Facial genetics and forensics take centre stage at ECR

Watch this session on ECR Live: Friday, March 3, 10:30–12:00, Room B
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Forensics and facial genetics will be in the spotlight at ECR 2017 as the ‘ESR meets Belgium’ session offer a look at medical imaging’s most original contributions to healthcare and crime investigation.

Advanced decomposition of brain MRI or facial 3D surface images into modules, tailored for associations with underlying genetic variations.

Dr. Peter Claes from Leuven, Belgium, will present his work in facial genetics in a session titled ‘Imaging genetics and beyond: facial reconstruction and identification’.

Claes is a senior research expert in the Medical Image Computing research group of the Processing of Speech and Images division of the Electrical Engineering department at Leuven Catholic University.

He uses CT, MRI and 3D surface imaging modalities to grasp the link between people’s appearance and underlying genetic variations.

“Your appearance is genetically driven. In families there’s a strong link, even more so between identical twins, who share the same DNA profile and almost the same face. Physical features also influence your brain, the way you think. A lot of facial characteristics are shared, for example in Down’s syndrome patients, who present with the same features whether they are European or Asian,” he explained.

The link between genetic disorders and facial genes has been of interest to scientists for a while, but research is slow and tedious.

Claes became interested in facial genetics after working in craniofacial morphometrics to help correct morphological abnormalities and anomalies, and in craniofacial reconstruction to identify victims.

To help decipher facial genetics, Claes uses the computer-based craniofacial reconstruction programme he developed for victim identification, and combines 3D surface processing, statistical modelling, analysis, mapping and prediction techniques. He has also created an array of algorithms and software for investigators who plan to use 3D facial datasets. Last year, he also co-organised the first international workshop on facial genetics in London.

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Education central to improving imaging data quality in oncology clinical trials

Watch this session on ECR Live: Thursday, March 2, 16:00–17:30, Room X
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Imaging data is key in multicentre clinical trials for cancer research but quality control is currently a major impediment, bringing the validity of the trials into question and potentially impacting on the quality of drugs put on the market, a panel of experts will argue today in a session held by the ESR and the European Organisation for Research and Treatment of Cancer (EORTC) at the ECR.

Imaging is increasingly contributing to cancer research thanks to the development of innovative techniques that depict functional and molecular processes. In most oncological clinical trials, imaging is now the primary criteria used to evaluate progression of disease or efficiency of the drug being tested.

The best way to obtain valuable imaging measurements is to involve the imagers who take part in these trials and educate the clinician investigators, experts will explain in the session.

When it comes to imaging in cancer research, a number of issues take centre stage. Difficulties associated with integrating imaging biomarkers into trials have been neglected compared with those relating to the inclusion of tissue and blood biomarkers, largely because of the complexity of imaging technologies, safety issues related to new contrast media, standardisation of image acquisition across multivendor platforms and various post-processing options available with advanced software, as reported recently in The Lancet by the EORTC and leading researchers.

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Mar 2017
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Eminent neuroradiologist to give honorary lecture at ECR 2017

Watch this session on ECR Live: Thursday, March 2, 12:15–12:45, Room A
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In recognition of his significant impact on the field of neuroimaging and his service to organised radiology, Professor Mauricio Castillo from Chapel Hill, NC, United States, has been invited to deliver the Wilhelm Conrad Röntgen Honorary Lecture ‘Dissatisfaction, burnout and inequality: three major challenges in radiology’ at ECR 2017.

Professor Mauricio Castillo from Chapel Hill, United States

Professor Mauricio Castillo from Chapel Hill, United States, will deliver the Wilhelm Conrad Röntgen Honorary Lecture today at 12:15 in Room A.

Mauricio Castillo is the James H. Scatliff distinguished professor of radiology, chief and programme director of neuroradiology at the University of North Carolina in Chapel Hill. He is currently president of the American Roentgen Ray Society.

Originally from Guatemala, Prof. Castillo completed his radiology and neuroradiology training at the University of Miami School of Medicine, Jackson Memorial Medical Center, and Emory University School of Medicine, Affiliated Hospitals in Atlanta respectively.

His specialty and subspecialty choice was in large part motivated by his mentors.

“When I was a medical student, I was fortunate to work in the only teaching hospital that had a CT scanner and two board-certified radiologists. I was very impressed by the impact of imaging in patient care and by the way these two professionals used their large base of knowledge of medicine to generate a differential diagnosis based on imaging findings. Later on, while I was a resident, I developed a close relationship with Dr. Robert Quencer, which led me to become a neuroradiologist. One should never underestimate the influence we may have on our trainees and the influence our mentors have had on us,” he said.

