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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.

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

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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