ECR TODAY THURSDAY, FEBRUARY 28 - European Society of Radiology
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THURSDAY, FEBRUARY 28 ECR TODAY
WOMEN IN FOCUS – THE BIGGER PICTURE
WF 1 – LEADING BY EXAMPLE
Thursday, February 28, 12:30–14:00, The Church
CHAIRPERSON
H. Hricak; New York, NY/US
SPEAKERS & PANELLISTS
D. Akata; Ankara/TR, L.E. Derchi; Genoa/IT, C. Estrampes; Paris/FR, M.H. Fuchsjäger; Graz/AT,
H. Hricak; New York, NY/US, L. Leong; Hong Kong/CN, C. Palmer; London/UK
WF 2 – CHANGING THE IMAGE OF WOMEN
IN LEADERSHIP: GENERATIONAL DIFFERENCES
AND SIMILARITIES
Thursday, February 28, 15:45–17:00, The Church
MODERATOR
R.A. Kubik-Huch; Baden/CH
SPEAKERS & PANELLISTS
U.I. Attenberger; Mannheim/DE, C. Hess; San Francisco, CA/US, R.A. Kubik-Huch; Baden/CH,
E.A. Morris; New York, NY/US, M.F. Reiser; Munich/DE, V. Vilgrain; Paris/FR
WF 3 – WOMEN IN CHALLENGING ENVIRONMENTS
Friday, March 1, 14:00–15:15, The Church
MODERATOR
R.G.H. Beets-Tan; Amsterdam/NL
SPEAKERS & PANELLISTS
Ş. Bahar Özvarış; Ankara/TR, E. Balogun; Lagos/NG, R.G.H. Beets-Tan; Amsterdam/NL,
D. Husseiny Salama; Cairo/EG, S.F. Khan; Islamabad/PK, L. O’Riordan; Ipswich/UK
WF 4 – LEADERSHIP AND MENTORSHIP
Friday, March 1, 16:00–17:25, The Church
MODERATOR
J.E. Husband; London/UK
SPEAKERS & PANELLISTS
M. Abdel-Wahab; Vienna/AT, C. Beardmore; Guildford/UK, H. Hricak; New York, NY/US,
J.E. Husband; London/UK, V.P. Jackson; Tucson, AZ/US, G.P. Krestin; Rotterdam/NL,
G. McGinty; New York, NY/US
All sessions will have dedicated rooms for remote viewing
and will be streamed live online. More info at myESR.org/wif.
ECR TODAY 2019 EUROPEAN CONGRESS OF RADIOLOGY
DAILY NEWS FROM EUROPE’S LEADING IMAGING MEETING | THURSDAY, FEBRUARY 28, 2019
3 9 17 25
HIGHLIGHTS CLINICAL CORNER TECHNOLOGY & RESEARCH COMMUNITY NEWS
African radiologists call for Can you do more to improve New MRI scanners and patient-centric A success story with new challenges:
more cooperation with the ESR communication of critical accessories target productivity and better European Radiology, the ESR’s
in radiation protection information to patients? clinical outcomes flagship journal continues to grow
BY FRANCES RYLANDS-MONK
Knowing your differentials
will unlock migration-related
diagnoses
Migration has created new challenges for clinical radiology, largely due to the number
of imported diseases that it generates.
This trend necessitates the use of and crucially to raise awareness of
novel imaging strategies and differ- them among radiologists and other
ent ways of approaching interpre- health professionals.
tation. At today’s session, ‘Radiology “The health issues of immigrants
and migrations’, ECR 2019 delegates are manifold and in many situa-
will hear about the latest think- tions they are very challenging to
ing from specialists in the field and physicians. Awareness of these con-
learn how to tackle migration-re- ditions is mandatory to ensure good
lated cases. clinical practice for these patient
The total number of asylum seek- populations that carry a huge bur-
ers in countries across the Euro- den in chronic, infectious, mental,
pean Union has increased from and neurological diseases,” Akhan
around 15,000 to almost 1.4 million said.
