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Downloaded on the Device )NSIGHTSª)MAGINGª ªª3UPPLª 3n3ª $/)ªS ª Postgraduate Educational Programme Categorical Courses (CC) EFOMP Workshop (EF) ESR meets Sessions (EM) European Excellence in Education (E³) Honorary Lectures (HL) Mini Courses (MC) Multidisciplinary Sessions (MS) New Horizons Sessions (NH) Opening Lecture (OL) Professional Challenges Sessions (PC) Refresher Courses (RC) RTF - Radiology Trainees Forum (TF) Special Focus Sessions (SF) State of the Art Symposia (SA) " # # !"# "# # A B C D E F G S1 !"!"! " # A B C D E F G S2 !"!"! 12:30 - 13:30 Room E2 Learning Objectives: 1. To understand the indications for percutaneous image-guided biopsy. The Beauty of Basic Knowledge: Skeletal Radiology 2. To learn about the practical aspects of biopsy, needle selection and guidance techniques. MC 26 A 3. To learn how to approach difficult lesions and avoid complications. Plain radiographs: analysis and 14:00 - 15:30 Room C interpretation Interactive Teaching Session Moderator: V.N. Cassar-Pullicino; Oswestry/UK E³ 220 A-001 12:30 The treated breast: what you need to know Plain radiographs: analysis and interpretation I. McCall; Devon/UK ([email protected]) A-003 14:00 A. Imaging after treatment of breast cancer The radiograph remains a quick and inexpensive imaging modality. Factors to M.H. Fuchsjäger; Graz/AT ([email protected]) Thursday evaluate include the thickness and outlines of cortical bone, the density and pattern of trabecular bone and the presence or absence of periosteal new Imaging after treatment of breast cancer is for confirmation of lesion removal, bone. The position of lesions within the bone, their outline, size and margin and identification of postprocedural fluid collections, detection of residual or whether they are single or multiple also provide important diagnostic recurrent cancer and screening for metachronous cancers. Posttherapy information. Adjacent soft tissues are affected by many conditions, particularly changes - which include fluid collections, edema, skin thickening, architectural trauma and infection and are integral to image interpretation. While MRI is distortion, scarring and calcifications - are mainly due to surgery, axillary essential for internal joint structures, radiographs demonstrate subchondral dissection and radiotherapy. The greatest treatment-related changes occur 6- bones, alignment, erosions and surrounding soft tissues. Knowledge of normal 12 months after therapy, and mammographic stability is achieved after two to radiographic anatomy and variants is essential. In trauma, subtle changes in three years. For mammography, pre- and all posttherapeutic images have to bone alignment, discontinuity of bone outline or alteration in density of be compared. Ultrasound is the method of choice for evaluation of fluid trabecular bone may indicate injury. Generalised increased or decreased bone collections. MRI is for problem solving (i.e. differentiation between scar and density indicates imbalance in bone creation or loss due to systemic diseases relapse) and should not be performed prior to 12 months after therapy to avoid and may be difficult to recognise at an early stage, but is recognisable when false-positive diagnoses. Dystrophic calcifications may develop in areas of fat localised in comparison to the unaffected bone. Localised reduced density may necrosis mimicking malignancy. Fat necrosis predominantly occurs at the result from hyperaemia, disuse or from replacement by cysts and sclerotic treated site; however, it can develop anywhere in the ipsilateral breast. Its reaction by trauma and infection, while primary and secondary bone tumours appearance may be indistinguishable from cancer at all imaging modalities. To may result in either response. Other features including cortical expansion or differentiate between fat necrosis and other common post-treatment changes scalloping and marginal bone response internal calcification will refine the from relapse, it is important to know the timeline when these changes occur diagnosis. Periosteal new bone in differing patterns results from local insult or and schedule follow̻up imaging accordingly. Mammography serves as the more generalised metabolic and haemodynamic changes, while soft tissue basis for postoperative surveillance. Ultrasound is helpful in the early swelling, muscle and ligament outline alterations and presence of calcification postoperative phase, whereas MRI is the method of choice, especially for provide vital clues to disease recognition and diagnosis. differentiation of scar and relapse in the later postoperative phases. Learning Objectives: Learning Objectives: 1. To learn about the current role of plain radiographs. 1. To understand common features related to breast surgery. 