Revision History
The physician shall have the responsibility for all aspects of the study including, but not limited to, reviewing all indications for the examination, specifying the pulse sequences to be performed, specifying the use and dosage of contrast agents, interpreting images, generating official interpretations (final reports), and assuring the quality of both the images and interpretations. The physician interpreting breast MRIs must have knowledge and expertise in breast disease and breast imaging diagnosis.
All physicians who supervise and/or interpret MRI examinations must be licensed medical practitioners who meet the following minimum criteria:
Requirements for Physicians Supervising and Interpreting MRI Examinations | ||
Initial Qualifications | ||
Radiologist(Board-Certified)
| Radiologist(Not Board-Certified)
AND
| Other Physician(MR imaging limited to a specific anatomic area)All of these:
|
Continuing Experience | ||
On renewal, all MR interpreting physicians must meet one of the following:
Additional information regarding continuing experience requirements | ||
Continuing Education | ||
On renewal, meets one of the following:
Additional information regarding continuing education requirements | ||
Occasional readers who are providing imaging services to and for the practice are not required to meet the interpreting physician initial qualifications or continuing experience requirements; however, the reads of all occasional readers combined should not exceed 5% of the total volume of reads per practice and per modality. There must be an active written review process in place at the institution for occasional readers based on each institution’s credentialing requirements. Validation of this process will take place during any site visit by the ACR.
Requirements for Physicians Supervising and Interpreting Cardiac MRI Examinations | ||
Initial Qualifications | ||
Radiologist(Board Certified) | Radiologist(Not Board-Certified) | Cardiologist*(Cardiac ONLY) |
| All of these:
| American Board of Internal Medicine (ABIM) certification in cardiology with completion of Level 2 training or higherLevel 2 Requirements (All of these):
Level 3 Requirements (All of these):
Nuclear Medicine Physicians-(Cardiac Only)All of these:
*ACCF/AHA Clinical Competence Statement on Cardiac CT and MRI |
Continuing Experience | ||
Upon renewal, radiologists reading Cardiac MRI exams must have read 50 exams over the prior 24-month period. The cardiac examinations interpreted will count toward the overall continuing experience for other MR modules. | Upon renewal, cardiologists reading Cardiac MRI examinations must have continuing experience in accordance with level 2 requirements or higher – 50 examinations each year. | |
Additional information regarding continuing experience requirements | ||
Continuing Education | ||
Upon renewal, physicians must have earned at least 15 CME hours in MRI (half of which must be category 1) in the prior 36 months. These should include CME in Cardiac MRI as is appropriate to the physician’s practice needs. | Upon renewal, cardiologists must have earned at least 30 hours of coursework in the prior 36 months, in accordance with level 2 requirements. | |
Additional information regarding continuing education requirements | ||
The following are required for all physicians supervising and/or interpreting breast MRI examinations (interpretation of exams for documentation must be within the past 36 months):
Requirements for Physicians Supervising and Interpreting Breast MR Examinations | ||
Initial Qualifications | ||
Radiologist: Board-Certified | Radiologist: Not Board-Certified | Other Physician |
Certified since 2008 by the American Board of Radiology (ABR), American Osteopathic Board of Radiology (AOBR), Royal College of Physicians and Surgeons of Canada (RCPSC), or College des Medecins du Quebec (CMQ). Radiologists graduating from residency after 6/30/14 must be board-eligible as defined by the ABRIf certified before 2008:
| All of these:
| All of these:
|
Please note that a fellowship in Breast MRI is not required to meet the initial qualifications. Conversely, a fellowship in Breast MRI does not automatically mean the physician meets the initial requirements; however, if the fellowship provided for one of the required experience levels, the physician would meet the requirements. | ||
Continuing Experience | ||
On renewal, documents one of the following:
Additional information regarding continuing experience requirements | ||
Continuing Education | ||
On renewal, documents one of the following:
Additional information regarding continuing education requirements | ||
Biopsies performed under MRI guidance may be counted toward initial and continuing experience. A bilateral breast exam of one patient is considered one examination.The requirements specify that physicians must complete 15 hours of continuing education(half in category 1) in the prior 36 months specific to the imaging modality or organ system. These CE credits may be in MRI, breast, or a combination of MRI and breast. As examples, the following would meet the continuing education requirements for the Breast MRI Accreditation Program:
| ||
Intravascular Contrast Media
Onsite Personnel to Ensure Safety
On site, there must be a radiology or other physician OR qualified person who is acting under the general supervision of a physician. This individual must:
Have received training and meet institutional periodic competency guidelines at evaluating patients and diagnosing and differentiating different types of adverse reactions to contrast material.
Be able to recognize when medical intervention is required for hypersensitivity immediate reaction or physiology adverse event due to contrast administration.
Be trained and legally permitted to administer prescription medications (e.g. antihistamine, intravenous fluid, beta agonist inhalers, epinephrine) and other appropriate interventions independently or under a standing orders/algorithmic approach under state law or regulations, and under local, institutional, site and facility policies, guidelines and rules. These interventions are those indicated for urgent response to a contrast material adverse event as listed in the ACR Manual of Contrast Media or similar local policies or guidelines.
When qualified to act under general supervision of a physician, be able to consult with the supervising physician within an appropriate timeframe.
Has minimum BLS certification.
Understand when to call for assistance and how to activate emergency response systems.
If the general supervision by a physician is performed remotely, the process should comply with all federal/state law or regulations and local, institutional, site and facility policies, guidelines, or rules related to telemedicine. This remote general supervision should be available whenever contrast material is administered and include the standard post administration monitoring as dictated by all federal/state law or regulations and local, institutional, site and facility policies, guidelines, or rules.
Overall staffing should take into account the timeliness of available emergency response systems.
*Note: Other physicians include radiology residents and fellows
Radiologist Led Teams
In order to ensure quality in diagnostic imaging, it is essential that the supervising professional be able to assess the quality of an image relative to the capability of the equipment and diagnostic demands, ensure diagnostic quality, and minimize unnecessary radiation exposure to the patient and personnel. Onsite personnel should continue to be part of the radiologist led teams. To ensure that, APRNs and PAs should continue to work alongside physicians-led teams.
Oversight and Supervision
The supervising interpreting physician reviews, discusses, and confirms the diagnosis of the physician being supervised. The supervising interpreting physician does not have to be present at the time of initial interpretation; however, the supervising physician must review and, if necessary, correct the final interpretation. Supervision may also be accomplished through a formal course that includes a lecture format in addition to all of the following:
A database of previously-performed and interpreted cases
An assessment system traceable to the individual participant
Direct feedback regarding the responses
Examples of suitable assessment systems are an audience response system, a viewbox- or monitor-based program or an individual CD-ROM or web-based instruction system.
| Next: Technologist: MRI/Breast MRI |  |