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)

  • Board certified in radiology or diagnostic radiology 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)

  • If board certified before 1995, must also meet the following: supervision, interpretation, and/or review and reporting of 300 MRI examinations within the last 36 months

  • Radiologists graduating from Residency after 6/30/14 must be board-certified/eligible as defined by the ABR

Radiologist 

(Not Board-Certified)

  • Completion of an accredited diagnostic radiology residency program

AND

  • Interpretation and reporting of 500 MRI examinations in the past 36 months

Other Physician 

(MR imaging limited to a specific anatomic area)


All of these:

  • Completion of an accredited specialty residency

  • 200 hours Category I Continuing Medical Education (CME) in MRI including, but not limited to: MRI physics, recognition of MRI artifacts, safety, instrumentation, clinical applications of MRI in the subspecialty area where MRI reading occurs

  • Interpretation and reporting of 500 MRI cases in that specialty area in the past 36 months in a supervised situation. For neurologic MRI, at least 50 of the 500 cases shall have been MRA of the central nervous system.

Continuing Experience

On renewal, all MR interpreting physicians must meet one of the following:

  • Meets Maintenance of Certification (MOC) requirements for ABR or the Osteopathic Continuous Certification (OCC) for AOBR

  • Physicians reading MRI exams across multiple organ systems must have read 200 exams over the prior 36 months.

  • Physicians reading organ system-specific exams (i.e., body, abdominal, musculoskeletal, head) across multiple modalities must read a minimum of 60 organ system-specific MRI exams in 36 months; and a total of 200 cross-sectional imaging (MRI, CT, PET/CT and ultrasound) studies over the prior 36 months (the 60 organ system-specific exams are included in the 200 cross-sectional imaging studies).

Additional information regarding continuing experience requirements

Continuing Education

On renewal, meets one of the following:

  • Meets MOC requirements for ABR or the OCC for AOBR

  • 150 hrs CME (including 75 Cat 1) in prior 36 months pertinent to physician’s practice patterns)

  • 15 hrs CME (half must be Cat 1) in prior 36 months specific to the imaging modality or organ system

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)

  • Board-certification in radiology or diagnostic radiology 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)

  • If board-certified before 2008, must also meet the following: supervision, interpretation, and/or review and reporting of 75 Cardiac MRI examinations in the past 36 months

  • Radiologists graduating from residency after 6/30/14 must be board-certified/eligible as defined by the ABR

All of these:

  • Completion of an Accreditation Council for Graduate Medical Education (ACGME) radiology residency

  • Supervised interpretation of 75 Cardiac MRI cases in the past 36 months

  •  Completion of at least 40 hours of Cat 1 CME in cardiac imaging, including cardiac MRI, anatomy, physiology, and/or pathology or documented equivalent supervised experience in a center actively performing cardiac MRI.

American Board of Internal Medicine (ABIM) certification in cardiology with completion of Level 2 training or higher


Level 2 Requirements (All of these):

  • Board certification or eligibility, valid medical license, and completion of a 3-month (cumulative) specialty residency or fellowship in Cardiac MR

  • 150 Cardiac MR examinations; in at least 50 of these, the candidate must be physically present and involved in the acquisition and interpretation of the case

  • Completion of 30 hours of courses related to MR in general and/or CMR in particular


Level 3 Requirements (All of these):

  • Board certification or eligibility, valid medical license, and completion of a 12-month (cumulative) specialty residency or fellowship in CMR

  • 300 Cardiac MR examinations; in at least 100 of these, the candidate must be physically present and involved in the acquisition and interpretation of the case

  • Completion of 60 hours of courses related to MR in general and/or Cardiac MR in particular


Nuclear Medicine Physicians-(Cardiac Only)

All of these:

  • Completion of an Accreditation Council for Graduate Medical Education (ACGME) - approved training program in nuclear medicine

  • Specific training in MRI within an ACGME accredited training program, or 160 hours of category 1 CME in MRI to include, but not limited to: MRI physics, recognition of artifacts, safety, instrumentation, and 40 hours specific to cardiovascular MRI

  • Interpretation and reporting, under the supervision of a qualified physician, of at least 75 cases of MRI of the cardiovascular system during the past 36 months


*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 ABR

 

If certified before 2008 : 

  • 15 hrs Cat 1 CME in MRI (must include clinical applications of MRI in breast imaging, MRI artifacts, safety and instrumentation) AND

  • Oversight, interpretation and reporting of 150 breast MRIs (or 100 supervised) in the last 36 months.

All of these:

  • Completion of Accreditation Council for Graduate Medical Education (ACGME) - or American Osteopathic Association (AOA) - approved diagnostic radiology residency program

  • Interpretation and reporting of 100 supervised breast MRIs in the last 36 months

  • 15 hrs Cat 1 CME in MRI (Must include clinical applications of MRI in breast imaging, MRI artifacts, safety and instrumentation)

All of these:

  • Completion of Accreditation Council for Graduate Medical Education (ACGME) - approved residency program in specialty

  • Interpretation and reporting of 300 supervised breast MRIs in the last 36 months

  • 200 hrs Cat 1 CME in MRI (Must include clinical applications of MRI in breast imaging, MRI artifacts, safety and instrumentation)

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:

  • Meets MOC requirements for ABR or the OCC for AOBR

  • 150 hrs CME (including 75 Cat 1) in the prior 36 months pertinent to the physician’s practice patterns

  • 15 hrs CME (half of which must be Cat 1) in the prior 36 months specific to the imaging modality or organ system (CME may be in MRI, breast, or a combination)

 

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:

  • 15 hours of CE in MRI of any body part (e.g. brain, musculoskeletal or breast): this is acceptable because MRI is the imaging modality

  • 15 hours of CE in breast ultrasound: this is acceptable because the breast is the organ system

  • 15 hours of CE in mammography: this is acceptable because the breast is the organ system

  • 15 hours of CE in breast MRI: this is acceptable because it meets both the organ system condition and the modality condition



Regarding intravascular contrast media: A properly certified and/or licensed healthcare professional may perform the injection of intravascular contrast media so long as a radiologist or his/her physician designee is present and immediately available to furnish assistance and direction throughout the performance of the procedure. The physician need not be in the same room.


Regarding 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.



Revision History for this Article

Date

Section

Description of Revision(s)

12-12-19

All

Article created; FAQs incorporated; No criteria changes



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