General Radiography/General Medicine Topics:

Childhood Nutrition and Disease (3 CE)

Renee Tetreault-Abiad takes an in-depth look at the nutritional factors that affect the health of American children. She points out dietary trends and considers factors that contribute to inadequate nutrition in children. She lists health ramification associated with obesity and identifies important factors in the prevention of obesity. Also considered is the effect of diet on heart disease, cancer, asthma, and immune system function. The effects of specific nutritional deficiencies on a child’s health and cognitive function are explored. Factors that affect the development of eating patterns in childhood and how children develop food preferences are reviewed. Daily nutritional requirements for children of various ages are listed and the advantages and disadvantages associated with nutritional supplementation are debated. Renee concludes by providing strategies that will instill good nutritional practices in children. Expires August 15, 2009. Approved for 3 Category A (Direct) credits for ARRT; NMTCB; Florida (Pers Dev). Focus: Pediatrics

Forensic Radiology (2 CE)

One of our most popular, this article reveals many fascinating aspects of forensic radiology. Written by Lois Romans, it begins with a brief history of the development of forensic medicine and provides insight for those professionals that wish to get involved in this intriguing area of radiology. It looks at how imaging sciences can aid in the determination of identity and illustrates its usefulness in situations that involve mass causalities. The article shows how radiology applies to the evaluation of injury and death including osseous injuries, gunshot wounds, suicide and other trauma. It recognizes the contribution of radiology in uncovering nonviolent crimes such as smuggling, larceny, and art forgery and how it contributes to public health and clinical research. Regardless of what area of radiology you are currently involved in, you are sure to find this article enthralling! Expires August 15, 2009. Approved for 2 Category A (Direct) credits for ARRT; NMTCB; Florida. Focus: General Imaging

Patient Communication (1.5 CE)

This article, written by Lois Romans, has been incorporated in some hospital departments into a benchmark training module. The goal of this article is to outline the importance of developing effective patient communication skills by, 1) Recognizing why effective communication skills are important, 2) Understanding the communication process, and 3) Developing practical ways to improve patient communication skills. Expires July 15, 2009. Approved for 1.5 Category A (Direct) credits for ARRT; NMTCB; Florida. Focus: Patient Care

Leadership Skills for Technologists (1.5 CE)

This article, written by Lois Romans, has been incorporated in some hospital departments into a benchmark training module. Get your career on the right track! This article discusses the importance of leadership skills and reviews qualities that make leaders great. It considers the question of whether leadership traits are inborn or learned. It also outlines what leadership is not. The reader is presented with an overview of different theories of leadership. Steps are outlined to help the reader to improve personal performance. Expires July 15, 2009. Approved for 1.5 Category A (Direct) credits for ARRT; NMTCB; Florida. Focus: Management

Urinary Tract Calculi (1 CE) ***EXTENDED***

Written by Lois Romans, this article defines the terminology and epidemiology related to urinary tract calculi. It lists the various types of kidney stones and reviews the factors associated with their formation. It includes a description of the typical presentation of kidney stones and compares the advantages and limitation of various imaging modalities in the diagnosis of urinary tract calculi. Expires May 15, 2011. Approved for 1 Category A (Direct) credit for ARRT; NMTCB; Florida; Iowa [General X-ray]. Focus: Urology, CT, US

Flat-Panel Digital Radiographic Detector Technology (1 CE)

Written by David Neumann. There are several types of digital detector technologies presently in clinical use for medical radiography. These include computed radiography (CR), amorphous selenium direct radiography (DR) drum systems, charge-coupled device (CCD) based systems of several kinds, selenium-based flat panels, amorphous silicon flat panels using cesium iodide scintillators, and gadolinium-based flat panels. This article provides an overview of the technology used in the more recently developed direct-readout flat-panel radiographic imaging systems. Expires April 15, 2010 Approved for 1 Category A (Direct) credit for ARRT; NMTCB; Florida; Iowa [General X-ray].

