Curricula for Teaching MRI Safety and MRI/CT Contrast Safety To Residents: How Effective Are Live Lectures and Online Modules?

Purpose The advent of the diagnostic radiology core examination and the new ACGME “milestone” evaluation system for radiology residents places new emphasis on topics in MRI and CT safety, and MRI and CT contrast agents. We evaluated whether either lecture-based teaching or online modules would improve baseline resident knowledge in these areas, and assessed which intervention was more effective. Methods Before didactic intervention, 2 cohorts were created from 57 radiology residents, with equal numbers and a matched level of training. The residents were tested on their baseline knowledge of MRI, MRI contrast safety, and CT contrast safety, using a multiple-choice examination. One group attended a live, 1-hour lecture on the preceding topics. The other engaged in 3 short online educational modules. After 6 weeks, the residents were again tested with the same questions to assess for improvement in their understanding. Results Both the module and lecture cohorts demonstrated a statistically significant increase in questions answered correctly on CT contrast safety (13.1%, P < .001, and 19.1%, P < .001, respectively), and on MRI and MRI contrast safety (12.9%, P < .001, and 14.4%, P < .001). The preintervention and postintervention scores, and degree of improvement postintervention, were similar for the module versus lecture groups, without a statistically significant difference (P = .70). Resident confidence improved in both groups, for both modalities. Conclusions Focused didactic intervention improves resident knowledge of MRI and CT safety, and MRI and CT contrast agents. Live lectures and online modules can be equally effective, allowing residency programs flexibility

Curricula for Teaching MRI Safety and MRI/CT Contrast Safety To Residents: How Effective Are Live Lectures and Online Modules?

Purpose The advent of the diagnostic radiology core examination and the new ACGME “milestone” evaluation system for radiology residents places new emphasis on topics in MRI and CT safety, and MRI and CT contrast agents. We evaluated whether either lecture-based teaching or online modules would improve baseline resident knowledge in these areas, and assessed which intervention was more effective. Methods Before didactic intervention, 2 cohorts were created from 57 radiology residents, with equal numbers and a matched level of training. The residents were tested on their baseline knowledge of MRI, MRI contrast safety, and CT contrast safety, using a multiple-choice examination. One group attended a live, 1-hour lecture on the preceding topics. The other engaged in 3 short online educational modules. After 6 weeks, the residents were again tested with the same questions to assess for improvement in their understanding. Results Both the module and lecture cohorts demonstrated a statistically significant increase in questions answered correctly on CT contrast safety (13.1%, P < .001, and 19.1%, P < .001, respectively), and on MRI and MRI contrast safety (12.9%, P < .001, and 14.4%, P < .001). The preintervention and postintervention scores, and degree of improvement postintervention, were similar for the module versus lecture groups, without a statistically significant difference (P = .70). Resident confidence improved in both groups, for both modalities. Conclusions Focused didactic intervention improves resident knowledge of MRI and CT safety, and MRI and CT contrast agents. Live lectures and online modules can be equally effective, allowing residency programs flexibility

Effects of TCDD on the Fate of Naive Dendritic Cells

The environmental contaminant, 2,3,7,8-tetrachlorodibenzo-p-dioxin (TCDD), causes immune suppression via activation of the aryl hydrocarbon receptor. Dendritic cells (DCs), the professional antigen-presenting cells in the immune system, are adversely affected by TCDD. We hypothesized that TCDD alters DC homeostasis, resulting in a loss of DCs in naive mice. To test this hypothesis, C57Bl/6 mice were gavaged with either vehicle or an immunosuppressive dose of TCDD (15 μg/kg). TCDD exposure decreased the frequency and number of splenic CD11chigh DCs on day 7 when compared with vehicle-treated controls. TCDD increased the expression of CD86 and CD54, while decreasing the frequency of splenic CD11chigh DCs expressing CD11a and major histocompatibility complex (MHC) class II. Moreover, TCDD selectively decreased the CD11chighCD8α−33D1+ splenic DCs specialized at activating CD4+ T cells but did not affect the regulatory CD11chighCD8α+DEC205+ splenic DCs. TCDD did not alter the number or frequency of CD11clow splenic DCs but decreased their MHC class II and CD11a expression. Loss of splenic CD11chigh DCs was independent of Fas-mediated apoptosis and was not due to alterations in the numbers of common DC precursors in the bone marrow or their ability to generate steady-state DCs in vitro. Instead, increased CCR7 expression on CD11chigh DCs suggested involvement of a migratory event. Popliteal and brachial lymph node CD11c+ cells showed elevated levels of MHC class II and CD40 following TCDD exposure. Collectively, this study shows the presence of a TCDD-sensitive splenic DC subpopulation in naive mice, suggesting that TCDD may induce suppression of T-cell-mediated immunity by disrupting DC homeostasis