The potential influence of corticosteroid medications on magnetic resonance imaging (MRI) outcomes is a relevant consideration in diagnostic radiology. For example, alterations in blood sugar levels induced by these medications could impact the contrast enhancement patterns observed in certain MRI procedures, particularly those used to visualize tumors or inflammation.
Understanding the interplay between these medications and imaging results is crucial for accurate interpretation and diagnosis. This knowledge enables radiologists to differentiate true pathological changes from medication-induced effects, leading to more informed clinical decisions and preventing misdiagnosis. Historically, awareness of such drug interactions has evolved alongside advancements in MRI technology and a deeper understanding of pharmacological effects. This awareness highlights the importance of a comprehensive patient history, including current medications, before conducting and interpreting MRI scans.
This article will explore the various types of corticosteroids, their mechanisms of action, and specific examples of how they might influence different MRI modalities. Furthermore, it will discuss the implications for patient preparation and potential adjustments to imaging protocols when patients are undergoing corticosteroid treatment.
1. Steroid Type
The specific type of corticosteroid medication administered can significantly influence its potential impact on MRI results. Different corticosteroids possess varying degrees of glucocorticoid and mineralocorticoid activity, which can affect metabolic processes and thus influence image contrast. For example, dexamethasone, a potent glucocorticoid, exhibits a stronger influence on glucose metabolism compared to prednisone. This difference translates to potentially greater variability in contrast enhancement during MRI procedures, particularly in studies evaluating inflammation or tumors. Understanding these distinctions allows radiologists to better interpret imaging findings and account for potential medication-induced changes.
Categorizing steroids based on their chemical structure, potency, and predominant metabolic effects provides a framework for understanding their individual impacts on MRI studies. Mineralocorticoids, such as fludrocortisone, primarily affect electrolyte balance and fluid regulation, with less direct impact on glucose metabolism. Therefore, their influence on MRI results might manifest differently compared to glucocorticoids. Furthermore, the route of administration (oral, intravenous, inhaled) and the duration of treatment can also modulate the extent of these effects. For instance, prolonged high-dose glucocorticoid therapy may lead to more pronounced changes in tissue characteristics visible on MRI compared to short-term, low-dose treatment.
In conclusion, recognizing the specific type of steroid medication a patient is receiving is paramount for accurate MRI interpretation. This awareness, combined with knowledge of the medication’s pharmacological properties, allows for more informed clinical decisions. Considering the diverse effects of various steroid types on metabolic processes and tissue characteristics is crucial for distinguishing true pathological changes from medication-induced artifacts in MRI scans. This nuanced understanding underscores the need for detailed patient medication histories and careful consideration of potential drug-imaging interactions.
2. Dosage and Duration
The dosage and duration of corticosteroid therapy play a crucial role in determining the extent to which these medications might influence MRI findings. Higher doses and prolonged administration generally correlate with a greater likelihood of observable effects on imaging results. This is due to the cumulative impact of corticosteroids on various metabolic processes, including glucose regulation and inflammation modulation, which can alter tissue characteristics and contrast enhancement patterns in MRI scans. Understanding this dose- and duration-dependent relationship is essential for accurate interpretation and diagnosis.
-
Cumulative Effects on Glucose Metabolism
Corticosteroids influence glucose metabolism, and higher doses administered over extended periods can lead to more pronounced hyperglycemia. This altered metabolic state can affect contrast uptake in certain MRI sequences, potentially mimicking pathological changes or masking underlying disease activity. For example, in brain imaging, hyperglycemia can alter the blood-brain barrier permeability, influencing contrast agent distribution and potentially confounding interpretations.
-
Suppression of Inflammation and Tissue Repair
While the anti-inflammatory effects of corticosteroids are therapeutically beneficial, prolonged and high-dose administration can suppress normal tissue repair mechanisms. This can affect the appearance of tissues on MRI, particularly in musculoskeletal imaging where inflammation and edema are key diagnostic features. Chronic suppression might lead to delayed healing or misinterpretation of the underlying condition’s severity.
-
Impact on Fluid Balance and Electrolyte Levels
Some corticosteroids, particularly those with mineralocorticoid activity, can influence fluid balance and electrolyte levels. Long-term use and higher doses can exacerbate these effects, potentially leading to changes in tissue density and signal intensity on MRI. This can confound interpretation, particularly in abdominal imaging where fluid shifts and electrolyte imbalances can mimic or obscure other pathologies.
