A new beginning in cancer imaging has just begun, says Beets-Tan
Professor Regina Beets-Tan is chair of the department of radiology at The Netherlands Cancer Institute in Amsterdam, full professor of radiology at the University of Maastricht and adjunct professor of abdominal and oncological radiology at the University of Southern Denmark. She will present the Wilhelm Conrad Röntgen Honorary Lecture, titled ‘Oncologic imaging: a new beginning has just begun’ at ECR 2019.
She shared a few thoughts with us on the future of her specialty in an interview ahead of the congress.
ECR Today: You have chosen quite an iconic and broad topic for this honorary lecture. What points will you cover exactly?
Regina Beets-Tan: The audience will get a glimpse of the future of cancer care and the role of imaging. The world of cancer medicine is changing rapidly. Major steps forward have been taken. Advanced imaging and computing technology, screening programmes; these all will result in the early detection of more tumours. Minimally invasive treatment, including interventional therapy, will have an increasingly important role. Targeted therapy, which specifically hits the cancer genes, and immunotherapy, which uses the patient’s own immune system to kill cancer cells, will result in prolonged survival of patients who are in the final stage of metastatic disease. It will be ‘precision medicine’; we do not want to give the wrong treatment to the wrong patient. As advocated by Prof René Bernards, a respected leader in cancer research at the Netherlands Cancer Institute: ‘Within 15 years, cancer will become a chronic disease’. And I believe this is true. This transformation will change the way we will practice oncologic imaging. This will require us to recreate our discipline. With this lecture, I would like to take my young colleagues on a 20-minute journey towards their future.
ECRT: Your field of research is abdominal and oncologic imaging, especially MRI of rectal cancer. What are the latest developments in rectal cancer medicine?
Regina Beets-Tan: Colorectal cancer screening programmes and modern technology in imaging and endoscopy have resulted in the detection of early and smaller rectal tumours. Multimodality treatment of advanced rectal cancer that combines radiotherapy with chemotherapy, or even with immunotherapy, has resulted in more complete responses, which brings the need for surgery in these cases into question. The focus will be on quality of life. It is going to be more minimal invasive treatment and local tumour excision rather than rectal amputation. We are going for active surveillance (Watch and Wait) for complete responders after treatment. It will be paramount to perform accurate selection and follow-up of patients, and accurately predict who will truly benefit from organ preservation. Modern imaging technology (functional MRI, molecular imaging) together with endoscopy brings us very far. Yet some problems remain unsolved, like the accurate assessment of nodal disease. There is still a lot of work to do and investment in research investigating the role of modern imaging and computing imaging in colorectal cancer management is much needed.
ECRT: What are the challenges facing radiologists today and tomorrow?
Regina Beets-Tan: Radiology surely has challenges lying ahead, but challenges create new opportunities. Imaging technology and computational imaging are used not only in our own discipline but also in the clinical specialties around us. We should not be protective. Fear should not dictate our acts. As much as we learn from clinicians, we need to be willing to teach back. We cannot monopolise knowledge. We can invent and investigate, but after that we need to share. By sharing our knowledge we gain respect. It is without doubt that imaging technology and diagnosis remain the mainstay of radiology. These are skills that are truly ours, for which our clinical colleagues really need us and, above all, respect us. I am convinced that by combining the technological and digital progress with a thorough understanding of the disease and treatment options, we will strengthen our role in the multidisciplinary team.
There could not be a more exciting time for the oncological radiologist, because a new beginning in cancer imaging has just begun.
Wilhelm Conrad Röntgen Honorary Lecture
Thursday, February 28, 12:15–12:45, Room A
Oncologic imaging: a new beginning has just begun
Regina G.H. Beets-Tan; Amsterdam/NL