Continuum: Lifelong Learning in Neurology—Neuroimaging, Volume 22, Issue 5, October 2016
Neuroimaging October 2016;22(5)
Continuum: Lifelong Learning in Neurology® is designed to help practicing neurologists stay abreast of advances in the field while simultaneously developing lifelong self-directed learning skills.
Upon completion of this Continuum: Lifelong Learning in Neurology Neuroimaging issue, participants will be able to:
• Understand basic MRI physics and technology and how to acquire and interpret MRIs
• Describe the foundation and utility of multimodal CT and MRI and collateral imaging in all stages of ischemic stroke diagnosis and management
• Discuss the significance of neuroimaging in the management of patients presenting with hemorrhagic stroke, the various neuroimaging tools available to clinicians to aid in management, and the common neuroimaging findings that help identify the underlying etiology of hemorrhagic stroke
• Accurately use structural and functional neuroimaging protocols in the evaluation and treatment of patients with focal and generalized seizure disorders and identify the limitations and potential diagnostic indications of neuroimaging investigations in people with epilepsy
• Recognize the imaging features of common congenital malformations and discuss how their appropriate identification can impact diagnosis and treatment
• Discuss the role of neuroimaging in the diagnosis and management of neuro-ophthalmic disorders
• Recognize the usefulness of MRI sequences in characterizing tumor types and discuss the usefulness of posttreatment MRIs in distinguishing tumor recurrence from treatment-related changes such as pseudoprogression and pseudoresponse
• Identify the imaging characteristics of common and less often encountered intracranial cysts and differentiate benign entities from pathologic processes
• Discuss the utility of different imaging modalities in diagnosing pathologic lesions in the sellar and parasellar regions
• Recognize the imaging features of common spinal cord disorders, including disorders of the spine that secondarily affect the spinal cord
• Recognize neuroimaging characteristics of central nervous system demyelinating disorders
• Recognize which neuromolecular imaging tests are clinically available and what the indications are in different disorders
• Discuss the clinical uses of ultrasound examination in cerebrovascular, neurodegenerative, and peripheral nervous system diseases
• Discuss the recent potential safety concerns associated with the use of gadolinium-based contrast agents
• Understand the basics of the Federal Anti-Kickback Statute and Stark Law in relation to physician investment or ownership in a variety of health care enterprises
• Discuss potential safety risks associated with MRI scans performed on patients with implanted medical devices, current US Food and Drug Administration (FDA) safety labeling for objects in the MRI environment, and advantages and challenges of magnetic resonance conditional devices
This Continuum: Lifelong Learning in Neurology Multiple Sclerosis and Other Demyelinating Diseases issue covers the following core competencies:
• Patient Care and Procedural Skills
• Medical Knowledge
• Practice-Based Learning and Improvement
• Interpersonal and Communication Skills
• Systems-Based Practice
Laszlo L. Mechtler, MD, FAAN, Co-Guest Editor
Medical Director, DENT Neurologic Institute; Director, DENT Headache, Neuro-Oncology, and Imaging Centers, Amherst, New York; Professor of Neurology and Oncology, University at Buffalo; Chief of Neuro-Oncology, Roswell Park Cancer Institute, Buffalo, New York
aDr Mechtler has received personal compensation for serving as board advisor for Supernus Pharmaceuticals, Inc; for serving as guest editor of Current Pain & Headache Reports and Neurologic Clinics; as a speaker for Allergan, Pernix Therapeutics, and Teva Pharmaceutical Industries Ltd; and as a consultant for Green Grass Advisors. Dr Mechtler provided expert consultation for legal testimony for DOPF, P.C.
bDr Mechtler reports no disclosure.
Joshua P. Klein, MD, PhD, FANA, FAAN, Co-Guest Editor
Chief, Division of Hospital Neurology, Department of Neurology, Brigham and Women’s Hospital; Associate Professor of Neurology and Radiology, Harvard Medical School, Boston, Massachusetts
aDr Klein has received personal compensation as a coauthor and editor and for serving on the editorial board of McGraw-Hill and as a consultant for Advance Medical and Best Doctors, Inc. Dr Klein has given expert medical testimony for Anaesthesia Associates of Massachusetts and HeplerBroom LLC.
bDr Klein reports no disclosure.