-
Variable Response based on Individual Patient Factors
The impact of dosage and duration can vary significantly depending on individual patient factors, such as age, underlying health conditions, and concurrent medications. For example, patients with pre-existing diabetes might experience more pronounced hyperglycemia with corticosteroid therapy, leading to greater variability in MRI contrast enhancement. Understanding these individual variations emphasizes the importance of a thorough patient history and careful consideration of potential drug interactions.
In summary, the dosage and duration of corticosteroid treatment are critical factors influencing the potential for altered MRI results. The cumulative effects on metabolic processes, inflammation, and fluid balance can significantly impact tissue characteristics and contrast enhancement patterns, potentially confounding image interpretation. Careful consideration of these factors, along with patient-specific variables, is essential for accurate diagnosis and informed clinical decision-making. This underscores the importance of clear communication between the referring physician, radiologist, and patient regarding corticosteroid use and its potential implications for MRI studies.
3. Specific MRI sequence
The influence of corticosteroids on magnetic resonance imaging (MRI) outcomes varies significantly depending on the specific MRI sequence employed. Different sequences utilize distinct magnetic field gradients and radiofrequency pulses, resulting in varying sensitivities to tissue characteristics altered by corticosteroid use. Understanding this interplay between medication and sequence parameters is crucial for accurate image interpretation and diagnosis. For example, T1-weighted images are sensitive to fat content and are less susceptible to corticosteroid-induced changes, while T2-weighted images, highlighting water content and inflammation, may demonstrate more pronounced alterations due to the anti-inflammatory effects of these medications. Similarly, fluid-sensitive sequences like FLAIR (Fluid Attenuated Inversion Recovery) might exhibit changes in signal intensity in areas where corticosteroids influence edema or inflammation.
Specific examples of sequence-dependent effects include alterations in contrast enhancement patterns. Gadolinium-based contrast agents, commonly used in MRI, distribute differently based on tissue characteristics and vascular permeability. Corticosteroid use can influence both factors, leading to variable enhancement patterns depending on the sequence used. For instance, dynamic contrast-enhanced MRI, often used in oncological imaging, might reveal altered perfusion patterns in tumors due to the effects of corticosteroids on vascular permeability. This can confound interpretations regarding tumor activity or response to therapy. Furthermore, diffusion-weighted imaging (DWI), sensitive to the movement of water molecules within tissues, may exhibit altered signal intensity in areas where corticosteroids influence inflammation and cellularity. This highlights the importance of selecting appropriate MRI sequences and interpreting results in the context of corticosteroid use.
In summary, considering the specific MRI sequence employed is crucial when evaluating potential corticosteroid-induced effects on imaging results. Different sequences possess varying sensitivities to tissue characteristics altered by these medications, impacting image contrast, enhancement patterns, and signal intensity. Recognizing these sequence-dependent effects facilitates accurate image interpretation and prevents misdiagnosis. This underscores the importance of tailoring MRI protocols to individual patients, considering their medication history, and correlating imaging findings with clinical context for comprehensive and reliable diagnostic assessments.
4. Tissue being imaged
The type of tissue being imaged is a critical factor influencing how corticosteroids might affect MRI results. Different tissues have varying compositions, cellular structures, and vascular properties, leading to distinct responses to corticosteroid medications. These variations can manifest as changes in signal intensity, contrast enhancement, and apparent tissue characteristics on MRI. Consequently, understanding the specific tissue under investigation is crucial for accurate interpretation of imaging findings.
-
Brain Tissue
Corticosteroids can impact brain imaging by altering glucose metabolism and blood-brain barrier permeability. This can influence contrast uptake and potentially mimic or mask pathological processes. For instance, reduced inflammation due to steroid use might obscure subtle lesions, while altered glucose metabolism could simulate increased metabolic activity, confounding interpretations in conditions like tumors or infections.
-
Musculoskeletal Tissues
In musculoskeletal imaging, corticosteroids can suppress inflammation and edema, which are key diagnostic features in conditions like arthritis or tendonitis. This suppression can lead to an underestimation of disease activity or mimic improvement, potentially delaying appropriate interventions. Furthermore, chronic steroid use can affect bone density and cartilage integrity, leading to subtle changes visible on MRI.