Prof. Castillo’s research interests include paediatric neuroimaging, application of new imaging techniques and medical literature editing. Read more…

Prominent Brazilian radiologist to shed light on Zika virus imaging at ECR 2017

In recognition of her major achievements in neuroimaging and advancement of the field, Professor Maria de Fátima Viana Vasco Aragão from Recife, Pernambuco, Brazil, will present the Guest Lecture ‘Breaking News from Latin America: How to recognise Zika virus infections on imaging studies’ at ECR 2017.

Maria de Fátima Viana Vasco Aragão is professor of radiology at the Maurício de Nassau University and Scientific Director of the Multimagem Diagnostic Centre in Recife, Brazil. She is also financial director of the Diagnostika Endoscopy and Radiology Clinic in Recife.

Prof. Vasco Aragão received her medical degree from Pernambuco Federal University in 1987 and completed her residency in radiology at Ribeirão Preto Faculty of Medicine, University of São Paulo. She did fellowships in CT and MRI and in neuroradiology at the Med Imagem Beneficencia Portuguesa, São Paulo, and later completed a research fellowship at Mount Sinai Hospital Center in New York, US.

She always knew she would become a doctor and chose radiology because she recognised early on the field’s value in diagnosis and treatment.

Maria de Fátima Viana Vasco Aragão is professor of radiology at the Maurício de Nassau University and Scientific Director of the Multimagem Diagnostic Centre in Recife, Brazil.

Maria de Fátima Viana Vasco Aragão is professor of radiology at the Maurício de Nassau University and Scientific Director of the Multimagem Diagnostic Centre in Recife, Brazil.

“My mother is a retired biologist and biology teacher. I have never forgotten the moment she taught me what a cell was. In my family, educators predominated and my great aunt was the first woman in Pernambuco, my home state, to graduate from medical school, in 1935. Perhaps on account of this family background I made up my mind to become a doctor. As an intern student of medicine, I was very impressed when I took my patients to be examined by CT and US. Even though there was only one CT scanner in my city, I succeeded in having all my intern patients examined, when indicated. My tutors were impressed by the swiftness with which cases were resolved. Thus I learned that radiology not only helps to quickly define diagnosis in most patients, but also provides a clear prognosis for the most adequate treatment. At the end of the course I began considering the possibility of specialising in radiology, even though 29 years ago, for most people, a radiologist was not a doctor. Shortly after graduation, I sat for a test and won a place in radiology at the first attempt, and radiology has been my passion ever since. I would like to say that I am grateful for having had great mentors, including the neuroradiologist Dr. Sérgio Santos Lima, who was my director during my fellowship in the Med Imagem Beneficencia Portuguesa, and the head and neck radiologist, Dr. Peter Som, who was one of my directors during my research fellowship at Mount Sinai Hospital Center New York,” she said.

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Hybrid imaging contents to heighten delegates’ interest at ECR 2016

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ECR Today spoke with ECR 2016 Congress President, Prof. Katrine Åhlström Riklund, deputy head of the department of radiation sciences and director of the medical school at Umeå University, Sweden, to find out a little bit about next year’s annual meeting.

ECR 2016 Congress President, Prof. Katrine Åhlström Riklund, from Umeå, Sweden.

ECR 2016 Congress President, Prof. Katrine Åhlström Riklund, from Umeå, Sweden.

ECR Today: What will be the highlights of ECR 2016?
Katrine Åhlström Riklund: It is hard to tell what the specific highlights will be more than one year ahead, due to the rapid development of imaging. The highlights will be the entire congress through its well-developed programme, which covers the whole range of education from student level to advanced subspecialists. I should say the added content of hybrid imaging in several sessions would make the programme even more attractive. Besides the educational and scientific programme, the grand opening ceremony and social activities will also be memorable events.

ECRT: Will there be any new additions to the programme?
KAR: As always, there will be innovations at the ECR. The content of hybrid imaging will be spread across several sessions and not in one single session. The new session formats introduced at ECR 2015, with the European Excellence in Education (E3) programme – divided into five levels (the Rising Stars programme, European Diploma Prep Sessions and Beauty of Basic Knowledge programme, ECR Academies and ECR Master Classes) will be continued. These levels cover the entire span from undergraduate medical education to subspecialised continuing professional development. Getting involved in the sessions is important for retaining knowledge.

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Comprehensive personalised imaging transforms cardiothoracic disease management

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Watch this session on ECR Live: Sunday, March 8, 8:30–10:00, Room E1
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Besides personalised imaging, a new paradigm is emerging in radiology that should re-shape clinical practice and benefit the patient immensely. Supported by new technologies that enable radiologists to image the body faster and better, radiologists are now trying to broaden their focus during examinations.

If there is a field where these advances make a tremendous difference, it is cardiothoracic imaging, an area where diseases are more often than not intertwined. Cardiovascular and chest radiologists will explain how the comprehensive personalised approach impacts their work and try to convince radiologists on both sides to take an interest in the other, in a New Horizons session on Sunday at the ECR.

