Imaging in Interventional 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.]

Computed Tomography: 1.00
Safety: 0.25
Radiation Safety and Dose: 0.25
Procedures: 0.75
Neck and Chest: 0.25
Abdomen and Pelvis: 0.50

Magnetic Resonance Imaging: 0.75
Procedures: 0.75
Body: 0.75

Nuclear Medicine Technology: 0.75
Procedures: 0.75
Endocrine and Oncology Procedures: 0.75

Registered Radiologist Assistant: 1.00
Safety: 0.25
Patient Safety, Radiation Protection, and Equipment Operation: 0.25
Procedures: 0.75
Abdominal Section: 0.50
Thoracic Section: 0.25

Sonography: 0.75
Procedures: 0.75
Superficial Structures and Other Sonographic Procedures: 0.75

Radiation Therapy: 2.00
Procedures: 2.00
Treatment Sites and Tumors: 2.00

Vascular-Interventional Radiography: 0.75
Procedures: 0.75
Nonvascular Procedures: 0.75

Outline

1. Introduction
2. Imaging For Procedure Planning
3. Imaging for Targeting
   1. Advances in Real-time Imaging
   2. Three-dimensional Visualization
   3. Contrast Agents
   4. Image Fusion
   5. Navigation
   6. Robotics
   7. Physician Access to the Patient
   8. Radiation Exposure
4. Imaging for Intraprocedural Monitoring
5. Imaging for Intraprocedural Control of Treatment
6. Imaging for Postprocedural Therapy Assessment

Objectives

Upon completion of this course, students will:

1. understand the benefits of image-guided procedures
2. know the ideal properties of medical imaging during interventional oncology procedures
3. list the five key roles in image-guided therapy and interventional oncology
4. understand the first step in interventional oncology
5. identify which imaging modalities deal with anatomic imaging
6. understand the importance of pre-procedure image cross-referencing
7. list the four types of interventional procedures
8. know how blood is supplied to the liver
9. recall how cancer cells in the liver receive blood supply
10. describe the type of view offered by intra-procedural imaging
11. list the new imaging techniques used when planning interventional oncology procedures
12. discuss the type of imaging that best details treatment area, anatomy, interventional tools, and physiologic information
13. know the meaning of ALARA
14. understand the advantages to using CT fluoroscopy for interventional oncology procedures
15. be familiar with cone-beam computed tomography
16. know the uses of contrast media during interventional oncology procedures
17. list the levels of reactions to iodine-based contrast material
18. discuss contrast agent use in ultrasound in conjunction with radiofrequency ablation
19. understand which metabolic imaging study has impacted detection and staging of cancer
20. describe the challenges to fusing multiple modalities
21. explain the advantages of hybrid interventional suites
22. know how navigation technology in multi-modality image fusion assists the interventional oncologist
23. be familiar with the use of robotics in interventional imaging
24. discuss patient access in the different imaging modalities
25. describe the limitations of interventional imaging via computed tomography
26. explain the three principles of radiation protection
27. understand how navigation software and fusion imaging decrease radiation exposure
28. know the year in which the “Image Wisely” campaign was launched
29. understand monitoring during interventional imaging
30. be familiar with the various procedures that demonstrate post-embolization hemostasis
31. define cryotherapy
32. understand which imaging modalities visualize ice ball formation during cryotherapy
33. understand using Doppler ultrasound to assess blood flow after embolization
34. understand the use of mid-procedure angiography for control of interventional procedures
35. explain how imaging is used for post-procedure management
36. discuss imaging features associated with viable tissue identification after interventional oncology procedures
37. understand the types of tissues that remain after ablation therapy
38. list the goals of embolization therapy
39. explain the Choi criteria for assessing post-therapy tumor attenuation
40. identify the new imaging techniques that provide improved post-therapy tumor assessment