-
Abdominal Organs
Corticosteroids can influence fluid balance and bowel motility, potentially impacting abdominal MRI interpretations. Changes in fluid distribution can mimic ascites or obscure small lesions, while altered bowel motility might affect the clarity of bowel wall visualization. Furthermore, corticosteroids can impact the appearance of inflammatory bowel disease, making it challenging to assess disease activity accurately.
-
Tumors
The impact of corticosteroids on tumor imaging can be complex. While these medications can reduce peritumoral edema, improving tumor delineation, they can also mask inflammatory responses and affect contrast enhancement patterns. This can complicate the assessment of tumor size, margins, and vascularity, impacting treatment planning and response evaluation.
In conclusion, the specific tissue being imaged plays a crucial role in determining how corticosteroids might affect MRI interpretations. Varying tissue compositions and responses to these medications can lead to a wide range of effects on imaging characteristics, including signal intensity, contrast enhancement, and apparent tissue structure. Recognizing these tissue-specific effects is paramount for accurate diagnosis and informed clinical decision-making. Careful consideration of the tissue under investigation, alongside the patient’s corticosteroid regimen, is essential for accurate interpretation and appropriate management.
5. Indirect Metabolic Effects
Corticosteroids exert a wide range of metabolic effects beyond their primary anti-inflammatory and immunosuppressive actions. These indirect metabolic effects can significantly influence MRI results, often in subtle and complex ways. Understanding these indirect pathways is crucial for accurate image interpretation and avoiding misdiagnosis. These effects can manifest in various tissues and organ systems, impacting image contrast, signal intensity, and even the apparent size and structure of anatomical features.
-
Glucose Metabolism Alterations
Corticosteroids can induce hyperglycemia by increasing gluconeogenesis and reducing insulin sensitivity. This altered glucose metabolism can influence contrast uptake in tissues, particularly in the brain, where it can affect blood-brain barrier permeability and simulate increased metabolic activity. This can confound interpretations in conditions like tumors or infections, where increased glucose uptake might be misinterpreted as pathological activity.
-
Fluid and Electrolyte Imbalance
Some corticosteroids, particularly those with mineralocorticoid activity, can affect fluid and electrolyte balance, leading to sodium retention and potassium excretion. These shifts can influence tissue hydration and signal intensity on MRI. For instance, increased fluid retention might mimic edema or ascites in abdominal imaging, while electrolyte imbalances can affect muscle function and appearance on musculoskeletal MRI.
-
Impact on Lipid Metabolism
Corticosteroids can influence lipid metabolism, leading to changes in fat distribution and potentially affecting signal intensity in fat-containing tissues. This can be particularly relevant in imaging of the liver, where fatty infiltration can be influenced by steroid use. These changes can complicate the assessment of liver conditions or mimic other pathologies.
-
Effects on Bone Metabolism
Long-term corticosteroid use can negatively impact bone metabolism, leading to decreased bone density and increased risk of osteoporosis. These changes can be subtle but detectable on MRI, particularly with dedicated bone density sequences. This highlights the importance of considering steroid use when evaluating bone health in imaging studies.
In summary, the indirect metabolic effects of corticosteroids represent a significant consideration when interpreting MRI results. These effects, ranging from altered glucose metabolism and fluid balance to impacts on lipid and bone metabolism, can influence image characteristics in various tissues and organ systems. Accurate interpretation requires a comprehensive understanding of these indirect pathways and careful correlation of imaging findings with clinical context, including the patient’s corticosteroid regimen and overall health status. Recognizing these subtle but important influences can prevent misdiagnosis and ensure appropriate patient management.
6. Contrast Enhancement Changes
Contrast enhancement in MRI relies on the differential uptake of gadolinium-based contrast agents by various tissues. Corticosteroid use can significantly alter this uptake, leading to changes in image contrast and potentially confounding diagnostic interpretations. The mechanisms underlying these changes are multifaceted and relate to corticosteroid-induced alterations in vascular permeability, inflammation, and cellular activity. For instance, reduced inflammation due to steroid therapy can decrease vascular permeability, leading to diminished contrast enhancement in areas of inflammation. This can mask active inflammatory processes or mimic treatment response in conditions like multiple sclerosis or inflammatory bowel disease. Conversely, in some cases, corticosteroids can increase vascular permeability, leading to enhanced contrast uptake, potentially mimicking disease activity or complicating the assessment of tumor margins.
