22 TECHNOLOGY & RESEARCH ECR TODAY | WEDNESDAY, FEBRUARY 28, 2018 ECR TODAY | WEDNESDAY, FEBRUARY 28, 2018 TECHNOLOGY & RESEARCH 23

BY ERIK RANSCHAERT, PETER VAN OOIJEN, WIRO NIESSEN BY GUY FRIJA EuSoMII: radiologists EuroSafe Imaging as role model should actively engage in for medical radiation protection imaging informatics initiatives worldwide Medical imaging informatics is a rapidly evolving field in radiology thanks to new The EuroSafe Imaging campaign was launched by the European Society of Radiology technologies that have evolved at a dazzling pace over the past few years; in areas such as (ESR) in 2014 to support and strengthen medical radiation protection across Europe using radiomics, machine , augmented and , and 3D planning and printing. a holistic, inclusive approach. The ESR and the EuroSafe Imaging Steering Committee The European Society of Medical Imaging Informatics (EuSoMII) is convinced that issued a Call for Action to better achieve the EuroSafe Imaging objectives: promoting radiologists’ should be more actively engaged in these developments as they are vital to appropriateness in radiological imaging, maintaining radiation doses within diagnostic the future of radiology. reference levels, using the ALARA principle and promoting the use of up-to-date equipment, empowering patients, and joining forces with various stakeholders. try exhibition there was a machine The common thread throughout example, the physical principles of learning area where dozens of AI most presentations at the RSNA and MRI. This will enable them to better start-ups demonstrated their activi- EuSoMII Academy was that radiolo- understand the decision processes ment of diagnostic reference levels ties and some clinical use cases. gists should not feel threatened by that are active in artificial intelli- (DRLs), the organisation of radia- Likewise, the EuSoMII Academy AI, but view it as a source of support, gence, and to gain a better insight tion protection training courses for on AI, which took place one week as long as they are eager to embrace in what’s going on in the ‘black healthcare staff and the promotion earlier at the Erasmus MC University these new developments, and are boxes’ in which these automated of safe paediatric imaging. Medical Center in Rotterdam, was willing to actively coordinate and choices and proposals are being Last but not least, the Image fully booked. Approximately 50% of steer their clinical usability. made. To increase knowledge in In addition to EuroSafe Imaging’s Gently Alliance and Image Wisely the participants were radiologists, As Dr. Keith Dreyer, Vice Chair- medical imaging informatics, a spe- comprehensive activities to pro- initiative need to be highlighted. and the rest were a mix of IT profes- man of Radiology at Massachu- cialised training programme should mote quality and safety in medical The mission of the Image Gently sionals, clinical physicists and indus- setts General Hospital, stated at the be developed and implemented to imaging in Europe, it is also com- Alliance, launched in 2007, is to try representatives. This made it a RSNA: “Radiologists and AI will be train radiologists in this area. mitted to promoting radiation pro- improve safe and effective imaging unique meeting of radiologists and far better together than either one EuSoMII wants to increase aware- tection beyond Europe’s borders. care of children worldwide through technological experts in the field. alone.” According to Dreyer the ness among radiologists of this In particular, EuroSafe Imaging advocacy. Recently, the Image Gen- Imaging is one of the most greatest challenge however lies in on-going revolution in radiology and is supporting safe imaging initi- tly Alliance launched the ‘Think The EuSoMII Academy took place in Rotterdam on November 18, 2017. advanced areas of AI, and will the creation of an AI ecosystem increase their engagement in these atives worldwide and attending A-Head’ campaign to promote the undoubtedly have a huge impact in which new applications can be new developments in a multidis- conferences and meeting all over justification and optimisation of CT Medical imaging informatics, also to combine imaging data with data on diagnostics and prognostics created, validated, approved, inte- ciplinary environment. To achieve the world to inform others about imaging in minor paediatric head known as radiology informatics, is from other medical disciplines through revolutionising medical grated, surveyed and adopted. This this it will, for example, organise EuroSafe Imaging’s activities and to trauma. This campaign is targeted a subspecialty of biomedical infor- such as genetics and metabolomics, image acquisition, analysis and sub- ecosystem should be based on a hands-on workshops in deep learn- inspire further action. at a broad spectrum of healthcare matics that aims to improve the which has increased the number of sequent clinical decision support. framework in which radiologists ing. Several webinars on the topic EuroSafe Imaging is represented professionals who care for children efficiency, accuracy, usability and stakeholders in this domain. Smart will improve and other healthcare profession- of imaging informatics will also be at more than 50 events annually in the acute care setting, as well as reliability of medical imaging ser- EuSoMII aims to stimulate con- image quality, enable more accurate als involved in imaging informat- offered in 2018, and the programme around the globe. Its represent- patients and their families. vices within the healthcare enter- sultation and the exchange of infor- and