annually in the last two decades, Radiologists need to be aware This photo shows part of a search-
stated Prof. Okan Akhan, who will of the types of infectious diseases and-rescue exercise that simulated
moderate the session. These people immigrants suffer from, such as migrants arriving by boat during
are fleeing from violence, torture, tuberculosis, HIV, viral hepatitis, a Summer School on Refugee and
persecution, and political or eth- malaria, schistosomiasis, echinococ- Migrant Health, held in July 2017
nic oppression, and are unable to cosis, neurocysticercosis or similar in Syracuse, Italy. If migrants are
return to their country of origin. In diseases that reflect epidemiology in a serious medical condition and
addition, the number of economic in the country of origin. Addition- treatment cannot wait until arrival Every migrant that arrives on board undergoes security screening, has their
migrants seeking a better life has ally, immigrants may present with in port, the Italian Coast Guard identification checked and photo taken, and undergoes initial medical screen-
also increased, he noted. psychological problems, chronic launches a medical evacuation ing by the Italian Relief Corps of the Order of Malta (CISOM). Any potentially
Whatever the reason for migra- diseases resulting in polymorbid- operation by helicopter to immedi- urgent or infectious cases are reported to representatives of the Maritime,
tion, the health of these individ- ity, cancer, and neurological dis- ately transfer them to a medical fa- Air and border Health Office (USMAF) of the Italian Ministry of Health for
uals is important for their social eases and acute or chronic malnu- cility onshore. (Provided by WHO/ treatment isolation or emergency evacuation as required. (Provided by WHO/
inclusion and integration in society, trition. These conditions may result Paolo di Pietro) Paolo di Pietro)
which in turn has an impact on the in anaemia, growth disorders, men-
sociopolitical and economic out- tal and physical development dis-
come for this population, accord- orders, immunosuppression, neu- spreading across Europe, mainly their daily practice, and they must plications, lower mortality rates,
ing to Akhan, professor of radi- ropathy, bone disorders and other due to migration. CE has a preva- remember that what they think is shorter hospital stays, and lower
ology and chief of interventional organ dysfunction, and it is easy to lence of 1% in rural Turkey, and it is a simple cyst may in reality be more recurrence rates, he said.
radiology and abdominal imaging overlook these aspects during daily also endemic in southern Europe, complex and dangerous for the Dr. Bernadette Abela-Ridder,
at Hacettepe University Hospital clinical work, he explained. including the Balkan countries, patient, Akhan suggested. team leader on neglected zoonotic
in Ankara, Turkey. Besides gener- Radiological examination of southern Italy, France, Spain, and After ultrasound diagnosis of diseases and neglected tropical dis-
ating discussion about the reasons these patients is crucial because Portugal. Case numbers are also CE and classification, radiologists eases (NTDs) in the Department
for migration and its humanitarian imaging plays an important role in growing in other parts of Europe should follow up with MRI and MR for the Control of NTDs of the
consequences, he hopes speakers the diagnosis and differential diag- due to immigration and travel to cholangiopancreatography (MRCP) World Health Organization (WHO)
will provide analysis of the impor- nosis of most of these diseases, but and from endemic regions. This when communication between the in Geneva, Switzerland, will pro-
tance of migration-related diseases many radiologists in western Euro- means that diagnostic imaging and cystic cavity and the biliary system vide her insight into how migra-
and how to recognise them clini- pean countries are not familiar interventional procedures for CE is suspected. Whenever possible, tion is impacting incidence and
cally and radiologically. with them. treatment is becoming an impor- the disease should be treated with outcomes.