For years, the trend was for radiologists to subspecialise as much as they could. Cardiovascular radiologists and chest radiologists would focus on their own area with little or no interest beyond that. But among these subspecialists, an increasing number are now changing their approach, as mounting evidence shows that diseases of the heart and chest are very often related, according to Dr. Christian Loewe, deputy head of the section of cardiovascular and interventional radiology at the Medical University of Vienna, Austria.

Dr. Christian Loewe is deputy head of the cardiovascular and interventional radiology section at the Medical University of Vienna, Austria.

Dr. Christian Loewe is deputy head of the cardiovascular and interventional radiology section at the Medical University of Vienna, Austria.

“In the past patients were investigated by either focusing on chest or cardiac diseases. This choice was mainly driven by their first clinical examination. However, there are a lot of situations and diseases where chest problems are caused by cardiac diseases and vice versa. There’s a huge interaction between heart and chest, and that’s why it’s interesting and important to look at this relationship in more detail today,” he said.

To prove his point, Loewe, a cardiovascular radiologist, will talk about acute and chronic chest pain during the session. Some of the most severe causes of chest pain are due to cardiovascular diseases, including myocardial infarction or acute aortic diseases. However, acute chest pain can also be caused by a number of pulmonary diseases, including pulmonary embolism, pneumonia and others. Therefore, radiologists must learn the different life-threatening disorders that cause chest pain, whether they are respiratory or cardiovascular.

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Population imaging studies gain ground in healthcare

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Watch this session on ECR Live: Thursday, March 5, 16:00–17:30, Room L1
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Imaging large cohorts of people enables scientists to collect information useful for science and emphasises radiology’s role in healthcare. From the most recently available imaging biomarkers to data such as genomics and metabolomics, Thursday’s dedicated Professional Challenges Session will show just how useful population imaging studies have become in the prognosis of countless diseases.

When radiologists follow a cohort of people for 20 or 30 years, the benefits for the patient increase tremendously. If a radiologist performs a CT examination of a patient’s coronary arteries and finds calcification, chances are that the patient will have a heart attack within the next few years. Unfortunately at this stage, the patient is usually out of the radiologist’s reach.

The fluid-attenuated inversion recovery axial image of a 26-year-old female participant shows multiple, bilateral, asymmetric, linear and ovoid hyperintensities that are located perpendicular callososeptal characteristic of multiple sclerosis

The fluid-attenuated inversion recovery axial image of a 26-year-old female participant shows multiple, bilateral, asymmetric, linear and ovoid hyperintensities that are located perpendicular callososeptal characteristic of multiple sclerosis

However, if patients chose to participate in a population study, they will be checked on a regular basis, and radiologists will be able to access previous information and initiate appropriate treatment earlier, significantly
improving patient outcome.

Securing imaging data is always tricky and population imaging studies are an opportunity for radiologists to access this data. Showing the relevance of imaging findings highlights radiology’s role in the medical continuum, according to Prof. Norbert Hosten, of the Ernst-Moritz-Arndt University in Greifswald, Germany, who will chair
the session Thursday.

“Our way to prove that radiology can make people healthier and happier is to do large population imaging studies. Radiology can develop the kind of data that are necessary to prove that our methods really help the patient,” he said.

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Experts sound the alarm on dangers facing radiologists

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Watch this session on ECR Live: Wednesday, March 4, 16:00–17:30, Room E2
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Remember HAL 9000, the murderous computer in ‘2001: A Space Odyssey’? This scenario doesn’t seem too far off when it comes to radiologists and the constant evolution of their technology. Luckily, they can still stay in control if they change their behaviour and remain at the head of the imaging process, experts will argue during a Professional Challenges session today at the ECR.

Radiologists must claim their place in the medical team if they are to survive. They must come out of the shadows and show that they can bring added value to the team, according to Jim Reekers, professor of interventional radiology at the University of Amsterdam, who will chair the session.

Jim Reekers, from the University of Amsterdam, will chair the session on the role of the radiologist.

Jim Reekers, from the
University of Amsterdam, will
chair the session on the role of the
radiologist.

“I want to make my colleagues aware that they should step out of their offices and act as doctors who work in multidisciplinary teams. Being the photographers or doctors who only give a report with a picture will not secure their future and the reason is very simple: anybody can make and look at a picture nowadays. The difference the radiologist brings is that he or she can give an interpretation of the picture within the context of a patient’s clinical situation. So the radiologist should become a doctor who gets involved with the patient’s situation,” he said.

There is more than one way to do this. For starters, to be on the same level as clinicians, radiologists must behave as such. That means they have to do more than just show the images in multidisciplinary team meetings, they have to sit and discuss them with the doctors.