automated analysis of MRI, CT ics and data-intensive domains in will be available at eusomii.org. The atives regularly attend meetings The American Image Wisely ini- prise. As radiology is an inherently mation between the various parties scans, x-rays and any other medical medicine are included, i.e. biomed- EUSOMII annual meeting will take organised by the International tiative launched in 2009 aims to data-driven and technology-driven involved and to increase the active images, and be able to detect signs ical computer scientists, clinical place in October 2018 in Rotterdam, Atomic Energy Agency (IAEA), the raise awareness and provide up-to- specialty, radiologists have become participation of radiologists in sci- in the recordings that are not pos- physicists, healthcare institutions, where many research projects and World Health Organization (WHO) date educational resources for leaders in medical imaging infor- entific research related to imaging sible with the human eye1. Deep professional organisations, indus- new developments will be presented. and the Heads of European Radi- radiology professionals and refer- matics. The field of imaging infor- informatics. This is reflected in the learning in particular has recently trial and pharmaceutical players ological Protection Competent ring clinicians regarding the use of matics is not only rapidly expand- composition of the EuSoMII board, been shown to rival or outperform and regulating authorities. Such Erik Ranschaert, MD, PhD, is Authorities (HERCA). ionising radiation in adult medical ing in radiology, other specialties on which radiologists, computer sci- human performance in a number an AI ecosystem should be able to Radiology Consultant at ETZ EuroSafe Imaging also had a imaging examinations. Building such as cardiology, dermatology, entists, and medical physicists from of tasks. Therefore, AI applications support and facilitate the standard- Tilburg, the Netherlands, and strong presence at various talks Photo taken during the IAEA International Conference on Radiation Protection in Medicine: Achieving Change in awareness through the initiative’s neurology, pathology and ophthal- all over Europe and other parts of will increasingly be integrated into isation of the entire development Vice-President of the EuSoMII. and poster sessions at the IAEA Practice (December 11–14, 2017, Vienna). From left to right: Monika Hierath, ESR EU/Int. Affairs Department, Renato annual pledge is one of the major mology are also increasingly using the world are represented. the daily radiological workflow, process of AI software, from crea- Peter Van Ooijen, MSc, PhD, International Conference on Radia- Mendonca, ISR Treasurer, David Koff, CanadaSafe, Boudjema Mansouri, Arab Safe & AFROSAFE-FR, Dina Husseiny, aspects of the initiative. digitised images. As a result, imag- The digitisation in radiology is which means that it can be con- tion through to adoption. It should is Associate Professor at the tion Protection in Medicine: Achiev- Egypt, Guy Frija, EuroSafe Imaging, Donald Frush, Image Gently Alliance, Maria Perez, WHO, Michael Kawooya, The International Society of ing informatics is becoming a spe- increasing at a breath-taking speed, sidered as one of the main game guarantee the optimal integration University of Groningen, UMCG, ing Change in Practice held in AFROSAFE-EN, William Mayo-Smith, Image Wisely, Luis Donoso, ISR President-Elect, El Hadj Niang, Senegal. Radiology Quality and Safety Alli- cialism-transcending discipline. a fact that cannot be ignored. At the changers in radiology. and added value of AI applications. Groningen, the Netherlands, and Vienna, Austria, in December 2017. ance (ISRQSA) acts as an umbrella This development is demon- RSNA 2017 convention it became As well as automated image Imaging informatics is an inter- a EuSoMII Board Member. Discussions at the conference con- providing and raising survey on the awareness and appli- cal techniques in terms of safety, organisation for these radiation strated by the progressively ongo- clear that a seismic shift is taking analysis, many other AI supported disciplinary field enabling its prac- Wiro Niessen, MSc, PhD, is firmed for EuroSafe Imaging that awareness. Since its launch, Africa cation of the principles of the Bonn standardisation and optimisation protection initiatives. The overar- ing shift in many hospitals towards place in healthcare and that the applications will emerge which are titioners to better understand and Professor of Biomedical Image their work is helping them achieve has made reasonable progress in Call for Action amongst Canadian of image scanning, and to apply it ching objective for the ISRQSA in the integration and use of imaging age of artificial (AI) has able to improve the value of radiol- analyse medical images. If radiol- Analysis at Erasmus MC in their objectives. However, EuroSafe implementing some areas of the healthcare professionals work- to medical policy. the area of radiation safety is to data throughout the health enter- begun. At many of the AI-related ogy services, such as tools to intel- ogists want to be actively involved Rotterdam, the Netherlands, and Imaging concluded that still more Bonn Call for Action, despite lim- ing with radiation equipment in Arab Safe is the most recent safe establish a strategic plan for global prise. Besides radiologists and scientific sessions it was standing ligently minimise the radiation and reap maximum benefit from a EuSoMII Board Member. training, more awareness and more ited resources. medical imaging. Activities will be imaging