Autoimmune Diseases (2.5 CE)

The term “autoimmune disease” refers to a varied group of more than 100 illnesses. Although some of these diseases are rare, others, such as Crohn’s disease, diabetes mellitus, and multiple sclerosis are seen frequently in patients requiring diagnostic imaging studies. Written by Lois Romans, this article explains the concept of auto-immunity. Basic information is given about a number of conditions and includes what organs may be affected, what symptoms are typically associated with the condition, and how the condition can be diagnosed. Expires May 15, 2011. Approved for 2.5 Category A (Direct) credits for ARRT; NMTCB; Florida. Focus: General Medicine

Common Childhood Sports-Related Injuries (2.5 CE)

It is a well-accepted fact that participation in physical activities such as organized sports is beneficial to a child physical health. Although the benefits surely outnumber the risks, injuries occur and technologists are often among the first health professionals to respond. Author Tami Moskal, discusses the advantages of youth sports as well as the risks inherent in participation. Her emphasis is on measures that can be taken for children to avoid injury. Expires May 15, 2011. Approved for 2.5 Category A (Direct) credits for ARRT; NMTCB; Florida. Focus: General Medicine

A Questions of Ethics (2 CE)

In the radiology department technologists are frequently involved in questions of medical ethics. Author Lois Romans looks at the theoretical aspects of ethical decision making by considering questions such as: What exactly is clinical ethics? How can ethics be distinguished from morality? How do clinical ethics differ from law? Expires May 15, 2011. Approved for 2 Category A (Direct) credits for ARRT; NMTCB; Florida. Focus: General Medicine; Management

A Look at Alternative Medicine (1 CE)

Technologists are well acquainted with traditional Western medical practices. Complementary and alternative medicine (CAM) offers a different perspective on healthcare. Written by Lois Romans, this article defines the various types of CAM, looks at the demographics of CAM users, and lists both the advantages and drawbacks of using CAM therapies. Expires May 15, 2011. Approved for 1 Category A (Direct) credit for ARRT; NMTCB; Florida. Focus: General Medicine

CT Topics:

Radiation Exposure to Pediatric Patients from CT (1 CE)

Author Lois Romans explains the factors that have contributed to the growing concern over the radiation dose delivered to pediatric patients during a CT exam. Lois explains how various technical factors affect the CT dose and points out special considerations relevant to the use of CT for pediatric patients. The article also points out how the perception of risk may influence how a patient’s family understands the risks associated with CT. It concludes with specific strategies for reducing dose while maintaining adequate image quality. Expires August 15, 2009. Approved for 1 Category A (Direct) credit for ARRT; NMTCB; Florida; Iowa. Focus: CT

Iodinated Contrast Media in Body Computed Tomography (1 CE)

Written by Lois Romans, this general information article defines characteristics that make iodinated contrast agents useful in radiologic exams. It reviews generally accepted concepts concerning the use of iodinated contrast in body CT, lists areas of contrast protocols that remain controversial, reviews the general phases of tissues enhancement, and explains issues surrounding specific components of injection protocols including scan delay time, injection flow rate, and contrast volume. Expires July 15, 2009. Approved for 1 Category A (Direct) credit for ARRT; NMTCB; Florida; Iowa [CT]. Focus: General Radiography, CT

Radiation Dosimetry in CT (1 CE)

Author Lois Romans believes it is the responsibility of each imaging professional to understand the benefit versus the risks of any procedure they perform. Armed with this knowledge technologists can maximize positive aspects of the procedure while minimizing any negative aspects. This article provides that knowledge by reviewing the basic radiation dose concepts as they relate to CT, defining commonly used terms, and explaining how dose is calculated. It outlines the effects of various technical factors on radiation dose and then concludes with a discussion of strategies for reducing dose while maintaining adequate image quality. Expires July 15, 2009. Approved for 1 Category A (Direct) credit for ARRT; NMTCB; Florida; Iowa (CT). Focus: CT

