Objectives
  • To develop state-of-the-art diagnostic strategies for different tumour types

  • To be able to communicate with imagers and patients with regard to the different diagnostic imaging tests

Awareness
  • Awareness of the existence of different imaging techniques, particularly cross-sectional imaging techniques (computed tomography (CT), magnetic resonance imaging (MRI)) and hybrid imaging techniques (positron emission tomography (PET)/CT, MR/PET)

  • Awareness of image-guided diagnostic interventions and image-guided therapies

  • Awareness of staging systems based on imaging examinations

  • Awareness of the existence and limitations of general and cancer-specific treatment response systems

  • Appreciation of imaging-related safety issues

  • Awareness of the cost-effectiveness of different imaging techniques

Knowledge
  • Knowledge of the principles and technical limitations of different diagnostic imaging techniques, in particular CT and MRI, and their associated costs

  • Familiarity with safety-related issues concerning CT: radiation exposure in relation to patients’ age and prognosis, iodinated contrast media-related risks and side effects

  • Familiarity with safety-related issues and contraindications to MRI: relevance of implantable medical devices, pregnancy and claustrophobia, gadolinium-based contrast media-related risks and side effects

  • Understanding of the usage of image-guided diagnostic and therapeutic interventions, their limitations, as well as potential complications

  • Familiarity with pre-test probabilities of disease in individual patients, and estimation of the potential impact of the non-invasive imaging tests and invasive image-guided tests on management, given the expected impact on post-test probabilities

  • Knowledge of the role of different imaging tests (particularly CT and MRI) in staging of specific tumours, eg, TNM (see chapter 4.2.6), Ann Arbor, International Federation of Gynecology and Obstetrics (FIGO)

  • Familiarity with the breast imaging reporting and data system (BI-RADS) and prostate imaging reporting and data system (PI-RADS) classifications, and their clinical implications

  • Familiarity with the Response Evaluation Criteria in Solid Tumours (RECIST) (see chapter 4.2.9)

  • Familiarity with cancer-specific treatment response criteria, eg, the Lugano Classification of the International Conference on Malignant Lymphoma (ICML; previously known as Cheson Criteria) for lymphoma, and the Choi Response Criteria for gastrointestinal stromal tumour (GIST)

Skills
  • Ability to formulate a specific question in a referral form, to provide a clinical differential diagnosis to the imaging specialist; include comorbidities or other clinical data relevant to the examination

  • Ability to explain the basic principles and actual conduct of any ordered imaging test or image-guided intervention to patients; include information on special preparations (eg, fasting) for the imaging examination, where appropriate

  • Ability to provide patients with information on complications, side effects, contraindications, as well as radiation exposure related to imaging examinations or image-guided interventions

  • Ability to assign patients to radiography, ultrasound, CT, MRI or hybrid imaging (PET/CT, MR/PET) examinations, based on tumour type, specific question and patient safety profile

  • Ability to order image-guided diagnostic interventions in cases where non-invasive imaging examinations are inconclusive or inappropriate

  • Ability to order image-guided therapeutic interventions in cases where systemic treatment or surgery are not applicable

  • Ability to apply TNM, Ann Arbor and FIGO staging systems, based on information provided in the imaging reports (supplemented by biopsy, where appropriate)

  • Ability to apply RECIST 1.1, Lugano and Choi Criteria for treatment response assessment, based on information provided in the imaging reports (supplemented by biopsy, where appropriate)

  • Ability to interpret BI-RADS and PI-RADS scores, and to draw conclusions for the clinical management

  • Ability to discuss imaging findings and reports, as well as strategies of validation, with radiologists and nuclear medicine physicians during multidisciplinary tumour boards