ECR TODAY 2007 Daily news from Europe’s leading imaging congress
SUNDAY, MARCH 11, 2007
Published by the European Society of Radiology
Journal editors Molecular Downhill world focus on high imaging probes cup goes to standards fatty plaques Swiss veteran
See page 3 See page 7 See page 7 Fix your systems to cut error rates Inside Today Radiology must learn from the auto- systemic errors causing up to 98,000 motive and aviation industries to deaths per year and costing US$50 eliminate errors and improve patient billion a year. Errors are oft en not safety. Th at is the view of Dr. William recorded, and complications are R. Brody, president of the Johns Hop- expected and even rewarded. • EU funds for imaging kins University in Baltimore, Mary- research land, US, who delivered Saturday’s He urged radiologists to consider p. 3 W.C. Röntgen Honorary Lecture. implementing the Toyota approach to quality. It is based on a zero-defect • Impressions from “When an error occurs, it is every- mentality that is driven from the bot- the second day of one’s responsibility, not just one tom upwards and is built-in, not con- the congress person,” he said. “Our current atten- tracted out or enforced from above. p. 5 tion has been focused on assigning Th e company’s strategy is based on blame rather than fi xing the system empowering its workers, encourag- • Cardiovascular that creates the problems. We have ing teamwork and communication, MRI targets to begin by admitting that hospitals and simplifying every procedure. Dr. William R. Brody from Baltimore atherosclerosis cause many fatalities due to serious Lessons can also be learnt from the p. 7 and preventable errors.” aviation industry’s rigorous policies ers, and infections from in-dwelling build and implement quality systems. on crew resource management. central venous catheters. Th e Center Th e number one killer disease in the for Innovation and Patient Safety was “Th e key to reducing medical errors ments in safety represent by far the US is not cancer or heart disease but Staff at Johns Hopkins identifi ed three established, and small groups were set is to set an audacious goal of zero greatest opportunity to improve variability in care, Brody said. Vari- main problem areas: medical errors, up to redesign processes. Manage- errors. Th at aft er all is what the patient care, but hospitals must ability in the delivery of care leads to poor communication among care giv- ment consultants are never used to patients expect,” he said. “Improve- invest in safety, not cut costs.”
Stroke care demands a fresh approach
By Paula Gould stroke. Th is is where radiologists fi t in. all strokes are equal, but in reality Results from recent clinical trials to its ability to dramatically reduce the “Th e goal of imaging is to diagnose the they are not, said Prof. R. Gilberto show that the time window for treat- risk of haemorrhagic transformation In the developed world, around precise type of stroke so that appro- González, chief of neuroradiology ing stroke could be extended, possibly and true intracerebral haemorrhage. 10% to 15% of patients die following priate management can be promptly at Massachusetts General Hospital, up to nine hours. Th ese same trials acute stroke, 30% to 60% will survive implemented in each patient,” said Dr. Boston. What is needed is a triage have also validated the concept of an Dedicated stroke centres should with long-term disabilities, and 20% Majda M. Th urnher, associate profes- protocol that takes account of the ischaemic penumbra, that is, an area ensure they have the manpower to to 25% will require a hospital stay. sor of neuroradiology at the Medical diff ering physiology of acute ischae- of potentially salvageable tissue sur- carry out these techniques day and Th ese frightening statistics could be University of Vienna. mic strokes. rounding infarcted, dead brain. Imag- night and during holiday periods, he improved if radically diff erent strat- ing may be used to identify the pres- said. Th ey should also be prepared to egies were adopted for managing Th e current standard of practice is “Th ings are changing. We are at a ence of this penumbra. deal with more complex neurovascu- stroke patients, according to speakers to send patients for thrombolytic crossroads in terms of stroke therapy,” lar cases, since some patients present- at yesterday’s state-of-the-art sympo- therapy within three hours of symp- he said. “We are about to change the An increasing number of stroke ing with ischaemic stroke symptoms sium. tom onset. Once this time window paradigm.” patients are being treated with may actually have subarachnoid has passed, then treatments such as endovascular methods rather than haemorrhage or a ruptured aneu- Selecting who is likely to benefi t from intravenous tissue plasminogen acti- No more than 6% of potential patients thrombolytic therapy, said Prof. rysm. intervention is essential for eff ec- vator (tPA) are not generally con- with ischaemic stroke receive tPA Michael Forsting, chair of radiology tive management of acute ischaemic sidered. Th is protocol assumes that at present. González blames this on and neuroradiology at the Univer- “Th ere is no space for small stroke the strict three-hour time window, sity of Essen. He recommends that centres. We have to think big,” he said. and the marginal cost-benefi t ratio. mechanical recanalisation is included “We need a lot of people who can treat A study of 230 consecutive patients in any endovascular repertoire, owing these patients.” undergoing tPA at MGH, however, revealed how patients’ outcome was strongly linked to the precise nature of their stroke, as observed on imag- ing. Th e results implied that the tPA success rate could be boosted signifi - Costs down – quality up. cantly if it was only off ered to patients Proven Excellence. who had suff ered a minor stroke. Leading edge refurbished systems. “A minority of strokes are due to Proven Outcomes in Refurbished Systems. proximal occlusions, approximately Healthcare budgets are tight, but the demand for latest 25%, but they account for the major- technology equipment is growing. We offer tailor-made ity of poor outcomes, virtually all solutions world wide, with outstanding price/performance ratios and new equipment warranties. the deaths, and the majority of costs. We are there for you at ECR, EXPO D. Th ese are the ones that are less likely to be recanalised by intravenous tPA,” www.siemens.com/proven-excellence Prof. Majda M. Th urnher from Vienna Prof. R. Gilberto González from Boston González said.
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myESR.org ECR TODAY HIGHLIGHTS SUNDAY, MARCH 11, 2007 3
Journal editors get tough on dubious research
By Paula Gould Prof. Albert L. Baert, editor-in-chief the journal considers to be a dupli- of European Radiology. cate publication, and what possible Th e web is oft en blamed for making sanctions may be imposed on the it easier to commit plagiarism, yet “Some authors are so eager to have discovery of such a paper. Most the reverse seems to be true in the another citation with their name on identical or overly similar publica- realm of radiology research. Inter- the manuscript that they reveal that tions are fl agged up by reviewers net access and web-based tools are they have submitted the same or following online citation searches, making it easier to identify possi- similar manuscript to another jour- said Prof. Anthony Proto, editor of ble duplicate papers, according to nal,” he said. Radiology. But again, the discovery the editors of three leading jour- of dubious authorship may be down nals. Baert will write to an author per- to luck. sonally if any doubts are raised Th e American Journal of Roent- about research submitted to Euro- “On three separate occasions, genology moved to a new web- pean Radiology. Th e author’s view another journal sent the same paper based online submission and peer of what constitutes original research to the same reviewer at the same review system in February 2007. will oft en vary from that of the jour- time. What a coincidence that is,” he Th is programme provides review- nal. Many radiologists believe that said. “We have also been informed ers with direct links to related top- taking data they have reported on of a duplicate publication by a ics, and allows them to search for previously and performing a diff er- librarian who picked up the same work produced by the same author. ent kind of analysis does not class as article published twice.” Sometimes this reveals some inter- duplication. Baert begs to diff er. Taking a hard line on duplicate publication are Prof. Robert Stanley, Prof. Albert L. Baert, esting duplication of eff ort, said Proto will always ask authors of and Prof. Anthony Proto. Prof. Robert Stanley, editor-in- Discovering dud papers is still some- suspected duplicates to justify why chief of AJR. times due to pure serendipity. In one their paper is not redundant. If he is prevalent it is, how oft en it occurs, more and more diffi cult for authors memorable case concerning AJR, a unconvinced by the explanation, the I really don’t know. But I think the to duplicate.” “We do worry about that, but we are reviewer found himself reading a paper will then be passed to selected online scenario is going to make it getting on top of duplication a lot paragraph that seemed oddly famil- associate editors or deputy editors. more than was possible in the past iar. He then realised that the section If they agree unanimously that the when the Internet didn’t exist,” he had been lift ed word for word from paper is unoriginal, and the author said at Saturday’s Ask the Editors one of his own papers. still disputes this, then Radiology session. will issue a notice and notify univer- “Th e editors can do so much and so sity offi cials. Variety adds spice to lives Reviewers assessing the quality of can the reviewers, but sometimes a paper can now use online tools to you just have to be lucky,” Stanley “We have published probably four or check the relevance of citations. Th is said. fi ve notices of duplicate publications of Austrian radiologists process may inadvertently uncover since I have been editor,” he said. almost identical publications that Radiology’s guidelines for authors “So it is not commonplace, at least By Philip Ward Radiologists must recognise injuries are being considered elsewhere, said include a section explaining what in terms of our recognition. How from rock climbing, said Dr. Andrea Versatililty and resourcefulness Klauser, also from Innsbruck. Th e are essential everyday qualities for upper extremities account for 75% Austrian radiologists, it seems. If of injuries and overuse syndromes. the Wiener Schnitzel, Sachertorten, A missed diagnosis leads to persist- and fi ne wine are not creating health ent pain, early osteoarthritis, and Europe pledges cash to support problems, then the national obses- restricted use of motion and fl exion sion with active sports is doing so. contractures. Dynamic ultrasound is the main imaging modality used knowledge economy Presenters at Saturday’s ECR meets in these cases. Austria session gave extensive By Frances Rylands-Monk Dr. Jean-Luc Sanne, neurobiologist ing research, and so does patient details about imaging of lifestyle- Prof. Dr. Herwig Imhof, chairman and scientifi c offi cer in diagnostics care. Dr. Silvana Del Vecchio, induced disorders. On leaving the of the department of radiology at Calling all budding imaging at the health directorate of the DG nuclear medicine physician at the packed lecture hall, the audience the Medical University of Vienna, researchers: proposals under the Research at the European Commis- Federico II University Hospital of must have felt like refraining from provided reassurance that overall, European Commission’s 7th Frame- sion in Brussels. Naples in Italy, called for diagnostic all such activities. radiology in Austria is in excellent work Programme (http://cordis. imaging to be more molecular, espe- shape. Over 2.4% of gross national europa.eu/fp7) are due by April 19, “Funding became necessary to pro- cially in oncology. “Because tumours Mountain-biking injuries are product was invested in research with a second deadline of Septem- mote Europe above its competi- are molecularly diff erent in each increasingly common. Up to half in 2005, compared with less than ber 18. Th e EU is keen to assure tion and is in line with the Lisbon patient, doctors should treat patients of injuries tend to be of an ortho- 0.9% in 1993, and imaging receives its future fi nancial health through Agenda established four years ago. diff erently based on the cancer traits paedic nature, while other aff ected a decent share. Th is is in stark con- a robust R&D base in science and We want to be the best economy of their tumours,” she said. areas are the head, spine, chest, face, trast to the 1940s, when more than technology, and wants to avoid a in the world so we are relying on abdomen, neck, and genitourinary 50% of staff in the medical faculty further brain drain to the US and innovation,” said Sanne, who spoke Proliferation without limits is an region, according to Dr. Ferdinand in Vienna had to leave their jobs or Asia. Funding of €3–12 million is at Saturday’s molecular imaging ses- important feature of cancer cells, Frauscher, from the department of were killed in the second world war, available for many projects. sion run by the European Federa- and she off ered this as an exam- radiology II at the Medical Univer- he said. tion of Organisations for Medical ple of how imaging can help tailor sity of Innsbruck. Th e seven-year FP7 boasts a €50.5 Physics (EFOMP). treatment. “If you can look at prolif- Imhof recognised the contributions billion budget and a specifi c inter- eration, you can monitor both anti- “Mountain biking can cause scrotal of many famous Austrian radiolo- est in new drug development and Th e economy stands to gain from proliferative therapy and therapy for injuries and may cause fertility prob- gists, especially Guido Holzknecht, medical imaging, according to advances made in molecular imag- other biological processes in cancer lems, but with the use of protective Robert Kienböck, Arthur Schüller, through molecular imaging.” measures the risk can be markedly Martin Haudek, Ernst Georg Mayer, reduced,” he said. “A saddle-suspen- and Felix Fleischner. Del Vecchio supports starting from sion system results in a signifi cant a biological standpoint to work out decrease in the amount of shock.” a hypothesis of expected evidence, then to decide which modality to Frauscher has just completed a use based on spatial resolution study of 85 mountain bikers with a and the sensitivity required to best median age of 25 years and 50 on- image that evidence. road cyclists with a median age of 23. Testicular and extratesticular While the vision of translating cur- disorders were much more frequent rent research to a clinical setting is in the former group. He noted that an exciting prospect, doctors won- scrotal pathology in mountain bik- der if it will bear out in the reality ers may result from a high rate of of daily practice. A resounding yes repeated microtrauma of the scrotal came from Del Vecchio and col- contents, causing testicular vascular Dr. Jean-Luc Sanne from Brussels Dr. Silvana Del Vecchio from Naples leagues in the audience. “We are damage. Th is is a possible reason for close,” she said. pathological semen profi les. Dr. Ferdinand Frauscher from Innsbruck
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myESR.org ECR TODAY HIGHLIGHTS SUNDAY, MARCH 11, 2007 5
Harry’s highlights from second day of ECR 2007 Our dedicated photographer, Harry Schiffer, fought his way through the crowds to find out who was making the news during the second day of the congress. On this page is a selection of what he saw through the lens of his camera. More photos from Harry will appear in tomorrow’s edition of the daily newspaper.
A press briefi ng on ‘Th e Future of Medicine – Medicine of the Future’ was held at the Hotel Imperial on Saturday morning. Th e panel of experts discussed the diseases of the 21st century and the research race Prof. Gerhard Mostbeck, President of the Austrian Society of Radiol- between the US and Europe. ECR President Prof. Christian J. Herold ogy, moderated yesterday’s well attended ECR meets Austria session moderated the session, and the speakers were Dr. William R. Brody, on imaging of lifestyle-induced disorders, together with ECR 2007 Prof. Philippe Grenier, Prof. Liselotte Hojgaard, Dr. Elias Zerhouni, President Prof. Christian J. Herold. Dr. Stephen Golding and Dr. Wolfgang Schütz.
Delegates seeking a boost of vitamin C can treat themselves to a glass of freshly-squeezed fruit juice. Visitors to the heavily laden fruitstand, located on the fi rst level, can choose from oranges, apples, bananas, pineapples or mangoes.
Many radiologists have a passion for photography outside of work. Just take a look at the stunning exhibition of landscape and portrait photos on the ground fl oor of the Austria Center. From the large number of entries, the judges had to select 10 photos to display at ECR. Shown here are Th e True Colours of Nature, by Dr. Baki Yagci, Denizli, Turkey; Th e Mask, by Dr. Lothar Ponhold, Vienna; Noon Nap by Dr. Richard Schoenfeld from New Jersey, US; Give Peace a Chance, by Jack Cumming, Bedford, Massachusetts. Th e organiser was Prof. Franz Kainberger, and Prof. Michael Fuchsjäger was head of the jury. A new hands-on workshop entitled ‘Dancing with Workstations’ off ers insight and experience in a range of powerful workstation applications. Th e workshop focuses on computer-aided diagnosis, quantitative image analysis and interactive 3D visualisation.
You may have noticed that people have tended to take a little longer than usual over their toilet breaks during ECR. Th e reason? Some thought-provoking quotes are displayed on the mirrors in the lava- tories throughout the Austria Center. ECR Today’s Managing Editor, Julia Patuzzi, chose these quotes. Take a look for yourself, but make sure you don’t miss that all-important lecture …
If you’re suff ering from aches and pains aft er the fi rst two arduous days at the congress, then make sure you spend some recuperation time at the massage centre, located close to Room G/H on the lower level. Th e service is free of charge, showing just how much ECR cares for its delegates. Th e centre is run by MorEnergy, Vienna, and is sponsored by Siemens. Th ousands of delegates fl ocked to yesterday’s early morning sessions – the hot topics presented in the educational and scientifi c programme being much more enticing than an extended late-morning breakfast.
