REPRESENTATIVE
CASE STUDIES
UPDATED 6/27/2008
The purpose of reviewing representative cases is to evaluate
the interpretive and technical
quality of the laboratory as a whole. In order to do this, it
is necessary for the ICAMRL
reviewers to evaluate representative cases from as many medical
and technical staff
members interpreting or performing any magnetic resonance examinations
in the
laboratory as possible. The cases submitted must be contemporary
(i.e., performed with current personnel on current equipment). Failure to provide
representative cases from
the current personnel may result in delay of accreditation and
request for additional case
studies.
Note: **If the annual testing volume is less than 300 but greater than 150, the laboratory must submit 2 additional case studies for that testing area. If annual testing area is less than 150, the laboratory must submit 3 additional case studies for that testing area. All additional case studies submitted should demonstrate pathology.
The number of cases to be submitted per laboratory
is dependent upon the type of
accreditation requested (i.e.: Body, Cardiovascular, Musculoskeletal,
Neurological) and
the number of magnets within the laboratory. All case studies
must be selected from
within the twelve (12) months immediately prior to submission
of the application. Each case must include a sufficient number of
images to support the final diagnosis and a
signed copy of the final report. A copy of any worksheets and/or
preliminary reports, if
generated, should be submitted as well.
The following information must be on or included
with all submitted CDs or filmed
images:
- patient
age or date of birth
- patient
ID
- date
of the examination
- type
of sequence
- TR
- TE
- TI
(if applicable)
- flip
angle (if not 90°)
|
- slice
thickness
- interslice
gap
- field
of view/matrix
- acquisition
time
- size
scale
- image
location
- slice
number
- laboratory
name
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Guidelines
for case selection and organizing cases to be submitted:
1. Case selection is magnet dependent.
You must submit the required sample cases for each magnet
in use in your laboratory.
2. The case studies submitted (CD, DVD or film) must include a copy of the final
report.
3. Case studies submitted for review should be submitted on CDs in standard DICOM format (JPEG, PNG or other image formats are not acceptable). The images should be either uncompressed or submitted with JPEG Lossless compression. The CD should also contain a directory (DICOMDIR) which provides useful information such as Patient Name, Date of Exam, List of Sequences, etc. The presence of a DICOM viewer will be permitted as long as the viewer is not embedded and required to view the images.
4. Each exam for review should be submitted on a separate CD and appropriately labeled with the Patient Name, Date of Exam and Body Part imaged. It is recommended to review the CD on a remote system prior to submission to ICAMRL to ensure that the images can be downloaded.
5. As explained in the General Instructions, two complete
copies of the application are
to be submitted. This includes the representative case studies;
two complete sets of the representative cases, including reports,
etc., are to be submitted.
Note:
All material submitted to the ICAMRL will be handled with
strict confidentiality.
CASE
STUDY REQUIREMENTS:
Note: If your laboratory does
not perform the required exams listed below, please contact
the ICAMRL to discuss possible alternatives.
- BODY
ACCREDITATION
**ONLY 1 NORMAL CASE STUDY, THE REMAINING CASES MUST DEMONSTRATE PATHOLOGY
Case
One - 1 upper abdomen (i.e.: liver or kidney
or pancreas)
Case
Two - 1 soft tissue pelvis (i.e.: ovaries or
prostate)
Case
Three - (choose one of the following):
1
breast (for breast only, see below**); or
1 soft tissue neck; or
1 brachial plexus; or
1 mediastinum (non-cardiac)
Case
Four - Body MRA (non-cardiac) if performed
**Breast MR only: Submit 3 case studies on CD or DVD (with the viewer installed) of all sequences required. Please submit 1 normal study, and 2 other studies demonstrating pathology. The reports and protocol sheets must also be included.
- CARDIOVASCULAR
ACCREDITATION
TO
BE SUBMITTED ON CD WITH VIEWER INSTALLED
Case
One - 1 complete gated cine cardiac examination
in either a normal patient or in a patient with valvular
heart disease
Case
Two - 1 complete gated cine cardiac examination
in a post myocardial-infarction patient
Case
Three - 1 complete aortic study demonstrating all
sections of either the thoracic or abdominal aorta in
a patient with pathology
- MUSCULOSKELETAL
ACCREDITATION
**ONLY 1 NORMAL CASE STUDY, THE REMAINING CASES MUST DEMONSTRATE PATHOLOGY
Case One - 1 knee
Case
Two - 1 shoulder (if shoulder exams are not performed,
choose one of the following:
1 wrist; or
1 ankle; or
1 foot; or
1 elbow
Case
Three - Choose one of the following not
represented in Case Two:
1
wrist; or
1 ankle; or
1 foot; or
1 elbow; or
1 TMJ; or
1 spine (cervical, lumbar, thoracic)
______ other
- NEUROLOGICAL
ACCREDITATION
Case
One - 1 abnormal brain (MS or tumor)
Case
Two - 1 normal spine
Case
Three - 1 spine with herniated disc
Case
Four - 1 MRA including Extracranial and Intracranial
vessels (if performed)
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