He added that it was important For instance, the incidence of tant topic for western and northern different percutaneous techniques
to keep discussing the phenome- cystic echinococcosis (CE), other- European radiologists, who increas- which, compared to surgery, are
non of migration-related diseases, wise known as hydatid cysts, is ingly will encounter this disease in associated with fewer major com- continued on page 3
myESR.org #ECR2019
EUROPEAN DIPLOMA IN RADIOLOGY – QUESTION OF THE DAY
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will raffle amongst the winners a free
examination fee for the examination
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that will take place within the ECR 2020
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find the EDiR Question of the Day, and
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further interesting resources to prepare the
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for the examination.
BLOG.MYEBR.ORG
ECR TODAY | THURSDAY, FEBRUARY 28, 2019 HIGHLIGHTS 3
continued from page 1 Outbreaks of dengue, Leishmani- because of health problems. Better
asis and schistosomiasis have been data on disease prevalence and bur- Professional Challenges Session
With increasing levels of con- recorded in low prevalence areas den in migrant populations remain
Thursday, February 28, 08:30–10:00, Studio 2019
flict, civil unrest, poverty, and per- where intermediate hosts could key to increased awareness in host
secution, there are an estimated allow for local transmission. The countries, and timely access to PC 5 Radiology and migrations
68.5 million people currently for- prevalence of Chagas disease (also appropriate care for migrants, she »»Chairperson’s introduction
cibly displaced worldwide. Mal- known as American trypanosomi- continued. O. Akhan; Ankara/TR
nourished people with poor hous- asis), strongyloidiasis and schisto- Providing radiology tips dur-
»»Impact of migration on health: WHO perspective
ing and sanitation and restricted somiasis in migrant populations ing the session, Dr. Tim Weber, sen-
S. Severoni; Copenhagen/DK
access to healthcare results in ranges from 4.2% to 48.5%, 11% to ior physician at Heidelberg Univer-
populations at a high risk of dis- 56.1%, and 5.8% to 44% respectively. sity Hospital in Germany, will shed »»Importance of migration for neglected tropical diseases: WHO
ease, especially NTDs, stated Picking up on the issue of hyatid light on the patterns to look for perspective
Abela-Ridder. cysts, Abela-Ridder noted that cases and how to evaluate unusual radi- B. Abela-Ridder; Geneva/CH
Global migration is changing of CE and neurocysticercosis have ological conditions, after combin- »»Clinical importance of the diseases related to migration
the epidemiology of many of these also been detected in Europe, with ing patients’ radiological and epide- T. Junghanss; Heidelberg/DE
diseases with the emergence and 53% of neurocysticercosis cases miological features for differential »»Radiology of the diseases related to migration
re-emergence of NTDs in non- or attributed to immigrants. diagnosis. T. Weber; Heidelberg/DE
low-endemic countries. The lack Systematically screening migrant Finally, the panel discussion will
of awareness, diagnostics and populations on arrival to a host focus not only on raising aware- »»Panel discussion: How do we raise awareness among health
treatment in host countries poses country to reduce disease progres- ness among health professionals professionals to recognise diseases related to migration? How
a challenge to appropriately diag- sion and severity should be consid- but also on how future education can we adapt migration and migration related diseases into our
nosing and treating affected indi- ered, but she cautioned that effort programmes might adopt migra- education?
viduals, and to establishing the was needed to ensure that individ- tion-related disease imaging into
endemic foci of disease, she said. uals are not discriminated against the curriculum.
BY MÉLISANDE ROUGER
African radiologists call for more
cooperation with the ESR in
radiation protection
ESR meets Session African radiologists will share their knowledge and
Thursday, February 28, 10:30–12:00, RoomB experience of medical imaging practice in their
ESR meets Africa
EM 1 Radiology in Africa: facing challenges and opportunities respective countries, today during the ‘ESR meets
Presiding: L.E. Derchi; Genoa/IT Africa’ session. Examples of cooperation with the
H.A. Gharbi; Tunis/TN
European Society of Radiology will be presented,
»»Chairperson’s introduction
L.E. Derchi; Genoa/IT
notably in radiation protection, a field where efforts
H.A. Gharbi; Tunis/TN between Europe and Africa are starting to pay off.