2. To appreciate the strengths and weaknesses of plain radiographs in 2. To recognise changes related to non-surgical treatments. musculoskeletal disease. 3. To understand methods for analysing radiographic abnormalities and an 14:45 approach to their correct interpretation. A-004 B. Imaging after treatment of benign breast conditions 12:30 - 13:30 Room F1 J. Camps Herrero; Valencia/ES ([email protected]) The Beauty of Basic Knowledge: Interventional Radiology Breast radiologists need to be familiar with post-treatment imaging findings in patients with breast cancer, but often patients are also imaged after a diagnosis of benign entities which are treated surgically (fibroadenomas, radial MC 25 A scars, papillary lesions) or after a percutaneous diagnosis of a high-risk lesion which has undergone a surgical biopsy to avoid underestimation (atypical Needles and samples: a practical ductal hyperplasia, lobular neoplasia or flat epithelial atypia). These procedures will leave an imprint on the breast which can be a cause of concern approach to image-guided biopsy due to the surgical scar. Furthermore, imaging findings after plastic surgery for Moderator: mastopexy, reduction mastoplasties, implants or auxiliary techniques M. Bezzi; Rome/IT (lipofilling, hyaluronic acid) are becoming frequent in our daily practice and have their peculiarities that can overshadow breast cancers. Interventional A-002 12:30 percutaneous procedures can also be a cause of tissue distortion. There are Needles and samples: a practical approach to image-guided biopsy advanced systems for biopsy (BLES) and for percutaneous removal of benign M. Bezzi; Rome/IT ([email protected]) lesions (fibroadenomas, papillomas), which use large-gauge needles and have to be accounted for due to their trace in the breast tissue. Percutaneous needle biopsy has been a mainstay of oncologic diagnosis for Learning Objectives: almost three decades, since the advent of ultrasound and CT. The basic 1. To understand common features related to breast surgery. principles of fine-needle aspiration and core needle biopsy can be applied to 2. To recognise changes related to non-surgical treatments. almost any site in the body, with subtle differences in technique depending on Author Disclosure: the organ being investigated and the imaging modality utilised. While J. Camps Herrero: Advisory Board; Bayer. Speaker; Bayer. excisional biopsy is still appropriate in certain cases, percutaneous needle biopsy has become the standard of care in the diagnosis of most tumors throughout the body and is also used to diagnose noncancerous conditions, such as infection. Percutaneous biopsy is also beneficial in the staging of patients with cancer, particularly when another treatment method may be more appropriate than surgical resection. The advantages of percutaneous biopsy over surgical excisional biopsy include time and cost savings and reduction in morbidity. The aim of this course is to discuss the practical aspects of biopsy, needle selection, and guidance techniques and to show how to approach difficult lesions and avoid complications. A B C D E F G S3 !"!"! 16:00 - 17:30 Room B is associated with broad-spectrum antibiotic treatment or chemotherapy. Neutropeniccolitis is characterised by right-sided colonic and ileal involvement, GI Tract whereas ischaemic colitis is characterised by a vascular distribution pattern and history. Diverticulitis is a focal, asymmetric process with fascial thickening and inflamed diverticula. The diagnosis of ischaemic colitis is suspected when RC 301 the distribution of the colon wall involvement follows the vasculature. The ischaemic changes are commonly segmental, especially in the left colon in Cross-sectional imaging of colitis elderly patients. Learning Objectives: A-005 16:00 1. To learn about the most common cause of colitis through cross-sectional Chairman's introduction imaging in both immune-competent and immune-compromised patients. S.A. Taylor; London/UK ([email protected]) 2. To become familiar with differentiating infectious, inflammatory, ischaemic and autoimmune conditions based on cross-sectional imaging criteria. Cross-sectional imaging is playing an increasing role in the diagnosis, staging 3. To understand the limitations of cross-sectional imaging in differentiating and follow-up of colitis. Often, the radiologist diagnoses colitis on cross- between its causes. sectional imaging, and the clinician requires the most likely diagnosis. Alternatively, imaging is used to assess the severity of a known colitis and A-008 16:51 Thursday monitor treatment response. This session will describe state-of-the-art C. The role of cross-sectional imaging in colonic inflammatory bowel protocols for assessing the inflamed colon using CT, MRI
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