Whitepaper: Training in Diagnostic and Interventional Breast Radiology. / Whitepaper: Weiterbildung in der bildgebenden und interventionellen Mammadiagnostik.

PURPOSE: Breast imaging represents an integral part of radiology and is subject to strict quality controls. Regarding this, precise diagnostics including multimodal assessment by mammography, sonography, and MRI, including image-guided biopsy and localization procedures, is often decisive and must be performed by experts with profound knowledge and skills in all of these procedures.However, due to numerous restructurings, breast imaging has been shifted more and more towards large, specialized centers, resulting in less patient exposition and training opportunities for radiologists in smaller sites. The following whitepaper summarizes the current circumstances and discusses opinions of the participating societies. MATERIALS: Under the leadership of the German Roentgen Society (DRG) and with the participation of the DRG's AG Mammadiagnostik, the CAFRAD (Chefarztforum Radiologie), the KLR (Konferenz der Lehrstuhlinhaber für Radiologie e. V.), the DRG's Forum Junge Radiologie (FJR) and the Berufsverband der Deutschen Radiologen e. V. (BDR), possible solutions were discussed and consented for a structured training in breast radiology in the future. RESULTS: In addition to the teaching provided at the primary workplace, qualified training should be ensured through flexible, multi-institutional, interdisciplinary, and cross-sectoral collaboration. Furthermore, the integration of online case collections and close cooperation with certified breast cancer centers and mammography screening units is recommended. It is indispensible that online courses and case collections adhere to the standards of the national societies and include a maximum of one third of the required cases. CONCLUSION: In order to provide training in breast radiology at a high professional level, a paradigm shift with closer cooperation of all participants is necessary. This includes close collaboration of the breast imaging societies with the federal medical associations to establish new teaching concepts like e-learning in the training schedule of radiologists. KEY POINTS: · Breast diagnostics is an integral part of radiology training.. · Due to recent restructurings, smaller training centers have difficulties in meeting the case numbers demanded by the Specialist Training Regulations (WBO). Improved integration of the new structures and their adaptation to the needs of education are necessary to guarantee standardized high-quality training of young radiologists.. · The integration of certified case collections enables quality-assured training, even across regions in online-based formats. In accordance with the "blended learning principle", up to one-third of the required number of patient studies can be substituted with cases from a certified case collection.. · Legally secured short- and medium-term internships may complement training in radiology.. CITATION FORMAT: · Sauer ST, Bley TA, Wenkel E et al. Whitepaper: Training in Diagnostic and Interventional Breast Radiology. Fortschr Röntgenstr 2023; 195: 699 - 706.

[Modern mid-field magnetic resonance imaging in private practice : Field report]. / Moderne Mittelfeld-Magnetresonanztomographie in der Niederlassung : Erfahrungsbericht.

BACKGROUND: With the 0.55 T magnetic resonance imaging (MRI) scanner "Free.Max", a new device concept in the mid-field sector is being introduced into the market. New technologies and artificial intelligence (AI) applications as well as a new coil concept compensate for the disadvantages of the lower field strength and the widest examination tunnel measuring 80 cm. OBJECTIVES: An initial assessment was made with regard to the suitability of the 0.55 T scanner in the private practise environment. The goal was to analyse whether measurement parameters, examination protocols and image quality meet requirements and expectations. MATERIALS AND METHODS: About 2020 examinations were carried out using the Free.Max scanner. To assess the image quality and measurement parameters, about 20% of those patients had previously undergone comparative examinations of the same body parts with comparable examination protocols based on five different 1.5 T scanners in the same practice. RESULTS: This MRI device has the potential to meet the quality standards and expectations of the assessing radiologists. The measurement time is about 30 min per patient. The signal-to-noise ratio does not achieve that of images obtained using high-field scanners but allows for sufficiently safe diagnosis. Susceptibility to motion artefacts is higher and to metal artefacts lower. The concept of flexible coils and a tunnel width of 80 cm is perceived as comfortable by patients. CONCLUSIONS: The new 0.55 T scanner has the potential to partially replace high-field machines in the private practise setting. The profitability of the device will depend on the cost difference compared to the high-field scanner as longer acquisition times are currently required, which reduces examination frequency. Further developments in the mid-field sector are to be expected.

[Financing perspectives for multiparametric magnetic resonance prostatography]. / Finanzierungsperspektiven der multiparametrischen Magnetresonanz-Prostatographie.

BACKGROUND: Not only is the evidence for multiparametric magnetic resonance prostatography clearly proven based on current research, the S3 guideline for prostate cancer recommends its use prior to invasive biopsy. Remuneration through the GKV does not occur. OBJECTIVES: The negotiations concerning the inclusion in the EBM (German Uniform Evaluation Standard) Catalogue of statutory health insurance funds take place in a highly politicized environment and under economic priorities. The routes that are possible in the complex registration procedure are described. MATERIALS AND METHODS: Radiology associations (Berufsverband der Deutschen Radiologen [BDR] und Deutsche Röntgengesellschaft [DRG]) have supported their methods with evidence and quality assurance. Special contracts with health insurance funds, coordinated at the level of the federal states, pave the way and accelerate accreditation. RESULTS: The definition of the service according to the EBM, the recommendation concerning remuneration as well as supporting documents and a functional quality assurance system have been made available to the Joint Valuation Committee of physicians & health insurance funds as part of the application for approval. CONCLUSIONS: Due to the nature of the system, the presented evidence and quality assurance, as well as the development of special contracts, have inevitably been transferred to radiology and the unified work of their associations. The imaging modality prostatography shows the advancement of radiological methods for dedicated multiparametric organ diagnostics.