Watch this session on ECR Live: Thursday, March 5, 16:00–17:30, Room L1
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Imaging large cohorts of people enables scientists to collect information useful for science and emphasises radiology’s role in healthcare. From the most recently available imaging biomarkers to data such as genomics and metabolomics, Thursday’s dedicated Professional Challenges Session will show just how useful population imaging studies have become in the prognosis of countless diseases.

When radiologists follow a cohort of people for 20 or 30 years, the benefits for the patient increase tremendously. If a radiologist performs a CT examination of a patient’s coronary arteries and finds calcification, chances are that the patient will have a heart attack within the next few years. Unfortunately at this stage, the patient is usually out of the radiologist’s reach.

The fluid-attenuated inversion recovery axial image of a 26-year-old female participant shows multiple, bilateral, asymmetric, linear and ovoid hyperintensities that are located perpendicular callososeptal characteristic of multiple sclerosis

However, if patients chose to participate in a population study, they will be checked on a regular basis, and radiologists will be able to access previous information and initiate appropriate treatment earlier, significantly
improving patient outcome.

Securing imaging data is always tricky and population imaging studies are an opportunity for radiologists to access this data. Showing the relevance of imaging findings highlights radiology’s role in the medical continuum, according to Prof. Norbert Hosten, of the Ernst-Moritz-Arndt University in Greifswald, Germany, who will chair
the session Thursday.

“Our way to prove that radiology can make people healthier and happier is to do large population imaging studies. Radiology can develop the kind of data that are necessary to prove that our methods really help the patient,” he said.

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Watch this session on ECR Live: Thursday, March 5, 8:00–10:00, Room E2
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Radiology is changing. Its possibilities are expanding; its place in healthcare has evolved. However, it has also become more vulnerable to financial turmoil. The future of the profession will depend on how radiologists decide to act and how well they can cope with external factors, a panel of experts will explain during today’s Professional Challenges Session at the ECR.

Prof. Gabriel Krestin,
from Erasmus MC,
University Medical Center
Rotterdam, will
speak about upcoming challenges
for radiologists in today’s session.

The emergence of quantitative imaging and the development of imaging biomarkers are transforming the face of radiology. An increasing number of biomarkers are being validated and accepted as measures for prognosis, diagnosis or therapy monitoring. The transition from research to clinical practice has started in many areas, and clinical radiologists have become aware of this evolution. They must learn how to use these new tools, but it is tempting to resist change, especially when it brings extra work, according to Prof. Gabriel Krestin, professor and chairman of the department of radiology at Erasmus MC, University Medical Center Rotterdam, the Netherlands.

“Radiologists don’t like to perform measurements in daily practice because they are not used to it. They haven’t been trained for that and it’s time consuming. For instance, if you do a cardiac examination, extracting quantitative data from that examination takes up to 30 minutes, so you need dedicated personnel to do that – preferably radiographers. The workflow of the radiologist could be seriously disrupted if he/she had to perform such extensive post-processing of images, and the consequence would be a decrease in efficiency, particularly because nobody pays for the additional measurements,” he said.

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Watch this session on ECR Live: Wednesday, March 4, 16:00–17:30, Room E2
Tweet #ECR2015E2 #PC4A

Remember HAL 9000, the murderous computer in ‘2001: A Space Odyssey’? This scenario doesn’t seem too far off when it comes to radiologists and the constant evolution of their technology. Luckily, they can still stay in control if they change their behaviour and remain at the head of the imaging process, experts will argue during a Professional Challenges session today at the ECR.

Radiologists must claim their place in the medical team if they are to survive. They must come out of the shadows and show that they can bring added value to the team, according to Jim Reekers, professor of interventional radiology at the University of Amsterdam, who will chair the session.

Jim Reekers, from the
University of Amsterdam, will
chair the session on the role of the
radiologist.

“I want to make my colleagues aware that they should step out of their offices and act as doctors who work in multidisciplinary teams. Being the photographers or doctors who only give a report with a picture will not secure their future and the reason is very simple: anybody can make and look at a picture nowadays. The difference the radiologist brings is that he or she can give an interpretation of the picture within the context of a patient’s clinical situation. So the radiologist should become a doctor who gets involved with the patient’s situation,” he said.

There is more than one way to do this. For starters, to be on the same level as clinicians, radiologists must behave as such. That means they have to do more than just show the images in multidisciplinary team meetings, they have to sit and discuss them with the doctors.

“Have a junior show the images for you. While my junior presents the pictures, I am sitting together with the other specialists, and suggesting treatment and follow-up options or further diagnostic investigation. It is important to sit with the other doctors. There’s a big difference in how people see me. I’m one of them instead of being the guy who shows the pictures,” Reekers said.

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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.

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With the development of functional imaging, the way patients are imaged has changed, and so has the role of the radiologist. While taking pictures in the basement of a hospital was considered good enough in the twentieth century, radiologists are now required to act as clinicians within multidisciplinary teams. Subspecialisation has become necessary for radiologists in order to keep their leading position in image interpretation. But that is not the only field where radiologists should take the lead, some experts believe. If radiologists were to increase their contribution further up in the diagnostic phase, it would have a significant impact on clinical outcomes and healthcare management. A panel of eminent radiologists will explore ways to do so during a dedicated Professional Challenges Session at ECR 2013.

Professor Andy Adam, professor of interventional radiology at the University of London, will speak about the role of the radiologist in the 21st century.

In the past, radiologists were expected to act as technicians with excellent knowledge of the anatomy. But with the creation of functional imaging, things have become more complicated. The capacity to depict and interpret functions using MRI or PET/CT scans calls for more than the ability to read images, and now thorough knowledge of functional processes and organ systems is expected of radiologists.

Meanwhile, many physicians have been increasingly working with images in recent years. For instance surgeons rely on images to prepare for an intervention, and so do radiotherapists to determine the necessary dose and precise location of a tumour to be destroyed. As their experience with reading images is growing, it is likely that these specialists will find it easier to do so without the help of radiologists in the future.

To put it in a nutshell, if radiology is to achieve its full potential, radiologists will have to make a clinical contribution as well. “If radiologists wish to retain their role as experts in image interpretation, they will not only need a thorough understanding of imaging, but also a detailed understanding of anatomy and pathophysiology, and they will need to subspecialise. That is really something we have to take into account in the future. Radiologists will have to get closer to the patient and talk to the referring physician or surgeon. They will have to become more like clinical doctors than they have been until now,” said Andy Adam, professor of interventional radiology at the University of London.

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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.”

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