Cochlear Implants & MRI Safety

This is a guest article from MED-EL, the innovation leader in hearing implants.

You don’t want to have to turn a patient away from an MRI scan. But active medical implants, such as pacemakers or cochlear implants, can make MRI scans challenging.

Many implants are associated with risks during MRI, even if they are “MR Conditional”. This can be especially challenging in real-world settings, because “MR Conditional” only means that there are conditions and restrictions, without letting you know how to proceed or how likely it is that your patient will have a safe, comfortable MRI scan.

However, it’s important to understand that not all implants are created equal—especially when it comes to MRI safety.

Today, we’re going to take an in-depth look at why a design issue causes complications with certain cochlear implants. Then we’ll look at why magnet technology makes all the difference with a whole range of hearing implants designed specifically for MRI safety.

Read more…

24
Apr 2019
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ECR 2019 Cases of the Day Quiz Winners

The Cases of the Day Quiz featured 20 challenging cases covering different sections of radiology.
The cases were shown during ECR 2019 and attendees were encouraged to submit their diagnosis.
From the 374 participants, the following solved most cases correctly:

Elliott Rees; Sawston, Cambs/UK
Filip Vanhoenacker; Antwerp/BE
Ümit Tüzün; Istanbul/TR
Artur Komorowski; Owczary/PL
Manabu Minami; Yokohama/JP
Jan Balak; Prague/CZ
Martina Slamova; Nove Mesto Na Morave/CZ
Diogo Roriz; Coimbra/PT
Veronika Pesti; Budapest/HU
Timothy Sadler; Cambridge/UK
Miguel Correia da Silva; Porto/PT
Vendoti Nitheesha Reddy; Bengaluru/IN

To view the cases of ECR 2019 please click here. 

Congratulations to all winners!

20
Mar 2019
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The best submissions for the “Just a cyst?” interlude at ECR 2019

Dear Friends,

Over the last couple of years, one of the last sessions at the ECR has always covered 20 interesting cases from various subspecialties, which the audience is asked to solve in an interactive way to broaden and update their knowledge.

In between, the very best submissions from the global radiological community have been presented in an interlude lecture. The best submission has always been awarded with a prize and a certificate.

Due to time limits, not all submitted cases can actually be shown onsite, but the session’s rising popularity has resulted in increasing numbers of submissions of excellent quality and didactic value. This is why we would like to give our submitters the opportunity to reach a broader audience by posting the best cases here on the ESR Blog.

We all use the term “cyst” a great many times every day. It comes in handy, when we are dealing with something roundish and not solid. Mostly, we want to convey the message to clinician and patient: “nothing to worry about, just fluid”. But is it always that simple? What does the location tell us and are there any additional findings useful to report? Are they “leave me alone” lesions by definition or should we sharpen our awareness to separate the needle in the haystack? When you start to think about it, you might run into the risk of seeing danger everywhere.

Below, we are pleased to present the best submissions for the “Just a cyst” interlude at ECR 2019:

19
Mar 2019
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Incoming ESR President lays out clear vision for ECR 2020

By Julia Patuzzi

It is a well-established tradition that on the final day of the congress, ECR Today looks ahead to next year’s ECR. We therefore spoke with Professor Boris Brkljačić from Zagreb, Croatia, the incoming ESR President, who is in charge of ECR 2020. He shared with us some of his ideas and plans for the next European Congress of Radiology.

ECR Today: Professor Brkljačić, the first visual impression of the next congress is always the congress poster. For ECR 2020 you chose artwork by the award-winning Canadian illustrator Peter Diamond, depicting a young woman looking at a small object floating just above her cupped hand. Can you tell us a little about how this particular design came about?

Incoming ESR President Boris Brkljačić is professor of radiology and vice-dean at University of Zagreb School of Medicine, Zagreb, Croatia, and chair of the Department of Diagnostic and Interventional Radiology of University Hospital ‘Dubrava’ in Zagreb.