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myESR.org ECR TODAY HIGHLIGHTS SUNDAY, MARCH 11, 2007 7
Cuche crowned Hearts leap as cardiovascular downhill champion molecular imaging edges forward
Swiss veteran Didier Cuche secured Bad conditions meant the race was By Frances Rylands-Monk to be characterised for prompt and Annexin A5, a protein which binds this year’s World Cup downhill title interrupted for 90 minutes because appropriate action. to all dominant features of vulnerable when he won his fi rst race of the sea- of poor visibility and at one stage it In conventional imaging both sta- plaques including apoptosis, infl am- son in the campaign’s penultimate seemed as though it could be can- ble and dangerous plaques have a Due to its multi-component compo- mation and intra-plaque rupture, race in Kvitfj ell, Norway. Th e victory celled. “I nearly started celebrating very similar appearance, but new sition, plaque is a tricky pathology may provide an ideal targeting agent gave Cuche his fi rst major title in over when they were about to cancel the techniques using contrast-enhanced to image, sometimes moving from with increasing uptake associated 10 years of racing, as he is 168 points race,” said Cuche. “It was not easy to high-resolution MR molecular imag- fatty streak to complex plaque in a with plaque instability, according to ahead of Marco Büchel from Liech- re-focus when they decided to con- ing can help to determine when to single lesion and needing multi-con- Dr. Leonard Hofstra, a cardiologist at tenstein with just one race remaining. tinue the competition but I was able treat atherosclerotic plaques and trast MRI characterisation and a 3D the University Hospital of Maastricht, Canada’s Erik Guay was 0.06 seconds to and I’m really happy with the way I when to leave them alone. approach to study the spatial progres- the Netherlands. He hopes that the behind in second place while Büchel skied and the way I kept my nerve. It’s sion of the disease. binding abilities of Annexin could be was a further 0.23 seconds back. Th e a great feeling aft er all the fi ghts I’ve “Doctors need to distinguish between applied to other diseases. Austrian Michael Walchhofer came in had over the last two years. It’s amaz- stable plaques and unstable lesions “Th e biologist needs to identify fi ft h, and Peter Fill from Italy sixth. ing; I can’t explain what I’m feeling that have the potential to rupture,” exactly what’s going on in terms of “Agent uptake could be predictive of right now.” said Dr. Emmanuelle Canet Soulas, the plaque’s chemical content, such conditions such as heart failure and physiologist and MRI researcher at as the presence of macrophages or scar formation, but larger studies are the University Hospital of Lyon in lymphocytes, a thin fi brous cap and needed,” said Hofstra, adding that France. In cases of atherosclerosis, the likelihood of apoptosis,” she told molecular imaging is pivotal in the leading cause of mortality in Western attendees at Saturday’s mini-course development of drug targeting. countries, vascular wall disease needs on molecular imaging. “Targeted agents could also be loaded Multiple cellular targets such as mac- with drugs that kill tumour cells and rophages, smooth muscle cells, and act like biological cruise missiles,” he T-lymphocytes, as well as molecular said. Such targeting could result in targets such as infl ammation, throm- better treatment of cancer with fewer bus, enzymes and receptors, require side eff ects. While improved therapy a multiple strategy involving agents is an important aspect of such inno- that bind to the specifi c components. vative techniques, doctors are keen to underline the advantages of this Th e next step is for a pharmaceuti- relatively non-invasive tool for early cal study of MR-specifi c probes in detection. Mantra-style, Hofstra Swiss veteran Didier Cuche wins downhill world cup for the fi rst time. the aortic arch and carotids in mice, reiterated the last line of his opening according to Canet Soulas. It could be Chinese proverb: superior doctors another fi ve to ten years before clini- prevent the disease.
Dr. Emmanuelle Canet Soulas from Lyon cal trials in targeted molecular imag- -??4!+%9/5PDFing is initiated in humans.
PS 1 Bright or not so bright? The future of biomedical imaging and imaging research
Sunday, March 11, 12:15–13:15, Room B
Moderators: N. Gourtsoyiannis; Iraklion/GR DcZYZhi^cVi^dc#BVcneVi]h# C.J. Herold; Vienna/AT
E.A. Zerhouni; Baltimore, MD/US The role of imaging sciences in medicine of the future: View of the NIH LZ aaiV`Z
L. Højgaard; Copenhagen/DK ndji]ZgZ Time for a new perspective in medical imaging research: View of the European Medical Research Councils (EMRC)
3-D x-ray acquisition NdjggVY^dad\nYZeVgibZciVcYndjgeVi]idY^\^iVa^hjc^fjZ#NZi!ndjg\dVaidegdk^YZi]Z]^\]ZhiaZkZad[ XVgZ^hh]VgZYldgaYl^YZ#LZ`cdl#;djcY^c&d[ZkZgn']dhe^iVah!6\[V=ZVai]8VgZldg`hVadc\h^YZ GE’s VolumeRAD 3-D x-ray application provides physicians with multiple high- gVY^dad\^hihZkZgnYVn#DjghnhiZbVi^XhiZehid^ciZ\gViZYY^\^iVagVY^dad\nVaadlndjidVYkVcXZVindjg resolution slice images of the human anatomy, including the chest, abdomen, dlceVXZ!l^i]dji_ZdeVgY^o^c\XjggZcihnhiZbhdg^ckZhibZcih#I]^hVaadlhndjidX]ddhZi]Zhdaji^dch ndjlVci/VYkVcXZY^bV\^c\hnhiZbh!^ciZ\gViZYG>H$E68H$GZedgi^c\!hde]^hi^XViZYYViVbVcV\ZbZci! extremities, and spine. The product makes it possible to acquire a series of dg^ciZ\gViZYY^\^iValdg`[adlh[dggVY^dad\n!bVbbd\gVe]n!XVgY^dad\nVcYi]Z]ZVai]XVgZZciZgeg^hZ#Hd low-dose projection images during a single examination. It is likely to lead to VhndjXdch^YZgndjgX]dhZceVi]!aZidjgegdkZcZmeZg^ZcXZhjeedgindjgcZmihiZe!VcYZkZgnhiZeV[iZgi]Vi# the increased use of tomography in the form of digital volumetric imaging, lll#V\[V#Xdb$]ZVai]XVgZ and it may well see digital volumetric imaging superseding other techniques in some clinical settings. AZVgcbdgZVWdjidjgegdkZchdaji^dch#K^h^i6\[V=ZVai]8VgZVi:8G!:med7!Wddi]'&'#
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99426_Z1005_260x405_en.indd 1 07.02.2007 14:57:47 Uhr ECR TODAY 2007 LOWER/ENTRANCE LEVEL 9
Daily news from Europe’s leading imaging congress SUNDAY, MARCH 11, 2007
Ultrasound vendors pack high off ers optional transoesophageal and stress echocardiography capabilities. Inside Today Th e smaller X300 machine is being performance into a smaller package promoted as an ideal choice for the emergency room. By John Bonner larger machines,” says GE Health- “When miniaturising components • ESMRMB reaches out to care Europe marketing manager you will also have to make the user “With an operator-friendly console the younger generation Handheld ultrasound devices are Pierre Radzikowski. interface smaller and that may cause that helps to reduce arm and hand p. 10 emerging as a vital tool for both problems. We have designed a new movement, and its small, light- radiologists and clinicians, as a visit weight transducers, the X300 takes • Foetal and maternal MRI to the ECR technical exhibition will the pain and pressure out of routine p. 11 confi rm. scanning,” Siemens states. • Subspecialty and National Th e latest generation of ultra-com- Philips Medical Systems is focus- Societies pact ultrasound products forms sing attention on the needs of its p. 11, 12 one of the fastest growing seg- established partners in the hospital ments of the European ultrasound radiology department. Th e com- • MRI for injuries in upper market, according to industry ana- pany will be introducing several extremities lysts. new technologies and products as p. 13 part of its Vision 2007 and Perfor- Th ese technologies can provide a mance 2007 ultrasound systems. • List of exhibitors valuable service to doctors working Th ese refi nements are intended to p. 14 in remote locations, and in situations allow better volumetric imaging, where ultrasound data can inform provide new tools for interventional rapid decision-making. Handheld procedures, and shorten examina- clinicians able to provide improved ultrasound is proving particularly tion times. Th ey will also facilitate patient care, they are doing it more useful in the operating suite, allow- Th e Acuson X500 system is an advanced, multi-specialty system suitable for a wide range of investigations for congenital heart simply and easily,” said Barbara ing surgical staff to perform accu- radiology and cardiology applications. (Provided by Siemens Medical Solutions) disease by providing a real-time 3D Franciose, CEO, Philips Medical Sys- rate regional nerve blocks, and for transducer optimised for paediatric tems, Ultrasound and Monitoring. doctors working in an emergency simpler interface aft er long studies of echo examinations. “Th ese enhancements are just the room setting. how they are used. Th is has involved start of many exciting developments reducing the number of keys, which “Th e new intelligent ultrasound sys- that will help improve the diagnos- But this won’t leave radiology depart- makes workfl ow easier,” Grimaldi tems and volumetric imaging are tic capabilities of the physician and ment staff out in the cold. Th ey will said. “Th e doctor is never more than dramatically expanding the clinical provide the patient with advanced, continue to play a central role in two or three clicks away from the value of ultrasound. Not only are cost-eff ective health care.” the process, according to Giorgio best image he can get. Th at is essen- Grimaldi, business manager for tial in the emergency ward situation GE Healthcare’s European compact because time is critical and answers ultrasound division. Radiologists’ must be available in seconds.” work is essential in providing the more detailed information avail- Siemens Medical Solutions has plans able from whole organ and system- to take the miniaturisation process based scans following initial ‘rough one step further with its new pocket and ready’ investigations. Th ey will ultrasound system, Acuson P10. also ensure appropriate use of the Siemens has not yet completed the new technologies through training, development phase for this product, advice, and support for their clinical and if the Acuson P10 does appear colleagues. on the ECR stand, it will be as a Th e Acuson X300 features an ultra-com- pact, performance-oriented system design ‘work in progress’. It is barely eight years since the fi rst for clinical effi ciency, and has an operator- handheld systems were introduced, friendly console that helps to reduce arm Instead, Siemens will be showcasing and hand movement. and in that time there has been (Provided by Siemens Medical Solutions) its new lightweight, mobile Acuson remarkable progress in enhancing X300 and X500 systems, both of Ultrasound examination using Logiq e shows gallbladder calculi. (Provided by GE Healthcare) performance. which incorporate the company’s Such detail is essential for urgent ErgoDynamic imaging system “Until maybe two years ago, hand- diagnostic tasks, such as fi nding design and a broad range of clinical held systems were synonymous a small amount of abdominal or capabilities. with low image quality, but we cardiac fl uid, an abdominal aortic Technical Exhibition have now been able to introduce aneurysm, or an early ectopic preg- Th e X500 system has been designed compact systems – like the Logiq e nancy. Another challenge facing as an advanced, multi-specialty sys- Opening hours: – which gives the same high defi ni- vendors designing compact systems tem suitable for a wide range of radi- Sunday – Monday: 10:00–18:00 tion images that you get with the is maintaining ease of use. ology and cardiology applications. It
“Fresh
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1304449 [EmpowerMR New Prod Inse1 1 1/30/2007 4:54:34 PM myESR.org ECR TODAY 10 SUNDAY, MARCH 11, 2007 ENTRANCE LEVEL
ESMRMB reaches out to the younger generation
By Monika Hierath, ESR Offi ce their personal balance between edu- In line with its policy to reach out ESMRMB – School of MRI 2007 Applied MR Techniques, cation and the latest science. Th e to the younger generation, the Advanced Course Th e core message of last year’s second measure concerns the cost renowned School of MRI educa- Applied MR Techniques, September 13–15, Innsbruck/AT Annual Scientifi c Meeting of the of attending ESMRMB meetings. tional programme has been further Basic Course European Society for Magnetic expanded for 2007. A total of 14 June 7–9, Vilnius/LT Advanced Cardiac MR & Resonance in Medicine and Biology For many students and residents courses are off ered at two diff erent CT Imaging (ESMRMB) held in Warsaw, Poland, in training, fi nancial constraints educational levels. In 2007, a new Advanced Head and Neck September 20–22, Munich/DE in September was clear: To provide form a key obstacle to attending course on clinical fMRI is intro- MR Imaging students and junior researchers international conferences. In view duced and the courses on vascular June 7–9, Brescia/IT Advanced MR Imaging of with an international platform to of this issue, the Society decided to MRI and MR of the head and neck the Musculoskeletal System meet experts, to present their work make another serious commitment will be re-launched. Residents in Advanced Neuro Imaging: September 27–29, Rome/IT and to indulge in high-quality edu- and truly reach out to the youth: training in less developed countries Diff usion, Perfusion, cational programmes. One undis- At ESMRMB 2006, students and are invited to submit an application Spectroscopy Advanced Breast & Pelvis puted key to the next generation’s residents in training were admit- for the grant scheme! June 14–16, Cairo/EG MR Imaging success is connecting people early ted to the annual meeting for free, October 4–6, Madrid/ES on, both across institutions and as long as they registered within the With the Lectures on Magnetic Advanced MR Imaging of countries as well as across research advance-registration window. Resonance the ESMRMB contin- the Vascular System Advanced MR Imaging of areas. Getting connected is the basis ues to off er teaching courses that June 27–29, Maastricht/NL the Abdomen of spreading knowledge and ideas, ESMRMB is glad and proud to make are especially designed to provide October 25–27, Pisa/IT teaming up in research collabora- these contributions to getting juniors the physical fundamentals of MR Advanced MR Imaging of the tions, and, not least, exposing one’s connected and up to speed for a bril- imaging, diff usion, perfusion, fl ow Vascular System – Hands On Advanced MR Imaging of work to others for critical and com- liant MR career and is pleased to and spectroscopy, as well as aspects June 30, Maastricht/NL the Musculoskeletal System petitive appraisal. All of these pro- report that the Society’s outreach of applications of these techniques November 8–10, Cape Town/ZA cesses are best catalysed by face-to- seems to address a true demand in in clinical and biochemical research Applied MR Techniques, face encounters and presentations at the community: Abstract submis- and development. Th e ESMRMB Advanced Course More information on all ESMRMB international meetings. sion for the ESMRMB 2006 congress and its Education and Workshop (French language) activities can be found at increased by 22% compared to the Committee are convinced that there June 28–30, Toulouse/FR www.esmrmb.org. Th e ESMRMB has therefore decided annual meeting in 2005 and the over- is a strong need and request to pro- For any enquiries, please send an to reach out to the younger genera- all attendance reached over 1,000, a vide these kinds of courses that are Advanced MR Imaging of e-mail to offi [email protected]. tion by making its annual meetings record-high in the recent history of dedicated towards the needs of MR the Abdomen even more accessible and attractive the congress. Th e ESMRMB had the physicists and other basic scientists July 12–14, Izmir/TR for this group. Th e new policy has pleasure to welcome a large num- working in a clinical or research two essential elements: In a fi rst ber of delegates from Central and environment. Clinical fMRI – move the annual meeting’s educa- Eastern Europe, in particular from Th eory and Practice – NEW! tional profi le is strengthened. Th e the host country Poland. Th e Polish More information on the course September 6–8, Aalborg/DK 2006 meeting in Warsaw off ered Society of Magnetic Resonance even programmes and online registration teaching sessions throughout, giv- held its conference back-to-back is available at www.esmrmb.org. ing attendees the freedom to choose with the ESMRMB meeting.
