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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ESR initiatives to strengthen the visibility and role of imaging in personalised medicine

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An interview with Prof. Hans-Ulrich Kauczor, Heidelberg/DE, ESR Research Committee Chair

ECR Today: What are the Research Committee’s objectives?
Hans-Ulrich Kauczor: Our main tasks are to periodically survey the needs of the research community, as well as develop recommendations for radiologists to engage with different fields of research and innovation. We also work to assess the current status and develop recommendations on how to improve education in research and to provide strategic recommendations for the research field to the executive council. Last but not least, we aim to leverage cooperation between research disciplines and foster networking and liaising with scientific biomedical European societies.

Hans-Ulrich Kauczor is professor and chairman of radiology at the University of Heidelberg and director of diagnostic and interventional radiology at University Hospital Heidelberg in Germany. He chairs the ESR’s Research Committee.

Hans-Ulrich Kauczor is professor and chairman of radiology at the University of Heidelberg and director of diagnostic and interventional radiology at University Hospital Heidelberg in Germany. He chairs the ESR’s Research Committee.

ECRT: Why is it important to have a dedicated ESR subcommittee for imaging biomarkers?
HUK: The Subcommittee on Imaging Biomarkers was established to address the issues concerning the future development of image-derived quantitative biomarkers, its assessment, validation and standardisation.

The development of imaging biomarkers has become an integral part of modern medicine with a huge potential to advance the development of personalised medicine. Different types of imaging biomarkers (anatomical, functional, and molecular) are used for the detection and treatment of major diseases including cancer, cardiovascular diseases, neurological and psychiatric diseases, musculoskeletal disorders, metabolic diseases, as well as inflammatory and autoimmunity based diseases. In contrast to other biomarkers, imaging biomarkers have the advantage of remaining non-invasive. They are also spatially and temporally resolved, non-destructive and repeatable over a long period, and have the potential for broad application. But before imaging biomarkers can be widely adopted, measures for standardisation and quality assurance must be implemented.

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Rising Stars exposes students to “the charms of radiology,” says former ECR President

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ECR Today spoke with Professor Małgorzata Szczerbo-Trojanowska, from Lublin, Poland, patron of the Rising Stars programme.

ECR Today: The Rising Stars programme is under your patronage this year. What motivated you to take on this role?

Malgorzata Szczerbo-Trojanowska: Medical students and residents will create the shape of radiology in the future. Therefore, those of us who care for our specialty should make an effort to encourage the best, brightest and most enthusiastic students to choose diagnostic imaging as their professional career.

I am very pleased to be involved in the preparation of the Rising Stars programme, which aims to create an interesting educational agenda for students and to encourage them to actively participate in the congress sessions specifically designed for them.

Professor Małgorzata Szczerbo-Trojanowska is Head of the Department of Interventional Radiology and Neuroradiology at the Medical University in Lublin, Poland. She served as ECR Congress President in 2010.

Professor Małgorzata Szczerbo-Trojanowska is Head of the
Department of Interventional Radiology and Neuroradiology at the
Medical University in Lublin, Poland. She served as ECR Congress
President in 2010.

I think this programme is a very important initiative of the European Society of Radiology and the ECR. Having been an academic teacher for many years, I am aware of the great significance of undergraduate education. It has always been my aim as chairperson of the radiology department at my university to offer attractive forms of radiology teaching and to expose students to the charms of radiology from the early years of their education. This is the way to raise their interest in this specialty and get them involved in radiology research. It is in the best interest of the future of radiology. So when I was offered to take patronage of the Rising Stars programme, I didn’t hesitate for even a second.

ECRT: Why should a medical student or radiology trainee take part in this programme?

MST: The European Congress of Radiology, one of the world’s leading radiological meeting, offers medical students and residents a unique opportunity to see the greatest scientists, practitioners, lecturers and teachers present some fascinating achievements of modern radiology. There are also many chances to learn the state of the art in a wide variety of imaging methods for a plethora of diseases, and to find answers to complex problems of contemporary medicine provided by world-renowned experts. Participation in the ECR shows the importance of radiology in patient care, its great impact on other areas of medicine, and its relevance in the progress of medicine.

By taking part in the Rising Stars programme, medical students, radiology trainees and radiography trainees have an opportunity to give a presentation on the results of their own research work and opinions, or ideas, related to medical studies. Visiting the ECR technical exhibition is always an exciting and stimulating experience, providing a unique opportunity to become acquainted with cutting-edge technologies and new solutions.

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New ESR President wants to draw national societies close

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ECR Today caught up with incoming ESR President Professor Lorenzo Bonomo at ECR 2014, and asked him about his vision for the year to come.

ECR Today: What are your plans and ambitions regarding your presidency?
Lorenzo Bonomo: It is with great pride that I take on the presidency of one of the most important and prestigious international scientific societies in the world. I’m also particularly pleased that my presidency coincides with the ESR’s tenth anniversary, which we’ll be celebrating next year.

New ESR President, Prof. Lorenzo Bonomo, from Rome.

New ESR President, Prof. Lorenzo Bonomo, from Rome.

