Watch this session on ECR Live: Wednesday, March 4, 08:30–10:00, Room E1
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Hearing loss can present many difficulties and obstacles to sufferers, and with ageing populations it’s set to become a major healthcare challenge. Many conditions such as congenital malformation of the inner ear or hypoplastic cochlear nerve can also lead to hearing loss, and sometimes deafness.

Fortunately, many new treatments are available to recover hearing, both partially and completely. Imaging plays an increasingly important role in therapy planning and follow-up, and there is hope on the research front, experts will show during a dedicated Special Focus session on Wednesday morning.

Microtia – congenital anomaly of external and middle ear, resulting in
conductive hearing loss. External auditory canal is not patent (arrow),
mastoid process is underdeveloped (arrowhead)

The prevalence of auditory problems in the Western world has doubled over the past 30 years. It is estimated that between 15 and 17% of the population will suffer hearing loss, due to ageing or congenital malformation, but also bad habits, according to Agnieszka Trojanowska, a radiologist at Lublin University Medical School, Poland, who will
chair the session.

“We start to see young adults in their early 30s with sensorineural hearing loss or other related problems because of high frequency noise, which is typical for listening to music. Twenty years ago, such a condition was linked with working in fabrics or on the street. But the good news is that even if you use your iPod a lot, the degree of hearing
loss is light to moderate, so this is not something that will considerably affect your life,” she said.

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Watch this session on ECR Live: Monday, March 10, 08:30–10:00, Room B
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Shoulder imaging and intervention are becoming more important in clinical practice as ageing populations and patient expectations have increased demand. The shoulder is also one of the joints in the human body that can suffer from a number of pathologic conditions, in both young and elderly patients, such as rotator cuff tears and tendinosis, subacromial-subdeltoid bursitis, calcific tendinopathy, and degenerative conditions.

Shoulder imaging and surgery have developed in parallel over the last 20 years, and the introduction of minimally invasive surgical techniques has revolutionised shoulder interventions, which have been facilitated by accurate pre-operative diagnosis. The shoulder is an anatomic area that is very commonly evaluated with musculoskeletal ultrasound as it is accurate, quick, cheap, easily performed, well-tolerated by patients and can be combined with a dynamic examination and interventional procedures.

“MRI provides more general information about the shoulder, but many patients find the examination unpleasant due to noise and pain. Others are excluded from MRI because of claustrophobia or having an embedded electronic device such as a pacemaker. Also MRI cannot be performed as a dynamic examination, it often misses rotator cuff calcification, and the equipment is very expensive. As in many other fields, both techniques rely on high-quality equipment and are operator or interpreter dependent”, said Dr. Ian Beggs, musculoskeletal radiologist at the Royal Infirmary of Edinburgh.

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Watch this session on ECR Live: Monday, March 11, 16:00–17:30, Room F1
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Tablet computers can be a surprisingly divisive subject. The passion with which some people argue the relative merits of competing devices and operating systems can be almost frightening. In the field of medicine, however, there appears to be very little argument about the top product, with professionals from many disciplines enthusiastically embracing the iPad as a tool for research, education and general communication. Instead the most important debate is focused elsewhere, on matters of data security and patient privacy.

As mobile technology spreads throughout the hospital, data naturally follows, and it is slowly falling into the hands of an increasingly broad spectrum of people. Radi-ologists and clinicians therefore need to be aware, not just of the many mobile applications and resources that can potentially aid their work, but of the associated risks and best practices concerning the use of tablet technology.

Dr. Erik Ranschaert (left – pictured here with Dr. Jan Schillebeeckx) from ‘s-Hertogenbosch, the Netherlands, will speak on mobile telera-diology with tablet computers in this Special Focus Session

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Watch this session on ECR Live: Monday, March 11, 08:30–10:00, Room N/O
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Organ-sparing surgery and radiation treatment such as intensity-modulated radiotherapy (IMRT) – often combined with chemotherapy – have increased the need for advanced imaging in the head and neck during pre-treament and post-treatment stages. Precision is vital as any tumour that remains undetected outside the treatment field could adversely affect the patients’ prognosis and survival, according to Professor Vincent Vandecaveye, from the department of radiology at the University Hospitals Leuven in Belgium.