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myESR.org ECR TODAY LOWER LEVEL SUNDAY, MARCH 11, 2007 C 11
Foetal MRI supplies answers for some ultrasound-detected pathologies
By Frances Rylands-Monk ing cases carrying a poor prognosis, and genetically determined diseases Th e availability of high-frequency which may carry a recurrence risk in transducers, use of the transvaginal further pregnancies,” said Dr. Peter approach, introduction of 3D/4D Brugger, associate professor at the techniques, and the possibility of Center of Anatomy and Cell Biology processing information in a way at the Medical University of Vienna. comparable to radiological cross- Foetal MRI is about establishing an sectional methods have led to sub- accurate diagnosis. Some pregnant Th oracic portion of the oesophagus during stantial improvements in prenatal patients wish to have a foetal MRI fl uid passage; sagittal plane in a 16-week foetus. H = heart; white arrows = oesopha- ultrasound. In the meantime, a vari- as soon as possible once ultrasound gus; arrowhead = trachea. ety of sequences have been adjusted suggests that something is wrong (Provided by Dr. G. Malinger) for prenatal MR purposes, providing because it brings more clarity to a more subtle tissue information nec- situation and can tell parents at an Diff usion-weighted MRI may lead essary for investigating extra central- early stage what to expect at birth. to fi ndings such as a brain tumour nervous system foetal organs, partic- High-quality images are needed as or a cyst exerting pressure on adja- ularly aft er the 17th or 18th gestational they are fundamental to decision- cent tissue, and which in some cases Coronal T1-weighted image aft er 28 weeks Th ick-slab T2-weighted image aft er 22 week, when soft -tissue contrast is making in the management of a will necessitate a Caesarean section gestation excludes suspected malformation. weeks gestation. MRI indicated due to spina It shows slight hyperintensity of the cere- bifi da. In the region of the spinal defect, better than with ultrasound. pregnancy, sometimes leading to at 32 weeks. Because foetal tumours bral cortical plate and ganglionic eminence a fl uid-fi lled sac can be seen. In addition, the painful decision of termination grow very quickly, the foetus may of the germinal zone adjacent to the frontal the increased width of the supratentorial While many pathologies are well or confi rming the possibility of in stand a good chance of healthy sur- horns of the ventricles. Th e unmyelinated ventricles, the small posterior fossa, and white matter appears more hypointense normal legs are shown. Th e diagnosis of recognised aft er birth, doctors are utero surgery or therapy. vival if delivered before term, and than the basal ganglia. Th e pituitary gland Chiari II malformation is made at a glance. now beginning to gather knowledge tumours can now be diagnosed is bright. Two hyperintense punctate struc- (Provided by Dr. D. Prayer) about how these may present in ear- Ultrafast T2-weighted imaging early enough for the clinician to fol- tures in the upper neck region correspond to deep expansions of the buccal fat pad. lier stages of development, in par- sequences are still the mainstay in foe- low the growth pattern and take the At the base of the neck, the hyperintense ticular, minor brain malformations. tal MRI due to their high tissue con- most appropriate action. thyroid is perceptible. In the abdomen, note “Th e placenta, crucial for feeding In future, early recognition of such trast, and their higher resolution (now medium-hyperintense liver and marked the foetus, is a functional organ from hyperintensity of meconium-fi lled parts of pathologies may become possible. approximately 1 mm per pixel) has For early deliveries, lung matura- the colon. Subcutaneous fat layer is weakly the beginning to the end of its exis- improved their ability to depict more tion may be assessed by maturation- hyperintense. (Provided by Dr. D. Prayer) tence and is ideal to study with MRI “Foetal MRI is an additional tool, subtle lesions and pathologies, he associated MR signal changes and due to its high blood fl ow and blood once suspicious fi ndings have been said. Further sequences are now avail- by measurement of the lung vol- volume,” said Prof. Penny Gowland, seen with prenatal ultrasound. It able that selectively visualise tissues, umes. Th e latter can also be done by Evidence of this lies partly in the fact physicist at Sir Peter Mansfi eld Mag- may confi rm the suspected ultra- organs, and pathologies, and supply ultrasound, but will become more that the abstracts of the First World netic Resonance Centre, University sound fi ndings, add additional further information that enables doc- diffi cult with increasing gestational Conference of Foetal MR imaging of Nottingham, UK. detail, or alter the diagnosis. MRI tors to better characterise lesions. age because of bone artifacts from were published in the largest obstet- may also be important in evaluat- the rib cage. With the degree of lung ric ultrasound journal, Ultrasound Causes of in utero growth retarda- maturation essential for survival, in Obstetrics and Gynecology, in tion, now more commonly called the clinician needs to know if the May 2006. foetal growth restriction (FGR), can baby will breathe aft er it is born. If be related to reduced blood fl ow Special Focus Session not, extracorporeal membrane oxy- “Th ere is more communication from the uterine wall and can be genation must be prepared. between modality specialists for investigated with functional MRI. Sunday, March 11, 16:00–17:30, Room G/H each patient. Th ey’re also going to Th e earlier FGR is detected and diag- “Th ere is a long history behind the each other’s conferences. Th at’s why nosed, the longer the clinician has SF 12 Fetal and maternal MR imaging evolution of foetal imaging, but co- I considered it important to give a to evaluate clinical options such as operation between MRI and ultra- talk together with an ultrasound early delivery, or the more promptly • Chairman’s Introduction sound has intensifi ed over the last specialist like Dr. Gustavo Malinger such decisions can be made. D. Prayer; Vienna/AT couple of years and each fi eld seems from the Wolfson Medical Centre, • Fetal MR: Indications, techniques and safety issues more willing to learn from the Holon, Israel,” added Prayer. “General radiologists need to know P.C. Brugger; Vienna/AT other,” said Dr. Daniela Prayer, asso- applications of MRI beyond adult • Whole fetus imaging: When ultrasound? When MRI? ciate professor of radiology, clinic Studies of the placenta using MRI imaging,” she said. “MR imaging of G. Malinger; Holon/IL, D. Prayer; Vienna/AT of radiodiagnostics at the Medical may also increase, particularly in the foetus is going to become rou- • MR imaging beyond the fetus University of Vienna, and chair of cases of a slow-growing foetus. tine, possibly in fi ve years for grossly P.A. Gowland; Nottingham/UK today’s special focus session. abnormal foetuses and maybe in 10 years for FGR foetuses.”
Staff box Radiological Society of Editorial Board Layout ESR Executive Board Nina Ober, ESR Graphic Department Bosnia and Herzegovina Editors Marketing & Advertisements Michael J. Lee, Dublin/IE Erik Barczik, E-mail: [email protected] Clare Roche, Galway/IE Th e Radiological Society of Bosnia 130 radiology specialists, 30 radiol- these events as lecturers, modera- Contact the Editorial Offi ce and Herzegovina has a long tradi- ogy subspecialists, 50 residents, 120 tors and participants. Managing Editors ESR Offi ce tion and has existed since 1968, ini- radiographers/radiological technol- Monika Hierath, Vienna/AT Neutorgasse 9 Julia Patuzzi, Vienna/AT AT – 1010 Vienna, Austria tially as a part of the Radiological ogists and 50 nurses. By procurement of the most con- Philip Ward, Chester/UK Society of former Yugoslavia. temporary equipment (such as 64 Phone: (+43-1) 533 40 64-16 Th e society’s agenda includes slice CT; 1.5 T and 3.0 T MRI) we Contributing Writers Fax: (+43-1) 533 40 64-448 John Bonner, London/UK E-mail: [email protected] As an independent association, the improvement of the scientifi c and intend to take part in up-to-date Paula Gould, Holmfi rth/UK Radiological Society of B&H was educational activities of members courses of modern radiology and Monika Hierath, Vienna/AT ECR Today is published 4x during ECR founded in 1996 and since then it and the society itself, by organising make our contribution to the scien- Julia Patuzzi, Vienna/AT 2007. Circulation: 8,000 Frances Rylands-Monk, has become the main institution national radiology congresses every tifi c fi eld. St. Meen Le Grand/France Printed by Angerer & Göschl, Vienna 2007 that defi nes the aims and develop- four years and intersectional meet- Karen Sandrick, Chicago, IL/US ment strategy of radiology in our ings every year. Our third radiology Our future mission is to continue co- Brenda Tilke, Maidenhead/UK myESR.org country. It also coordinates the Congress is planned for October operation with ESR, EIBIR, RSNA work of all sections of the radiologi- 2007. and other European and interna- cal community. tional associations; to introduce Th e Editorial Board, Editors and Contributing Writers make every eff ort to ensure that no inaccurate or mis- leading data, opinion or statement appears in this publication. All data and opinions appearing in the articles Our society actively participates in PACS to B&H radiology and to make and advertisements herein are the sole responsibility of the contributor or advertiser concerned. Th erefore the Editorial Board, Editors and Contributing Writers and their respective employees accept no liability whatso- All radiology institutes and depart- diff erent international and Euro- the Radiological Society of B&H an ever for the consequences of any such inaccurate or misleading data, opinion or statement. Advertising rates valid as per January 2007. ments in the country are members of pean meetings, congresses and important part of the European fam- Unless otherwise indicated all pictures © ESR Offi ce the national society, which includes courses, with members attending ily of radiology associations.
myESR.org ECR TODAY 12 SUNDAY, MARCH 11, 2007 ENTRANCE LEVEL
European Society of Gastrointestinal and Abdominal Radiology
ESGAR, with its over 700 active Caseiro-Alves. Th e programme, We are committed to keep promot- members, is one of the largest and available on the ESGAR website ing the visibility of all our initia- most active subspecialty societies (www.esgar.org), covers all of the tives, mainly through the website, in Europe, thanks to its well struc- latest issues and hot topics in our which represents an ‘open window’ tured organisation and its growing rapidly evolving discipline. for allowing immediate and easy scientifi c and educational activi- contact between ESGAR and its ties, which are highly visible at the As a brief reminder, the next annual members, as well as all radiologists annual meeting and in the work- meetings will be held in Istanbul in involved in gastrointestinal and shop programme. 2008 and Valencia in 2009. abdominal fi elds. I would particu- larly like to invite the latter to follow Th e last annual meetings were very Th e educational mission of ESGAR our initiatives, hoping that they may well attended and gathered a large is also ensured by the rich workshop consider the opportunity to join our number of participants, not only programme, together with the CT society in the future. from Europe but also from many colonography workshops, which far away countries, thus making the are running effi ciently and are Carlo Bartolozzi, ESGAR President ESGAR meeting a truly interna- well received all over Europe (see tional congress. At the same time, p. 25). In 2007, the fi rst edition of Future ESGAR annual meetings our meeting has kept its tradition the workshop series, devoted to RF of giving our attendees the opportu- ablation procedures in the liver, will ESGAR 2007 nity to get together in a warm and be held in Pisa (March 26–28), thus Lisbon, Portugal, June 12–15, 2007 friendly atmosphere that facilitates satisfying the widespread interest in the presentation of scientifi c results abdominal interventions. ESGAR 2008 and discussion about the emerging Istanbul, Turkey, June 10–13, 2008 issues of our subspecialty. An important asset of the society is represented by its corporate mem- ESGAR 2009 Th ere is no doubt that, following bers, which include Agfa, E-Z-EM, Valencia, Spain, June 23–26, 2009 this long series of successful meet- GE Healthcare, Guerbet, Medicsight ings, ESGAR 2007 in Lisbon (June and Bayer-Schering. Th ey give con- ESGAR IMAGE-GUIDED 12–15) will represent a memorable tinuing support to the society, not ABLATION WORKSHOP occasion for all of us and will allow only fi nancially, but also by provid- Pisa, Italy, March 26–28, 2007 us to appreciate the organisational ing useful insights in the planning skills and the scientifi c competence of our scientifi c and educational Further information is available on of the meeting president Prof. Filipe activities. the ESGAR website www.esgar.org.
myESR.org ECR TODAY LOWER LEVEL SUNDAY, MARCH 11, 2007 C 13
MR imaging sheds light on diverse range of injuries in upper extremities
By Karen Sandrick tigated. MRI is typically used to For example, in an entrapment neu- Orthopedic Hospital, Invalid Foun- detect external causes of compres- ropathy, a nerve that runs along the dation, Helsinki, Finland. Patients with compressive or entrap- sion to a nerve, identify patterns of arm may be entrapped at diff erent ment neuropathies of the elbow, muscle denervation, and exclude points along its course in a normally In general, MRI evaluates chondral forearm, wrist, or hand may go other pathologies that may mimic tight tunnel or space, even though defects and loose bodies around straight to sonographic examina- compressive and entrapment neu- clinical manifestations of a sen- the elbow, stress fractures and bone tion, particularly in some parts of ropathies. sory or motor defi cit are the same marrow oedema at the fracture site, Europe. In skilled hands, ultrasound whether the entrapment is high up tendon degeneration in tendinosis can produce images that reveal Evaluation of patients with MRI in the elbow or distal in the wrist. as well as ligament injuries in pos- pathology as well as MR images nevertheless requires a thorough terolateral rotatory instability, and can do. But while the diagnosis of knowledge of anatomy and the man- “Th e radiologist has to be familiar articular erosion in radiocapitellar a tendon rupture is a relatively sim- ifestations of pathology on imaging with the anatomical areas where chondromalacia. ple matter with ultrasound, in the studies, because fi ndings may easily the nerve is typically compressed,” assessment of specifi c neurological be overlooked. he said. “Th e radiologist also has According to Lohman, the choice of to be aware that many compressed the imaging place is crucial to facili- neuropathies are produced by nor- tate the interpretation of MR images. mal variants, such as tight spaces or Studies have shown that oblique cor- fi brosis tunnels.” Anconeus epitrochlearis. Th ere is an acces- onal views are indicated for assess- sory muscle (arrow) producing compression ing the ulnar and radial collateral of the ulnar nerve. (Provided by J. Beltran) Carpal tunnel syndrome is such a ligaments as well as the ligaments frequent and clear-cut problem that and cartilage of the wrist. Lohman most patients are sent to surgery is a strong clinical impression of a recommends using fl uid-sensitive based only on clinical or electromyo- fracture that radiographs are not sequences, such as T2-weighted fat graphic fi ndings. Even in the workup detecting. MRI also may show bone suppression or short T1-inversion of these patients, MRI has a place bruise, which is not visible on plain recovery (STIR). Th ese sequences when the clinical diagnosis is incon- x-rays, as the cause of an increased act like a natural contrast agent in clusive, symptoms are severe, and a amount of joint fl uid, explained the joint fl uid, she said. tumour, aberrant muscle involve- Dr. Martina Lohman, ORTON ment, or an infi ltrative process may be present, and the surgeon may Dr. Javier Beltran from Brooklyn, New York Dr. Martina Lohman from Helsinki need to extend the scope of surgery or further explore the involved area. Refresher Course injuries, such as nerve entrapment “Th at’s why it’s important to have a In an MRI examination of a patient and compression, the technique heads-up impression of what you with carpal tunnel syndrome, radiol- Sunday, March 11, 16:00–17:30, Room E1 requires considerable experience, are going to look for so that even ogists typically look for enlargement expertise, and patience, said Dr. when you have the appropriate of the median nerve proximal to the RC 1210 Elbow/Wrist Javier Beltran, Maimonides Medical clinical information, you can focus tunnel, high signal intensity on T2- Center, Brooklyn, New York. more on these little nerves that show weighted imaging, obliteration of Moderator: A. Blum; Nancy/FR subtle changes of signal intensity. the deep fat plane, and bowing of the • A. MR imaging of acute injuries Radiologists in Europe conse- You have to be prepared to under- retinaculum. C.M. Lohman; Helsinki/FI quently are turning to MRI, which stand the clinical manifestations of • B. Overuse syndromes in sports can exquisitely visualise soft -tissue these entities and understand the Although x-rays are the primary M. Padrón; Madrid/ES involvement of compression neu- relationship between what is given means of investigation of possible • C. Nerve entrapment syndromes ropathies in the upper extremity from the clinical standpoint and bone trauma or dislocations of the J. Beltran; Brooklyn, NY/US and cover a wide spectrum of the what the radiologist needs to look wrist or elbow, MRI is the imag- anatomic area that is being inves- for in the MRI exams,” Beltran said. ing method of choice when there
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tter we can serve you! are, the be Cubital tunnel syndrome. Note the thickening and increased signal of the ulnar nerve in the we cubital tunnel (arrow). (Provided by J. Beltran) bigger The
Visit us at the ESR booth in the entrance hall
Recurrent carpal tunnel syndrome. Note the thickening and increased signal of the median myESR.org nerve, surrounded by scar tissue, post carpal tunnel release. (Provided by J. Beltran)
myESR.org ECR TODAY 14 SUNDAY, MARCH 11, 2007 LIST OF EXHIBITORS
List of exhibitors Society booths Company Booth Location Company Booth Location All Society booths are located on the entrance level.