Real-life examples illustrate the practical significance of understanding these contrast enhancement changes. In oncologic imaging, corticosteroids can reduce peritumoral edema, leading to improved visualization of tumor margins. However, this can also mask the true extent of tumor infiltration into surrounding tissues. Similarly, in neurological imaging, decreased contrast enhancement in areas of inflammation following steroid treatment can be misinterpreted as resolution of the underlying pathology, potentially leading to premature discontinuation of therapy. In musculoskeletal imaging, suppressed inflammation due to corticosteroids can lead to reduced contrast enhancement in areas of active inflammation, masking the true extent of the pathology and potentially delaying appropriate interventions. Therefore, recognizing the potential influence of corticosteroids on contrast enhancement is crucial for accurate image interpretation and treatment planning.
In summary, corticosteroid-induced changes in contrast enhancement represent a significant consideration in MRI interpretation. These changes stem from the complex interplay between corticosteroids and vascular permeability, inflammation, and cellular activity. Understanding these mechanisms and their potential impact on various tissues is essential for accurate diagnosis and informed clinical decision-making. Recognizing the potential for both diminished and enhanced contrast uptake due to corticosteroid use highlights the importance of correlating imaging findings with clinical context and considering the patient’s medication history for comprehensive and reliable diagnostic assessments. Failure to account for these effects can lead to misdiagnosis, delayed treatment, and suboptimal patient outcomes.
7. Impact on Diagnostic Accuracy
The potential for corticosteroids to alter MRI findings has significant implications for diagnostic accuracy. Misinterpretation of steroid-induced changes can lead to both false-positive and false-negative diagnoses, impacting patient management and outcomes. Understanding how these medications influence various imaging parameters is therefore crucial for radiologists and clinicians interpreting MRI studies. Accurate interpretation requires careful consideration of the patient’s medication history, the specific tissue being imaged, and the MRI sequence employed.
-
Masking of Underlying Pathology
The anti-inflammatory effects of corticosteroids can mask underlying pathology by reducing edema and inflammation. This can lead to false-negative results, particularly in conditions like inflammatory bowel disease or multiple sclerosis, where inflammation is a key diagnostic feature. For example, a patient with active Crohn’s disease receiving high-dose corticosteroids might exhibit reduced bowel wall thickening on MRI, potentially leading to an underestimation of disease activity or even a missed diagnosis.
-
Mimicking Disease Activity
Conversely, corticosteroid-induced changes can also mimic disease activity, leading to false-positive diagnoses. Altered glucose metabolism due to steroid use can increase contrast uptake in certain tissues, potentially simulating tumor activity or infection. In musculoskeletal imaging, steroid-induced fatty infiltration in muscle can mimic pathological changes, leading to diagnostic confusion.
-
Confounding Treatment Response Assessment
Corticosteroids can confound the assessment of treatment response. Reduced inflammation due to steroid therapy can mimic a positive response to other treatments, leading to premature discontinuation of effective therapies or misinterpretation of treatment failure. This can be particularly problematic in oncology, where accurate assessment of tumor response is crucial for guiding treatment decisions.
-
Challenges in Longitudinal Monitoring
The dynamic nature of corticosteroid-induced changes can create challenges in longitudinal monitoring of disease progression or treatment response. Changes in imaging findings related to steroid use can be difficult to distinguish from true disease progression or regression, complicating the interpretation of serial MRI scans. This underscores the importance of consistent imaging protocols and careful consideration of medication history when evaluating changes over time.
In conclusion, the impact of corticosteroids on diagnostic accuracy in MRI necessitates careful consideration of various factors. The potential for both false-positive and false-negative results highlights the importance of a comprehensive understanding of how these medications influence imaging characteristics. Integrating patient medication history, clinical context, and a nuanced interpretation of MRI findings is crucial for mitigating the potential for misdiagnosis and ensuring appropriate patient management. Accurate diagnosis relies on a multidisciplinary approach, with open communication between referring clinicians, radiologists, and patients, to navigate the complexities of corticosteroid-induced changes in MRI and arrive at reliable diagnostic conclusions.
