FACULTY REPRESENTATIVE: Dr. Barak Friedman
Phone: ALWAYS cover phone x23-7058
Location: Depends on the site Body CT W attending covers Fluoro "RF" (check QGenda)
Morningside reading room (Clark 3rd floor, 23-4226) or
West reading room corner (4th floor, 23-7058)
PACS worklist: BODY MR_QN/BC/BI etc, and also BODY VASC_CT/MR BC etc. (separate list), and read:
MRCP, MR Abd, MR Pelvis*, MR Abd/Pelv
Some MR Pelvis studies are erroneous/are MR hip (MSK) studies; please notify the MSK team to read with MSK attendings
For the following studies, read with/send to Dr Kagen only:
MRA Abd/Pelvis (DIEP, fibular) for preoperative planning of flap surgeries
Lymphedema studies
If MR or MRA Chest, please notify the Chest team/attending to read these
FACULTY REPRESENTATIVE: Dr. Kamath. 2 east-side attendings cover on any given day. Check schedule here (click for link, intranet only)
Phone: 59416 (AKA, 212-824-9416. if IT issues: call 47880)
Location: Mt Sinai Hospital
Hess Building (1470 Madison Ave)
Directions inside: Take elevator down to SC2, turn right, then on left need to tap badge to enter door, walk down short hallway, go through another door, then turn right (last door on right).
If full, you can read in the main Basement/Lower floor reading room
PACS Worklist:
RA1000 (preferred): ask an east side fellow for the list on Day 1
WFM is also installed on all stations as an alternative; if WFM then these 2 lists:
RA Body MR Unread
RM MR Body Unread
8:00a – until attending dismissal (approximately 5:00 pm)
Additional duties may require you to stay later than 5:00pm, patient care always comes first. Leave together with co-residents/don't abandon them. Confirm with attendings before leaving.
Make sure 23-7058 is covered until 4 pm when Eve person arrives
MR tech numbers:
M: 23-3493 / 23-3485
West: 23-8420 / 36-3372
BI: 20-2563
BC/Chelsea: 212-367-0119
JB/787: 23-8333 and 45-0513
PACC: 44-8872
Brodsky: 23-8951, 23-8707
Queens: 718-808-7990 (ask for MR tech)
Brooklyn/MSB: 718-951-2930
Mandatory conferences
Body ICC Conference, Thursdays 4 PM
Zoom link here ("Conference" page)
1st Thursday of Month:
Systemwide, MSH / MSW presents (rotating)
2nd Thursday of Month:
if MSH presented on 1st Thurs...
then Internal MSW-only ICC here
3rd Thursday of Month:
No Conference
4th Thursday of Month:
if MSW presented on 1st Thurs...
then Internal MSW-only ICC here
*Body MR + Body CT residents present. R1s may be excused from presenting Body ICC in 1st half of the year, but may choose to present in 2nd half of the year/in their 2nd Body rotation and onwards.
Liver conference with GI fellows, 3rd Friday 8 AM
All US + Fluoro + Body CT/MR residents attend
one Body CT South resident (R2-R4) presents (schedule on Amion --> "Clinic" --> "TB").
Optional conferences
Trauma Conference (Join Here) - Fridays 7 am
Colorectal/GI Tumor Board, every Monday from 5pm-6pm. Cases are presented by Body attendings, look for email + Zoom invite from Stephanie Diaz.
Please discuss with MSH attending(s)/fellow(s)
Review overnight reports that were prelim'd as one-liners and write a full report on them
Prioritize ED & inpatient cases
Check and dictate Vascular PACS worklist regularly.
Refer to LINK
First thing to do when starting this rotation, take the following:
All Body MR residents are expected to present at Body ICC when scheduled.
Junior residents (R2-R3) may be asked to give a short 20-30 minute talk on a body MRI topic of choice.
Residents should protocol at least 1 week ahead of time. Also, at the end of the week, be sure to protocol the upcoming weekend cases so that the call residents don't have to deal with MRI protocols last minute.
Use the following Body MRI RIS Filter
Junior (R1-R2) resident should prioritize protocoling all sites in RIS, always with guidance of the R3-R4 senior resident who should monitor protocoling is done accurately and on-time.
Use script! If the script is not available and there is any question, you can either:
(1) Review Epic note(s) if available, OR
(2) Directly contact the ordering physician (Epic chat, email, or call), OR
(3) If above fails, in RIS comment box, write “Call radiologist with script” for MRI tech to call you
Note: Use comment or note box as needed, to help MR technologists (and yourself) when reviewing later
If you do not know the right protocol, ask or leave it blank. Guessing is not acceptable
If Liver study, specify contrast in protocol or comment box (specifically if it is Eovist or not)
For others (ie Prostate, Enterography), protocol all of them -- however can leave comment box empty.
Dr. Kagen will protocol MRAs & Lymphedema studies
Review and read supplementary articles organized by R level
Resident prepared teaching cases
Body MRI by Evan Siegelman
Additional Reading:
Primer on MR Imaging of the Abdomen and Pelvis by Diego R. Martin, Michele A. Brown and Richard C. Semelka
Liver MRI: Correlation with other Imaging Modalities and Histopathology by Shahid M. Hussain, J.L. Gollan and R.C. Semelka)
G-drive Rotation Files
My computer - (G:) drive - Dept - Rad1 - Rad - Body MRI
YouTube Videos on Dr. Michael Lipton's MRI course
Dr. Lipton is an associate professor of radiology at Albert Einstein College of Medicine and associate director of its Gruss Magnetic Resonance Research Center
1.5T Fat Fraction (IDEAL IQ sequence)
Put ROI on Liver in FatFrac IDEAL IQ sequence, get Avg Fat %
< 5: Normal
6-17: Mild
17-22: Moderate
> 22: Severe
Fat Fraction (In/Out of Phase)
IN – OUT x 100
2(IN)
Hepatic steatosis MRI calculator
Columbia University calculator
Liver iron quantification using increasing TEs
Iron Deposition Calculations:
Put ROI on Liver in R2* sequence, get Avg R2*
Use Avg R2* to calculate T2* = (1/R2*) x 1000
Go to http://www.columbia.edu/~sj2532/t2_star.html and put T2* value to get Liver Iron Concentration mg/g (Normal Range: 0.17-1.8)
Table 3 describes the mandatory diagnostic criteria for HCC classification in patients with chronic liver disease
Standardizes the language that radiology reports must include to qualify for exception points
Hepatic nodules must be classified according to OPTN criteria
Nodules < 1 cm are too small to characterized and are NOT considered for additional priority on the transplant waiting list
All HCC are categorized as class 5 lesions
Non-diagnostic study is class 0 (images not of sufficient quality to confidently apply the criteria) à repeat study with same or alternative acceptable modality
Likert scoring criteria