Boris Brkljačić: The ESR Office provides several options for the congress poster, created by professional designers, and the Congress President and PPC members select one. The selected solution was the best among the proposed options. It resembles Rembrandt’s artwork, with sharp light and dark contrast, and is in good accordance with the slogan for ECR 2020: ‘A Clear Vision for Radiology’. The small floating object represents artificial intelligence, which will be an important topic at the congress, and the names of the ECR 2020 ‘ESR meets’ countries are visible at the bottom of the poster. The 2020 poster contains fewer colours and illustrations compared to the 2019 poster, and is concordant with the visual style of the ESR’s main scientific publication, the journal European Radiology.

ECRT: As the new ESR President, you are also chairperson of the Programme Planning Committee for ECR 2020, which has already been working on preparing the scientific programme for a few months. Can you tell us something about the highlights of the 2020 programme or any specific focus we can expect?

BB: I am very fortunate to have selected excellent Programme Planning Committee members, who are hard-working and dedicated experts in their fields. Planning has already been running at full speed for a few months in order to create a well-balanced programme of very high-quality professional, educational and scientific content. New Horizons Sessions, State of the Art Symposia and Special Focus Sessions have already been selected and mostly created; they are very relevant and balanced, so that young radiologists and experts in particular radiological fields will have interesting sessions to choose from in all areas of radiology. Emerging and hot topics will be covered, like lung cancer screening, artificial intelligence, stroke diagnosis and treatment, and many others. I expect that the plenary/honorary sessions should be the highlight of the congress, as they are interesting for all participants, regardless of their age and expertise. Read more…

How to deal with common diseases in Pakistan: the radiologist’s perspective

by Katharina Miedzinska

Each country has its own special healthcare challenges to shoulder. In Pakistan, a densely populated country located in South Asia, with an estimated population of more than 200 million, major healthcare challenges include exceptionally high prevalence rates for certain diseases. During today’s ‘ESR meets Pakistan’ session, some of the country’s top radiologists will discuss the role radiology plays in managing three of the most common ones: oral cancer, chronic hepatitis and tuberculosis.

Many diseases are common in Pakistan, among them endemic and epidemic infectious diseases, emerging infections, and an increasing burden of non-communicable diseases. The actual burden of infections with the hepatitis B and C virus (HBV, HCV) is approximately seven percent, making Pakistan a country with one of the highest prevalence rates for viral hepatitis in the world. Approximately ten million people in Pakistan are infected with HCV alone. Following the acquisition of the virus, acute HCV infection can progress to chronic infection, which in turn is associated with several morbidities, such as liver cirrhosis and cancer. Besides hepatitis, also malaria, the polio virus (which still circulates in core-reservoirs across Pakistan, although with lesser intensity), dengue outbreaks, and other infectious diseases pose a serious threat to public health security. Over the past few decades, Pakistan has suffered a great deal from these and other infectious diseases. Global warming, changing climate conditions, environmental degradation, and other ecological determinants have a direct effect on these diseases and result in the emergence or re-emergence of infectious entities. The causes of such disease outbreaks are complex and often not well understood.

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03
Mar 2019
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CEUS ready for clinical paediatric use argues UK expert

Professor Paul Sidhu is Professor of Imaging Sciences at King’s College London and consultant radiologist at King’s College Hospital, where he helped pioneer contrast-enhanced ultrasound (CEUS), a technique that can potentially be used to image children just as well as adults, in reduced time, and without the downsides of radiation and toxicity. Professor Sidhu will make the case for CEUS use in paediatric radiology today during the Luigi Oliva Honorary Lecture.

There is no question that ultrasound is the most child-friendly imaging technique. The modality has countless benefits for young patients: no ionising radiation, no sedation or anaesthesia, and ease of use, to name a few. “Ultrasound is the most suitable modality for imaging children, as they don’t have to stay still. Parents can be present during the examination to support their child. The radiologist can stop and start the examination without losing information, plus children have low body fat and are better suited to ultrasound,” Sidhu said.

Professor Paul Sidhu from King’s College London will argue for CEUS use in paediatric radiology in today’s Luigi Oliva Honorary Lecture.

