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IAC Newsletter

A picture is worth a thousand words.

This proverb is such a simple statement, and yet the meaning holds reverence not only to the image, but to the creator as well.

Related to the importance of images, the representative case studies submitted by the applicant laboratory are the most significant aspect of the ICAMRL accreditation application and their evaluation is heavily weighted in the accreditation decision. The purpose of reviewing the representative cases is to evaluate the interpretative and technical quality of the laboratory as a whole, as related to The Standards. As an integral part of the case study evaluation, the corresponding final reports are reviewed for accuracy, format and content.

A vital component of the ICAMRL peer review process, case study evaluations are performed by professionals in the field of magnetic resonance imaging, with concentrated expertise in cardiovascular, breast, musculoskeletal and neuro imaging. Specifically, the reviewers are cardiologists, neurologists, magnetic resonance technologists, orthopaedic surgeons and radiologists. The individuals selected to become application reviewers for the ICAMRL receive in-depth, structured training based upon objective review principles and criteria.

When evaluating examination performance, the application reviewers utilize a series of specific questions to measure compliance with The Standards, thus eliminating reviewer bias.

Components of the ICAMRL image evaluation include:

• Patient Positioning
• Signal to Noise (SNR)
• Artifact Assessment
• Resolution
• Image Uniformity
• Off Axis Slice Positioning
• Patient Motion
• Filming
• Protocol/Sequence Selection

The ICAMRL application reviewers evaluate representative cases from as many medical and technical staff members interpreting or performing magnetic resonance examinations in the laboratory as possible. The applicant laboratory is instructed to submit contemporary (i.e., performed with current personnel on current equipment) cases.

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 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: 1) patient age or date of birth; 2) patient ID; 3) date of the examination; 4) type of sequence; 5) TR; 6) TE; 7) TI (if applicable); 8) flip angle (if not 90 degrees); 9) slice thickness; 10) interslice gap; 11) field of view/matrix; 12) acquisition time; 13) size scale; 14) image location; 15) slice number; 16) laboratory name.

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