So much has been done over the past few years thanks to the work of my predecessors, the Executive Council, the statutory committees, subcommittees, working groups and the tireless and efficient support of the ESR staff. Many of the objectives in the roadmap approved in 2012 have been achieved together with other new important projects, started during Prof. Frija’s presidency, and it will be my duty to consolidate and bring them to a conclusion. Among them are the development of a clinical decision support system in Europe, the creation of an accreditation council, and a strengthening of relations with other scientific societies in Europe and the EuroSafe Imaging Campaign. The whole learning, education and training field certainly requires close attention and a collaborative vision.

I would also like to draw the national societies closer, by intensifying dialogue with them, trying to understand their needs, and helping them to promote and increase the visibility of radiology. I would like my role to be that of a facilitator supporting the ongoing projects and promoting the start of new activities that committee chairpersons intend to achieve.

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Mar 2014
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Experts share strategies to help radiologists justify their imaging decisions

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Watch this session on ECR Live: Sunday, March 9, 16:00–17:30, Room F1
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Evidence-based radiology, comparative effectiveness research and health technology assessment all play a role in the radiologist’s decision-making nowadays. Radiologists must ensure that they are imaging patients at the right time using the right test, and they need to justify radiological examinations and imaging-based interventional procedures on the basis of the best available evidence. The dedicated Special Focus session today at ECR 2014 will teach attendees how to use evidence to justify imaging decisions in day-to-day clinical practice.

The case against overtesting

The case against overtesting

Evidence-based radiology is a relatively new approach designed to inform clinicians of the most appropriate technique to use in a given clinical scenario. It has always been an important topic, but people have recently become more aware of this theme and expect more justification from the physicians, according to Professor Myriam Hunink, who will chair the session. She is a professor of radiology and clinical epidemiology at the Erasmus University Medical Centre in Rotterdam, the Netherlands, and adjunct professor of health decision sciences at Harvard University, Boston, USA.

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MRI reveals the human connectome

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Watch this session on ECR Live: Friday, March 7, 16:00–17:30, room BRB
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Radiologists often say that the brain is the next frontier. But as diffusion MRI techniques progress, the most mysterious organ in the human body starts to unveil more and more of its secrets, and what was once inconceivable a decade ago is now almost at hand.

White matter fibre pathways of the brain as depicted with MR tractography. (Provided by Patric Hagmann, CHUV-UNIL, Lausanne, Switzerland)

White matter fibre pathways of the brain as depicted with MR
tractography.
(Provided by Patric Hagmann, CHUV-UNIL, Lausanne, Switzerland)

Researchers are now better able to understand how neurons connect with one another and how disease affects these connections in the human brain. The production and later study of maps of neural connections obtained with MRI are vital to this task. A dedicated New Horizons session will cover this fascinating topic today at the ECR.

Patric Hagmann, who will chair the session, is an attending physician and neuroradiologist at Lausanne University Hospital (CHUV, Centre hospitalier universitaire vaudois) in Switzerland. In his introduction, he will describe what he calls the connectome, a term he coined in his thesis on diffusion MRI and brain connectomics back in 2005*.

“We could sum up the connectome as a comprehensive map of neural connections in the brain. The production and study of connectomes is what we refer to as connectomics; it may range from a detailed map of neurons and synapses within part of, or all of, the nervous system to a description of the functional and structural connectivity between all cortical areas and subcortical structures,” he said.

In his presentation, Hagmann will not only introduce important concepts related to connectomics like scaling, the relation between structural and functional connectivity, and the integration-segregation, but also show how advances in MRI facilitate the mapping of the human connectome.

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Mar 2014
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American and European emergency radiologists compare experiences

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Watch this session on ECR Live: Friday, March 7, room F1
Four separate sessions, starting 08:30, 10:30, 14:00, and 16:00
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For the fourth year in a row, the European Society of Radiology (ESR) and the Radiological Society of North America (RSNA) will hold a joint course on a hot topic in radiology. After oncologic imaging for the past three years, emergency radiology will be under the scope of North American and European radiologists, who will share and compare their experiences in the dedicated Mini Course today at the ECR*.

MDCT is the best modality for identifying lesions as subtle as active mesentric bleeding and infiltration (arrow) caused by blunt abdominal injury (lap-belt compression). (Provided by András Palkó)

MDCT is the best modality for identifying lesions as subtle as active mesentric bleeding and infiltration
(arrow) caused by blunt abdominal injury (lap-belt compression). (Provided by András Palkó)

Medical emergencies and trauma are responsible for high levels of morbidity and mortality in all age groups worldwide, and trauma is the leading cause of death in people younger than 45. Consequently, the use of imaging in emergency departments has been increasing exponentially since the 1990s. The demand for CT examinations from emergency departments is, for instance, growing annually by 5% to 15%, depending on the institution.

Even with all the advanced tools imaging has to offer, trauma remains a challenge for most emergency services, according to Ulrich Linsenmaier, associate professor of radiology and head of the department of diagnostic and interventional radiology at KMPP Clinics in Munich, Germany. “Even for advanced level 3 medical centres running their own emergency radiology unit, it is a challenge to integrate advanced radiology services into an interdisciplinary team treating patients with acute traumatic and non-traumatic emergencies,” he said.

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Mar 2014
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