CT Imaging of the Adrenal Gland (1 CE) ***EXTENDED***

Written by Lois Romans, this article reviews the anatomy and physiology of the adrenal glands. It outlines various disorders that affect the adrenal glands and summarizes available literature regarding imaging characteristics that indicate benign or malignant adrenal masses. It explains the process for calculating adrenal washout from pre-, post- and delayed contrast CT images. Expires May 15, 2011. Approved for 1 Category A (Direct) credit for ARRT; NMTCB; Florida; Iowa [General X-ray]. Focus: CT (body)

CT Image Quality (1 CE)

Written by Lois Romans, this article provides a basic overview of the concepts involved when evaluating CT image quality. It explains the factors that affect spatial resolution, including matrix size, pixel size, field-of-view, voxel size, slice thickness, focal spot size, blur, MTF and the Nyquist Sampling theorem. It also explains the factors that affect low-contrast resolution which include contrast scale, contrast detail curves, receiver operator characteristics, noise and dose. Expires July 15, 2009. Approved for 1 Category A (Direct) credit for ARRT; NMTCB; Florida; Iowa (CT). Focus: CT

Role of First-Pass, Dynamic Brain-Perfusion CT in the Evaluation of Hyperacute Stroke (1 CE) ***EXTENDED***

Written by Mark Pierce, this article lists the imaging techniques that have been used for the evaluation of stroke, and explains the epidemiology of stroke. The basic anatomic structure of the brain is reviewed. The classification of stroke is explained. General techniques involved in performing CT brain perfusion are outlined. Expires May 15, 2011. Approved for 1 Category A (Direct) credit for ARRT; NMTCB; Florida; Iowa [General X-ray]. Focus: CT (neuro)

CTA of Living Renal Transplantation Donors (1 CE)

Author,Mark Pierce outlines the historical development of using live organs for renal transplantation. Mark explains the role of CT in the preoperative evaluation of donor nephrectomy and points out the advantages of using CT angiography over traditional imaging methods. CTA protocols are introduced as well as scanner-specific technical aspects such as pitch and Z-axis coverage. Normal renal vascular anatomy and its common variants are also covered. Expires July 15, 2009. Approved for 1 Category A (Direct) credit for ARRT; NMTCB; Florida; Iowa [CT] Focus: CT

A Profile of Stroke (with an Introduction to CT Perfusion) (1 CE) ***EXTENDED***

Written by Lois Romans, this article provides an excellent overview of stroke. It defines categories of stroke: ischemic, hemorrhagic, and hypotensive as well as its subclassifications, which include thrombotic, embolic, lacunar, intracerebral hemorrhage, subaracnoid hemorrhage, and arterovenous malformation. The symptoms, demographics, and risk factors of stroke are discussed. The article also provides a brief overview of one imaging method used for diagnosis. Expires May 15, 2011. Approved for 1 Category A (Direct) credit for ARRT; NMTCB; Florida; Iowa [General X-ray]. Focus: Neurology

The Role of Contrast Media in the CT Department (6 CE)

Written by Lois Romans, this article begins by reviewing the basic anatomy and physiology of the appendix; the origin and development of appendicitis are then explored. This background material is followed by a review of literature and outlines the role CT plays in the detection of acute appendicitis. Expires May 15, 2011. Approved for 6 Category A (Direct) credits for ARRT; NMTCB; Florida. Focus: CT

MRI Topics:

Basic Principles of MRI Safety (1 CE)

Written by John Posh, this article defines static magnetic fields and explains how they are quantified. It lists the bioeffects possible from exposure to static magnetic fields, describes cryogens, defines time-varying or gradients magnetic fields, and describes radiofrequency magnetic fields. It lists possible adverse effects associated with MRI exams and provides strategies for working with patients. Expires July 15, 2009. Approved for 1 Category A (Direct) credit for ARRT; NMTCB; ARMRIT; Florida. Focus: MRI

