Intensive care units are special working environments, presenting radiologists with complex cases and patients with severe conditions. Diagnostic imaging examinations and the work of the radiologist have to be adapted towards these special circumstances, which can be one of the biggest challenges when working in an intensive care unit. Today there is a strong need for accurate, clinically relevant radiological input, which often has to be worked out while facing a lack of adequate image material and patients suffering from life-threatening conditions.
Prof. András Palkó from Szeged, Hungary, will chair the session on imaging in intensive care patients.
The ECR 2013 Special Focus Session on imaging in intensive care patients, chaired by ESR Past-President, Professor András Palkó from Szeged Medical School in Hungary, will give an up-to-date overview on the use of common imaging methods in the ICU environment. Special Focus Sessions are clearly aimed at in-depth analysis and the promotion of scientific debate between the speakers and their audience.
“The intensive care unit is a very special environment requiring special expertise from both the technicians and the radiologists working in a technically challenging situation. The patients are typically in very severe conditions, frequently unconscious, and almost always connected to life-support and monitoring equipment,” Prof. Palkó pointed out some of the difficulties of working in an ICU.
As a result of this, the majority of imaging examinations are performed on patients with limited ability to cooperate and often at the bedside. Reports are then typically written with insufficient clinical information, based on technically limited images, even though the need for accurate imaging material and radiological information is even greater than in standard clinical settings.
As acknowledged in last year’s ESR white paper on the subject, the concept of personalised medicine (PM) is becoming an increasingly hot topic. The patient-centred principles of PM have the potential to take over as the dominant philosophy in clinical healthcare in the relatively near future, which would see the focus of the medical world gradually shifting away from the current system of ‘disease care’, towards an approach based on prediction and prevention. However, although most radiologists are aware of the idea of PM and rightly consider medical imaging to already be among the most personalised aspects of healthcare, there is perhaps a need for more awareness of the exact nature of this new paradigm, and specifically a need for recognition – from within and outside the discipline – of the role that medical imaging should play.
ESR President Prof. Gabriel P. Krestin will chair the Professional Challenges Session on personalised medicine
A Professional Challenges Session at ECR 2013, chaired by the ESR President, Prof. Gabriel Krestin, will aim to raise awareness of the core principles of PM and highlight the factors that radiologists will need to consider in order to adapt their approach to training, clinical practice and research.
“The whole idea of PM, and the role of imaging within it, is relevant to all of us,” said Krestin, from the Erasmus Medical Centre, Rotterdam, Netherlands. “It is a concept that will gain in importance in the coming years and it will have an increasing influence on the way we work as radiologists. I think many people have heard of PM, but certainly not everyone will have a sound conception of exactly what it is or its full implications for imaging and our daily practice. To be aware of this, and the possibilities that will probably multiply in the coming years, is very important.”
The optimisation and justification of procedures is vital when using CT as an imaging modality; particularly on children, who are more sensitive to ionising radiation than adults. Therefore, it is crucial that all those who use CT understand the physics behind the equipment and ultimately use this understanding to minimise the potential risks while maximising the potential benefits to each individual patient. Patients should also be informed of the risks and benefits of undergoing a CT scan. World-renowned experts will explain these issues in detail during a Special Focus Session at ECR 2013.
“Not all radiologists and technicians are aware of the latest dose reduction strategies. Some are not necessarily so well-informed and perhaps do not realise how important this is. We believe that it is a question of trying to get everybody to a certain level of knowledge and expertise,” said Dr. Catherine Owens, paediatric radiologist and CT unit lead at Great Ormond Street Children’s Hospital in London, U.K.
Heart disease affects a very large number of people worldwide, and the consequences can be serious and even lethal. Here, and perhaps more than in many other areas of medicine, imaging has helped to improve treatment and prevention. It does so by detecting the disease at an early stage, sometimes even before its emergence, especially in patients at risk of ischaemic heart disease.
Today, diagnosing cardiac patients has become routine for many radiologists. However, some of them may not know of recent developments in this field and they may need to refresh their knowledge. A panel of experts will update both general and specialised radiologists with the latest information available on cardiac imaging, during the dedicated Mini Course ‘Organs from A to Z: Heart’ at ECR 2013. After an introduction to heart anatomy and the main imaging protocols, the course will focus on valvular diseases and cardiomyopathies; two pathologies commonly encountered in radiology practices.