8. Pre-scan Medication Disclosure
Accurate interpretation of magnetic resonance imaging (MRI) studies relies heavily on a comprehensive understanding of patient-specific factors, including current medications. Pre-scan medication disclosure, particularly regarding corticosteroid use, is essential due to the potential for these medications to influence imaging results. This disclosure allows radiologists to consider potential medication-induced changes when interpreting scans, thus improving diagnostic accuracy and patient management. Omitting such information can lead to misinterpretation of imaging findings, potentially resulting in delayed or incorrect diagnoses.
-
Enhancing Diagnostic Accuracy
Providing a complete medication history, including details about steroid type, dosage, and duration of therapy, allows radiologists to differentiate true pathological findings from medication-related effects. This knowledge enhances diagnostic accuracy, especially in cases where corticosteroid use might mimic or mask disease activity. For instance, disclosed steroid use might explain unusual contrast enhancement patterns or altered signal intensities, preventing misdiagnosis of inflammation or tumor activity.
-
Optimizing Imaging Protocols
Pre-scan medication disclosure can influence imaging protocol selection and optimization. Awareness of corticosteroid use might prompt adjustments to imaging parameters, such as sequence selection or contrast agent administration, to minimize potential medication-induced artifacts and maximize diagnostic yield. For example, knowing a patient is on long-term steroid therapy might influence the choice of sequences used for musculoskeletal imaging to better evaluate bone density changes.
-
Facilitating Informed Clinical Decision-Making
Accurate medication information empowers informed clinical decision-making. By understanding the potential influence of corticosteroids on MRI findings, clinicians can better correlate imaging results with clinical symptoms and laboratory data. This comprehensive approach facilitates more accurate diagnoses and personalized treatment plans, ultimately improving patient outcomes. For example, disclosed steroid use can help clinicians differentiate between medication side effects and disease progression, guiding decisions regarding treatment adjustments.
-
Minimizing Adverse Events
While rare, certain MRI procedures may carry a small risk of adverse events, particularly for patients with specific medical conditions or taking certain medications. Pre-scan medication disclosure allows the MRI team to assess and mitigate potential risks associated with corticosteroid use, such as interactions with contrast agents or exacerbation of underlying conditions. For example, knowing a patient is on high-dose steroids might prompt closer monitoring during the MRI procedure to manage potential blood sugar fluctuations.
In conclusion, pre-scan medication disclosure, especially regarding corticosteroid use, is paramount for accurate and reliable MRI interpretation. This proactive communication ensures that radiologists and clinicians have the necessary information to consider potential medication-induced effects on imaging findings, optimizing diagnostic accuracy and patient care. Open communication between patients and healthcare providers is essential for navigating the complexities of drug-imaging interactions and ensuring optimal diagnostic outcomes.
Frequently Asked Questions
This section addresses common inquiries regarding the potential influence of corticosteroid medications on magnetic resonance imaging (MRI) examinations.
Question 1: Do all corticosteroids affect MRI results equally?
Different corticosteroids possess varying potencies and metabolic effects. Therefore, their influence on MRI findings can differ significantly. For example, glucocorticoids like dexamethasone exert a stronger influence on glucose metabolism compared to mineralocorticoids like fludrocortisone. This difference can lead to varying degrees of alteration in contrast enhancement and signal intensity.
Question 2: How does the duration of corticosteroid use impact MRI findings?
The duration of corticosteroid therapy plays a crucial role. Prolonged use, especially at higher doses, increases the likelihood of observable effects on MRI results. Cumulative metabolic effects, including alterations in glucose regulation and inflammation modulation, contribute to these changes.
Question 3: Can corticosteroids mask underlying pathologies on MRI scans?
The anti-inflammatory properties of corticosteroids can mask underlying inflammation, potentially obscuring pathologies on MRI. This masking effect can lead to false-negative results, particularly in conditions where inflammation is a key diagnostic feature, such as inflammatory bowel disease or multiple sclerosis.
Question 4: Could corticosteroid use lead to a misdiagnosis on an MRI?
Corticosteroid use can potentially lead to misdiagnosis on MRI due to its influence on various imaging parameters. Both false-positive and false-negative results are possible. Altered glucose metabolism can mimic increased activity in some tissues, while suppressed inflammation can mask underlying pathologies.
Question 5: Should corticosteroid use be disclosed prior to an MRI examination?