Diffusion and Perfusion MRI in Acute Stroke Imaging (1 CE) ***EXTENDED***

Written by Andy Trovinger, the goal of this article is to familiarize the reader with the use of diffusion and perfusion MR imaging in the setting of acute cerebral ischemia. It explains MR imaging methods including Fast (or Turbo) – Spin Echo, Fast Gradient Echo, and Echo Planar Imaging (EPI). Expires May 15, 2011. Approved for 1 Category A (Direct) credit for ARRT; NMTCB; ARMRIT; Florida. Focus: MRI (neuro)

Musculoskeletal MRI: The Ankle, Foot, Wrist and Hand (1 CE) ***EXTENDED***

Written by Andy Trovinger, this article points out the benefits of using MRI in musculoskeletal imaging. It explains the differences between the techniques of joint MRI and that of extremity MRI. Anatomy of the joints and the supporting structures of the foot ankle, wrist and hand are reviewed and descriptions of MRI techniques for each are provided. Expires May 15, 2011. Approved for 1 Category A (Direct) credit for ARRT; NMTCB; ARMRIT; Florida. Focus: MRI (musculoskeletal)

Using High-Dose Gadolinium-Enhanced MRI Studies in the Clinical Setting (1 CE)

Written by Kimberly Luse, this article reviews several MRI study protocols that have used high dose gadolinium. Readers will understand the evolution of gadolinium administration as it pertains to MRI and be provided a synopsis of research studies that examine the effectiveness of high dose gadolinium enhanced MRI. These studies look at different diagnostic criteria and body parts to be examined, various magnetic field strengths, different doses of gadolinium, and different methods of injection. Expires July 15, 2009. Approved for 1 Category A (Direct) credit for ARRT; NMTCB; ARMRIT; Florida. Focus: MRI

Taking MRI to Heart (1 CE)

Author Kimberly Luse introduces the reader to the MRI evaluation of the heart. She lists the specific physical properties inherent in cardiac MRI and explains special techniques used for optimum visualization of the heart and coronary arteries. Kim outlines contrast considerations in heart images and provides examples of pathology often demonstrated by cardiac MRI. Expires July 15, 2009. Approved for 1 Category A (Direct) credit for ARRT; NMTCB; ARMRIT; Florida. Focus: MRI (cardiology)

Contrast-Enhanced Magnetic Resonance Angiography (1 CE)

Written by Steven Thibodeau, this article identifies the benefits of contrast-enhanced MRA by comparing it with the two-dimensional time-of-flight technique. It looks at various methods of timing the arrival of contrast media and provides tips on calculating the minimal dose necessary to perform quality exams. The article also points out the hazards inherent in CE-MRA. Expires July 15, 2009. Approved for 1 Category A (Direct) credit for ARRT; NMTCB; ARMRIT; Florida. Focus: MRI

Fundamentals of MRI, Part II (1.5 CE)

This article by Joseph Hornak, the second in a series, will familiarize the reader with the characteristics of spin. Upon completion the reader will be able to explain, as it relates to spin physics, the properties of energy, transition, Boltzmann statistics, T1 processes, spin packets, precession, T2 processes, rotating frame of reference, pulsed magnetic fields, spin relaxation, and Bloch equations. Expires July 15, 2009. Approved for 1.5 Category A (Direct) credits for ARRT; NMTCB; ARMRIT; Florida. Focus: MRI (physics)

Fundamentals of MRI, Part III (1 CE)

The third article in the series by Joseph Hornak will familiarize the reader with the use of magnetic resonance phenomenon to produce a signal and explain the method of converting this signal into usable information using Fourier transform. Concepts explained in this installment include time domain NMR signal, the +/- frequency convention, the 90-FID sequence, the inversion recovery sequence, chemical shift, Fourier transform, phase correction, convolution theorem and digital FT. Expires August 15, 2009. Approved for 1 Category A (Direct) credit for ARRT; NMTCB, ARMRIT; Florida. Focus: MRI

Nuclear Medicine Topics:

Theories and Practice of Radiation Safety in Nuclear Medicine (1 CE)

