11th Annual Meeting Clinical MR Society 2007

Welcome everybody, this year's annual meeting will be held at the Hilton La Jolla Torrey Pines ,California and will feature state-of-the-art educational sessions, SAM sessions, MR Registry Review, a half-day economics workshop, as well as numerous networking opportunities. I will be there for you , will be your eyes and ears.
I am very excited to be the technologist from Minnesota ,I will be representing St.Paul Radiology at that fantastic event.
I will take this chance to connect with colleagues, to update my skills & enjoy an excellent family-oriented venue.
08/14/2007
I landed in San Diego on Wednesday night June 21st and quickly drove to the hotel so I could attend the Presidential welcome reception.
San Diego welcomed me with very nice sunny, pleasant weather…but I would say almost cold , in Minnesota we had upper 90F and 70% humidity that day.
Entire meeting was divided by sessions for physicians ,technologists and both. I have to admit some of the physicians sessions were much more interesting then technologist‘s lectures.

The main part of the meeting started on Thursday 7:00 am in the morning with registration and nice breakfast almost “Swedish table “ style.

Our 1st speaker Dr. John Reeder, MD spent time talking and presenting images of the elbow. He showed us slides of the injuries in the athletes .
He also spooked about: Panner’s disease, OCD, medial injuries, ulnar neuropathy, median nerve ,ulnar collateral ligaments injuries, medial, lateral epicondylitis ,tennis injuries, radial injuries.
2nd speaker was dr.Michael B. Zlatkin he spoke about MR Fingers and Toes. I have to admit I never witnessed such a long presentation about MR fingers and toes. I guess I should attend more conferences.
It was very interesting and educational. One and the most important lesson learned to all MR Technologists should be: use as smallest dedicated 4 or 8 channel coil available for each case and small FOV as possible.
Next presentation was about MR of shoulder presented by Dr. M. Zlotkin..
After short break we were listening to several presentations about lower extremities.One of the power point presentations was by Dr. Mark H. Awh, he showed us how 3T images can improve dramatically visualization of the articular cartilage-images were just awesome. A water excitation technique, such as 3D-WE DESS (water excitation double-echo steady state) shortens the typical acquisition time while maintaining excellent image contrast. Articular cartilage remains of relatively high signal intensity, and cartilage thickness is well seen due to the high contrast with subchondral bone. However ,the high signal intensity from cartilage remains scientifically lower than the signal from fluid, which becomes very bright with the water excitation techniques. The result is a highly orthographic image that is reminiscent of a more traditional fat-suppressed technique.
Since I am registered MR Technologist I really did not need to go to the next technologists session about MR Registry Exam but still I decided to go so I could bring some information to my collages back home who are not registered yet.
After very busy day (from 07:00 -17:30) everybody adjourned to the next room for vendors presentations forum and wine tasting reception.

It was very nice being able to taste wine especially when the meeting was held in sunny California.

My second day I started with the nice long swim in the hotel's pool.
Everything is getting faster with MR, like using propeller technique help to eliminate any patients motion even if patient moves all the time during the scan. We could go on and on…
unfortunately I do not have enough space to write about everything I saw.
We had a lot of discussion about 3T and why 3T will replace 1.5T:
3T has twice the S/N of 1.5 T
Parallel imaging :SENSE, ASSET, iPAT
-Allows trade off of S/N for speed
-Halve the time,40% S/N reduction
Phased array coils
-128 elements in the future
Next day was even more intense especially when we could see what is for MRI the next 10 Years -Quo Vadis presentation by William G. Bradley Jr. M.D. PhD.
We are going to have new ultra short techniques:
UTE with 8 microsecond TE possible,
Ability to get signal from short T2 solids,
Ultra short MR bores 118cm deep,
A new Dixon Technique Water Only Images
FUTE (fat suppressed Ultra short TE) to image Articular Cartilage, with short T1 and T2 can visualize cartilage layer.


