ESR staff writer Mélisande Rouger was in Madrid on November 8 and took the chance to catch up with members of the Spanish Society of Medical Radiology (SERAM) celebrating the International Day of Radiology.

Fans of medical imaging celebrated the 2nd International Day of Radiology (IDoR) on November 8, with many events taking place all over the world. More than 100 radiology-related societies observed the day and organised their own events, including SERAM, who held a well attended public event at the headquarters of the Spanish Association Against Cancer, in Madrid.

IDoR, which was launched by the European Society of Radiology (ESR), the Radiological Society of North America (RSNA) and the American College of Radiology (ACR) last year, aims to bring radiology closer to the public. This year’s theme was lung imaging, and Spanish radiologists provided clues on how to highlight the role of the radiologist in lung disease management in their lectures last Friday.

From left to right: Dr. Inmaculada Herráez Ortega, Dr. Angel Gayete Cara, Ms. Elena Serrano García, Dr. Joaquin Ferreiros Dominguez, Dr. Carmen Ayuso Colella, Dr. Eva Castañer Gonzalez and Dr. Jesus De La Torre Fernandez.
Photo courtesy of SERAM.

Read more…

B-0816 Breast tomosynthesis versus digital mammography: evaluation of diagnostic potential in women with abnormal screening mammograms

M. Mohamed Aly | Monday, March 11, 10:30 – 12:00 / Room F2

Purpose: To compare the diagnostic potential of digital mammography with tomosynthesis.
Methods and Materials: 100 women with abnormal screening mammograms,187 findings, and definite imaging or histopathological diagnosis were included. The screening mammography interpretation consisted of direct comparison of the tomosynthesis (DBT) examination with full field digital mammography (FFDM) images. The study radiologists subjectively rated the equivalence of the image quality of both the DBT and the FFDM examinations with no use of additional mammography, magnification views or comparison mammography. The next step was categorising the findings in both FFDM and DBT separately according to BIRADS classification and the statistical analysis evaluated the p values of DBT and FFDM as well as their sensitivities.
Results :All findings categorised as BIRADS 3 according to mammography showed reduction in number,particularly for masses, when examined with tomosynthesis. The image quality of tomosynthesis was subjectively rated as equivalent (53.5%) or superior (43.3%) to digital mammography in 96.8% of the total of findings; the test was highly significant (p <0.001). For masses, tomosynthesis image quality was rated as equivalent in 40.5% or superior in 58.1% of findings. Masses were 53 % of findings in which tomosynthesis had superior image quality. The FFDM Sensitivity was of 91.9 % compared with 95.2% for DBT.
Conclusion: The diagnostic potential of digital breast tomosynthesis is superior to that of full-field digital mammography by evaluating their image quality and their sensitivity. Based on a subjective analysis, DBT showed a significantly higher image quality compared with digital mammography in all finding types, especially in the characterisation of masses.

Ultrasound study of the pancreas with CPS (CEUS) and ARFI (elastography): improving the diagnosis of pancreatic tumours

M. D’Onofrio | Friday, March 8, 12:30 – 13:30 / Room L/M

Image fusion enables us to perform a direct, on-screen correlation between a current ultrasound study and a previously performed CT or MRI exam. Using this ability, the spatial resolution of the ultrasound image can be added to the superior overview of a CT or MRI providing additional clinical confidence, lesions first noted on CT or MRI may be more easily detected and characterised on ultrasound and interventions such as biopsies and tumour ablations may be guided by a combination of modalities. Participants in this symposium will become familiar with how image fusion adds another dimension both to diagnostic and interventional ultrasound.

Dear Friends,

To compensate for the subtle findings in the previous case, I am presenting an obvious one in a 69-year-old man with chest pain. What would be your diagnosis before CT?

Check the images below and leave your thoughts in the comments section. The answer will be added on Friday.

1. Endothoracic goiter
2. Aortic aneurysm
3. Thymoma
4. None of the above

Read more…

This year the European Society of Radiology (ESR) will again invite three national radiological societies and a partner discipline to take part in the popular ‘ESR meets’ programme during its annual meeting, the European Congress of Radiology (ECR). Delegations from Russia, home country of ECR 2014 President, Professor Valentin Sinitsyn, Mexico and Serbia will present their latest achievements in imaging. The European Society of Cardiology (ESC) will focus on the cooperation between cardiologists and radiologists in the field of cardiac imaging. The European Federation of Radiographers Societies (EFRS) will also take part in joint sessions with Russian radiographers, to stress the role of this important partner discipline.

Read more…

The International Day of Radiology (IDoR) takes place in just a couple of days’ time, on November 8, and this year the focus is on lung imaging. The ESR chose to approach this theme by creating a book on the subject, with the help of the European Society of Thoracic Imaging (ESTI), which will be published to coincide with this year’s IDoR.

ESTI board members, including several contributors to the forthcoming book, gathered in Vienna recently to discuss plans for their society, so we took the opportunity to ask them why it is necessary to inform the public of the importance of radiology in healthcare.