This article by Alan Vespie, describes the nature of radioactivity and examines the several types of radioactive emissions that are relevant in nuclear medicine technology. It describes particulate radiation, bremsstrahlung radiation, positron emission, annihilation reaction, electromagnetic radiation, isomeric transition, and electron capture. The biological effects of radiation, including stochastic effects, radiation hormesis, and deterministic or non-stochastic effects, are defined. It concludes by outlining factors associated with acute radiation syndrome including the prodromal and latent stages. Expires August 15, 2009. Approved for 1 Category A (Direct) credit for ARRT; NMTCB; Florida; Iowa. Focus: Nuclear Medicine

Review of Epidemiology for the Nuclear Medicine Technologist (1 CE) ***EXTENDED***

Written by Norman Bolus, this article provides a brief history of epidemiology and explains the underlying assumptions of this science. It outlines the three major types of epidemiology studies and lists the criteria necessary for a valid statistical association. It defines epidemiologic terms and explains what is accepted as proper correlation of cause-and-effect relationships. Expires May 15, 2011. Approved for 1 Category A (Direct) credit for ARRT; NMTCB; Florida; Iowa [Nuclear Medicine]. Focus: General Science, Nuclear Medicine

Radionuclide Imaging in Acute Coronary Syndromes (1 CE) ***EXTENDED***

Written by Dr. Brian Abbott, this article reviews diagnostic techniques used for patients presenting in the ED with chest pain. It explains the advantages and drawbacks to using rest SPECT for the detection of myocardial infarction and myocardial ischemia. It provides a list of practical considerations involved in the decision to use rest SPECT in the ED triage of acute chest pain. Expires May 15, 2011. Approved for 1 Category A (Direct) credit for ARRT; NMTCB; Florida; Iowa [Nuclear Medicine]. Focus: Nuclear Medicine (cardiology)

Image Processing & Filtering Techniques of Static & Dynamic Images (1 CE)

Written by Alan Vespie, this article makes the mathematical and scientific principles used in the manipulations and enhancement of images in the nuclear medicine department easy to understand. It describes static imaging issues, including image scaling, background subtraction, smoothing/filtering, digital subtraction, normalization, and image profiling. It reviews dynamic imaging issues, including image summation/addition, temporal filtering, and time activity curves. Expires July 15, 2009. Approved for 1 Category A (Direct) credit for ARRT; NMTCB; Florida; Iowa [General X-ray]. Focus: Nuclear Medicine (physics)

Gated SPECT Myocardial Perfusion Imaging: A Review (1 CE)

Author April Mann, provides a step-by-step review of gated SPECT examinations. It looks at the anatomic orientation of the heart as it pertains to the exam and identifies potential sources of artifact and error associated with this imaging technique. The five criteria used to evaluate the quality of a gated SPECT exam are outlined. An explanation of how extra-cardiac activity can interfere with the assessment of myocardial perfusion is provided. Applications of gated SPECT imaging are listed. Instructions will allow the technologist to accurately calculate left ventricular ejection fraction. Expires July 15, 2009. Approved for 1 Category A (Direct) credit for ARRT; NMTCB; Florida; Iowa [Nuclear Medicine]. Focus: Nuclear Medicine (cardiology)

Nuclear Brain Imaging: Stroke (1 CE) ***EXTENDED***

Written by Alan Vespie, this article introduces the reader to aspects of brain physiology that relate to nuclear medicine imaging. It explains the classification system of nuclear medicine brain imaging agents and looks at hydrophilic, lipophilic and metabolic agents. Expires July 15, 2009. Approved for 1 Category A (Direct) credit for ARRT; NMTCB; Florida; Iowa [Nuclear Medicine]. Focus: Nuclear Medicine (radiopharmaceuticals)

Ultrasound/Echocardiography Topics:

Scanning Safely: Musculoskeletal Disorders in the Sonographer’s Workplace (1 CE)