3Mensio Medical Imaging, NL 11 Ext. Expo A Linos Photonics, DE 121 Expo A American Association for Women in Radiology 3W-Informed, NL 542 Expo E Lodox Systems, BE 304 Expo C Armed Forces Institute of Pathology Adani, BY 323 Expo C MCI Optonix, US 40 Ext. Expo A Asian Oceanian Congress of Radiology 2008 Seoul Agfa HealthCare, BE 214 Expo B Mecall, IT 403 Expo Foyer D Association of Radiologists of Ukraine Albatross Projects, DE 120 Expo A Med.e.Com, FR 109 Expo A Cardiovascular and Interventional Radiological Society of Europe Alliance Medical, UK 4 Ext. Expo A Medcomp Interventional, US 501 Expo E Chinese Society of Radiology Aloka Holding Europe, CH 333 Expo C MedConSol, DE 41 Ext. Expo A College of Radiographers UK Aloka Holding Europe, CH 336 Expo C Medelkom, LT 37 Ext. Expo A Computer Assisted Radiology and Surgery, Germany American College of Radiology, US 545 Expo E Median Technologies, FR 342 Expo C Croatian Society of Radiology American Medical Sales, US 41 Ext. Expo A Medical Imaging International, US 553 Expo E Czech Radiological Society American Roentgen Ray Society, US 552 Expo E Medicor Medical Supplies, BE 348 Expo C Deutsche Röntgengesellschaft Anzai Medical, JP 506 Expo E Medicsight , UK 34 Ext. Expo A Deutsches Röntgenmuseum Apelem, FR 341 Expo C Medis medical imaging systems, NL 3 Ext. Expo A European Congress of Interventional Oncology 2008 Arcoma, SE 106 Expo A Medison, KR 522 Expo E European Coordination Committee of the Radiological, Electromedical Array Corporation Europe, NL 15 Ext. Expo A Medisys, FR 349 Expo C and Healthcare IT Industry ATS, IT 404 Expo Foyer D Medos, DE 6 Ext. Expo A European Federation of Organisations in Medical Physics aycan Digitalsysteme, DE 24 Ext. Expo A Medrad Europe, NL 329 Expo C European Project FP6 Az Corporation, RU 114 Expo A Medtron, DE 16 Ext. Expo A European School of Interventional Radiology Barco, BE 201 Expo B Mercury Computer Systems, DE 343 Expo C European Society for Magnetic Resonance in Medicine and Biology Bayer Schering Pharma, DE 317 Expo C Merge Healthcare / Cedara Software, NL 23 Ext. Expo A European Society of Breast Imaging Bayer Schering Pharma, DE 318 Expo C Metaltronica, IT 211 Expo B European Society of Cardiac Radiology Beijing Choice Electronic Technology, CN 530 Expo E Mindray, CN 515 Expo E European Society of Gastrointestinal and Abdominal Radiology Beijing Wandong Medical Equipment, CN 514 Expo E Mindways Software, US 504 Expo E European Society of Head and Neck Radiology Biodex Medical Systems, US 1 Ext. Expo A MR-Schutztechnik Kabinenbau, DE 215 Expo B European Society of Musculoskeletal Radiology Biospace med, FR 304a Expo C National Display Systems, NL 339 Expo C European Society of Neuroradiology Blue X Imaging, IT 108 Expo A NEC Display Solutions Europe, DE 42 Ext. Expo A European Society of Paediatric Radiology BMI Biomedical International SRL, IT 523 Expo E NeoRad, NO 122 Expo A European Society of Thoracic Imaging BoneSupport, SE 30 Ext. Expo A Neusoft Medical Systems, CN 517 Expo E European Society of Urogenital Radiology Bracco, CH 101 Expo A Ningbo Xingaoyi Magnetism, CN 535 Expo E Faculty of Radiologists, Royal College of Surgeons in Ireland BrainLAB, DE 321 Expo C Noras Roentgen- und Medizintechnik, DE 125 Expo A Hellenic Radiological Society CAD Sciences, US 110 Expo A NordicNeuroLab, NO 528 Expo E Hellenic Society for Ultrasound in Medicine and Biology Campden Publishing, UK 537 Expo E Olympus Winter & Ibe, DE 13 Ext. Expo A Integrating the Healthcare Enterprise Europe Canon Europa, NL 104 Expo A Orthocrat, IL 505 Expo E International Cancer Imaging Society - Cancer Imaging Celon medical instruments, DE 13 Ext. Expo A Parker Laboratories, US 17 Ext. Expo A International Congress of Radiology 2008 Morocco Cerner Deutschland, DE 310 Expo C Pausch technologies, DE 340 Expo C International Diagnostic Course in Davos Chison Medical Imaging, CN 532 Expo E PEHA Med. Geraete , DE 308 Expo C International Society for Magnetic Resonance in Medicine Civco Medical Solutions, US 503 Expo E Philips Medical Systems, NL 102 Expo A International Society of Radiographers & Radiological Technologists Codonics, US 520 Expo E Philips Medical Systems, NL 119 Expo A Japan Radiological Society Confirma Europe, DE 19 Ext. Expo A Planar Systems, FI 208 Expo B Korean Radiological Society ContextVision, SE 527 Expo E Planilux-Gerätebau Felix Schulte, DE 41 Ext. Expo A Management in Radiology Control-X Medical, HU 320 Expo C Planmed , FI 344 Expo C Österreichische Röntgengesellschaft CPI International, CH 326 Expo C PrimaX International, FR 404 Expo Foyer D Polish Medical Society of Radiology D.A.T.A. Corporation - Automed, AT 21 Ext. Expo A Protec, DE 27 Ext. Expo A Radiological Society of Saudi Arabia Dastor, IT 36 Ext. Expo A PTW-Freiburg, DE 26 Ext. Expo A Radiology Trainees Forum DatCard Systems, US 29 Ext. Expo A Quantum Medical Imaging, US 512 Expo E RadiotechnologInnen Österreichs Del Medical Imaging, US 315 Expo C Radcal, US 302 Expo C Romanian Society of Radiology and Medical Imaging Diagnostic Imaging Europe, US 547 Expo E Radiological Society of North America, US 544 Expo E Royal Belgian Radiological Society DigiMed-mcs / Esinomed , DE 127 Expo A Radiology OneSource Europe, BE 304 Expo C Royal College of Radiologists DIRA, RU 526 Expo E Raymed, CH 314 Expo C Russian Association of Radiology DMS Apelem, FR 341 Expo C Reichert, DE 543 Expo E School of MRI Dr. Goos-Suprema, DE 5 Ext. Expo A Rein EDV - MeDiSol, DE 14 Ext. Expo A Sociedad Española de Radiologia Medica Dr. Sennewald Medizintechnik, DE 12 Ext. Expo A REM , IT 405 Expo Foyer D Societa Italiana di Radiologia Medica DRTech Corporation, KR 524 Expo E Rendoscopy, DE 408 Expo Foyer D Société Française de Radiologie Dunlee Medical Components, DE 324 Expo C Rimage Europe, DE 347 Expo C Society of Hungarian Radiologists Dynamic Imaging, US 22 Ext. Expo A Rogan-Delft, NL 325 Expo C Society of Specialists in Radiology Russia Ebit AET, IT 123 Expo A RTI Electronics, SE 322 Expo C Turkish Society of Radiology Echonet, the Ultrasound Network, GR 550 Expo E Sanochemia Diagnostics International, CH UK Radiological Congress Edge Medical Devices, IL 33 Ext. Expo A 205 Expo B WFUMB 2009 Sydney hosted by ASUM Eizo Nanao , JP 521 Expo E Scanditronix Wellhöfer, DE 309 Expo C Ella Legros, FR 113 Expo A Schiller, CH 305 Expo C Elsevier, NL 536 Expo E Schulte Felix Gerätebau, DE 41 Ext. Expo A EMC , US 508 Expo E Sectra, SE 525 Expo E EMD Technologies, CA 38 Ext. Expo A Sectra, SE 407 Expo Foyer D Esaote, IT 518 Expo E Sedecal, ES 212 Expo B Etiam, FR 112 Expo A Shantou Institute of Ultrasonic Instruments, CN ETS-Lindgren, UK 25 Ext. Expo A 533 Expo E European Hospital, DE 539 Expo E Shenzhen Emperor Electronic Technology, CN European Hospital, DE 551 Expo E 531 Expo E EZEM, US 332 Expo C Shimadzu Europa , DE 328 Expo C Fluke Biomedical, US 346 Expo C Sidam , IT 111 Expo A Fogale nanotech, FR 511 Expo E Siemens Medical Solutions, DE 409 Expo D Fujifilm Europe , DE 103 Expo A Siemens, Display Technologies and OEM Business, DE Gammex-RMI , DE 307 Expo C 210 Expo B GE Healthcare, UK 202 Expo B SonoScape , CN 516 Expo E GE Healthcare, UK 209 Expo B Sony Europe, UK 18 Ext. Expo A GE Healthcare, UK 213 Expo B Soyee, KR 401 Expo Foyer D General Medical Merate, IT 312 Expo C Springer , DE 549 Expo E Georg Thieme Verlag, DE 548 Expo E Suinsa Medical Systems, ES 327 Expo C Gilardoni, IT 204 Expo B Swiss Medical Care, CH 35 Ext. Expo A GIT Verlag , DE 546 Expo E Swissray Medical , CH 513 Expo E Gruppo Soluzioni Tecnologiche , IT 502 Expo E systema, DE 44 Ext. Expo A Guerbet, FR 331 Expo C Taramed Distribution , IE 14 Ext. Expo A Healthcare IT Management, BE 554 Expo E Technix, IT 337 Expo C Healthcare IT Management, BE 555 Expo E Tecnologie Avanzate , IT 14 Ext. Expo A Hitachi Medical Systems Europe , CH 519 Expo E Teknova Medical Systems , CN 534 Expo E Hologic, US 311 Expo C Telemed, LT 116 Expo A Hoorn Holland, NL 126 Expo A TeraRecon, US 20 Ext. Expo A Hospital, BE 554 Expo E Thales Electron Devices, FR 406 Expo Foyer D Hospital , BE 555 Expo E The Medipattern Corporation, CA 45 Ext. Expo A I.A.E., IT 402 Expo Foyer D Thieme & Frohberg , DE 541 Expo E iCAD, US 117 Expo A Toshiba Electronics Europe , UK 350 Expo C iCRco, US 128 Expo A Toshiba Medical Systems Europe, NL 316 Expo C im3D , IT 107 Expo A Totoku Electric, DE 14 Ext. Expo A Image Diagnost International , DE 28 Ext. Expo A Trixell, FR 406 Expo Foyer D Imaging Diagnostic Systems, US 115 Expo A Tyco Healthcare / Mallinckrodt, DE 105 Expo A Imaging Management, BE 554 Expo E ulrich medical, DE 330 Expo C Imaging Management, BE 555 Expo E Ultrasonix Medical Corporation, CA 352 Expo C Imedco, CH 217 Expo B Unfors Instruments, SE 345 Expo C IMIX ADR, FI 2 Ext. Expo A VacuTec Meßtechnik, DE 301 Expo C Innomed Medical, HU 216 Expo B Varian Medical Systems, DE 313 Expo C Instrumentarium Dental, FI 303 Expo C VDL Konings Medical Systems, NL 529 Expo E Intelligence in Medical Technologies, FR 510 Expo E VIDAR Systems Corporation, US 338 Expo C Intermedical Italia, IT 306 Expo C Villa Sistemi Medicali, IT 315 Expo C International Hospital Equipment & Solutions, BE Visus Technology Transfer, DE 206 Expo B 538 Expo E Vital Images, NL 335 Expo C Invivo, US 124 Expo A VuCOMP, US 41 Ext. Expo A Italray, IT 334 Expo C Wide EU Office, NL 32 Ext. Expo A J B Damgaard, DK 43 Ext. Expo A Wiroma, CH 39 Ext. Expo A Kiran Medical Systems, IN 118 Expo A Wisepress Online Bookshop, UK 540 Expo E Kodak [Eastman Kodak Company], UK 203 Expo B X-Parts France, FR 31 Ext. Expo A Konica Minolta Medical & Graphic Imaging, DE Ziehm Imaging, DE 319 Expo C 207 Expo B Zonare Medical Systems, US 351 Expo C Kyphon, BE 509 Expo E Maertens Medical, DE 539 a Expo E Companies and societies are listed in alphabetical order. Leidel & Kracht Schaumstoff-Technik, DE 507 Expo E
myESR.org ECR TODAY LOWER LEVEL SUNDAY, MARCH 11, 2007 C 15
MASSAGE Room POINT Room I G/H Room
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myESR.org ECR TODAY 2007 1st LEVEL 17
Daily news from Europe’s leading imaging congress SUNDAY, MARCH 11, 2007
Imaging plays increasing role in PET-CT is now considered the strongest tool for staging lung can- Inside Today cer and can obviate the need for pre-operative staging of lung tumours mediastinoscopy. Some surgeons are inclined to carry out a medias- By Frances Rylands-Monk “Because imaging has changed example, if the patient can be con- tinoscopy regardless of a negative • Scourges of modernism dramatically in the past few years, sidered a candidate for surgery. PET-CT scan of the lymph nodes, p. 18 Lung cancer remains a common doctors can now better select lung and Vilar feels it is the radiologist’s disease in the Western world, kill- cancer patients for diff erent treat- Vilar is sure that decisions regarding role to tell the surgeon why there • CAD technology ing around 150,000 people per year ments,” he said. “However, the long-term patient management can- is enough evidence for trusting, or p. 19 in the US alone. Choosing the most pitfalls of imaging lie in the false not ultimately be achieved through not, the PET-CT. eff ective imaging tools for diagnosis positive diagnoses stemming from teleradiology. “Teleradiology is good • Interventional Radiology and treatment evaluation is vital for misrecognition of artefacts and nor- in emergency situations, but for the “Th ere is a need for face-to-face p. 21 patient management. Correct stag- mal structures that simulate disease. most eff ective management of lung contact between team members,” ing of lung tumours enables clini- Th ese need to be recognised or the cancer, physicians should know the he added. “Used properly and with • Subspecialty Society cians to tailor treatment and follow- patient might end up in a chain of manner in which their colleagues resulting information handled by a p. 21 up, and is just as important as early treatment for nothing.” work. For example, surgeons come team, CT and PET-CT can save time detection and therapy assessment, from diff erent ‘schools’ of surgery and money, obviating surgery and • EIBIR according to the Spanish presenters Cáceres, who will be dealing with the and have diff erent requirements. hospital stays for patients, as well p. 22 of this morning’s session. issue of lung cancer screening, con- Th e radiologist should ascertain as facilitating tailor-made diagnosis curs, “Some doctors are hesitant about what exactly the surgeon wants to and treatment.” • Radiologists seen from Understaging a tumour remains one the reliability of screening because know,” he said. a different perspective of the greatest problems in lung can- there are many false positives of lung p. 23 cer imaging, according to Dr. José carcinoma. Most small shadows under Vilar, chief of radiology at Valencia’s 1 cm won’t be cancer, but if we oper- Dr Peset Hospital. He maintains ate on all screened patients with such that the key to improved lung can- shadows, it will cost a lot of money cer management is to accurately and carry risks for the patients.” stage the disease from the outset. He suggests that most people with “Up to 40% of lung cancer patients shadows of less than 1 cm should be are diagnosed with a less extensive followed up with multi-detector CT disease than in reality, resulting in (MDCT), possibly for up to or over patients being inoperable. Given two years to see the evolution of the that thoracotomy operations come shadow, in a long drawn-out screen- Th is patient had a pulmonary nodule positive for lung cancer. Th e CT scan did not show any Carcinoma of the lung discovered in an with a 2-3% mortality rate, surgery ing process, while shadows of over involved mediastinal lymph nodes. Th e patient was staged as T1 with CT, and therefore the asymptomatic 54-year-old smoker. cancer was thought to be resectable, but the PET-CT study showed a positive lymph node (Provided by Prof. José Cáceres) in these cases may not only be point- 1 cm should undergo further evalu- in the neck and the patient was restaged as non-resectable. PET should always be obtained less but may also expose the patient ation with other techniques, such before surgery for lung cancer. (Provided by Prof. J. Vilar) to unnecessary risks,” Vilar said. as PET. While a PET study is not always reliable for depicting small KODAK SATELLITE SYMPOSIUM Along with fellow speaker Prof. José lesions, a positive PET fi nding in a Cáceres, professor-in-chief of radi- nodule of more than 1 cm indicates ology at the Passeo Vall d’Hebron probable cancer, necessitating a General Hospital in Barcelona, he needle biopsy, surgical intervention plans not simply to deliver a lecture or thoracoscopy. but also to encourage fl oor partici- One pation by posing quiz-style ques- “Ideally, every heavy smoker past tions. Th e interactive session aims the age of 50 should get an MDCT to enlighten attendees about when every year. Th is will be expensive certain techniques for imaging lung in France and the US, and relatively cancer are used and why. cheap in countries such as Spain, but parallel to this, the eff ect on pub- Leader “PET-CT should always be per- lic health of lung cancer screening formed before operating on a should be evaluated,” Cáceres said. patient. Until recently we have only had anatomical information to work Besides correct staging, radiolo- Four with, but with PET we gain func- gists are playing an increasing role tional metabolic activity. High con- in the whole management process, sumption of glucose in lymph nodes which should involve collaboration and other tissues will be picked up, between the radiologist, oncologist, thus revealing possible metastases,” pathologist, and surgeon. Imag- Speakers Vilar said. ing is pivotal in locating and sizing tumours for radiotherapy. During Part of the session will deal with the treatment, fi ne delimitation of the semiology of cases, and the other tumour is mandatory to avoid radi- One part will be dedicated to imaging as ating normal tissues or not radiat- part of disease management, though ing the entire tumour. Imaging can Vilar thinks that the two are inextri- also evaluate response to radio- or cably linked. chemotherapy treatment during its course and aft erwards to see, for Discussion
E3 – European Excellence in Education
Imaging Management of Common Clinical Situations
Sunday, March 11, 08:30–10:00, Room R2
E3 920 Imaging management of lung cancer J. Cáceres; Barcelona/ES J. Vilar; Valencia/ES Kodak is a trade mark of Eastman Kodak Company. © Eastman Kodak Company, 2007
myESR.org ECR TODAY st 18 SUNDAY, MARCH 11, 2007 1 LEVEL
Scourges of 14 16 8 13 4 9 17 18 7 11 12 modernism 3 10 15
Modern times entail modern dis- 2 eases. A lot has changed in that 6 respect since the onset of industri- alisation. Work in open-plan offi ces or at digital workplaces, continuous 5 consumption of media and confron- 21 tation with advertisements, crowded buses and lonely homes – this does not only aff ect human relations. Th e 19 20 human body also has to cope with these novel challenges.
24 Th e illustration has been taken 22 from ‘Dr. Ankowitschs Illustriertem Hausbuch’ (Eichborn Verlag, 2006), 1 a collection of illustrated informa- tion and tips, not necessarily essen- tial for daily life. Th e illustration presents 24 diff erent illnesses and discomforts, the increasing onset of which is to be attributed to our change in lifestyle. Some of the ill- nesses are completely new and 23 could not be found in any medical literature about ten years ago.
Illnesses and Discomforts 7. Runner’s Knee 13. Disk Prolapse 19. Sex Addiction 1. iPod Th umb (Iliotibial Band Syndrome) 14. Migraine 20. Acute Hearing Loss 2. Panic Attack 8. Success Neurosis 15. Somatoform Autonomous 21. Golfer’s Elbow 3. Depression 9. Erectile Dysfunction Functional Disorder 22. ADHS (Attention Defi cit- 4. Stalking 10. Tourette Syndrome 16. Bulimia Nervosa Hyperactivity Disorder) 5. Overweight 11. Multiple Allergies 17. Binge Eating Disorder 23. Mobbing 6. Internet Addiction 12. Burn Out 18. Anorexia Nervosa 24. Restless Legs Syndrome
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myESR.org ECR TODAY st 1 LEVEL SUNDAY, MARCH 11, 2007 C 19
CAD technology: here today, widespread tomorrow?
