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…

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…

Prof. LLuís Donoso-Bach is chairman of the diagnostic imaging department at the Hospital Clínic of Barcelona and professor of radiology at the University of Barcelona. A true leader in European radiology, he has tackled many areas of radiology practice, including liver imaging, digital imaging, IT use in diagnostic radiology, and product development. He has also held the reins of the European Society of Radiology, serving as its president from 2015 to 2016, and sat on various ESR and ECR committees for many years.

Donoso, who is the newly appointed president of the International Society of Radiology, believes the future has much in store for radiology, as he explained ahead of receiving the ESR Gold Medal, the highest honour bestowed by the society, today at the ECR.

Prof. LLuís Donoso-Bach from Barcelona, a former ESR President, will receive the ESR Gold Medal, the highest honour bestowed by the society, today at the ECR.

The role of the radiologist, once marginal in healthcare, has become central in the provision of care, with the introduction of technologies like CT, MR, and interventional radiology. “You won’t find a single health facility running without an imaging department today. A patient hardly ever leaves the hospital without having had at least one imaging examination,” Donoso said.

Radiology has struck a balance between the technology and the clinic. It has become a strong discipline, which must continue to get closer to the patient by getting more involved in treatment and prevention, not just diagnostics, if it is to keep on growing.

Radiologists must go beyond detecting lesions and interpreting images, because machines already perform these tasks better than humans. “This role will be put in question in the years to come. I don’t see, in the near future, any possibility for reading images that haven’t already been pre-processed by a computer assisted detection and interpretation system.”

The radiologist’s role will rather be to answer clinical questions by integrating the imaging information together with clinical information, and putting it all in context.

Radiologists must include more information in their reports, from genomics and fields other than imaging, and not just issue recommendations. To continue to grow, radiologists must become more than radiologists and convert into “experts in imaging information,” Donoso believes. Read more…

Michael Grace Kawooya is a Professor of Radiology at the Ernest Cook Ultrasound Research and Education Institute and Professor Emeritus at the Makerere University College of Health Sciences in Kampala, Uganda. He has done much for the development of radiology in his country and the rest of Africa, but says efforts must continue to increase the number of radiologists and range of equipment, and to raise awareness of radiation safety. Kawooya believes Africa can learn a lot from European advances. His contributions to improving bilateral cooperation will be rewarded today as he receives ESR Honorary Membership.

Professor Michael G. Kawooya’s contributions to improving bilateral cooperation between Africa and Europe will be rewarded today as he receives ESR Honorary Membership.

ECR Today: How much has radiology advanced in Uganda?

Michael Grace Kawooya: Back in the late 1980s, radiology was very new to medical practice in Uganda, and its contribution to healthcare was not well understood. It was not given priority and was underfunded. There were only two radiologists in the country when I finished my residency and we were overwhelmed with work. Doctors were not willing to undertake radiology residency, fearing that radiologists didn’t earn much. Equipment was scanty and often malfunctioning. Many of these challenges still exist today, but to a lesser extent. Radiology is better understood and its role is now evident. The number or radiologists has increased to almost 70. This year alone, 20 doctors took up radiology residency. The number and range of equipment has also increased.

ECRT: Are there any regional trends in radiology in Africa?

MGK: The same challenges facing radiology in Uganda bedevil most of Africa, but North Africa, which is largely Arabic, and South Africa, which is wealthier, face fewer challenges. In these parts of Africa, radiology has flourished more compared to Central, East, and West Africa. The radiologist-to-population ratio is approximately 1:67,000 in Egypt, 1:1,600,000 in Uganda and 1: 8,000,000 in Malawi. The more affluent regions have higher numbers and range as well as sophistication of imaging equipment. They have more radiology training institutions and undertake more research. Read more…

Vijay M. Rao, MD, FACR is the David C. Levin Professor and Chair of the department of radiology at Thomas Jefferson University. She is also senior vice-president of Enterprise Radiology, Jefferson Health, and the immediate past president of the Radiological Society of North America. As she receives ESR Honorary Membership today, she looks back on 30 years of work in a field she describes as globally united.

Radiology has come a long way from the days of plain film hypocycloidal tomography in head and neck imaging, a subspecialty to which Prof. Rao has dedicated most of her career. Technological innovations such as ultrasound, CT, MRI and PET have revolutionised the field, allowing for earlier diagnosis and greater insights into the pathophysiology of a host of diseases and conditions.

Professor Vijay M. Rao from Philadelphia, immediate past president of the RSNA, will receive ESR Honorary Membership today during the Grand Opening.

Radiology continues to evolve from anatomic to more physiologic and functional assessment of disease processes, with more precise quantification and minimally invasive therapeutic options.

Rapid technological advances have led to tremendous growth in radiology along with associated costs. But the digital age has introduced a number of previously non-existent opportunities to transform radiology practice, using tools powered by informatics and machine learning (ML). “Radiologists should explore ways to utilise these technological advances to add value and reduce waste in healthcare,” she said.

Artificial intelligence (AI) and ML applications are valuable tools that make radiologists more effective and increase their contributions to personalised and precision medicine. “AI can assist radiologists at a time when we are challenged to provide imaging services that are faster, safer and affordable, as well as information that is quantitative and precise. These new technologies will improve workflows in our daily practice, freeing up time for us to better position ourselves as integral members of the patient’s healthcare team,” she said.

The move toward value-based imaging continues to be the biggest trend in the US, where emphasis is placed on volume when structuring radiology practice. “Policymakers lack understanding of imaging’s contribution to patient care and the extent of services that radiologists provide. That is why we have begun the necessary transition to a value-based model of care, where radiologists are actively consulting with patients and their referring physicians as part of the healthcare team,” she explained. Read more…

Professor Federico G. Lubinus is full professor of radiology and director of the radiology residency programme at the autonomous university of Bucaramanga (UNAB) in Colombia. He is one of the leaders in South American radiology and he believes that bringing back ultrasound to the heart of radiological practice is key to the future growth of the specialty. His efforts will be acknowledged today as he receives ESR Honorary Membership.