Disclosing corticosteroid use prior to an MRI is crucial. This information enables radiologists to consider potential medication-induced effects when interpreting scans, improving diagnostic accuracy and guiding appropriate patient management. This disclosure facilitates accurate image interpretation and informed clinical decision-making.
Question 6: How might corticosteroids affect contrast enhancement in MRI?
Corticosteroids can alter contrast enhancement patterns in MRI by influencing vascular permeability and inflammation. This can lead to either diminished or enhanced contrast uptake, depending on the specific tissue and the underlying pathology. These changes can complicate the assessment of disease activity or treatment response.
Open communication regarding medication history, particularly concerning corticosteroid use, remains essential for accurate MRI interpretation and optimal patient care. Disclosing all medications before an MRI scan allows radiologists to consider potential drug-related effects on imaging findings, leading to more accurate diagnoses and informed clinical decisions.
The subsequent section delves further into the specific mechanisms by which corticosteroids influence various MRI sequences and their implications for different clinical scenarios.
Tips for Patients Taking Corticosteroids and Undergoing MRI
The following tips provide guidance for patients undergoing MRI while taking corticosteroids to ensure optimal imaging results and accurate interpretation.
Tip 1: Disclose All Medications to the Radiology Team
Complete transparency regarding corticosteroid use, including the specific medication, dosage, and duration of therapy, is crucial. This information allows radiologists to consider potential medication-induced effects on imaging results, enhancing diagnostic accuracy.
Tip 2: Maintain Consistent Timing of Medication
Maintaining a consistent schedule for corticosteroid administration before the MRI, as advised by the prescribing physician, can minimize variability in imaging findings and improve interpretation consistency.
Tip 3: Inform the Radiologist of Any Relevant Medical Conditions
Disclosing relevant medical conditions, such as diabetes or kidney disease, which might be influenced by corticosteroid use, allows the radiology team to tailor the MRI protocol and interpret findings accordingly.
Tip 4: Arrive Prepared for Potential Blood Sugar Monitoring
Corticosteroids can affect blood sugar levels. Patients with diabetes or other conditions impacting glucose regulation should be prepared for potential blood sugar monitoring before, during, or after the MRI procedure.
Tip 5: Follow Pre-MRI Instructions Carefully
Adhering to pre-MRI instructions, including fasting guidelines or specific dietary restrictions, is essential for optimizing image quality and minimizing potential complications, particularly for patients taking corticosteroids.
Tip 6: Communicate Any Concerns or Questions
Patients should not hesitate to communicate any concerns or questions regarding the MRI procedure or potential interactions between corticosteroids and imaging results to the radiology team or referring physician.
Tip 7: Maintain Open Communication with Healthcare Providers
Maintaining open communication with all healthcare providers, including the prescribing physician and radiologist, ensures a coordinated approach to patient care and facilitates accurate interpretation of MRI findings in the context of corticosteroid use.
Following these recommendations contributes to the acquisition of high-quality MRI scans, accurate interpretation of results, and ultimately, informed clinical decision-making. The insights gained through adherence to these tips enhance diagnostic accuracy and contribute to better patient outcomes.
The subsequent conclusion summarizes the key takeaways regarding the complex interplay between corticosteroids and MRI findings.
Conclusion
The potential influence of corticosteroids on magnetic resonance imaging outcomes warrants careful consideration in diagnostic radiology. As explored throughout this article, the interplay between corticosteroid medications and MRI findings is multifaceted, influenced by factors such as steroid type, dosage, duration of therapy, specific MRI sequence employed, and the tissue under investigation. Corticosteroids can induce a range of effects, from altering glucose metabolism and impacting contrast enhancement to masking inflammation and potentially mimicking other pathologies. These effects underscore the importance of a thorough understanding of the potential interactions between corticosteroids and MRI for accurate image interpretation and informed clinical decision-making.
Accurate interpretation of MRI studies in patients receiving corticosteroid therapy necessitates a collaborative approach between referring clinicians, radiologists, and patients. Open communication regarding medication history, combined with a nuanced understanding of how these medications can influence imaging parameters, is essential for mitigating the risk of misdiagnosis and ensuring appropriate patient management. Continued research into the complex interactions between corticosteroids and MRI technology will further refine diagnostic capabilities and contribute to improved patient outcomes. This ongoing exploration emphasizes the dynamic nature of medical imaging and the importance of staying abreast of evolving knowledge to provide the highest quality patient care.