“Doctors form a team, and in this team radiologists are a very important group, but their role is not so well known. A lot of people think that we are only photographers, but we have a crucial role in making a diagnosis. It’s important for the public to know what role we play,” said Doctor Eva CastaÑer González, a radiologist working at the Corporació Parc Taulí in Sabadell, Spain.

Read more…

Dear Friends,

Today I am presenting the case of a 73-year-old woman who had preoperative radiographs for haemorrhoid treatment.

Check the two images below and leave me your comments and diagnosis in the comments. Come back on Friday for the answer!

Diagnosis:
1. Cyanotic heart disease
2. Acyanotic heart disease
3. No heart disease
4. None of the above

Read more…

In the course of preparing a book on lung imaging that will be published to mark the International Day of Radiology (IDoR), the ESR spoke to Nicola Bedlington, executive director of the European Patients’ Forum (EPF), who shared her views on healthcare in the EU and explained why she chose to participate in IDoR 2013.

ESR: What is the overall aim of your organisation?

Nicola Bedlington: Our vision is high quality, patient-centred and equitable healthcare for all patients throughout the European Union.
The European Patients’ Forum is an umbrella organisation that works with patients’ groups in public health and health advocacy across Europe. Our members represent specific chronic disease groups at EU level, or are national coalitions of patients. We currently represent almost 60 such organisations.
Our mission is to be the collective patients’ voice at EU level, manifesting the solidarity, power and unity of the EU patients’ movement, and to provide a strong and united patients’ voice in order to put patients at the centre of EU health policy and programmes. In this regard we are the key interlocutor with EU institutions on cross-cutting issues affecting all patients.

Nicola Bedlington, executive director of the European Patients’ Forum (EPF)

ESR: What exactly does your organisation do to meet this aim?

NB: The EPF helps to empower patients’ organisations through educational seminars, policy initiatives and projects. We coordinate best practice exchanges between patient organisations at European and national levels. Our programmes also help to strengthen organisational and advocacy capacity.

ESR: Your organisation has experience working with various chronic disease groups. Do many patients suffer from chronic diseases in the EU?

NB: Following consultation with our members we estimate there are at least 150 million patients with chronic conditions across the European Union. This figure is likely to increase given the ageing population.

ESR: Many EU countries face significant health budget cuts, leading to shorter hospital stays and less access to modern equipment (i.e. long waiting lists for MRI exams). How can patient care be promoted in this context?

NB: The EPF is working with its member organisations to ensure health is seen as an investment, and patients are not perceived as purely cost drivers. Major health inequalities exist across the EU which impact enormously on patients’ access to care.
Building on the three pillars of quality information, health literacy and empowerment, patients can be agents of change and sources of innovation, particularly in terms of equity and sustainability of care. There need to be meaningful opportunities for patient involvement throughout the healthcare sector. We promote meaningful patient involvement in all forms of innovation, whether it is in high or low technology, pharmaceuticals, information technology, social change or systems change. The patient community seeks partnerships with researchers, policy-makers and industry in order to achieve greater impact in this arena.

Read more…

Dear Friends,

Muppet saw this case while looking at daily chest radiographs and it caught his attention. We looked at the patient’s history and found that she was a 64-year-old female with back pain, who had a well-differentiated liposarcoma removed from her right thigh seven years earlier.

Do you see anything?
What do you think it is?

Check the images below and leave your thoughts in the comments section. The answer will be posted on Friday.

Read more…

B-0948 Computed tomography of the bowel: a prospective comparison study between four techniques

M. Revelli, F. Paparo, L. Bacigalupo, A. Garlaschi, L. Cevasco, E. Biscaldi, G. Rollandi | Monday, March 11, 14:00 – 15:30 / Room E2

Purpose: Our purposes were to compare the grade of bowel distension obtained with four different CT techniques dedicated for examination of small intestine (CT-enteroclysis and CT-enterography), colon (CT with water enema), or both (CT-enterography with water enema) and to assess patient tolerance towards each protocol.
Methods and Materials: We recruited four groups of 30 patients. Each group corresponded to a specific CT technique, for a total of 120 consecutive patients (65 male, 55 female; mean age 51.09±13.36 years). CT studies were evaluated in consensus by two gastrointestinal-dedicated radiologists who performed quantitative and qualitative analysis of bowel distension. Presence and type of adverse effects were recorded.
Results: CT-enteroclysis provided the best distension of jejunal loops (median diameter 27mm; range 17-32mm) compared with all other techniques (p<0.0001). Frequency of patients with an adequate distension of the terminal ileum was not significantly different among the four groups (p=0.0608). At both quantitative and qualitative analysis CT with water enema and CT-enterography with water enema determined a greater and more consistent luminal filling of the large intestine compared with the one provided by both CT-enteroclysis and CT-enterography (p<0.0001 for all colonic segments). Adverse effects were more frequent in patients from the CT-enteroclysis group (p<0.0028).
Conclusion: CT-enteroclysis allows an optimal distension of jejunal loops, but it is the most uncomfortable CT protocol. When performing CT with water enema, an adequate retrograde distension of the terminal ileum was provided in a high percentage of patients. CT-enterography with water enema provides a simultaneous optimal distension of both small and large bowel.