Ajay Abad, MD
Neuro-oncologist, Roswell Park Cancer Institute; Clinical Assistant Professor of Neurology, University at Buffalo, Buffalo, New York
aDr Abad has provided expert medicolegal testimony on tumor treatment field therapy.
bDr Abad reports no disclosure.
Bela Ajtai, MD, PhD
Neurologist, Neuroimager, DENT Neurologic Institute, Amherst, New York; Clinical Assistant Professor of Neurology, University at Buffalo, Buffalo, New York
aDr Ajtai has received personal compensation for speaking engagements from Allergan and Novartis AG.
bDr Ajtai reports no disclosure.
Andrei V. Alexandrov, MD, RVT
Semmes-Murphey Professor and Chairman, Department of Neurology, University of Tennessee Health Science Center, Memphis, Tennessee
aDr Alexandrov serves on the editorial board of the Journal of Neuroimaging.
bDr Alexandrov reports no disclosure.
Mirza A. Baig, DO
Neurologist, Neuroimaging Fellow, DENT Neurological Institute, Amherst, New York
a,bDr Baig reports no disclosures.
Konstantin Balashov, MD, PhD, FAAN
Professor, Department of Neurology, Robert Wood Johnson Medical School, Rutgers University, New Brunswick, New Jersey
aDr Balashov has served on the editorial boards of BMC Neurology and Neuroimmunology and Neuroinflammation, as chairperson of the health care advisory committee of the New Jersey chapter of the National Multiple Sclerosis Society, and as a consultant for Sanofi Genzyme and Teva Pharmaceutical Industries Ltd. Dr Balashov has received research/grant support and personal compensation for speaking engagements from Teva Pharmaceutical Industries Ltd and research/grant support from Biogen and the National Multiple Sclerosis Society.
bDr Balashov reports no disclosure.
John A. Bertelson, MD
Assistant Professor of Neurology, Dell Medical School, University of Texas at Austin; Clinical Assistant Professor of Psychology, University of Texas at Austin, Austin, Texas
aDr Bertelson has served on the medical advisory board of BrainGear and has provided expert medicolegal testimony on cases related to brain trauma.
bDr Bertelson reports no disclosure.
Riley Bove, MD
Assistant Professor of Neurology, University of California San Francisco, San Francisco, California
aDr Bove receives research/grant support from the National Institutes of Health and the National Multiple Sclerosis Society.
bDr Bove reports no disclosure.
Gregory D. Cascino, MD, FAAN
Whitney MacMillan Junior Professor of Neuroscience, Mayo Clinic College of Medicine; Enterprise Director of Epilepsy, Mayo Clinic, Rochester, Minnesota
aDr Cascino serves on the board of directors of the American Academy of Neurology and as an associate editor of Neurology. Dr Cascino receives royalties from Mayo Medical Ventures and UpToDate, Inc.
bDr Cascino reports no disclosure.
Robert Fenstermaker, MD, FACS, FAANS
Chair, Department of Neurosurgery, Roswell Park Cancer Institute; Professor, Department of Neurosurgery, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, Buffalo, New York
aDr Fenstermaker serves on the board of directors of and owns stock or stock options in MimiVax, LLC; receives personal compensation for meeting organization from prIME Oncology; and receives research/grant support from the Roswell Park Alliance Foundation.
bDr Fenstermaker reports no disclosure.
Joseph V. Fritz, PhD
Chief Executive Officer, DENT Neurologic Institute, Amherst, New York
aDr Fritz serves as a consultant for Allergan.
bDr Fritz reports no disclosure.
Ankur Garg, MD
Assistant Professor of Neurology; Director, Endovascular Surgical Neuroradiology Fellowship, University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma
aDr Garg serves on the membership committee of the Society of Vascular and Interventional Neurology.
bDr Garg reports no disclosure.
Ryan Hakimi, DO, MS
Director, Greenville Health System Neuro ICU; Director, Greenville Health System Inpatient Neurology Service Line; Clinical Associate Professor, University of South Carolina-Greenville, Greenville, South Carolina
aDr Hakimi has served on the board of directors and annual program committee of the American Society of Neuroimaging, on the editorial boards of the International Journal of Neurology and Neurotherapy and the International Journal of Neural Science and Brain Research, and on the annual program committee and as cochair of the fundraising committee of the Neurocritical Care Society.
bDr Hakimi reports no disclosure.