When it comes to radiology, South America has very similar challenges to the rest of the world and a number of regional trends, Lubinus explained. “Big workloads, turf battles with other medical specialties, and challenges imposed by teleradiology and artificial intelligence are some of the many difficulties we have to deal with, not only as radiological societies but also as radiologists wondering about the role of the specialty in the near future,” he said.

Professor Federico G. Lubinus, who will receive ESR Honorary Membership at today’s Grand Opening, is one of the leaders in South American radiology.

But radiology practice in the continent is uneven and a major difference concerns radiology training, according to Lubinus, who currently heads the Latin American Educational Forum, a group that brings together radiological societies of South America to develop and advance educational issues in the region. “Training is dependent on the regulations of each country. There is great diversity both in the number of years of study required to be a specialist and in the minimum requirements demanded in each country, which makes it difficult to standardise programmes and perform appropriate evaluation of knowledge,” said Lubinus.

Lubinus is also director of the scientific committee of the Asociación Colombiana de Radiología (ACR), a society he served twice as president. Under his aegis, the ACR worked to have a standardised training programme, a tool that is now recognised by the Colombian ministry of education as the basis for evaluation and certification of radiology graduates, and radiologists who have received their certification abroad.

For the past four years, the Latin American Education Forum has also engaged in developing a standardised academic residency programme as a reference instrument for the validation of qualifications of Latin American radiologists, to improve the much needed certification and recertification in radiology.

Read more…

Professor Valentin Sinitsyn is chair of radiology and head of the radiology department at the medical faculty of Moscow Lomonosov State University, Moscow. A pioneer in cardiac imaging in Russia, he has helped advance the field in his country, but believes there is still much to be done to increase MR and CT use. After 20 years of working to advance the ECR and European radiology, he will receive the ESR Gold Medal today.

Sinitsyn has witnessed the introduction of spiral and multidetector CT, high-field MRI and hybrid imaging, and the development of evidence-based radiology and medicine.

Professor Valentin Sinitsyn from Moscow, a pioneer in cardiac imaging in Russia, will receive the ESR Gold Medal today.

As he graduated from Sechenov Medical University in Moscow in 1984, cardiac CT and MRI did not yet exist. “With the help of these new modalities, radiology penetrated fields where it had never been used before, and the best example is cardiac imaging,” he said.

Sinitsyn started implementing cardiac imaging back in the 1980s and has very fond memories from that time. Although these were also harsh days for the field, he said.

“Most cardiologists and radiologists believed that cardiac MRI and CT were toys that were good for nothing in real clinical practice. I still remember my first case of apical hypertrophic cardiomyopathy diagnosed with cardiac MRI in 1987, when nobody could make a correct diagnosis,” he said.

Today he admits to being a little disappointed with the slow penetration of cardiac MRI and CT in Russian clinical practice. The benefits of modern cardiac imaging are well known, but the percentage of cardiac CT and MR examinations in cardiac imaging is just around 1%. “Low reimbursement for such examinations and insufficient knowledge and motivation from both radiologists and cardiologists are mostly to blame for this situation,” he said.

Read more…

by Prof. Bernd Hamm, ESR President

It is my great pleasure to welcome you to ECR 2018!

The European Congress of Radiology has attendees from all over the world – from over 140 countries and many diverse cultures. It is a multi-professional meeting where international experts can shake hands with students, medical residents exchange ideas with physicists, and radiographers share their perspectives with industry representatives.

I chose ‘Diverse & United’ as our congress motto this year, as radiology is such a diverse specialty, covering a huge range of medical and scientific topics: from ever more refined diagnostic options to image-guided minimally invasive treatment options. Alongside our diversity, as radiologists and radiographers we should also stay united, which is in the interest of our specialty and our patients. This is what our congress is: something to offer for everyone, regardless of profession, cultural background or specialisation.

ESR President Bernd Hamm is professor of radiology and chairman of all three merged departments of radiology at the Charité, Humboldt-Universität zu Berlin and Freie Universität. He is also clinical director of the Charité Center, which includes radiology, neuroradiology, nuclear medicine and medical physics.

Being Congress President in 2015 gave me the unique opportunity for re-evaluation and to implement new things that I feel strongly about as well as fine-tune features that already existed. It was generally important to me to introduce new ideas in order for those of you who’ve even been coming to Vienna for decades, just like me, to get the chance to experience multiple innovations.

MyT3 is a new session format, adapting the ECR even more to these fast-moving times. 240 daring colleagues will present their scientific thesis in just three minutes! As if this wasn’t dramatic enough, we decided to hold these speedy sessions on the Sky High Stage which overlooks the city of Vienna, as only the sky is the limit for this new generation of radiology professionals.

Additionally, we created another new session format, ‘Coffee & Talk’, which is highly interactive with much more time for discussion than usual and in a relaxed atmosphere, with the possibility to also enjoy a coffee or other hot beverage. The interesting lectures on offer in these sessions call for an exciting exchange, bringing together different statements and opinions as well as Viennese coffee culture.

For the first time, the CUBE will open its doors to you: a theme park for interventional radiology (IR), designed for residents who haven’t specialised yet. Challenges, quizzes, training and much more will be focused on IR in emergencies plus other everyday topics, including the aorta, oncology, peripherals, and stroke. Without wanting to give away too much, I recommend paying the Cube a visit during lunchtime for ‘the main event’: the daily highlight involving experts in the arena, less challenging as well as more challenging interventions and much more. Come and be part of it!

Read more…