Adding a contrast agent to ultrasound has been shown to improve diagnosis tremendously in applications where vascularity or haemo-dynamics must be assessed in real time. With CEUS, in the case of focal liver lesions, which are often difficult to characterise in adults and children on B-mode ultrasound alone, essential information from the arterial and portal venous phases aids diagnosis in minutes without needing CT or MR imaging. This alone should be a decisive argument for widespread CEUS use in the paediatric population, Sidhu explained.

“The combination of contrast with ultrasound allows for a more detailed assessment of the pattern of vascularity and dynamics in a continuous fashion for three to five minutes in real time, and it can be repeated as many times as necessary. The child does not need to keep still, and all the same focal liver characteristics seen in the adult are seen in the child. The ability to come to a clear diagnosis, with a single imaging examination is a great relief for the parents, often present with the child during the examination, rather than remote as with CT or MR imaging,” he said.

With CEUS, radiologists can obtain a lot of information in the first five minutes following the injection, the time window that the contrast agent lasts in the blood pool. This is more than enough to carry out the examination and make a conclusion. The technique can be used in every possible scenario from trauma to disease imaging, with great results. “Imaging with ultrasound in children is the most useful and informative procedure,” Sidhu concluded. Read more…

Radiology in Italy takes centre stage on day three of ECR 2019

By Becky McCall

The future status and development of the radiological profession look set to come under the microscope today during the eagerly anticipated ‘ESR meets Italy’ session. The major challenges ahead, including artificial intelligence (AI) and machine learning, are to be addressed by expert speakers.

“We feel that we have to be able to drive AI and not be driven by it. The Italian way of thinking may help our community to fight to ensure that AI does not supersede the human elements of care,” Dr. Corrado Bibbolino, head of the Forensic and Ethical Section of the Italian Society of Medical Radiology (SIRM), told ECR Today ahead of ECR 2019.

Dr. Corrado Bibbolino is a board member of the Italian branch of Choosing Wisely.

He fears AI may take over the role of the radiologist, and the personal aspects and skills may be lost.

“Patients may think that they are satisfied with AI, but it is not the same as dealing with a real person – it’s not like an automatic ticket machine in a railway station,” Bibbolino said. “Human characteristics like empathy and intuition are not there. A computer might resolve a problem, but it cannot ask the patient questions, feel the reaction, look into the patient’s eyes and think what the patient is thinking – these are things AI cannot do. This is the difference between a human and a robot. AI is important but it is not a substitute for a real radiologist.”

Bibbolino is a long-standing member of the Italian radiology community, having been active in healthcare policy and education for around 40 years. He contributed to the development of national guidelines for radiology practice, including the regulation of teleradiology, and his influence and leadership have led to the establishment of recent Italian laws on healthcare security, professional liability, and insurance reimbursement.

In today’s presentation, ‘Radiology in Italy’, of particular note and relevance will be his work with ‘Choosing Wisely’, which aims to promote dialogue around avoiding unnecessary medical tests and treatments. The initiative is involved with the so-called slow medicine movement, and focuses on a thoughtful, deliberate approach to patient care. Read more…

Welcoming all radiographers to ECR 2019

By Jonathan McNulty, EFRS President

Radiographers have long been involved in the European Congress of Radiology (ECR), and the European Federation of Radiographer Societies (EFRS) has had responsibility for developing the radiographers’ sessions since ECR 2012. However, it is only in recent years that the ECR has become the official scientific congress of the EFRS, and the European Society of Radiology (ESR), for medical imaging radiographers.

Over the past eight congresses, the radiographers’ programme has grown considerably, as has the participation of radiographers. A total of 2,177 radiographers and radiography students, from 75 countries, attended ECR 2018 and we look forward to welcoming even more to ECR 2019, which has now become one of the largest international gatherings of radiographers.

Dr. Jonathan McNulty is Associate Professor and Associate Dean of Graduate Studies at University College Dublin School of Medicine in Dublin, Ireland, and President of the European Federation of Radiographer Societies.