Joseph S. Kass, MD, JD, FAAN
Associate Professor of Neurology, Psychiatry, and Medical Ethics; Director, Neurology Residency Program; Chief of Neurology Service, Ben Taub General Hospital, Baylor College of Medicine, Houston, Texas
aDr Kass has received personal compensation for expert testimony in legal cases involving personal injury, defamation, and malpractice.
bDr Kass reports no disclosure.
Samuel Lapalme-Remis, MDCM, MA, FRCPC
Epilepsy Fellow, Mayo Clinic, Rochester, Minnesota
a,bDr Lapalme-Remis reports no disclosures.
David S. Liebeskind, MD, FAAN
Professor of Neurology; Director, Neurovascular Imaging Research Core, University of California Los Angeles, Los Angeles, California
aDr Liebeskind has served as an associate editor of the Journal of Neuroimaging and as a consultant to the imaging core laboratories of Medtronic and Stryker. Dr Liebeskind receives royalties from UpToDate, Inc, and grant/research support from the National Institutes of Health.
bDr Liebeskind reports no disclosure.
Michelle P. Lin, MD, MPH
Vascular Neurology Fellow, Johns Hopkins University School of Medicine, Department of Neurology, Baltimore, Maryland
a,bDr Lin reports no disclosures.
Jennifer W. McVige, MA, MD
Neurologist, Department of Neuroimaging and Headache Medicine for Adults and Children; Director of Concussion Center, DENT Neurologic Institute; Amherst, New York; Assistant Professor of Neurology, University at Buffalo, Buffalo, New York
aDr McVige has received personal compensation for speaking engagements from Avanir Pharmaceuticals, Inc, and Teva Pharmaceutical Industries Ltd, and receives research/grant support from the Harry Dent Family Foundation Inc.
bDr McVige reports no disclosure.
Robert S. Miletich, MD, PhD, FAAAS
Professor, Interim Chair, Residency Program Director, Medical Director of the Nuclear Medicine Technologist Program, Department of Nuclear Medicine, University at Buffalo, Buffalo, New York; President, University Nuclear Medicine, Inc, Buffalo, New York
aDr Miletich serves on the editorial board of the Journal of Neuroimaging and receives research/grant support from the William E. Mabie, DDS, and Grace S. Mabie Fund.
bDr Miletich reports no disclosure.
Bennett Myers, MD
Associate Clinical Professor, University at Buffalo, Buffalo, New York; Attending Neurologist, DENT Neurologic Institute, Amherst, New York
aDr Myers has served on the scientific advisory board of Biogen and has received personal compensation for speaking engagements from Biogen, Novartis AG, and Teva Pharmaceutical Industries Ltd. Dr Myers has provided expert medical testimony on brachial plexopathy as a complication of scalene nerve block.
bDr Myers reports no disclosure.
Nandor K. Pinter, MD
Research Fellow, DENT Neurologic Institute, Amherst, New York; Radiologist, Department of Neuroradiology, National Institute of Clinical Neurosciences, Budapest, Hungary
aDr Pinter receives research/grant support from the Harry Dent Family Foundation Inc.
bDr Pinter reports no disclosure.
Marcus Ponce de Leon, MD, FAAN
Residency Program Director, Department of Neurology, Madigan Army Medical Center, Tacoma, Washington; Assistant Professor, Uniformed Services University of Health Sciences, Bethesda, Maryland
a,bDr Ponce de Leon reports no disclosures.
Ernst-Wilhelm Radue, MD
Professor Emeritus, Consulting Neurologist, Chief Executive Officer of Biomedical Research and Training, Basel, Switzerland
aDr Radue has served as a consultant for Neurologische und Psychiatrische Universitäts Klinik Basel, has received personal compensation for speaking engagements from Novartis AG and Sanofi Genzyme, and receives royalties from Springer-Verlag GmbH.
bDr Radue reports no disclosure.
