TY - JOUR
T1 - Statement of the German Roentgen Society, German Society of Neuroradiology, and Society of German-speaking Pediatric Radiologists on Requirements for the Performance and Reporting of MR Imaging Examinations Outside of Radiology
AU - Hunold, Peter
AU - Bucher, Andreas Michael
AU - Sandstede, Jörn
AU - Janka, Rolf
AU - Fritz, Lars Benjamin
AU - Regier, Marc
AU - Loose, Reinhard
AU - Barkhausen, Jörg
AU - Mentzel, Hans Joachim
AU - Zimmer, Claus
AU - Antoch, Gerald
AU - Antoch, Gerald
AU - Schönberg, Stefan O.
AU - Barkhausen, Jörg
AU - Anton, Frank
AU - Neumann, Stefan
AU - Vogl, Thomas J.
AU - Dörfler, Arnd
AU - Körber, Friederike
AU - Weβling, Johannes
AU - Wucherer, Michael
AU - Zimmer, Claus
AU - Urbach, Horst
AU - Brockmann, Marc A.
AU - Pham, Mirko
AU - Weber, Werner
AU - Berlis, Ansgar
AU - Mentzel, Hans Joachim
AU - Von Kalle, Thekla
AU - Klee, Dirk
AU - Hahn, Gabriele
AU - Patsch, Janina
N1 - Publisher Copyright:
© 2021 American Institute of Physics Inc.. All rights reserved.
PY - 2021/9/1
Y1 - 2021/9/1
N2 - Background Magnetic Resonance Imaging (MRI) is a very innovative, but at the same time complex and technically demanding diagnostic method in radiology. It plays an increasing role in high-quality and efficient patient management. Quality assurance in MRI is of utmost importance to avoid patient risks due to errors before and during the examination and when reporting the results. Therefore, MRI requires higher physician qualification and expertise than any other diagnostic imaging technique in medicine. This holds true for indication, performance of the examination itself, and in particular for image evaluation and writing of the report. In Germany, the radiologist is the only specialist who is systematically educated in all aspects of MRI during medical specialty training and who must document a specified, high number of examinations during this training. However, also non-radiologist physicians are increasingly endeavoring to conduct and bill MRI examinations on their own. Method In this position statement, the following aspects of quality assurance for MRI examinations and billing by radiologists and non-radiologist physician specialists are examined scientifically: Requirements for specialist physician training, MRI risks and contraindications, radiation protection in the case of non-ionizing radiation, application of MR contrast agents, requirements regarding image quality, significance of image artifacts and incidental findings, image evaluation and reporting, interdisciplinary communication and multiple-eyes principle, and impact on healthcare system costs. Conclusion The German Roentgen Society, German Society of Neuroradiology, and Society of German-speaking Pediatric Radiologists are critical with regard to MRI performance by non-radiologists in the interest of quality standards, patient welfare, and healthcare payers. The 24-month additional qualification in MRI as defined by the physician specialization regulations (Weiterbildungsordnung) through the German state medical associations (Landesärztekammern) is the only competence-based and quality-assured training program for board-certified specialist physicians outside radiology. This has to be required as the minimum standard for performance and reporting of MRI exams. Exclusively unstructured MRI training outside the physician specialization regulations has to be strictly rejected for reasons of patient safety. The performance and reporting of MRI examinations must be reserved for adequately trained and continuously educated specialist physicians. Key Points: MR imaging plays an increasing role due to its high diagnostic value and serves as the reference standard in many indications. MRI is a complex technique that implies patient risks in case of inappropriare application or lack of expertise. In Germany, the radiologist is the only specialist physician that has been systematically trained in all aspects of MRI such as indication, performance, and reporting of examinations in specified, high numbers. The only competence-based and quality-assured MRI training program for specialist physicians outside radiology is the 24-month additional qualification as defined by the regulations through the German state medical associations. In view of quality-assurance and patient safety, a finalized training program following the physician specialization regulations has to be required for the performance and reporting of MRI examinations. Citation Format Hunold P, Bucher AM, Sandstede J et al. Statement of the German Roentgen Society, German Society of Neuroradiology, and Society of German-speaking Pediatric Radiologists on Requirements for the Performance and Reporting of MR Imaging Examinations Outside of Radiology. Fortschr Röntgenstr 2021; 193: 1050 - 1060.