In 2018, a total of 22 refresher courses, professional challenges sessions, special focus sessions, joint sessions, Rising Stars sessions, MyT3 sessions, and scientific sessions made up the radiographers’ programme. For ECR 2019, this will rise to 28 sessions, which will truly offer something for everyone. A special word of thanks must go to Dr. Andrew England from the University of Salford, UK, and a member of the EFRS Educational Wing Management Team, and Dr. Maríanna Garðarsdóttir from Landspitali University Hospital, Iceland, who are the co-chairs of the 2019 radiographers’ scientific subcommittee, and to their team for an excellent educational and scientific programme. Aside from the above sessions, we also look forward to the radiographers’ Voice of EPOS sessions, the involvement of radiographers in a series of sessions at the Cube 2.0 (a special programme dedicated to interventional radiology), and the EFRS Educational Wing annual meeting and our student session.

At ECR 2019, Room C on the 2nd level will become the new venue for most of the sessions in the radiographers’ programme. The Radiographers’ Lounge has also been relocated to Foyer C (outside Room C). In this area, the EFRS and ESR will welcome 20 national radiographers’ societies, along with some educational institutions, who are members of the EFRS Educational Wing, who will all have booths in this area. The radiographers’ Voice of EPOS stage will also be located in the lounge area, as will a number of research studies, requiring your participation, which will take place in the EFRS Radiographers’ Research Hub (Room 2.96). The Radiographers’ Lounge will thus be a great meeting place and, together with the rest of the EFRS Executive Board, I look forward to meeting you in this area and seeing you at the radiographers’ sessions. Read more…

Welcome to ECR 2019!

Welcome to the 25th ECR in Vienna!

Thanks for coming to be a part of ‘the bigger picture’!

 

By Lorenzo E. Derchi, ESR President

ECR 2019 marks an important anniversary. This will be the 25th ECR congress held in Vienna since 1991: a great achievement! Those who have been coming here since the beginning will find a meeting that has become bigger over the years, now including not only the Austria Center, but also many of the buildings surrounding it.

It is a true ‘congress city’, which has grown to accommodate the increasing numbers of delegates from all over the world. Those who are here for the first time will discover a congress with a wide range of opportunities to learn about the different aspects of our specialty, with sessions suited to all, from beginners to advanced professionals.

ESR President Prof. Lorenzo E. Derchi is Head of the Department of Radiology at the University of Genoa, Italy.

Over the years, the ECR has provided radiologists with a European platform for the presentation of research and debate and has been the key to the creation of a community of people working together and advancing in science and education together. This has been the result of the efforts of 24 Congress Presidents and Programme Planning Committees who, with the help of the well-structured and dedicated efforts of the ESR Scientific Programme Department, have worked as in a relay team, passing the baton from one to the next and ensuring continuity of aims and good results over the years.

The ECR has always been a creative meeting. It started with a ‘classical’ structure, made up of refresher courses, scientific presentations and posters, and, over the years, has incorporated various new ways for contributors to present scientific work. The first big innovation was in 2003, with the introduction of the electronic posters of EPOS. Then, in 2016, came the new session format ‘the Voice of Epos’ in which the scientific message of selected posters could be explained in person by their authors. Last year, the ‘MyT3’ presentations, the lounge meetings of ‘Coffee & Talk’ and the hands-on approach to interventional radiology of ‘the Cube’ were introduced. All these session formats have proven successful and will be continued, and even expanded, this year. Furthermore, an additional new session type will be launched, not only for ECR delegates, but also open to anyone who is interested in joining in. The ‘Women in Focus’ initiative will explore the challenges encountered by women in our field and in other medical and medical-related professions. It will open a debate over gender parity in our profession and will try to present role models to whom the ever-increasing number of women entering into radiology can relate. Read more…

Radiography: Because image matters


New floor-mounted radiography system – guest post by Siemens Healthineers

In radiography, the way patients and referring physicians perceive your institution can enhance – or hinder – your success. MULTIX Impact is an innovative digital imaging machine that makes a positive impression on patients, staff, and referring physicians. Its user-friendly, state-of-the-art technology is designed at an economical price to improve access to care and helps you produce excellent images in a more personal way. 

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