Rachel V. Rose, JD, MBA
Attorney, Rachel V. Rose Attorney at Law PLLC; Affiliated Faculty, Baylor College of Medicine, Houston, Texas
aMs Rose serves on the editorial board of BC Advantage and receives book royalties from the American Bar Association.
bMs Rose reports no disclosure.
Karanbir Singh, MD
Attending Neurologist, Director of Neurology/Neuroimaging, Apex Hospital, Jalandhar, Punjab, India
a,bDr Singh reports no disclosures.
Gabriella Szatmáry, MD, PhD
Director of Neuro-Ophthalmology, Director of Neuroimaging, Hattiesburg Clinic, Hattiesburg, Mississippi
a,bDr Szatmáry reports no disclosures.
Georgios Tsivgoulis, MD, PhD, MSc, RVT
Associate Professor of Neurology, Second Department of Neurology, University of Athens School of Medicine, Attikon University Hospital, Athens, Greece; Visiting Associate Professor of Neurology, Director of Stroke Research, Department of Neurology, University of Tennessee Health Science Center, Memphis, Tennessee
aDr Tsivgoulis serves on the editorial boards of Stroke and the Journal of Neuroimaging and has received research/grant support from the European Regional Development Fund.
bDr Tsivgoulis reports no disclosure.
Horst Urbach, MD
Professor, Director Department of Neuroradiology, University Medical Center, Freiburg, Germany
aDr Urbach serves as coeditor of Clinical Neuroradiology and on the editorial board of Neuroradiology and has received personal compensation for speaking engagements from Bracco, Stryker, and UCB SA.
bDr Urbach reports no disclosure.
Matthias Weigel, PhD
Senior Physicist, Radiological Physics, Department of Radiology, University Hospital Basel; Department of Biomedical Engineering, University of Basel, Basel Switzerland
aDr Weigel has received personal compensation for speaking engagements from the European Society for Magnetic Resonance in Medicine and Biology, the Magnetic Resonance Compact University Hospital Erlangen, and Vereinigung Südwestdeutscher Radiologen und Nuklearmediziner and royalties from the University Medical Center of the University of Freiburg for a patent for dynamic motion correction in MRI.
bDr Weigel reports no disclosure.
Roland Wiest, MD
Professor of Neuroradiology, Institute of Diagnostic and Interventional Neuroradiology, Inselspital, University of Bern, Bern, Switzerland
aDr Wiest receives research/grant support from the Swiss National Foundation.
bDr Wiest reports no disclosure.
Eduardo E. Benarroch, MD, FAAN
Professor of Neurology, Mayo Clinic, Rochester, Minnesota
a,bDr Benarroch reports no disclosures.
Adam G. Kelly, MD
Associate Professor of Neurology, University of Rochester Medical Center; Chief of Neurology, Highland Hospital, Rochester, New York
aDr Kelly has received research support from the Donald W. Reynolds Foundation.
bDr Kelly reports no disclosure.
bUnlabeled Use of Products/Investigational Use Disclosure
Methods of Participation and Instructions for Use
Continuum: Lifelong Learning in Neurology® is designed to help practicing neurologists stay abreast of advances in the field while simultaneously developing lifelong self-directed learning skills. In Continuum, the process of absorbing, integrating, and applying the material presented is as important as, if not more important than, the material itself.
The goals of Continuum include disseminating up-to-date information to the practicing neurologist in a lively, interactive format; fostering self-assessment and lifelong study skills; encouraging critical thinking; and, in the final analysis, strengthening and improving patient care.
Each Continuum issue is prepared by distinguished faculty who are acknowledged leaders in their respective fields. Six issues are published annually and are composed of review articles, case-based discussions on ethical and practice issues related to the issue topic, coding information, and comprehensive CME and self-assessment offerings, including a selfassessment pretest, multiple-choice questions with preferred responses, and a patient management problem. For detailed instructions regarding Continuum CME and self-assessment activities, visit aan.com/continuum/cme.
The review articles emphasize clinical issues emerging in the field in recent years. Case reports and vignettes are used liberally, as are tables and illustrations. Video material relating to the issue topic accompanies issues when applicable.
The text can be reviewed and digested most effectively by establishing a regular schedule of study in the office or at home, either alone or in an interactive group. If subscribers use such regular and perhaps new study habits, Continuum’s goal of establishing lifelong learning patterns can be met.