Figure 1: A) Example of a dilated cardiomyopathy (DCM). Cine-MR images in four-chamber view (left) and short-axis view (right) at end-diastole show significant dilatation of the LV cavity. Ejection fraction was <35% in this patient. (RA = right atrium; LA = left atrium; RV = right ventricle; LV = left ventricle) B) Example of an asymmetrical, apical hypertrophic cardiomyopathy (HCM). Cine-MR images in a four-chamber (left) and two-chamber view (right) in systole show a markedly thickened left ventricular myocardium predominantly of the apex, as compared with the basal segments (RV = right ventricle; LV = left ventricle).
The brain remains undoubtedly one of the most mysterious organs of the human body. Magnetic resonance imaging has helped to unveil some of its secrets, and major advances have been made in understanding how the brain functions. Recent developments with resting fMRI (rfMRI) and diffusion MRI (dMRI) indicate that scientists are beginning to see beyond the brain: they have actually started to visualise the human mind. This new information is particularly relevant for understanding complex processes such as dementia, autism and depression. It is also proving increasingly central to the diagnosis of comas and chronic disorders of consciousness.
Leading researchers will discuss where the latest advances have led them and what the future will bring in a dedicated New Horizons Session during ECR 2013. FMRI has been used for over twenty years to visualise changes in brain activity by comparing a task versus a control task, and showing and quantifying how much brain activity is involved in the process. The recent addition of rfMRI enables researchers to track networks that are randomly active. A patient lying in a scanner with no particular task to perform will usually start thinking about the trivialities of the day and go from one thought to the other (“Did I close the door before I left? What am I doing here?” etc.). Neuroresearchers can track this mind mumbling with complex mathematics and extract information from what they call the default mode network.
Fig. 1: Differences in functional connectivity from rfMRI between autistic patients and age- and gender matched controls: the major disconnection is between the cerebellum and frontal language areas.
The quality of the ECR’s sessions for radiographers has been given a welcome seal of approval from the European Federation of Radiographer Societies (EFRS) who recently elected the ECR as their official annual scientific meeting. EFRS president, Prof. Graciano Paulo, from the college of health technology of Coimbra, Portugal, has been coming to the ECR for more than a decade and firmly believes the upcoming congress boasts one of the best selections yet for radiographers. Here he gives his personal preview of ECR 2013 and each of these sessions, all of which you can find in the ECR 2013 Interactive Programme Planner by searching for ‘radiographers’.
Read on for Prof. Paulo’s preview of all the sessions for radiographers at ECR 2013 …
The ‘ESR Meets’ programme, as well as being an extremely popular part of every ECR, serves a very valuable purpose. The sessions have not only reinforced relationships with numerous European national societies since the programme’s introduction in 2003, but they have also represented the ESR’s first official connections with several societies, sometimes from other continents and, more recently, from other disciplines. This year’s partner society, the European-African Hepato-Pancreato-Biliary Association (E-AHPBA) takes the ‘ESR Meets’ programme one step further …
E-HPBA president, Prof. Pierre-Alain Clavien, from Zurich, Switzerland
It may feel like 2013 just began yesterday, but we’ve already turned the first corner into February, which means the ECR is not so much creeping up on us as sprinting at full speed. So, in the five weeks remaining before March 7, what can you do to make sure you get the most out of this five-day festival of everything radiological? Here are our five top tips to get you off to a good start.
ECR badges, patiently waiting to be mailed
1) Get your badge mailed to you
Nobody wants to turn up full of enthusiasm on the first morning, only to spend the first 30 minutes in the longest queue of the whole congress. Be one of the smart ones; register before February 6 and get your congress badge and CME stickers sent to your home. You’ll be glad you did when you waltz past the waiting masses at the onsite registration desks.
At ECR 2013, ‘ESR meets’ will mark Latin America’s return to the congress. After Argentina in 2010 and Brazil in 2011, Chile will be a guest of honour within the popular programme, which promotes dialogue between radiologists from all over the world. ECR delegates will be given the opportunity to learn about the latest developments in Chilean radiology and appreciate the local realities of this faraway, yet culturally similar country. The ESR spoke with Professor Miguel Ángel Pinochet, president of the Chilean Society of Radiology, ahead of the meeting.
Professor Miguel Ángel Pinochet from Santiago, president of the Chilean Society of Radiology
The Radiological Society of South Africa (RSSA) will be a guest of honour at ECR 2013, as one of the three national radiological societies participating in the ‘ESR Meets’ programme. The society, which represents radiologists from South Africa, Namibia and Botswana, is the second African radiological society to have been invited to take part in the popular programme. In a dedicated session that will hopefully begin a new area of collaboration between African and European radiologists, the RSSA’s delegation will focus on two of the biggest health issues in the region: HIV and tuberculosis.
RSSA President, Doctor Clive Wyndham Sperryn from Cape Town.