A must-read for every practicing sonographer! Author Kimberly Chadwell discusses the alarming increase of musculoskeletal disorders affecting sonographers. Terminology relating to work-related injuries is defined and occupational injuries common among sonographers are described. Categories of work-related injuries include muscular, nerve entrapment, tendon-related, neurovascular, and joint capsular disorders. Kimberly identifies the factors that place sonographers at increased risk and lists strategies that can reduce work-related injuries. She reviews exercise and stretching techniques and explains how developing certain routines can help to prevent injury. Finally, she clarifies the roles of sonographers, healthcare administration, and equipment manufacturers in creating a safe workplace for sonographers. Expires July 15, 2009. Approved for 1 Category A (Direct) credit for ARRT; NMTCB. Florida approval pending. Focus: US

Stress Echocardiography Basics (1 CE)

Written and illustrated by Andrew Horning, this article provides a step-by-step guide to performing stress echocardiography. It explains the procedures for obtaining an adequate patient history, explains the need for proper patient education, and demonstrates methods for preparing the patient. Andrew illustrates how a protocol for a resting echocardiogram is applied and lists the steps needed to perform a stress test. He evaluates images and explains the process of selecting the best. Basic concepts of image interpretation and digital imaging are introduced. Expires July 15, 2009. Approved for 1 Category A (Direct) credit for ARRT; NMTCB; Florida. Focus: Echocardiography

Musculoskeletal Ultrasound (1 CE)

Written by Stephanie Creel, this article first describes the basic principles associated with medical ultrasound. It then explains techniques and terms specific to musculoskeletal ultrasound. The advantages of musculoskeletal ultrasound over other modalities are cataloged. Clinical indications discussed include the evaluation of tendons and ligaments, muscle, bone, peripheral nerves, soft-tissue masses, soft-tissue infection and joint effusion, and foreign body detection. Expires July 15, 2009. Approved for 1 Category A (Direct) credit for ARRT; NMTCB; Florida. Focus: Ultrasound (musculoskeletal)

Contrast Echocardiography for the Evaluating Treatment of Left Ventricular Dysfunction (1 CE)

Written by Dr. Leo Baur, this article describes the historical development of contrast agents used in echocardiography. It explains how intravascular agents enhance echocardiographic images and it lists the types and characteristics of various agents. Technical guidelines for left ventricular opacification in harmonic studies are defined. Expires July 15, 2009. Approved for 1 Category A (Direct) credit for ARRT; NMTCB. Florida approval pending. Focus: US, Echocardiography

Application of Doppler Ultrasound in Echocardiography (1.5 CE)

Written by S. Michelle Bierig, this article describes the Doppler Effect and explains how it pertains to ultrasound. Included are instructions on calculating the speed of blood using the Doppler Effect equation, explanation and causes of artifact, and methods to optimize Doppler signals. The article describes how continuous wave, pulsed wave, and color flow Doppler detects blood flow along the sample cursor beam and the advantages and disadvantages of each. Doppler assessments for a variety of clinical indications are explored including aortic stenosis, left ventricular outflow, aortic regurgitation/insufficiency, mitral stenosis, mitral valve inflow, mitral regurgitation, tricuspid stenosis, tricuspid regurgitation, pulmonary stenosis, and pulmonary insufficiency. Expires August 15, 2009. Approved for 1 Category A (Direct) credit for ARRT; NMTCB; Florida. Focus: US, Echocardiography

Role of Echocardiography in the Diagnosis and Management of Heart Failure in the Elderly (1 CE)

Written by Drs. Vincent Sorrell and Navin Nanda, this article outlines the use of echocardiography in assessing heart failure. It describes how Doppler ultrasound can illustrate the severity of aortic stenosis and explains why it is ideal for assessing left ventricular function. The role of echocardiography in the assessment of diastolic function and mitral valve inflow is described. The relationship between left ventricle thickening and myocardial dysfunction is explored. The role of echocardiography to evaluate the effectiveness of treatment of heart failure in the elderly is clarified. Expires July 15, 2009. Approved for 1 Category A (Direct) credit for ARRT; NMTCB; Florida. Focus: US, Echocardiography