By Paula Gould evolves. Despite the improvements, be reimbursed for doing so. Uptake be cost-eff ective if the number of positives and minimise unwarranted however, many radiologists are still in Europe, however, has been con- women called for follow-up rises, but recalls. Does soft ware that fl ags malignan- not taking advantage of CAD. siderably slower. Th is is largely due the rate of cancer detection stays rea- cies on medical images help, hinder to the longstanding tradition of dou- sonably constant. “At the moment, if given a choice, or make no diff erence to patient “Great improvements can be seen in ble reading for breast screening in I would rely on a second reader for management? Th at’s a question that the latest versions of CAD soft ware Europe, she said. One area where breast CAD could be screening mammograms. But that’s has been dogging the radiology com- for lung CT, making the tool more used in Europe today, with relatively not to say that in a few years time I munity for several years. Automated effi cient,” said Dr. Catherine Beigel- As healthcare costs increase, breast- little controversy, is in training. Th e won’t be relying on CAD,” she said. detection systems are undoubtedly man-Aubry, radiologist at Pitié- screening providers in Europe will ‘show me one like it’ feature, which becoming smarter, strengthening Salpêtrière Hospital in Paris. “But undoubtedly look at replacing their brings up similar looking abnor- “Th e decision-making interface is arguments for their use. But no sys- the workfl ow for CAD systems is not second human pair of eyes with a malities and their correct diagnoses, where things need to improve. It’s tem is perfect, and doubts remain, optimised. Th e best CAD systems are soft ware package. Studies examin- could be a useful tool for trainees, not that breast CAD systems are bad, leading to a widespread policy of not always available on clinical work- ing the benefi ts of breast CAD have Given-Wilson said. What happens or that radiologists are bad, it is just ‘wait and see’. stations used for diagnosis.” produced contradictory fi ndings, tomorrow will depend on how the how they work together.” however. Th e switch may not even technology evolves to reduce false Systems requiring that CT datasets are transferred to a separate worksta- tion waste too much time, she noted. She thinks that lung CAD soft ware will remain underused unless it can be integrated into a reading worksta- tion or PACS.
A number of diff erent lung imaging problems can now be addressed with CAD. Th ese include detection of pul- monary embolism and quantifi cation of emphysema. Most systems, how- ever, have been designed to pick up lung nodules. Th e best systems have a sensitivity of around 85% for solid Dr. Catherine Beigelman-Aubry will speak nodules, whereas the sensitivity of a on CAD for the lungs at this aft ernoon’s human observer will be around 60%. refresher course. “Without a CAD system, screening Computer-aided detection is a good for lung nodules is a long and tedious idea in principle, the argument goes, task,” Beigelman-Aubry said. “Some but let’s not rush in yet. Th e technol- CAD systems may also depict non- ogy may still improve further given solid nodules with a higher sensitiv- time. For those who are tired of wait- ity than human observers. Th is is ing, speakers at this aft ernoon’s ses- important to consider because the sion will show exactly what CAD can prevalence of malignancy of these – and cannot – do today. nodules is around 10 times higher Right oblique view of breast with malignant microcalcifi cations and a mass. CAD places prompts for three microcalcifi cations (triangles) and than the solid nodules.” one mass (asterisk), correctly identifying the abnormal area. (Provided by Dr. R. Given-Wilson) “Th e theme that will be manifest in this session is that CAD methods Th e task of hunting for abnormali- are here, and at least some of them ties on screening mammograms are ready for clinical use,” said Prof. is fraught with similar problems. James Th rall, chair of the radiology Images are complex, and the department at Massachusetts Gen- changes indicative of a cancer can eral Hospital, and professor of radiol- be extremely subtle. Readers faced ogy at Harvard Medical School. “Th e with a large pile of screening mam- ones that are not quite ready for clini- mograms to report will inevitably cal use show substantial promise.” become fatigued. Little wonder, then, that there is a reasonably steady ‘miss Th is aft ernoon’s refresher course, to rate’ of 20%. be chaired by Th rall, will focus on three areas targeted by CAD develop- “It doesn’t matter how good your ers: mammography, lung CT, and CT radiologist is, or what country you colonography. All require radiologists are in. If you give a single reader a to be alert to subtle changes. CAD set of mammograms they will miss ticks this box, off ering consistent, high a number of cancers,” said Dr. Rosa- sensitivity to cancers. So far, so good. lind Given-Wilson, radiologist at St. George’s Hospital, London. Th e soft ware’s longstanding weak- Nodule in left upper lobe of lung detected and segmented by CAD soft ware. Note 3D view at Axial 1.25 mm-thick CT slice targeted to ness is its tendency to fl ag-up appar- Breast CAD packages are now preva- left base, which allows formal diagnosis by rotation. (Provided by Dr. C. Beigelman-Aubry) left upper lobe of lung. CAD shows a false positive marking relating to mucoid impac- ent abnormalities that are not actu- lent in the US. Radiologists who tion. (Provided by Dr. C. Beigelman-Aubry) ally malignancies. Progress is being previously worked alone can now made in this area as the technology double-check their fi ndings, and will
Refresher Course
Sunday, March 11, 16:00–17:30, Room N/O
RC 1205 What can computer-aided diagnosis (CAD) do today?
Moderator: J.H. Thrall; Boston, MA/US • A. CAD for mammography R. Given-Wilson; London/UK • B. CAD for the lungs C. Beigelman-Aubry; Paris/FR • C. CAD for CT colonography D. Bielen; Leuven/BE Axial CT slice targeted to right upper lobe of lung. Ground-glass opacity detected and segmented by CAD soft ware. (Provided by Dr. C. Beigelman-Aubry)
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Interventional Radiology: Challenges Facing The Next Generation
By Aoife Keeling, Dublin, IE ventional work in the 1960’s. Initially diagnostic radiology training which a lot of opposition, simulators have yet being performed. Th ere is a need other clinicians were sceptical that is advantageous for the trainee. advantages in allowing trainees to for day case and in-patient hospital Th e specialty of radiology has any life-saving procedure could be become familiar with equipment, pro- beds, along with out-patient clinics to entered the new millennium with performed via an incision smaller A recent development in the training cedure techniques, decision making further develop IR as a full specialty all guns blazing. Radiology is prob- than the tip of one’s little fi nger. Cur- arena is the introduction of simula- and profi ciency testing. Th e imple- in its own right. Th e establishment ably the fastest growing discipline rently, IR encompasses many dif- tors. Th e FDA has advocated that only mentation of the European Work- of dedicated IR cover is paramount, in medicine and has experienced ferent procedures and techniques when profi ciency for carotid stenting ing Time Directive will restrict our not only during working hours, but vast amounts of change over a rela- pertaining to all of the various ana- has been obtained on a simulator, will exposure and experience in the inter- also on a 24 hour basis. Th is situa- tively short time-span. As we all tomical systems, which forces sub one be allowed to stent a live carotid ventional suite by limiting our onsite tion already exists in many centres, know, there have been many recent division in some IR practices, namely artery. Other industries, particularly hours. Simulators have the potential particularly in the US, however, it is advances in the imaging fi eld and vascular, non-vascular and neuro. aviation, have used simulators for to allow further training at an off -site not the case elsewhere. Th e answer, also in the area of intervention. New Th is split in the ranks can oft en pose decades, so why shouldn’t we? Th e facility outside of working hours. as is usually the case, is funding and imaging technologies, such as PET/ as a diffi culty for the training of fear of changing the old adage of ‘see manpower. IR needs to attract more CT and MRI, have revolutionised the junior interventionalists who wish to While IR has expanded over the junior doctors who are committed search for cancer, along with ultrafast acquire skills and knowledge in all of recent past, it is still fi ghting a contin- and dedicated to patient care and the multislice CT, which has opened a these areas. ually escalating turf war with invasion future of this discipline. Also IR needs whole new fi eld in the ever increas- from a number of other medical spe- to maintain a keen interest in the area ing domain of population screening Th is phenomenon is seen to a cialities, particularly cardiologists and of research and development, as it is (eg. CT coronary angiography and greater extent in the United States, vascular surgeons. Th ere is certainly a relatively young specialty and there CT colonography). where diff erent departments run the enough work for everyone, with the are still many new techniques and diff erent divisions, and thus organ- ever increasing population and the equipment waiting to be described. Minimally invasive procedures are ise diff erent fellowships for training advent of multi-disciplinary patient desired among clinicians and patients purposes. Th erefore, radiologists in care, however, the challenge facing Trainees need to avail themselves of alike, to reduce hospital stays, avoid training have to obtain a number of the next generation of interventional- the opportunity that ECR, CIRSE general anaesthesia and reduce mor- fellowships, oft en in diff erent coun- ists is to maintain a service for both and other international societies pro- bidity and mortality, thus the spe- tries, in the various divisions, in patients and clinicians alike. Emerg- vide; to present scientifi c research in cialty of interventional radiology (IR) order to obtain adequate procedure ing interventionalists will have to a professional setting with discussion is rapidly expanding. It is in this sub- exposure. Also these IR fellowships Dr. Aoife Keeling is a junior radiologist at maintain their clinical acumen and in an open forum, with many world specialty of interventional radiology are undertaken aft er a full 4 – 5 year the Beaumont Hospital in Dublin. take responsibility for patient care experts at their annual meetings, and that I foresee the major challenges training scheme in diagnostic radi- before, during and aft er intervention. to make use of funding provided for facing the younger generation of ology, meaning that juniors oft en one, do one, teach one’! At present, research and development. radiologists over the coming years. spend up to 7 years following medi- simulators are not widely available Some conditions can be managed cal school graduation, before com- for training purposes but with more purely by IR, such as berry aneu- A concluding message to IR trainees: Charles Dotter was the father of IR mencing their chosen career path. funding, I feel that they will be a stan- rysms where diagnosis and endovas- the future of this clinically and intel- and is credited with performing and However, this route does allow for a dard part of IR training in the future. cular treatment are already standard, lectually stimulating and rewarding pioneering much of the early inter- basic clinical and all round IR and While they ‘simulate’ reality and have but in some centres follow-up is not specialty is in your hands.
CIRSE – Home to interventionists from around the world
Since its beginnings in the early and scientifi c sessions, covering all Image-Guided Radiofrequency 1980s, interventional radiology has topics in interventional radiology. Tumour Ablation Course experienced sustained growth due to At CIRSE 2006, a record-breaking in French language Athens, Greece the continuing development of pro- 4,700 attendees from various medi- (Ablation tumorale guidée par September 8-12 cedures to combat a large number cal fi elds gathered in Rome to enjoy l’image) of medical conditions. Today, more an educational programme of more March 30–31, 2007 CIRSE 2007 2 people than ever can be treated with than 100 hours, as well as 3,000m of Paris, France ANNUAL interventional radiological proce- technical exhibition. MEETING AND dures which, due to their cost eff ec- Image-Guided Radiofrequency POSTGRADUATE COURSE tiveness, benefi t the healthcare sys- CIRSE 2007 will take place in the Tumour Ablation Course tem as well as the patient. beautiful city of Athens, Greece, May 4–5, 2007 FIRST ANNOUNCEMENT from September 8–12. Lectures, Brno, Czech Republic Th e Cardiovascular and Inter- workshops and case review sessions ABSTRACT SUBMISSION ventional Radiological Society of will be grouped according to their Basic Vascular Interventions DEADLINE Europe (CIRSE), founded to accom- topics (vascular interventions, trans- Course Feb 12, 2007 modate the needs of the steadily catheter embolisation, non-vascular June 1–2, 2007 www.cirse.org growing community of interven- interventions, interventional oncol- Budapest, Hungary tionists, has over the past 20 years ogy and clinical practice) in order to become Europe’s most important facilitate itinerary planning. Advanced Vascular radiological subspecialty society Interventions Course and political platform for more than In 2006, the CIRSE Foundation June 15–16, 2007 2,000 interventionists from Europe established another important Lublin, Poland and overseas. educ ati onal project: the European School of Interventional Radiology. Non Vascular Upper GI CIRSE’s chief objective has been Th e ESIR aims at providing courses Interventions Course to provide training and continu- on interventional procedures spe- June 22–23, 2007 ing education to all interventionists cifi cally tailored to local needs. Th e Crete, Greece interested in the fi eld of interven- courses have been received with tional radiology. One of its most great interest, which is why the Image-Guided Radiofrequency important activities in this regard programme has been extended to Tumour Ablation Course Cardiovascular and Interventional Radiological Society of Europe C RSE is its annual congress, which has include six courses in 2007. December 7–8, 2007 become the most comprehensive Plymouth, United Kingdom interventional meeting in Europe. If you would like to fi nd out more If you would like to receive a copy of the CIRSE 2007 Preliminary Programme, Held in a diff erent European city about CIRSE and the ESIR, visit us please contact us at [email protected] every year, the CIRSE congress at our booth on the entrance level or off ers a large variety of educational online at www.cirse.org
myESR.org ECR TODAY st 22 SUNDAY, MARCH 11, 2007 1 LEVEL
EIBIR Scientific Director MR-based Cell Imaging: a new EIBIR addresses key issues in Network of Expertise in European European medical and medical and biomedical research
By Monique Bernsen, and potential of this approach, it is lent platform for such an initiative, biomedical research Rotterdam, NL also becoming painfully clear that including promotion of networking there is a high level of fragmenta- activities within Europe by coordi- By Jürgen Hennig, Freiburg, DE imaging for the progress in molecu- Th e increasing interest in the use of tion within this fi eld. A large varia- nating joint initiatives; facilitation lar research. It is slowly being recog- cells as therapeutic agents or vehicles tion in both type of paramagnetic of exchange of personnel, educa- As newly appointed Scientifi c Direc- nised that monoparametric mea- has resulted in a pressing need – the probe and labelling procedure have tion and technical infrastructure; tor of EIBIR, it is a great honour surements – as important as they ability to non-invasively image cells been described, even in papers from organisation of meetings and train- and pleasure to join in the eff ort are – off er only a limited and one- in vivo. Monitoring the fate of cells a single research group. Th is makes ing courses; and coordination of initiated by the European Society of dimensional view on living organ- following transplantation is essential comparison of the diff erent studies, research plans for the EU 7th Frame- Radiology (ESR) and – very specifi - isms. Th e key to understanding lies both for studies on the development and consequently defi nition of ‘best work Programme. As one of the cally – by Gabriel Krestin as found- in the observation of spatiotemporal of cell-based therapeutic strategies practice’, impossible. In addition, fi rst Networks of Expertise to be ing father. Th e initial conception relationships and coherences across and for monitoring the effi cacy and some fundamental issues still need launched by EIBIR, MR-based cell of EIBIR, namely to bring together all relevant scales: from molecular safety of such therapies. to be resolved; issues that are crucial imaging is expected to set the pace European researchers, organisa- to metabolic to microstructural to to safe and reliable implementation for future initiatives. Th e network is tions and societies involved in the physiological to systemic, under- Magnetic Resonance Imaging of MR-based imaging of paramag- currently preparing the submission fi eld of biomedical imaging, EIBIR standing the rhythm of life requires (MRI) is intrinsically non-invasive, netically labelled cells. Th ese issues of a proposal on in vivo image-guid- has already born fruit: the joint pro- understanding the interactions on has high spatial and temporal reso- include: assessment of the impact ance for cell therapy under the FP7 posal to EU for funding of the infra- all scales. lution capabilities, and can poten- of the paramagnetic probe or the health call and will hold a planning structure has been successful and an tially assess functional aspects of labelling procedure on the viabil- meeting during ECR 2007. Industry Panel has been inaugurated Function and malfunction of liv- tissues. Th ese features make MRI a ity, phenotype and function of the to support the initiatives of EIBIR. ing tissues depend on the interplay promising modality for in vivo cell cells; validation of the susceptibil- of its components at least as much imaging. ity artifacts as true representations as on the components themselves. of transplanted, labelled cells; and Simultaneous measurements of A prerequisite for imaging of cells means to translate susceptibility spatiotemporal variations – or in with MR is the association of para- artifact characteristics into qualita- other words imaging – are key to magnetic probes with the cells of tive and quantitative measures of such an understanding. EIBIR as interest. Th ese paramagnetic probes the transplanted cells. a consortium of Europe’s leading give rise to a disturbance in the imaging centres therefore has the local magnetic fi eld, which results In order to bring MR-based cell chance to play a major role in this in a susceptibility artifact on MR imaging to its full potential, a col- development and to establish itself images. How to best label cells with laborative eff ort is called for. as the reference centre for imag- paramagnetic probes has been the ing in Europe. Th e key expertise of subject of considerable interest over To this end, the European Institute the EIBIR members is in diagnostic the past fi ve years. Over 200 papers for Biomedical Imaging Research imaging. Th e success will depend have already been published on (EIBIR) intends to form a Network on our ability and willingness to this topic. While these studies have of Expertise on MR-based Cell Prof. Monique Bernsen launched the EIBIR Prof. Jürgen Hennig, embrace (but not overwhelm) the clearly demonstrated the feasibility Imaging. EIBIR provides an excel- cell imaging network. EIBIR Scientifi c Director multitude of disciplines involved in imaging from humans to animals to Th ree initiatives are already in an cells in clinical application, clinical advanced state of preparation: and pre-clinical research.