“Have a junior show the images for you. While my junior presents the pictures, I am sitting together with the other specialists, and suggesting treatment and follow-up options or further diagnostic investigation. It is important to sit with the other doctors. There’s a big difference in how people see me. I’m one of them instead of being the guy who shows the pictures,” Reekers said.

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New treatments give hope to hearing impaired

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Watch this session on ECR Live: Wednesday, March 4, 08:30–10:00, Room E1
Tweet #ECR2015E1 #SF1B

Hearing loss can present many difficulties and obstacles to sufferers, and with ageing populations it’s set to become a major healthcare challenge. Many conditions such as congenital malformation of the inner ear or hypoplastic cochlear nerve can also lead to hearing loss, and sometimes deafness.

Fortunately, many new treatments are available to recover hearing, both partially and completely. Imaging plays an increasingly important role in therapy planning and follow-up, and there is hope on the research front, experts will show during a dedicated Special Focus session on Wednesday morning.

Microtia – congenital anomaly of external and middle ear, resulting in conductive hearing loss. External auditory canal is not patent (arrow), mastoid process is underdeveloped (arrowhead)

Microtia – congenital anomaly of external and middle ear, resulting in
conductive hearing loss. External auditory canal is not patent (arrow),
mastoid process is underdeveloped (arrowhead)

The prevalence of auditory problems in the Western world has doubled over the past 30 years. It is estimated that between 15 and 17% of the population will suffer hearing loss, due to ageing or congenital malformation, but also bad habits, according to Agnieszka Trojanowska, a radiologist at Lublin University Medical School, Poland, who will
chair the session.

“We start to see young adults in their early 30s with sensorineural hearing loss or other related problems because of high frequency noise, which is typical for listening to music. Twenty years ago, such a condition was linked with working in fabrics or on the street. But the good news is that even if you use your iPod a lot, the degree of hearing
loss is light to moderate, so this is not something that will considerably affect your life,” she said.

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Mar 2015
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Interview: Nicola Bedlington, chairperson of the ESR’s Patient Advisory Group for Medical Imaging (PAGMI)

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Nicola Bedlington is executive director of the European Patients’ Forum (EPF) and chairperson of the ESR’s Patient Advisory Group for Medical Imaging (PAGMI). The goal of PAGMI is to bring together patients, the public and imaging professionals in order to positively influence advances in the field of medical imaging to the benefit of European patients. The group has contributed to the International Day of Radiology, which aims to raise public awareness of the benefits of medical imaging and has promoted the ESR’s patient information website. We asked Ms. Bedlington for her views on healthcare in the EU and why she chose to participate in the International Day of Radiology.

What is the overall aim of your organisation?
Nicola Bedlington: Our vision is high quality, patient-centred and equitable healthcare for all patients throughout the European Union. The European Patients’ Forum is an umbrella organisation that works with patient groups in public health and health advocacy across Europe. Our members represent specific chronic disease groups at EU level, or are national coalitions of patients. We currently represent almost 60 such organisations. Our mission is to be the collective patients’ voice at EU level, manifesting the solidarity, power and unity of the EU patients’ movement, and to provide a strong and united voice in order to put patients at the centre of EU health policy and programmes. In this regard we are the key interlocutor with EU institutions on cross-cutting issues affecting all patients.

Nicola Bedlington is executive director of the European Patients’ Forum, having joined the organisation in 2006, and chairperson of the ESR Patient Advisory Group for Medical Imaging.

Nicola Bedlington is executive director of the European Patients’ Forum, having joined the organisation in 2006, and chairperson of the ESR Patient Advisory Group for Medical Imaging.

What exactly does your organisation do to meet this aim?
Nicola Bedlington: The EPF helps to empower patient organisations through educational seminars, policy initiatives and projects. We coordinate best practice exchanges between patient organisations at European and national levels. Our programmes also help to strengthen organisational and advocacy capacity.

Your organisation has experience working with various chronic disease groups. Do many patients suffer from chronic diseases in the EU?
Nicola Bedlington: Following consultation with our members we estimate there are at least 150 million patients with chronic conditions across the European Union. This figure is likely to increase given the ageing population.

Many EU countries face significant health budget cuts, leading to shorter hospital stays and less access to modern equipment (i.e. long waiting lists for MRI exams). How can better patient care be promoted?
Nicola Bedlington: The EPF is working with its member organisations to ensure health is seen as an investment, and patients are not perceived as purely cost drivers. Major health inequalities exist across the EU which impact enormously on patient access to care. Building on the three pillars of quality information, health literacy and empowerment, patients can be agents of change and sources of innovation, particularly in terms of equity and sustainability of care. There need to be meaningful opportunities for patient involvement throughout the healthcare sector. We promote meaningful patient involvement in all forms of innovation, whether it is in high or low technology, pharmaceuticals, information technology, social change or systems change. The patient community seeks partnerships with researchers, policy-makers and industry in order to achieve greater impact in this arena.
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