer
14. describe the physical half-life carbon-11 PET radiotracers
15. list known limitations of PET imaging of prostate cancer using ¹⁸F fluciclovine
16. list the tissue types in the body from which NETs most commonly arise
17. list radiotracers that have been used for noninvasive diagnosis and staging of patients with NETs
18. describe an abbreviated MRI protocol for hepatic metastases from NETs
19. identify isotopes used for peptide receptor radionuclide therapy for NETs
20. identify the most common malignancy that affects the digestive system
21. describe the modality that is typically used to identify and diagnose rectal cancers
22. list imaging findings that make it difficult to diagnose lymph node metastases from rectal cancer at MRI
23. identify radiotracers that can increase reader confidence and detection of pelvic nodal metastases in patients with rectal cancer
24. list the MRI sequences that may improve detection of hepatic metastases from rectal cancer
25. describe the second most common malignancy of the digestive system
26. describe the utility of FDG PET in the staging of newly diagnosed pancreatic cancer
27. describe the standard of care treatment for patients with newly diagnosed pancreatic adenocarcinoma
28. describe challenges affecting CT and MRI imaging following treatment for pancreatic cancer
29. list examples of hepatobiliary cancers
30. identify imaging modalities that form the cornerstone for hepatocellular cancer diagnosis and monitoring response to treatment
31. identify PET radiotracers that target fibroblast activity
32. list the most commonly diagnosed gynecologic cancers
33. identify the best imaging modality for identifying primary gynecologic cancer tumors
34. identify the best imaging modality for identifying gynecologic cancer lymph node metastases
35. describe clinical symptoms that may indicate malignant transformation of neurofibromas