• Th e European Network for the Th e main issues for the imminent European collaboration in the field of Assessment of Imaging in Medicine future will be the 7th Framework (EuroAIM) plans to establish a net- Programme of the EU, where EIBIR work to assess radiological technol- will use its resources to address key biomedical image processing ogy through the cooperative net- issues in European medical and bio- work of the EIBIR-institutes. medical research through the excel- By Wiro Niessen, Rotterdam, NL data. Even stronger, computational extract quantitative parameters from lence of consortia formed by our techniques are a prerequisite to fully imaging data, and establish a clear • An image Processing Network will members. At the end of the day all In view of the rapid developments exploit the richness of the biomedi- relation between this parameter and be established among its Members success comes through the energy in imaging technology, biomedical cal imaging data that are acquired e.g. the state of disease. Contributing as a subnetwork on image process- and eff ort invested by individuals. image processing has become a very in biomedical research and clinical to the development and validation of ing and in particular imaging bio- An institute like EIBIR off ers noth- active and exciting area of research. practice. novel quantitative imaging biomark- markers. ing but an opportunity, an arena. With imaging technologies zooming ers is an important challenge for the Everything which has to be achieved in on anatomy and function from As an example, computational tools biomedical image processing com- • A Cell Imaging Initiative has been will be achieved through the eff ort the organ to the cellular/molecular will be essential towards the devel- munity. formed on the use of in vivo cell of our members. I am very confi - level, there is an increased interest opment of imaging biomarkers. imaging for research on cell based dent that EIBIR will be able to cre- in computational tools that enable Imaging biomarkers comprise ana- Europe has a strong tradition in the therapies. ate the critical momentum to drive the visualisation of imaging data, tomic, physiologic, metabolic, bio- fi eld of biomedical image process- the progress of medical imaging in the fusion and integrated analysis of chemical, biophysical, and molecular ing, with a large number of excellent Th e extremely positive resonance of Europe and I am very much looking imaging data from multiple imag- parameters which can be assessed research groups. One of the projects the EIBIR initiative demonstrates forward to working with our mem- ing modalities, and the quantita- through imaging. Imaging bio- within EIBIR is to bring these groups that this is a timely and highly rele- bers towards this goal. tive analysis of biomedical imaging markers are expected to have a large together by establishing a Biomedi- vant endeavour. ‘Molecular Imaging’ impact in medicine, e.g. for bet- cal Image Processing Network. Such is being used as a buzzword to illus- ter understanding the mechanisms a network will play an important trate the increasing importance of of disease, for drug discovery and role in improving European collab- development, screening, improved oration and coordination. Further- diagnosis, and monitoring of treat- more, it is aimed that through the ment. In drug discovery, it has the network more joint or common ini- potential to be used as a surrogate tiatives will be launched, e.g. within endpoint in clinical studies. In the EU 7th FP. screening and diagnosis, it may lead to more sensitive and specifi c diag- Th e fi rst steps to initiate this network nosis. In treatment monitoring, it have already been taken. A meeting may be used to assess the response was held in Rotterdam in early Feb- to treatment at an earlier stage, ruary in order to discuss the layout of enabling individualised patient treat- the network as well as possible pro- ment. However, to realise this poten- posals to be submitted under FP7. A Prof. Wiro Niessen initiated the EIBIR tial, a processing step is required to follow-up meeting of the network is Biomedical Image Processing Platform. reliably, accurately and reproducibly being held during ECR 2007.
myESR.org ECR TODAY LEISURE SUNDAY, MARCH 11, 2007 C 23
Butterflies can prove a fascinating hobby and a welcome relief from work stresses
By Robert Lavayssière, Sarcelles, FR variations. Its colours, diff erent shades of white or pale yellow with black patterns, always remind me of my other passion, music. For an MRI specialist like me, magnetism is never far away, even when I am pursuing my favou- rite hobby of butterfl y spotting. Danais Plexippus, or the monarch butterfl y, migrates from North Of course, regional variations on a larger scale are well known. Th e famous yellow butterfl y, Gon- America to a specifi c place in Mexico to mate. Researchers epteryx Rhamni, is entirely acid yellow in the North of France, have recently discovered that its black body contains melanin, but has large orange spots on the posterior wings in the South which is paramagnetic and enables it to orientate itself in the and is named Gonepteryx Cleopatra. Th e same phenomenon earth magnetic fi eld and to fi nd its way. takes place with some other species.
From a young age, butterfl y hunting was an ideal pastime for More than 30 years ago, I became interested in the interac- me because it was associated with science, observation, and tion between the environment and butterfl ies. I had already the outdoors. Later on, I also became keen on photography. noticed that some species were vanishing from my hunting Th e world of insects, including butterfl ies, is unlimited, and fi elds because of short-term climate variations (i.e. very cold some species are still being discovered when others are van- winters or dry summers), but also because of the extensive use ishing. It is a real fascination, not only because of shapes and of pesticides or the destruction of fi elds and forests. As a fre- colours but also because it belongs to our everyday life. Th ere quent visitor to the English counties of Suff olk and Norfolk, I is always an insect near where you are, even if you do not noticed that some southern species were increasingly common know where it is. in the North of Europe, especially in marshes and fi elds with a more northern extension of species distribution. While looking A butterfl y specialist develops a second sense of seeing what for Parnassius Apollo and subspecies in France, I noticed that others do not see, and also acquires a large fi eld-of-view. Soon they were found much higher than usual, above 2000m in the aft er our wedding, I remember my wife’s astonishment when I French Southern Alps or 600m in the Massif Central, meaning jammed on the brakes because I had seen an interesting speci- that they had to adapt to some temperature changes. Th ese are men of Anthocharis Cardamines on the side of the road! My clear warning signs, added to many others. interest in butterfl ies might be linked with medical imaging because a radiologist needs to look at things diff erently and I no longer hunt for butterfl ies because I do not want to reduce with method and order, even though I initially worked as a the biodiversity and act as a predator, even with unprotected haematologist and a pathologist. species. Also, my profession takes up too much time, and it Melanargia Galatea, which possesses chemical properties closely allied to those of is now impossible to leave my practice or other activities for I do not remember exactly when I fi rst became interested in quercetin. (Provided by Dr. R. Lavayssière) a hunting campaign because one needs at least two or three butterfl ies. It must have been hidden somewhere in my genes weeks on site and a lot of spare time when back home to take because my father, who was an editor for a big publishing company in France and a historian, wrote care of the specimens. I still read quite a lot, going to museums and sometimes attending the meet- an illustrated guide to French butterfl ies before I was born. I passed on the passion to my children, ings of the Société Française d’Entomologie. When travelling, whatever the reason, I still look for who started butterfl y hunting soon aft er their fi rst steps. butterfl ies to photograph or buy.
I recall spending hours when quite a young boy, looking at bugs, ants, and butterfl ies in bushes dur- Dr. Lavayssière is a private-practice radiologist in Sarcelles, France. ing my summer holidays. I did not mind either the sun or even missing lunch. When I was eight years of age, I was given the whole outfi t and a ‘professional’ butterfl y net made of natural silk and bamboo. I started making a rigorous scientifi c collection of French butterfl ies. I had access to a fully STOP BY OUR BOOTH AT ECR loaded library at home, and I learned the Latin names and regional variations throughout Europe from famous textbooks written by Boubée, Le Moult, and Higgins, for example.
A little later, I started collecting exotic butterfl ies and developed a strong desire to go and hunt them in the fi eld. As a teenager, I was lucky to travel to parts of Africa and Asia with either my mother or Visit the father, but I still chose to concentrate on European species. I realised quite early on that however committed I was, it was impossible to gather all the species. I specialised in Papilionidaes (butter- fl ies with tails and a very widespread distribution) and Morphidaes from South America, but I did keep an eye on some species for their peculiarities, such as behaviour and migration.
Just before going to medical school, I was hiking in the French Southern Alps and in the Durance Valley, looking for Graelsia Isabellae, which is a near extinct and a protected species. I began to realise how deep the interactions were between the environment and the species and subspecies. For example, the same species can have slightly diff erent subspecies from one valley to another, booth #547 (Expo E) to depending on the nature and colour of the soil, the exposure to light, and the vegetation. I have sign up to qualify for a found the same phenomenon with Papilio Ulysses in New Caledonia, which is usually blue, free subscription! metallic blue, with some black borders and tails. Some specimens are nearly black, with a lot of variations, and I have at least 30 diff erent versions I caught in less than one month.
Although Papilio Ulysses is beautiful, if not magnifi cent, my favourite is Melanargia Galatea, which is a very common butterfl y. It is humble but gregarious, with a tremendous number of Plus... VISIT DI’S ECR 2007 WEBCAST
Visit our Webcast from ECR! Log on beginning March 9 At DiagnosticImaging.com
Sponsored by an educational grant from HealthCare
Th e Lavayssière children have inherited their father’s passion for butterfl ies. Shown here are Alix, Alice, and Mark aft er a hunt in the Dordogne in 1995. (Provided by Dr. R. Lavayssière)
myESR.org ECR TODAY st 24 SUNDAY, MARCH 11, 2007 1 LEVEL
MEDITATION ROOM
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myESR.org ECR TODAY 2007 2nd LEVEL 25
Daily news from Europe’s leading imaging congress SUNDAY, MARCH 11, 2007 CT colonography wins support but still suffers Inside Today from lack of reliable data
By Brenda Tilke nography is more cost-eff ective than ers suggest. CAD should improve the colonoscopy examination for the • National Societies colonoscopy or barium enemas. radiologists’ ability to evaluate the bowel segment with the suspicious p. 26 Colorectal cancer is one of the most complete luminal surface of the CT colonography fi nding eventually common cancers in Europe, and CT colonography also has been abdominal wall. revealed the culprit – a small, undi- • ECR meets the Czech some proponents have hailed CT touted as more patient-friendly gested piece of sweet corn. Republic colonography as the way forward for than either barium enemas or colo- “CAD can be fantastic,” Halligan said. p. 27 noscopy, but these claims are not as “It’s diffi cult to come up with an imag- At today’s state-of-the-art session, a well grounded as they might appear ing situation where a second opin- panel of CT experts will weigh the • IMAGINE at fi rst glance, noted Prof. Steven ion, even from a computer, wouldn’t promise of CT colonography against p. 28 Halligan, consultant radiologist and be a good thing. Th e fi rst time I used the realities of its current applica- professor of radiology at University CAD, it immediately showed me a tions. Th e presenters will share their • An introduction to College Hospital in London. polyp I had just missed.” insights on CT colonography and its proteomics ability to identify polyps, fi nd cancers p. 29 “People were merely asked what they Even with CAD, however, some and aff ect patient compliance, and its would do if given the choice,” he readers still miss suspicious fi nd- potential role in general population • Arts & Culture in Vienna explains. “But that’s no guarantee of ings. While training is needed to use cancer screening. p. 30 what they would actually do. We need CAD eff ectively, no one seems to real evidence that CT colonography know exactly how much training is Imaging protocols for CT colonogra- would increase patient compliance. enough. Although CAD may show phy are being refi ned, observed Dr. study comparing CT colonography We don’t have that evidence yet.” radiologists fi ndings they have over- Jaap Stoker, department of radiology, to colonoscopy or barium enema for looked on CT colonography, how Academic Medical Centre, Amster- diagnosis. Recruitment for SIGGAR1 One of the drawbacks of traditional they handle those computer prompts dam, who will be the moderator of began in 2004, and will include 4,500 colonoscopy is the incidence of is more complex, and some observ- today’s session. Stoker and his col- older symptomatic patients. Accord- Prof. Steve Halligan from London adverse eff ects. Th e sedation needed ers simply ignore CAD prompts. leagues have found that matching ing to Halligan, SIGGAR1’s lead for colonoscopy does pose a risk to prone and supine positions might investigator, the focus will be on the diagnosis. Even wide-scale screening patients. Th ere is also a risk of per- False negatives are a relatively com- improve the accuracy of polyp detec- actual diagnosis of cancer, not the has some support, and researchers foration and haemorrhage, although mon problem. Generally the false tion. fi nding of polyps greater than 1 cm. have found that 64-slice CT colonog- the incidence of potentially serious negatives result from inadequate dis- Sponsored by the National Health raphy is both sensitive and specifi c for adverse eff ects in CT colonography tension of the bowel, but this error To help answer the question of Service (NHS) Health Technology the detection of polyps of all sizes in is thought to be less than 0.1%. can be corrected. False positives are whether CT colonography really is Assessment programme, SIGGAR1 asymptomatic patients. However, not more rare. In one instance of a false the future for colorectal cancer diag- will include CAD for image interpre- all clinical evidence is positive, espe- When combined with computer- positive, a radiologist found some- nosis, the Special Interest Group in tation. Results are expected towards cially for screening of asymptomatic aided diagnosis (CAD) soft ware, CT thing suspicious on CT colonogra- Gastrointestinal and Abdominal the end of 2008. patients, and there is no solid health colonography has the potential to be phy that simply was not seen with Radiology (SIGGAR) is conducting economic data showing CT colo- as accurate as colonoscopy, support- colonoscopy. A meticulous repeat of the fi rst large-scale truly randomised
HANDS-ON WORKSHOPS & DOCTOR TO DOCTOR TRAININGS CT-COLONOGRAPHY EUROPEAN SOCIETY OF GASTROINTESTINAL AND ABDOMINAL RADIOLOGY
Th e CT image shows a cancer (white arrows) adjacent to a small polyp (black arrow) detected by CAD with a Vitrea workstation. (Provided by Prof. S. Halligan) 2007/2008 ESGAR offers the following Workshops on CT-Colonography during the calendar years 2007 and 2008
ESGAR HANDS-ON WORKSHOPS State-of-the-Art 7th ESGAR Hands-on Workshop on CT-Colonography Symposium Malmö, Sweden September 12–14, 2007 Sunday, March 11, 16:00–17:30, Room C 8th ESGAR Hands-on Workshop on CT-Colonography SA 12 CT colonography Vigo, Spain
• Chairman’s Introduction April 9 –11, 2008 J. Stoker; Amsterdam/NL • The evidence Doctor to Doctor Trainings on CT-Colonography S. Halligan; London/UK Buc, France, May 10–11, 2007 • Present perspective Buc, France, November 5–6, 2007 A. Laghi; Rome/IT • New developments P. Rogalla; Berlin/DE Please visit the ESGAR website for further information. www.esgar.org
ESGAR_2007_CT_Postcard_lay.indd 1 19.02.2007 20:08:19 myESR.org ECR TODAY nd 26 SUNDAY, MARCH 11, 2007 2 LEVEL
Polish Medical French Society Society of Radiology of Radiology
Th e Polish Medical Society of Radi- extensive educational programme and a device for directly facilitat- Th e French Society of Radiology Th e SFR publishes its own review, ology will hold a national congress is planned, which will consist of ing the precise location of the main (SFR), which was founded in 1909, le Journal de Radiologie (12 issues/ this year, which will take place on morning refresher courses and beam for typical skull x-rays. is a non-profi t scientifi c organisa- year) along with 5 Continuing Medi- May 23–26 in Bydgoszcz. Professor lunch seminars. Th ere will also be (Cieszyński A.: Beiträge zu intra- tion, devoted to promoting and cal Education textbooks. Th e SFR Władysław Lasek, head of the radi- an electronic poster exhibition and oralen Aufnahmen der Zähne. I. Die developing the highest standards also publishes educational materi- ology department of the University during the congress a large techni- Einstellung des Hauptstrahles bei of radiology and related sciences als such as syllabi, CD-ROMs and of Nicolaus Copernicus, is president cal exhibition will take place. Over intraoralen Zahnaufnahmen mit- through education, research, and books on imaging. of the congress. 1,500 radiologists are expected to tels einer Orientierungstafel, 1907. the development and harmonisation attend the congress. Cieszyński A: Beiträge zur Technik of good practices. Overall member- At the international level, the SFR Th e main topics of the congress are: bei Zahnaufnahmen mittels Roent- ship of the SFR has doubled over the is also deeply involved in providing - functional imaging Th is year, the Polish Medical Soci- genstrahlen. Cor. F.Z, 1907; 4: 289- past 10 years and as of 2006 it has educational programmes and teach- - degenerative disorders of the ety of Radiology is celebrating two 303). more than 6,000 members. ing materials in French-speaking central nervous system important anniversaries; 100 years countries, with which the SFR has - diagnostic imaging of the respi- of dental radiology and 40 years of 1967 is recognised as the begin- Th e educational programmes are developed close cooperation over ratory system interventional radiology in Poland. ning of interventional radiology in mainly accomplished during the many years. - imaging of the musculoskeletal Poland. In this year, the fi rst angio- SFR’s annual congress, the Journées system Th e beginning of dental radiology plasty of the femoral artery was per- Françaises de Radiologie (JFR), Regarding the development of good - diagnostic imaging in trans- is associated with Professor Antoni formed using Dotter’s technique, by which takes place in Paris every practices and standards, the SFR has plantology Cieszyński’s publication of the iso- Doctor Wawrzynek in the radiology October. In 2006, the attendance published 2 essential guidebooks on - advances in cardiovascular metric rule and the fi rst radiological department of Katowice. It was the was over 16,000 people, including the clinical use of medical imaging imaging stomatological atlas, the fi rst copy of fi rst publication on the subject aft er 2,066 visitors coming from abroad and optimal procedures of imaging - progress in interventional radi- which is in the archives of Munich that of Charles Dotter. (especially from Belgium, Switzer- techniques. ology University. Antoni Cieszyński was (Wawrzynek Z., Lipka E.: A case of land, Maghreb, Africa, etc). Th e - radiation protection and safety a professor of stomatology at Lvov successful restoration of patency of 2006 Congress included 224 hours Th e SFR is also involved in diff er- - quality assurance in diagnostic University and was the author of the femoral artery. Polish Medical of CME and more than 600 elec- ent professional challenges at the imaging many technical innovations, includ- Journal (Polski Tygodnik Lekarski), tronic posters in all the subspecial- national level in partnership with - modern multimedia techniques ing an x-ray cassette for stereoscopic 1968, 28: 1110-1111). ties, with the ultimate mission of other French organisations (SRH, in teleradiology and data storing pictures, a holder for extra-oral pic- promoting innovation and quality CERF, FNMR), particularly in CME, Besides 60 scientifi c sessions, an tures, holders for intra-oral pictures of healthcare. Th e JFR’s technical evaluation of professional practices exhibition, also one of the largest in and accreditation of radiologists for the world, was spread over 15,000 interventional radiology. square meters, with 150 exhibiting stands. Electronic posters, as well For further information regarding the as courses recorded during the JFR, SFR and its various activities, please are available on our website. see our website at: www.sfrnet.org.
