ECR TODAY 2007 Daily News from Europe’S Leading Imaging Congress
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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. 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See it in action now at the ECR 2007 Hall A - Booth number: 104 www.canon-europe.com/medical [email protected] 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.