Overuse injuries in gymnasts and professional golfers

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Watch this session on ECR Live: Sunday, March 10, 08:30–10:00, Room E1

Overuse injuries due to excessive exercise are normally seen in professional athletes, but they are also becoming more frequent in amateur athletes. The Refresher Course on overuse injuries in sports will present three examples of how these injuries, caused by different sports, can be diagnosed and treated.

Gymnastic exercises, for example, are very demanding, not only on the axial but also the peripheral skeleton, and they involve strong forces due to hyperextensive and hyperflexion exercises. A certain degree of hypermobility and increased flexibility is necessary to perform some gymnastic exercises, and so training is required to improve this flexibility. Unnatural movements are sometimes necessary in order to increase this hypermobility and flexibility.

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Advanced MR imaging helps in interpretation of brain tumours

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Watch this session on ECR Live: Saturday, March 9, 16:00–17:30, Room G/H

Advanced MR imaging techniques such as perfusion and functional imaging have been a great help in improving the diagnosis and staging of brain tumours. Unlike conventional MR techniques, advanced MR techniques can be used to obtain information not only on the morphological, but also on the functional characteristics of tumours.

One of the most common types of brain tumour is glioblastoma, which is highly malignant and has a high cell reproduction rate due to the fact that it is nourished by a large network of blood vessels. According to the American Brain Tumour Association there are two types of glioblastoma: primary glioblastomas, which tend to form and make their presence known quickly by growing aggressively, and secondary glioblastomas, which are also aggressive but show slower growth and only represent 10% of all diagnoses.

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Vascular disease comes under growing scrutiny

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Watch sessions from this Categorical Course on ECR Live:

Imaging the arteries is a daily task for interventional radiologists like José Ignacio Bilbao, president of this year’s ECR, but other subspecialists should know about the main clinical problems associated with the blood vessels. The Clinical Lessons for Imaging Core Knowledge (CLICK) courses, starting this Saturday and finishing Monday, will present delegates with various clinical scenarios and state-of-the-art techniques for imaging vascular disease.

Cardiovascular events still account for the majority of deaths worldwide. Diabetes and hypertension are well-known risk factors that should be monitored and treated appropriately. But the combination of metabolic and cardiovascular factors should also be included in the equation, according to Lars Lönn, professor of vascular surgery and radiology at the National Hospital in Copenhagen. “Cardio-metabolic factors such as obesity are a major risk nowadays; for instance overweight people have a tendency to get fat in the liver, which also gives you a risk for diabetes,” said Lönn, who will chair the course, ‘How old are you in reality? Vascular age and clinical events,’ today at the ECR. Considering these factors is fundamental since the incidence of obesity will continue to rise in the near future, and with it the number of potential cardiovascular complications.

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08
Mar 2013
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ECR gives platform to radiographers in ultrasound management debate

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Watch this session on ECR Live: Friday, March 8, 16:00–17:30, Room F1

The global demand for medical imaging examinations has been growing rapidly over the past decade. Sustaining a workforce to match demand is becoming a challenge, as an increasing number of hospitals are facing a shortage of radiologists. Some countries have filled the gap by allowing radiographers to perform and interpret ultrasound examinations independently, to relieve the pressure on staff. This option continues to divide the European radiological community, and many seem to be against delegating a medical act to non-doctors. However, new educational opportunities and radiographers’ growing interest in medical science are challenging this concept, a panel of radiographers will show during a Special Focus Session chaired by a radiologist and a radiographer at ECR 2013.

Dean Pekarovic from the University Hospital of Ljubljana, Slovenia.

Dean Pekarovic from the University Hospital of Ljubljana, Slovenia.

Ultrasound is a widely available modality and many medical specialists are using it without the help of radiologists, sometimes without sufficient knowledge and to the detriment of patients. However, radiographers who have received proper theoretical and clinical training know how to best use the modality and read images correctly, according to Dean Pekarovic, a radiographer at the University Hospital of Ljubljana, Slovenia, and member of the advisory board of the European Federation of Radiographer Societies (EFRS). “Ultrasound is a very competitive field, everybody wants to use it. But not everyone has the ability to perform an examination and interpret images appropriately. Radiographers with specific training are able to carry out such examinations and can even write reports on their own,” he said.

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New ways to image cartilage could help prevent osteoarthritis

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Watch this session on ECR Live: Friday, March 8, 16:00–17:30, Room C

Osteoarthritis, a degenerative joint disease, affects a large number of people worldwide. But with the emergence of new MRI techniques, researchers believe they will be able to prevent its development in the near future. Experts will present the latest methods to assess cartilage tissue quality at a very early stage and discuss remaining challenges, in a dedicated New Horizons Session, today at the ECR.

Cartilage is composed of collagen and glycosaminoglycans (GAG), which are responsible for the biomechanical properties of cartilage tissue. An interesting way to image cartilage is to look at the amount of GAG, which decreases at the onset of tissue degeneration, a process which occurs due to ageing or an induced defect, for instance trauma or surgical intervention in the joints. If left untreated, a tissue defect can lead to osteoarthritis. GAGs are known to be among the earliest biomarkers of cartilage degeneration, and if a focal reduction in the amount of GAG can be identified, then therapy to avoid further damage can begin.