KODAK SATELLITE SYMPOSIUM Always anticipated – the Image Interpretation Quiz
Th e Image Interpretation sessions, two traditional highlights of every ECR, provide both education and entertainment. Two panels of distinguished radiologists will share their knowledge and diagnosis strategy with you.
In the ‘senior’ quiz, European couples will challenge each other in an enjoyable and exciting competition, where they will face tricky cases. Th e moderator will guide them, while two What defines progress in the charming but impartial referees will keep track of the scores and make sure that the audi- ence is entertained.
Registrants can study the cases onsite in EPOS™ and on dedicated terminals in the entrance Radiology hall and are encouraged to take part actively and submit their diagnoses. Th e winners will be announced on the ESR website aft er the congress.
Department? Sunday, March 11, 14:00–15:30, Room A Sunday March 11, 10:30–12:00 Image Interpretation Quiz ‘Couples for Europe’ Speakers Johannes Hezel Kiel/DE Michael Ricciardone Charleston/US Moderator: A.A. Bankier; Vienna/AT Peeter Ross Tallinn/EE Thomas J Vogl Frankfurt/DE Panellists: France/United Kingdom: L.M. Hertz-Pannier; Paris/FR, S.R. Desai; London/UK Greece/Turkey: A. Oikonomou; Alexandroupolis/GR, E.T. Tali; Ankara/TR www.kodak.com/go/ecr Germany/Austria: J. Scheidler; Munich/DE, P. Reittner; Graz/AT Italy/Hungary: S. Magnaldi; Trieste/IT, I. Lázár; Miskolc/HU
Referees: H.M.L. Carty; Liverpool/UK T. McLoud; Boston, MA/US
We would like to acknowledge the contribution of the following authors to the Image Inter- All attendees will be entered into a Prize pretation Quiz (in alphabetical order): A. Ba-Ssalamah, E. Eisenhuber, A. Koller, D. Prayer, Draw for a top of the range KODAK EASYSHARE Camera and Printer Dock. M.T. Schmook; Vienna/AT. Please pick up a leaflet on the Kodak booth or as you enter the Symposium.
Kodak and EasyShare are trade marks of Eastman Kodak Company. © Eastman Kodak Company, 2007
myESR.org ECR TODAY ECR MEETS THE CZECH REPUBLIC SUNDAY, MARCH 11, 2007 C 27
Czech experts present highlights of diagnostic imaging
For the fi ft h year in a row, the suc- ECRT: Th e amount of expenditure in Brussels, and until now all prob- MM: Of course there are. For MM: Th is is the fi eld where we cessful line of special events in the allocated to health can be interpreted lems have been suffi ciently solved. instance, many non-radiology doc- appreciate the cooperation with other frame of ‘ECR meets …’ is contin- as an indicator of the government’s tors want to do (and unfortunately specialties, and I hope the apprecia- ued at ECR 2007. Besides China and commitment to healthcare – so, ECRT: Do you notice a tendency actually do) ultrasound imaging tion is bilateral. We all feel a need for Austria, the programme introduces what rating has radiology attained among your fellow citizens to over- aft er only a short one-week course, this cooperation, and the results are the Czech Republic, a country right in the Czech society since 1989? estimate some positive features of and what is even worse – insurance seen in everyday clinical practice. in the heart of Europe, which – due MM: Money is always a problem, the past healthcare model? companies pay for it. Th is is quite Th ey are fi rst of all benefi cial for the to political and social changes – had not only in Eastern Europe, and MM: Unfortunately, yes. Especially a problematic fi eld, because this patient, which is our fi rst aim. to face some specifi c challenges over fi nancing of the healthcare system older citizens oft en overestimate is done not only by specialties like the last two decades. is problematic all around the world. ‘free’ healthcare and other things. I internal medicine or surgery, but ECRT: Groundbreaking new tech- On the other hand I have to say that hope this is only a temporary thing, by many more – urologists, trau- nologies such as molecular imaging A team of prominent Czech experts the amount of modern radiological which will be overcome with the matologists etc. We are of course are pushing the boundaries of radi- demonstrates the newest devel- equipment has increased substan- new healthcare system. working on the improvement of ology – how do you judge the impact opments in radiology in their tially since 1989, although it is still this situation, but this will probably of these techniques on healthcare in country and presents a fascinat- not enough. ECRT: Can you extrapolate diffi cul- become quite a long ‘battle’. Th ere the Czech Republic? ing programme under the heading ties with funding of reimbursement are also problems in interventional MM: As we are a small country, ‘Highlights of diagnostic imaging in ECRT: Public healthcare reforms principles to Eastern European radiology and cardiovascular radi- these new technologies are avail- the centre of Europe’. It focuses on are always an unfi nished agenda; countries? How do you judge the ology, which are the same all over able in a few hospitals only and are the experience with mammography particularly in former Eastern bloc situation? the world. not used in clinical practice yet. screening, multide- However, in the sci- tector CT and MR entifi c meetings of imaging of the heart, the national radio- PET/CT imaging of logical society, we are colorectal cancer, discussing fi rst out- foetal MRI and inter- comes of the Czech ventional procedures scientists already. in portal hyperten- sion. ECRT: In conclu- sion, please allow a Th e Czech Radiologi- personal question: cal Society consists What was your main of more than 1,200 stimulus for choosing members. Th eir your profession? practice covers the MM: Radiology whole spectrum of keeps me happy, radiological proce- because I can use the dures including the high-tech computers, latest methods such sophisticated equip- as molecular imag- ment and my brain ing, specifi c contrast altogether to help agents on MRI or other people. ultrasound imag- ing. Th e latter has ECRT: If a good fairy a special history in were to grant you a the Czech Republic, wish for your depart- since it was in Prague ment, what would where Johann Chris- you ask for? tian Doppler pre- MM: I do not need sented his fi rst lec- money, this can be ture about the principle now known countries those reform-steps have MM: I think this is not only a prob- ECRT: How is Czech radiology found, but I need men and women as the Doppler principle. to be viewed as an integral part of lem in the Eastern European coun- encountering the growing need for who will be happy to learn more and a basic transformation process. In tries, but in all countries with some a multidisciplinary approach in more, and use their brains for push- In an interview with ECR Today, which way has the past political level of healthcare reform. I do not radiology? ing radiology forward. Dr. Marek Mechl, President of the system aff ected the quality of radio- understand why the insurance of Czech Society of Radiology, from logical care in your country? material things (cars etc.) works Brno, outlines the role of radiology MM: Th e political system can defi - well, and with healthcare it does in the Czech Republic today and its nitely aff ect the patient care itself, but not. In my opinion, the healthcare evolution over the past years. I am not sure it can aff ect the peo- expenses should be covered partly ECR meets the ple. And the quality of care mostly by insurance and partly directly by ECR Today: Th e beginning of radi- depends on every single doctor and the patient depending on the type of Czech Republic ology as a science has induced many person in healthcare. In those times, procedure. pioneers – can you give a short sur- there was a shortage of modern radi- Sunday, March 11, 10:30–12:00, Room A vey on outstanding Czech pioneers ology equipment, but not of good ECRT: Skilled staff are a main and their legacy in radiology? specialists and doctors at all. premise for the implementation and EM 2 Highlights of diagnostic imaging in the centre of Europe Prof. Marek Mechl: Th e Czech maintenance of high-quality radio- Radiological Society was founded ECRT: How high would you con- logical services – what do you do Presiding: C.J. Herold; Vienna/AT on July 28, 1924. Th e fi rst presi- sider the impact of the national to promote postgraduate education M. Mechl; Brno/CZ dent, Prof. Rudolf Jedlička was one radiological society? and training in modern imaging • Introduction: Overview of the history of radiology in of the most important people in the MM: Defi nitely high. Our national methods? the Czech Republic fi rst years of radiology as a clinical radiological society is the only com- MM: We are just changing our M. Mechl; Brno/CZ specialisation. He was professor of munity which keeps all radiologists postgraduate education in order to • Interventional treatment of portal hypertension radiology and surgery, and unfor- together and covers their interests. align our system with the EU. Th is A. Krajina; Hradec Králové/CZ tunately died as a victim of x-ray refers also to radiology, which is • Breast cancer screening programme in the Czech Republic: overexposure. Th e fi rst national ECRT: Did the EU directives infl u- now separating into general radiol- Current status and future objectives congress of the society was held in ence and/or alter the daily practice ogy, neuroradiology, interventional M. Skovajsova; Prague/CZ 1926. Aft er the Second World War, of radiology? and paediatric radiology. Th is helps • The role of PET/CT imaging in the management of the real postgraduate education in MM: Only slowly, but yes. For young radiologists with choosing colorectal cancer radiology started. Th e key fi gures in instance the directives about x- their specialty, and we hope this will J. Votrubová; Prague/CZ the development of radiology were ray radiation (EURATOM etc.) or be the right system for the future • Which modality should be used in patients with chest pain: Prof. Věšín, Prof. Šváb, Dr. Zucker- quality control (ISO) and, last but development of radiology. MDCT or MRI? mann and many others. Th eir legacy not least, the upcoming directives J. Ferda; Plzen/CZ is still alive today: to maintain radi- concerning working hours and ECRT: Are there any turf battles • Fetal MRI: Current status in the Czech Republic ology as an independent medical duties, which are on the way. Not all with other specialties? And if so, P. Elias; Hradec Králové/CZ specialty and also as an interdisci- directives are of course useful and how are Czech radiologists develop- plinary fi eld, which cooperates with reasonable, however, in these cases ing a pragmatic, collaborative model
© che, commons.wikimedia.org other specialties. we have our political representation to improve the situation?
myESR.org ECR TODAY 28 SUNDAY, MARCH 11, 2007 IMAGINE
Computer-Aided Image-Based Diagnosis and Therapy
At this year’s IMAGINE exhibition, sequence registration, lesion and MeVis Research, the non-profi t R&D vessel analysis, quantitative diff u- centre for medical image comput- sion tensor imaging (DTI), visuali- ing in Bremen, Germany, presents sation of tractographybased uncer- soft ware assistants for image-based tainty, functional MRI (fMRI), and diagnosis and therapy. Th e soft ware workfl ow-optimised rendering is is developed and evaluated in close possible. cooperation with a worldwide net- work of more than 100 clinicians • Cardiac imaging: For the diag- from diagnostic and interventional nosis and therapy planning of coro- radiology, oncology, cardiology, and nary artery disease, the analysis of surgery. Th e soft ware applications cause and eff ect of myocardial dys- demonstrated by MeVis Research at function is of high interest. Soft ware the ECR cover a wide range of medi- assistance allows for an inspection of cal disciplines: from tumour analysis, coronary arteries, myocardial func- to cardiac and neuroimaging to liver tion, perfusion, and late enhance- surgery and interventions. ment based on MRI and CT. In a 3D visualisation, results from these Visitors to the IMAGINE exhibition examinations are combined to are invited to experience in hands- assess topological correspondences on presentations the capabilities and between impaired tissue and the usefulness of modern image analysis supplying coronaries. soft ware that is increasingly inte- grated into the clinical workfl ow. • Surgery and intervention plan- Important take home messages are: ning: Oncological liver surgery, living donor liver transplantation • Tumour volumetry: Con- (LDLT), and percutaneous radio Computer-assisted surgery planning: ventional monitoring of chemo- frequency ablation (RFA) of liver Patient-individual risk analysis for the hepatic veins in oncologic liver surgery. therapy via visual estimation or tumours are supported by image- RECIST is highly irreproducible based planning soft ware. Th e plan- and subjective. Soft ware tools for ning soft ware allows for a detailed the volumetric monitoring of che- preoperative risk assessment, e.g. of motherapy enable the radiologist the functional remaining volume to measure volume and growth of in the remnant/graft in surgery metastases and primary tumours and the risk of incomplete tumour in lung, liver, and brain as well as destruction when using RFA. enlarged lymph nodes with high reproducibility and accuracy. Th e clinical impact of the image- based soft ware assistants developed • Tumour analysis: Modern by MeVis Research is manifold. soft ware tools are able to analyse Changes in tumour volumes can dynamic contrast-enhanced MR be measured earlier and more pre- images of diff erent tumour enti- cisely than the diameters in stan- ties. Th ey provide one-click seg- dard RECIST criteria thus allowing mentation for the computation better monitoring of chemotherapy. of morphological parameters and Clinicians can identify ineff ective the distribution of kinetic proper- treatments earlier and therefore ties. Th e extraction of physiologic avoid unnecessary adverse eff ects in quantities can be based on diff er- patients and reduce costs. Image and ent model-based approaches (e.g. risk analysis in liver surgery planning Brix and Toft s Model). allow identifi cation of the patient or donor’s individual surgical strategy • Neuroimaging: Integrated soft - and thus minimising the risks associ- ware tools facilitate risk assess- ated with the intervention. Th e soft - ment and longitudinal analysis of ware assistants for surgery planning the human brain based on MRI have been used in more than 2,300 with applications in neurosurgery, clinical cases for liver, kidney, pan- radiation therapy, neurology, and creas, and other surgeries as well as Computer-based quantitative analysis: oncology. In particular, combined in studies of liver regeneration aft er Head, brain, and ventricles segmented from volumetric MR images. evaluation of automated inter- LDLT.