AB - Background Magnetic Resonance Imaging (MRI) is a very innovative, but at the same time complex and technically demanding diagnostic method in radiology. It plays an increasing role in high-quality and efficient patient management. Quality assurance in MRI is of utmost importance to avoid patient risks due to errors before and during the examination and when reporting the results. Therefore, MRI requires higher physician qualification and expertise than any other diagnostic imaging technique in medicine. This holds true for indication, performance of the examination itself, and in particular for image evaluation and writing of the report. In Germany, the radiologist is the only specialist who is systematically educated in all aspects of MRI during medical specialty training and who must document a specified, high number of examinations during this training. However, also non-radiologist physicians are increasingly endeavoring to conduct and bill MRI examinations on their own. Method In this position statement, the following aspects of quality assurance for MRI examinations and billing by radiologists and non-radiologist physician specialists are examined scientifically: Requirements for specialist physician training, MRI risks and contraindications, radiation protection in the case of non-ionizing radiation, application of MR contrast agents, requirements regarding image quality, significance of image artifacts and incidental findings, image evaluation and reporting, interdisciplinary communication and multiple-eyes principle, and impact on healthcare system costs. Conclusion The German Roentgen Society, German Society of Neuroradiology, and Society of German-speaking Pediatric Radiologists are critical with regard to MRI performance by non-radiologists in the interest of quality standards, patient welfare, and healthcare payers. The 24-month additional qualification in MRI as defined by the physician specialization regulations (Weiterbildungsordnung) through the German state medical associations (Landesärztekammern) is the only competence-based and quality-assured training program for board-certified specialist physicians outside radiology. This has to be required as the minimum standard for performance and reporting of MRI exams. Exclusively unstructured MRI training outside the physician specialization regulations has to be strictly rejected for reasons of patient safety. The performance and reporting of MRI examinations must be reserved for adequately trained and continuously educated specialist physicians. Key Points: MR imaging plays an increasing role due to its high diagnostic value and serves as the reference standard in many indications. MRI is a complex technique that implies patient risks in case of inappropriare application or lack of expertise. In Germany, the radiologist is the only specialist physician that has been systematically trained in all aspects of MRI such as indication, performance, and reporting of examinations in specified, high numbers. The only competence-based and quality-assured MRI training program for specialist physicians outside radiology is the 24-month additional qualification as defined by the regulations through the German state medical associations. In view of quality-assurance and patient safety, a finalized training program following the physician specialization regulations has to be required for the performance and reporting of MRI examinations. Citation Format Hunold P, Bucher AM, Sandstede J et al. Statement of the German Roentgen Society, German Society of Neuroradiology, and Society of German-speaking Pediatric Radiologists on Requirements for the Performance and Reporting of MR Imaging Examinations Outside of Radiology. Fortschr Röntgenstr 2021; 193: 1050 - 1060.
UR - http://www.scopus.com/inward/record.url?scp=85112697537&partnerID=8YFLogxK
U2 - 10.1055/a-1463-3626
DO - 10.1055/a-1463-3626
M3 - Journal articles
C2 - 33831956
AN - SCOPUS:85112697537
SN - 1438-9029
VL - 193
SP - 1050
EP - 1060
JO - RoFo Fortschritte auf dem Gebiet der Rontgenstrahlen und der Bildgebenden Verfahren
JF - RoFo Fortschritte auf dem Gebiet der Rontgenstrahlen und der Bildgebenden Verfahren
IS - 9
ER -