Sodium image in the axial plane of the patella shows the patellar cartilage. At the border from the medial to the lateral facet of the patella an area with decreased sodium signal-to-noise ratio (SNR) is visible which corresponds to a decreased content of glycosaminoglycan (GAG) although the cartilage thickness is preserved. This means an early stage of cartilage degeneration in this area with a focal loss of GAG. (Provided by Prof. Siegfried Trattnig and the MR Centre of Excellence)

Sodium image in the axial plane of the patella shows the patellar cartilage. At the border from the medial to the lateral facet of the patella an area with decreased sodium signal-to-noise ratio (SNR) is visible which corresponds to a decreased content of glycosaminoglycan (GAG) although the cartilage thickness is preserved. This means an early stage of cartilage degeneration in this area with a focal loss of GAG.
(Provided by Prof. Siegfried Trattnig and the MR Centre of Excellence)

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Endovascular procedures in HCC treatment

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Watch this session on ECR Live: Friday, March 8, 08:30–10:00, Room F1

There are a wide range of treatment options available when dealing with hepatocellular carcinoma (HCC), ranging from interventional and endovascular procedures to surgical interventions such as liver transplantation. The main reason for performing endovascular procedures when treating patients with hepatocellular carcinoma is the fact that liver neovascular networks are nourished exclusively by the arteries.

Liver tumours, both primary and metastatic, are almost entirely supplied by branches known as neo-vessels, which originate in the hepatic arteries. The surrounding peritumoural liver parenchyma is vascularised mainly by portal vein branches. When an HCC is larger than two centimetres in diameter the afferent vessel can be identified and then targeted via an arterial endovascular approach. These unique characteristics – dual vascular supply and the ability to identify the afferent vessels – are the rationale behind the use of endovascular treatments, and several different techniques have been developed over the last 30 years. Among the most frequently used are the infusion of chemotherapy and the introduction of particles, either as occluding devices or as carriers of an active agent, which attacks the tumoural cells and surrounding neovessels.

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ECR supports young radiologists, says rising star

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Dr. Alexander Sachs, the Rising Stars representative on the ESR’s Undergraduate Education Subcommittee, talked about his numerous projects and his passion for teaching in an interview with ECR Today.

ECR Today: When did you first take part in the Rising Stars programme?
Alexander Sachs: I first took part in the Rising Stars programme in 2011. I applied to present Sono4You, an ultrasound peer-teaching student project, which I had become involved in. It was the first time I gave a presentation in front of a large audience, but I thought I would just give it a try and so I took a practical approach.

Dr. Alexander Sachs from Vienna is the Rising Stars representative on the ESR’s Undergraduate Education Subcommittee.

Dr. Alexander Sachs from Vienna is the Rising Stars representative on the ESR’s Undergraduate Education Subcommittee.

ECRT: It seems it paid off since you were elected best student presenter.
AS: Yes, it did have some positive effects. The year after, the ESR asked me if I wanted to coordinate the Hands-on Ultrasound Workshops at ECR 2012, which are strongly connected to the Sono4You tutorials. It was a great opportunity. It went really well and we are repeating the experience this year, with one advanced session and three basic workshops.
I like the idea of raising young people’s interest in radiology. In doing so, I am in contact with many people internationally, be they students or teachers. I really enjoy meeting people of different ages with different ideas; it is quite interesting to see what happens, how they connect, and the results of their cooperation.

ECRT: Can you please tell us about some of the new features of Rising Stars at ECR 2013?
AS: The Sono4You workshops will offer more advanced content to match the level of first-year radiology residents. Generally, the contents will be more interesting; thanks to the feedback we received last year.
Another nice development is that people have become more motivated to enrol as tutors for the peer-teaching sessions. Last year, I really had to motivate people to do so, but now it is much easier, there is a much bigger interest on their part. More students are participating in the programme every year, and I am happy to add my experience or work to this initiative.

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07
Mar 2013
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Radiologists need more time and know-how to train doctors of tomorrow

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Watch this session on ECR Live: Thursday, March 7, 16:00–17:30, Room F1

Postgraduate radiology training is high on the agenda in Europe, with a great deal of attention in recent years being given to the harmonisation of educational standards across the continent, but there is a growing feeling within the discipline that radiology should not lose sight of the equally important issue of undergraduate education. Exposing undergraduates to radiology not only serves the obvious and vital purpose of inspiring potential radiologists, but also ensures that students who go on to follow careers in other disciplines are well versed in what radiology can offer and how it operates. In broad terms, the net result is a combination of helping to secure the discipline’s future and making life easier for its practitioners.

However, making sure undergraduates are given sufficient contact with radiology is no easy task. The competing clinical, managerial and academic demands on radiologists’ time and skills, which increase with every year, mean that any additional activities run the risk of being excluded. The time and resources needed, not just to teach, but also to carry out the necessary preparation for effective teaching, can often make it impossible to fit in to an already hectic schedule.

Professor Stephen J. Golding (left) from Oxford will chair today’s Professional Challenges Session on undergraduate teaching.

Professor Stephen J. Golding (left) from Oxford will chair today’s Professional Challenges Session on undergraduate teaching.

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07
Mar 2013
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ECR Today – Cardiac imaging in 2020: reaching new heights

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Watch this session on ECR Live: Thursday, March 7, 16:00–17:30, Room D2

Over the past decade, technological improvements have led to the widespread use of imaging modalities in the prediction, diagnosis and follow-up of coronary disease. Radiologists now have the ability to obtain information on the structure of cardiac muscle with MRI and evaluate cardiac arteries with CT, while hybrid imaging will soon allow them to do both. Cardiac CT will also provide more functional information in the future, and its use will continue to grow. Experts will present the newest and upcoming possibilities of cardiac imaging today at the ECR.

Advances in cardiac CT have brought its use in clinical routine to unprecedented levels. The main reason is that image acquisition optimisation strategies allow radiologists to assess blood vessels with the same efficiency as coronary angiography, non-invasively and almost instantaneously.

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06
Mar 2013
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