IMAGINE – the high-tech specialty exhibit
Aft er being absent at last year’s con- standing conferences regarding high- Th e focus is on CAD, interactive gress – and bitterly missed by many tech in radiology. visualisation, image-guided interven- delegates – a most popular feature of tions & robotics, and computer-based former meetings is reinstalled at ECR Th e main aim of IMAGINE in 2007, training. IMAGINE 2007 – IMAGINE, the high-tech spe- as well as in the following years, is cialty exhibit. to provide a platform at ECR to Th e location on the second fl oor of the show new technological develop- congress venue in Foyer A is ideally Opening Hours: Th e former IT committee of ECR, ments in the fi eld of diagnostic and suited for the presentation of IMAG- Prof. Davide Caramella, Prof. Wiro interventional radiology. In contrast INE, as it provides suffi cient space Sunday, March 11 08:00–18:00 Niessen (as successor of Prof. Bart to the technical exhibition which for all groups and for discussions in Monday, March 12 08:00–18:00 ter Haar Romeny) and Prof. Joachim shows already available products, front of the booths. It will therefore Tuesday, March 13 08:00–12:00 Kettenbach, together with the ECR IMAGINE focuses on research and help to intensify cooperation and Executive Committee, decided to re- gives a preview of future evolution further contact between individuals, 2nd level, Foyer A establish IMAGINE in 2007, since and trends. IMAGINE aspires to institutes and universities, thus add- an exhibit of such quality would function as an ‘antenna’ for devel- ing to ECR’s status as a perfect meet- certainly further contribute to ECR’s opments soon to come but not yet ing place for all those who want to be reputation as one of the world’s out- commercially available. part of the future of imaging.
myESR.org ECR TODAY RELATED SCIENCE SUNDAY, MARCH 11, 2007 C 29
Gene-hunters turn to proteins for the next mapping challenge
By John Bonner able. Advances in automation and One of the fi rst diagnostic tests of bioinformatics may be needed, how- this type is the prostate specifi c Cells from diff erent parts of the body ever, to process the masses of data antigen (PSA) test used to identify may look and behave quite diff erently, that will be generated. prostate cancer. Clinical benefi ts of but at the nuclear level they are like such work have so far been limited, identical twins. Th e genetic content Th e fi rst step in tracking proteins is though. Tests relying on the expres- of cells making up the body’s internal to create an antibody that attaches sion of a single protein have proven organs, skin, blood, and connective itself to a specifi c protein. Tissue to be unreliable in practice. tissue is the same. Th e only diff erences stains linked to the antibody should between these so-called somatic cells then reveal the target protein’s pres- Research involving multiple bio- are the ways that genes encoded in the ence in diff erent cells of the body. markers may produce better results. DNA are expressed or suppressed. Biological mass spectroscopy will For instance, investigators are exam- also be an invaluable tool for iden- ining specifi c proteins found in the Following on from the Human tifying unknown proteins. Another urine of patients with renal cell carci- Genome Project, discussed in yes- technique, 2D gel electrophoresis, noma as possible biomarkers. A third terday’s ECR Today, researchers now will be employed to separate out dif- of patients with renal cell carcinoma want to identify and characterise the ferent molecules from complex pro- will have metastatic spread by the estimated two million proteins pro- tein mixtures extracted from tissue. time their condition is diagnosed. duced by the 20,000 or so genes in Initial studies using urine protein the human body. Th is new project Genes, proteins and drugs biomarkers in at-risk individuals and will additionally study the dynam- Proteomics will undoubtedly play an patients already receiving treatment ics of protein expression. While the increasingly important role in drug led to earlier diagnosis and produced genome remains virtually constant discovery, diagnostics, and molecu- a signifi cant reduction in mortality. over time, the proteins it produces lar medicine, given the links between change in response to both internal genes, proteins, and disease. Approxi- From man to beast and external factors. mately 99% of all drugs are either pro- Humans are not the only species teins themselves or work by binding likely to benefi t from genomic and Th e study of all these diff erent pro- to a protein. proteomic research. Aft er all, Homo teins has been termed ‘proteomics’. sapiens was not the fi rst species to Th is has in turn spawned a number An understanding of the gene undergo complete DNA sequencing. Researchers are now turning their attention to identifying and characterising the estimated of sub-disciplines, such as glycopro- sequence, and post-transcriptional Th at honour belongs to the nema- two million proteins produced by the 20,000 or so genes in the human body. teomics and phosphoproteomics, changes in proteins linked to it, will tode worm Caenorhabditis elegans. in which researchers examine post- have obvious benefi ts in disorders Nor will humans be the last species species, such as cattle and chickens, organisms will help researchers treat translational chemical modifi cations caused by defects to a single gene. analysed in this way. and/or signifi cant disease agents, existing conditions, and predict and to proteins. Th is knowledge may aid research on for example, the causes of TB and prevent new, emerging infectious drugs that modify the shape of defec- Several more sequencing projects malaria. Similar studies of genomic/ diseases. Proteomics builds on knowledge tive proteins or mimic those that have focussed on important domestic proteomic interactions in these already gained from the genome patients are missing. project. Understanding the coding sequence contained in DNA allows Advances in proteomics have also researchers to characterise just a few heightened interest in the concept amino acids from a stretch of protein. of pharmacogenetics. Th is concerns Th ey can then search through exist- linking the effi cacy of a drug to the ing databases to match this segment genetic profi le of a specifi c popula- with the complete molecule. tion group or individual.
L INTERNATIONAL A Th e project is being coordinated by Diagnostics is an even more prom- N ACADEMY OF O I T MEDICAL the Human Proteome Organisa- ising area for clinical proteomics. A N R ULTRASOUND E tion, and is expected to take at least Identifi cation of specifi c proteins T N 10 years. Some progress has already expressed by cells in patients with I been made. Researchers announced various diseases could lead to a new the fi rst maps of about 400 diff erent range of accurate biomarkers. Th is proteins in March 2005. approach would be particularly valu- able in conditions where early diag- Advanced Course All the basic techniques needed to nosis is diffi cult, for example, ovarian complete the job are already avail- cancer. in Musculoskeletal 1 Ultrasound TEACHERS: LOCATION: Free Publications at Prof. Stefano BIANCHI Hotels van Oranje, University of Geneva, CH Noordwijk -NETHERLANDS
ECR 2007 Prof. Carlo MARTINOLI TIME: University of Genova, I May 4th - 5th, 2007
Final details available at the educational site www.sonoportal.net
Pick up your free copies of radiology journals and magazines ... Get free access to online radiology journals ...
ECR is proud to present its delegates with a new feature at this year’s meet- Contrast-Enhanced Ultrasound: ing. We are happy to have established a new form of cooperation with our "current" applications and partners in the publishing business, resulting in a new service for our visitors – the FREE PUBLICATIONS booth on the 1st level. 2 future challenges 33 publishers joined this new initiative and present more than 40 print media TIME: and almost 30 online journals. September 2007, 2 days
Free bags will be provided, so pick up as many magazines as you can carry. Final details available soon at the educational site www.sonoportal.net
myESR.org ECR TODAY 30 SUNDAY, MARCH 11, 2007 ARTS & CULTURE
Cultural rendezvous Meet the eighth muse What’s on today OPERA Staatsoper in a baroque Palais 19:30 Der Rosenkavalier by Richard Strauss, conductor Adam Fischer with Angela Denoke, Wolfgang Bankl, Elina Garanca, Marlis Petersen By Julia Patuzzi, ESR Offi ce Erlach to design the main part of the Slezak and Klaus Maria Brandauer, Volksoper palace. In 1694 the building of the and costumes based on sketches by 16:30 Der Freischütz by Carl Maria von Weber Just around the corner from the leg- Palais was completed. From 1745 up Pablo Picasso and Caspar Neher, Ber- endary Hotel Sacher there is a real until the 1970s (!) it was owned by tolt Brecht’s celebrated collaborator. CLASSICAL MUSIC gem to be discovered among the the Lobkowitz family, an art-loving Programmes and posters represent Musikverein innumerable museums of Vienna. aristocratic family from Bohemia, the evolution of graphics and layout 19:30 Concentus Musicus Wien, conductor Nikolaus Harnoncourt Th eatre lovers are invited to visit the whose best-known member, Duke from 1713 – the oldest programme W.A. Mozart incredible collections of the Austrian Franz Joseph Maximilian was an avid on display – up to little Jugendstil Museum for Th eatre, located in the supporter and admirer of Ludwig masterpieces to great examples of the JAZZ beautiful Palais Lobkowitz. van Beethoven. Th e great composer art of poster illustration. Amongst the Konzerthaus even dedicated his third symphony compilation of theatre photographs 19:30 Branford Marsalis Th e Palais Lobkowitz was the fi rst to Duke Lobkowitz, thus the great you may detect pictures of legend- The Jazz Saxophone legend eminent baroque palace in Vienna festival room of the Palais was aptly ary productions by Max Reinhardt, Porgy & Bess to be built aft er the second siege of named ‘Eroica-hall’. as well as documents of the Russian 20:00 Parasites & Kazuhisa Uchihashi (F/J) Vienna by the Turks in 1683. Th e avant-garde and early movie stills. court architect Giovanni Pietro Ten- Aft er a long period of being home THEATRE cala was commissioned to construct to various embassies and diplomatic Right now, a special exhibition enti- Akademietheater it and convinced the famous baroque representations, the Palais came into tled ‘Th e roles of Paula Wessely’ pres- 19:00 Arsen und Spitzenhäubchen by Joseph Kesselring master Johann Bernhard Fischer von the possession of the Republic of Aus- ents the life and times – and of course Burgtheater 17:00 Viel Lärm um nichts by William Shakespeare Odeon 20:00 Com di com com by Ulrike Kaufmann and Erwin Piplits Rabenhof 20:00 Galanacht by Werner Schneyder Schauspielhaus 20:00 Der Ubu-Komplex by David Maayan inspired by Alfred Jarry Theater in der Josefstadt 15:00 Die Möwe by Anton Tschechow 20:00 Der Revisor by Nikolaj Gogol Volkstheater 19:30 Cabaret by Masteroff / Kander / Ebb / Walker
Culinary treats
Just have a look on the right side and you will know for sure what today’s recipe will bring you: The mouth-watering, world-famous delicacy from one of the lead- ing hotels of the world – the legendary Sachertorte.
Sachertorte
Th e baroque Palais Lobkowitz houses the outstanding collections of the Museum for Th eatre. Ingredients for 1 cake, 9” in diameter, 2” high tria and for years was renovated and the roles – of Paula Wessely, one of Sacher batter refurbished. At long last, the Austrian the 20th century’s most esteemed 4 ¼ oz. butter Museum for Th eatre at Palais Lob- and eminent stage actresses in the 4 ¼ oz. liquid couverture kowitz was founded in 1991, fi nally German-speaking countries. With 2 1/8 oz. icing sugar gaining independence from the Aus- the help of numerous photographs, 4 oz. egg yolks trian National Library, whose theat- fi lms and personal memorabilia the 6 oz. egg whites rical collections from 1922 onwards exhibit documents her work, start- 5 oz. granular sugar created the basis for this museum. In ing with her years at the Volksthe- 4 ¼ oz. plain flour 1923, the largest private collection of ater in Vienna, to Prague and Berlin approx. 7 oz. apricot jam for filling and coating theatre-related artefacts of its time, and back to Vienna, where she was Sacher icing the collection of Hugo Th imig, leg- for decades one of the pillars and endary actor and artistic director of the main female protagonist of the Cream the butter together with the couverture and icing sugar. Gradually add the Burgtheater, was bought by the famous Burgtheater. the egg yolks. Beat the egg whites with the granular sugar until stiff. Stir National Library to add to its own together the two mixtures, fold in the flour. Fill into a cake ring and bake at treasures. 355°F (180°C) for approx. 60 minutes. lncrease the heat to 390°F (200°C) 10 minutes before the end of the baking time. Th e museum’s permanent exhibition Slightly round off the upper edge of the cake. Cut through once horizontally and presents the most beautiful and most fill with apricot jam. Place on a cake cardboard and coat the cake with piping interesting of the museum’s collec- hot apricot jam. Place on a glazing rack, prepare a non-flexible support (e.g. a tion of over 1.6 million objects, illus- Museum for Theatre ! board) for setting aside the iced cake. trating the fi elds of costume design, 1010 Vienna For the original Sacher icing have a look at the Sacher cookbook or contact stage design, photography, posters, Lobkowitzplatz 2 [email protected]. sketches, props, and other parts of www.theatermuseum.at the world of theatre. Th e costume collection alone consists of about 700 Opening hours pieces, providing an overview of 200 Tuesday – Sunday years of design and displaying outfi ts 10:00–18:00
worn by famous actors such as Leo (2) Theatermuseum Österreichisches ©
myESR.org ECR TODAY ARTS & CULTURE SUNDAY, MARCH 11, 2007 C 31
Places to see Visit the Belvedere – and enjoy a stunning view of Vienna
By Julia Patuzzi, ESR Offi ce completed just two years later in 1716. Hall, rooms sumptuously embellished from the Middle Ages to the pres- tav Klimt, is undoubtedly the main Today, the former living quarters and with stucco and frescoes (frescoes by ent day. In the Lower Belvedere the highlight of the Österreichische Gal- One of the most beautiful places in staterooms of this baroque summer Carlo Carlone, ceiling paintings by Museum of Medieval Art and the erie Belvedere’s collection. A further, Vienna, which you should not miss residence are still an impressive sight. Giacomo del Pò) and the chapel with Baroque Museum are located. equally important part of this section even if you only have little spare time, Attractions include the Marble Hall the exquisite altarpiece by Francesco of the collection is dedicated to the is the Belvedere Palace, a magnifi cent – adorned with frescoes by Martino Solimena. Th e collections of the 19th and 20th works of Oskar Kokoschka and Egon baroque ensemble. It ranks among Altomonte –, the state bedroom, Hall centuries are housed in the Upper Schiele, representing Austrian Early the world’s most beautiful and best of Grotesques and the Marble Gallery. Both palaces, which are masterpieces Belvedere. Th e second fl oor contains Expressionism. preserved historic palaces and parks. Th e Lower Belvedere also incorpo- of baroque architecture, were con- some 130 pictures and sculptures, Th e two palace buildings, the Upper rates the orangery and palace stables, nected by a symmetrical garden based off ering a representative survey of the Summing it up, the Belvedere seems to and Lower Belvedere, are linked by formerly used for the prince’s horses. on French and Italian examples. With development of art from the end of be one of the ‘musts’ during your stay in a unique baroque garden. Strolling its many garden sculptures, fountains, the 18th to the mid-19th centuries. In Vienna, presenting a spectacular exte- through this garden and relishing its In 1717, the decision was made to zoo, orangery (today the Museum of the categories of Neoclassicism and rior as well as marvellous treasures of unique atmosphere you may enjoy build the Upper Belvedere. Construc- Medieval Art), greenhouses for exotic Romanticism the portraits and atmo- art inside – a sight well worth visiting. one of the most renowned and stun- tion took place between 1721 and plants and a large volière, the park was spheric landscapes (such as those of ning views of Vienna. 1722 and the interior decoration was one of the most lavish and elaborate Caspar David Friedrich) dominate, Schloss Belvedere completed the following year. Th e European gardens of the 18th century. while the paintings of Ferdinand 1030 Vienna In 1714 the Austrian general Prince garden palace primarily served the Georg Waldmüller, Jakob Alt and oth- Prinz Eugen-Strasse 27 Eugene of Savoy (1663–1736) com- purpose of pomp and display. Th is is Th e Belvedere Palace houses the ers provide the highlights of the Bie- www.belvedere.at missioned the architect Johann Lucas refl ected in the elegant sala terrena Österreichische Galerie Belvedere, dermeier collection. Art of the period von Hildebrandt (1668–1745) to build (today the entrance hall), the grand one of the world’s most important around 1900, with key works by its Opening hours: the Lower Belvedere. Th e palace was staircase, the magnifi cent Marble museums, with collections spanning most important representative Gus- Tuesday – Sunday 10:00–18:00
Literary encounters
death, his wife Elisabeth took over The most famous cake in the world – the reins, which she still holds today together with her daughter.
and more of Vienna’s delicacies With this cookbook, you not only have a beautifully illustrated, com- By Nils Jensen, Viennese author, modern classic Austrian cuisine. famous cake. Th e exquisite delicacy, pact volume about modern Austrian Buchkultur Once, in the 19th century, Anna oft en imitated but only authentically cuisine at your hands, including Sacher, the then owner of the Sacher composed here, is still prepared fol- marvellous food photos and under- Th e calling cards of Vienna: fi rst and Hotel, ruled with a rod of iron and lowing the ancient recipe, which has standable instructions, but you also foremost Schönbrunn Palace, then established a noble worldwide rep- remained a well-kept secret of the learn in a nicely written historical the Lipizzaner, the leg- house up to this day. sketch about how the Sacher became endary white horses the Sacher, how everyday cooking in that present dressage However, some elements the Sacher’s kitchen works and what at the peak of perfec- of the secret have been the daily routines behind the scenes tion, and of course the revealed, since from the of a fi rst-class hotel are like. And all mighty cathedral in 1980s a cookbook has been this spiced with anecdotes and sto- the heart of town, the published again and again ries about table etiquette, famous metropolitan church presenting the fi nest dishes and infamous guests, secrets and of St. Stephen’s. Oh from the Sacher kitchen. mishaps. By the way, the Sacher has yes, and there is some- Now, a new Sacher Cook- a sister hotel in Salzburg, the city of thing else connoted book has been issued, com- Mozart. Here and there the same with this lovely city on piled by one of the leading values apply: a traditional family the banks of the beau- gourmets and restaurant business with highest quality stan- Alexandra Gürtler / ! tiful blue Danube, critics of Austria, Chris- dards and demands, which result Christoph Wagner especially by gourmets toph Wagner, together with in worldwide fame, not only for the The New Sacher Cookbook – the Sachertorte. utation for the house. Part of it is Alexandra Gürtler, the junior boss. Sachertorte. Favorite Austrian Dishes. based on the celebrated Sacher cui- Pichler Verlag. Th e name Sacher has long been sine, the right mixture of down-to- Her father, Peter Gürtler, cautiously The book is available in English, associated with quality gastronomy earth cooking with an international steered the hotel towards mod- Translation by Julia Patuzzi, ESR German, and Italian.
© Österreichische Galerie Belvedere Anzengruber / Toni ‘Wien’, Pichler Verlag of international standing, as well as touch and – well, of course the ern gastronomy and then, aft er his Offi ce.
myESR.org ECR TODAY nd 32 SUNDAY, MARCH 11, 2007 2 LEVEL
4 ESCR 6 ESGAR 8 EUSOBI 10 EuroPACS 5 ESPR 7 ESTI 9 CIRSE 11 ESHNR
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myESR.org