campaigned launched in efforts related to quality and safety. other physicians, IT experts, clinical room only, and several refresher dose in CT, improve the radiologi- developments in this field, they effective implementation of reg- In Canada, although the delivery planned according to the results of May 2017. It consists of both an Eng- This strategic plan should reflect physicists, various industry players courses were filled to capacity. More cal workflow, facilitate communi- should also receive training in Reference: ulations are needed worldwide to of healthcare is a provincial respon- both surveys. lish and French branch. The initiative the efforts of these campaigns. and vendors involved with medical than 100 researchers from around cation with referring doctors and and sub-fields of 1Artificial Intelligence in Health- better protect patients and health sibility, a focused national strategy LatinSafe was established in aims to impact the current diagnos- imaging are actively participating the world described the potential patients, and link image-derived and machine care, Bertalan Mesko, https://leanpub. professionals from undue radiation and a unified effort are needed to April 2016 with the aim to promote tic imaging practice, support self-reg- Prof. Guy Frija is Chair of the in this rapidly expanding discipline. and applications of AI in a variety information with other data for learning, similar to the training com/ArtificialIntelligenceinHealth- exposure related to medical imag- ensure radiation safety in med- safe diagnostic imaging in Latin ulation, increase awareness of radia- EuroSafe Imaging Steering There is also a growing tendency of clinical scenarios. At the indus- integrated diagnostics. radiologists already receive in, for care (accessed 7 December 2017) ing procedures. ical imaging. Thus, Canada Safe America, placing an emphasis on tion safety of patients, workers, and Committee and Co-Chair of the new The success of EuroSafe Imag- Imaging was launched in Decem- radiological protection of patients the general public, and promote a International Society of Radiology ing has inspired radiology societies ber 2015. The campaign is a multi- and staff. In particular, LatinSafe radiation safe culture. In particular, Quality and Safety Alliance. BY YULIA SHEVCHUK in other regions to follow suit and disciplinary undertaking with the uses educational activities to raise Arab Safe focuses on the establish- establish campaigns to promote vision to strengthen medical radi- awareness among radiologists, radiation protection. Due partly ation protection in patients and to referrers, technicians, patients and to EuroSafe Imaging’s example, a foster a culture of radiation safety the general public. number of campaigns have been in Canadian healthcare. As a first The Japan Safe Radiology initi- Medical imaging driving innovation launched in recent years. step, an environmental survey of ative was launched in June 2016. It The AFROSAFE campaign was all national and provincial organ- targets a variety of topics related launched at the Pan African Con- isations in Canada that involve to safety and efficiency of medi- Medical imaging is among the nostic tool. New imaging techniques hybrid and molecular imaging, Com- access to examinations quicker and step in medical imaging, and should gress of Radiology and Imaging medical imaging was performed to cal imaging including equipment/ most innovative fields in European help us to predict diseases, to see puter Aided Detection (CAD), and mean they are available everywhere, help us to optimise workflow and (PACORI) in February 2015 in Nai- identify if the organisations were scanner distribution, radiation healthcare. According to an analy- biochemical changes and as a result tumour-specific biomolecules tagged thereby optimising collaboration improve quality of service. robi, Kenya. The campaign consists following the Bonn Call for Action dose management, standardisation sis of data from the European Pat- to start treatment earlier,” said ESR with isotopes. All of these are dramat- between all specialists involved in Discoveries in medical imaging of an English and a French branch recommendations. The survey and optimisation of image quality ent Office, medical imaging patents President Prof. Bernd Hamm. ically increasing specificity and sensi- the treatment of patients. Real- have changed healthcare systems, and aims at raising awareness on showed that no single organisa- and the radiology report, as well have constituted almost one third Medical imaging is continually tivity of diagnostics and improving time visualisation helps to con- but there are many research pro- the need for medical radiation tion in Canada has implemented as appropriate use of imaging. The of patents in the field of medical developing and every year brings health outcomes for patients. trol interventional procedures or jects still being conducted and protection to prevent unnecessary all of the recommendations of the initiative aims to generate, analyse technology over recent years. us unique new clinical capabilities Information technology inno- analyse the function of the organ. maybe the most significant discov- medical radiation exposure. The Bonn Call for Action. Canada Safe and use a national of diag- “Imaging is no longer a pure diag- such as 3D imaging and printing, vations in medical imaging make Machine learning will be the next eries are yet to come. activities are primarily focused on Imaging now envisions another nostic imaging to improve medi-

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