Being able to use UTE technique you can show much easier the Achilles Tendon enthuses ,Achilles Tendon Tear, UTE of the PCL, the UTE of the meniscus images were just fantastic. The UTE technique was used to present the cortical bone, normal periosteum.We received a lot of information about the Parallel (Fast) Imaging Technique, tractography of the brain looked like out of space…so deep detail pictures I never had seen it before.
Our speaker spent some time talking about neurosurgical MRI units also.
After lunch we (technologists) listened to the following lectures started with : Imaging Techniques for MR of the Breast and we ended with the lecture about Diffusion /Perfusion Imaging.
It was another long day .
Our next lecture was presented by Elizabeth A. Morris M.D. from New York City, N.Y.
It was very interesting, After her presentation she said :male technologists can perform MR breasts exams very well ,patients have no problems with that.
During “Stump the experts” session we had several speakers from different vendors.
We had an opportunity to hear about the new developments and cutting-edge technology.
Vendor representatives talked about newest software for PACS systems, for software working on images , contrast products, coils and injectors. I think one of the most interesting presentation was done by William H. Faulkner, Jr., B.S., R.T. (R)(MR)(CT), FSMRT
about a new 1.0T extremity scanner. Just by listening to the presentation and seeing images seems like very logical way to image small joints. As we all remember we should following the main rule in MR scanning :use as smallest coil as possible for the area of scanning, to get excellent imaging result .The scanner has 6 coils for most extremities work .The unit has very high satisfaction rate from patients, it is very comfortable for the patients. They lay like in the lazy boy position and the magnet is being brought to the patient’s leg or a elbow, wrist, hand.
The unit is very small comparing to 1.5 T magnet.
“3T MRI: mastering the Challenges” was presented by L Tonnenbaum M.D. with a lot of slides of the brain, COW, extremities and abdominal cavity.
The challenges with SAR limitations, noise, surface coils, susceptibility artifacts, chemical shift, T1 contrast at 3T still will have to be work out, use of the enhanced parallel imaging like ASSET,SENSE,LAVA are very helpful .


Saturday and Sundays were easier “just 5 hours of the intense listening “but all lectures started at 7:00am .This afternoon we could go out and discover San Diego area. I decided to walk and after an hour I found myself on the great sandy beach .

During entire meeting we had a several lectures designed for technologists as follow:

- Preparations for the MR Registry Exam
Physics and Anatomy Review
- Breast MR Techniques and Pitfalls
Imaging Techniques for MR of the Breast
Pitfalls in Performing Breast MR
MRI of Breast Implants
- MRA Techniques and Applications
Contrast enhanced MRA
Peripheral MRA Runoff
Diffusion/Perfusion Imaging
- Artifacts, Fast Scanning and Intracranial Hemorrhage
Understanding MR Artifacts
Fast Scanning techniques
Intracranial Hemorrhage: A Practical Approach
- Body and Cardiac Imaging
Body MRI 2007: New Techniques & Old Pearls
Cardiac MR Overview…very well done
Frontiers of Cardiovascular MR & CT
-Body Applications, Abdominal Aorta and Safety Updates
Chemical Shift Imaging: Body Applications
MR Safety Update

MR safety concerns are always important and should be very strict.
Do we have enough warnings in our imaging centers about the danger of the magnetic filed? I think not enough.
It is important to:

• review/establish written safety guidelines

• establish annual safety "in services" for all MR personnel(including radiologists)

• practice patient removal from scan room for emergency treatment

• actually train new MR employees in MR safety

Here are great web sites for MR Safety:
http://www.mrisafety.com/
http://www.imrser.org/
http://www.fda.gov/cdrh/safety/mrisafety.html

I wanted to thank St. Paul Radiology for continues support of my education and professional journey in my MR carrier.
Also I would like to thank my supervisor
Debbie Siebell R.T. (CT)(MR) for her guides and her advise.

If you would like to see more pictures or short movies from around San Diego or different reports from my professional trips to Baltimore,US and to Mikolajki
in Poland please visit my newest blog http://radiologyinmyview.blogspot.com/

Any questions you may have ,please direct them to my
e-mail box: christophermri@gmail.com
If you would like to review meeting syllabus let me know.

Thank you very much for you patients reading it and
I am hoping I covered as much as I could in this small blog.

Christopher A. Jankowski R.T. (R ) (MR) ARRT
works as
a MRI Technologist for St. Paul Radiology, Minnesota

I am sorry I do not have any slides from the meeting, any photography, video were prohibited during all events.