It is important to spot any tumour recurrence as early as possible, especially in the post-treatment phase, in order give the patient the best possible chance of salvage treatment. The most common imaging methods in the head and neck area remain CT, MRI and PET-CT; each comes with its own advantages and disadvantages.

Multiparametric MRI for early treatment prediction of chemoradiation in oropharyngeal cancer: Upper row is pre-treatment MRI of right base of tongue cancer (a=contrast enhanced T1 as anatomical correlate; b=native b1000 diffusion-weighted image; c= ADC-map; d=perfusion-map of IUAC). Middle row is 2 weeks during chemoradiation: same imaging sets, tumour volume will not help. No significant change in b1000, ADC nor perfusion-MRI indicate non-response and thus high risk of tumour relapse after end of treatment. Tumour relapse at PET-CT 8 months after end of treatment, proven by histology (k). (Provided by Professor Vincent Vandecaveye)

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Watch this session on ECR Live: Sunday, March 10, 14:00–15:30, Room Z

The ability to spot pathological imaging findings among normal post-mortem signs of degeneration may not be a universal skill among radiologists, but it could prove to be a useful, if not essential one. As the reliability of modern forensic imaging rapidly improves, forensic pathologists are increasingly seeking the help of radiologists to examine bodies non-invasively, so they should be prepared to answer that call, according to experts who will speak in a Special Focus Session on ‘Advances in forensic imaging’ today. The development of techniques such as spiral volumetric CT and, more recently, MRI, have dramatically improved the ability of radiologists to determine causes of death and detect other crucial post-mortem signs, providing an invaluable service that can supplement, and in some cases replace, traditional autopsy.

Bone and metal maximum intensity projection (MIP) reconstruction (a) and volume-rendered (VR) 3D-CT reconstruction (b). Homicidal death: characteristic bony and metallic fragments on the exit side of the skull, where the bullet caused a large loss of brain, leading to shattering of the skull.

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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.

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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Intensive care units are special working environments, presenting radiologists with complex cases and patients with severe conditions. Diagnostic imaging examinations and the work of the radiologist have to be adapted towards these special circumstances, which can be one of the biggest challenges when working in an intensive care unit. Today there is a strong need for accurate, clinically relevant radiological input, which often has to be worked out while facing a lack of adequate image material and patients suffering from life-threatening conditions.

Prof. András Palkó from Szeged, Hungary, will chair the session on imaging in intensive care patients.

The ECR 2013 Special Focus Session on imaging in intensive care patients, chaired by ESR Past-President, Professor András Palkó from Szeged Medical School in Hungary, will give an up-to-date overview on the use of common imaging methods in the ICU environment. Special Focus Sessions are clearly aimed at in-depth analysis and the promotion of scientific debate between the speakers and their audience.

“The intensive care unit is a very special environment requiring special expertise from both the technicians and the radiologists working in a technically challenging situation. The patients are typically in very severe conditions, frequently unconscious, and almost always connected to life-support and monitoring equipment,” Prof. Palkó pointed out some of the difficulties of working in an ICU.

As a result of this, the majority of imaging examinations are performed on patients with limited ability to cooperate and often at the bedside. Reports are then typically written with insufficient clinical information, based on technically limited images, even though the need for accurate imaging material and radiological information is even greater than in standard clinical settings.

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The optimisation and justification of procedures is vital when using CT as an imaging modality; particularly on children, who are more sensitive to ionising radiation than adults. Therefore, it is crucial that all those who use CT understand the physics behind the equipment and ultimately use this understanding to minimise the potential risks while maximising the potential benefits to each individual patient. Patients should also be informed of the risks and benefits of undergoing a CT scan. World-renowned experts will explain these issues in detail during a Special Focus Session at ECR 2013.

“Not all radiologists and technicians are aware of the latest dose reduction strategies. Some are not necessarily so well-informed and perhaps do not realise how important this is. We believe that it is a question of trying to get everybody to a certain level of knowledge and expertise,” said Dr. Catherine Owens, paediatric radiologist and CT unit lead at Great Ormond Street Children’s Hospital in London, U.K.

Fig. 1

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