»»Structured strategies to combat radiation protection
challenges in Africa. What can the ESR do?
D. Husseiny Salama; Cairo/EG Africa is big, diverse and full of “Our main challenges are in and this has led to an increase in
»»Is imaging underused in Africa? East Africa as an example. possibilities. Its myriad of coun- training and the implementation medical imaging procedures using
Solutions: what can the ESR do? tries (54), languages, cultures of national legislation that can radiation, also in Africa.
S. Vinayak; Nairobi/KE and economic scenarios offers help organise the field, especially Unlike most of the continent,
unmatched potential, but it can regarding radiation protection,” Tunisia, Algeria and Morocco have
»»Interlude 1: Enjoy the difference between African and
also complicate the organisation of said Prof. Hassen Gharbi from dedicated guidelines on ionis-
European music
radiology. Tunis, Tunisia, who will co-chair ing radiation use. But even there,
H.A. Gharbi; Tunis/TN
Equipment and workforce tend the session with ESR President rules must be implemented to help
»»How to promote radiation protection in West Africa. Needs and to vary considerably from one Lorenzo Derchi from Genoa, Italy. healthcare professionals prescribe
expected role of the ESR country to another. For exam- Technological advances have examinations adequately.
E.H. Niang; Dakar Fann/SN ple, the radiologists’ ratio ranges opened new horizons for the appli-
»»Most important challenges for imaging in North Africa from 1 to 80 per million population, cation of ionising radiation in
L. Rezgui Marhoul; Tunis/TN depending on the country. healthcare all around the world continued on page 4
»»» Interlude 2: Enjoy the difference between Arabic and
European music
H.A. Gharbi; Tunis/TN
»»The WHO’s programme in Africa: the past, the present and the
future
M.D.R. Perez; Geneva/CH
»»Panel discussion: Radiology in Africa, reality and dreams
G. Frija; Paris/FR
L.E. Derchi; Genoa/IT
H.A. Gharbi; Tunis/TN
D. Husseiny Salama; Cairo/EG
S. Vinayak; Nairobi/KE
E.H. Niang; Dakar Fann/SN
L. Rezgui Marhoul; Tunis/TN
M.D.R. Perez; Geneva/CH
B. Mansouri; Algiers/DZ
K.M. Naidu; Cape Town/ZA
»»Conclusion
L.E. Derchi; Genoa/IT
H.A. Gharbi; Tunis/TN Prof. Dina Husseiny Salama and Prof. Hassen Gharbi, together with ESR President Prof. Lorenzo E. Derchi and Prof.
Guy Frija, Chair of EuroSafe Imaging, surrounded by delegates at the 5th African Society of Radiology conference in
This session is part of the EuroSafe Imaging campaign. January 2019, in Cairo, Egypt.
myESR.org #ECR2019
4 HIGHLIGHTS ECR TODAY | THURSDAY, FEBRUARY 28, 2019
continued from page 3 Justification of examinations ciate Institutional Members from
is another key aspect of radiation Africa, including Algeria, Egypt,
“There is a growing need for protection and the ESR is support- Ivory Coast, Mauritania, Morocco,
structured strategies and a holistic ing the use and uptake of imaging Nigeria, South Africa, Tanzania,
approach towards the full integra- referral guidelines, especially in Tunisia and Uganda.
tion of radiation safety and clinical LMICs. The ESR iGuide web por- Professionals in the field out-
imaging guidelines in Africa,” said tal is free to use for ESR radiologist side of Europe can also become cor-
Prof. Dina Husseiny Salama from members, and a model with unre- responding members of the ESR.
Cairo, Egypt. stricted access for LMICs is cur- Corresponding members are enti-
Prof. Husseiny Salama, who will rently under development. tled to a wide range of benefits,
talk about radiation protection “The ESR iGuide is an excellent including reduced registration fees
during the session, will highlight online tool to help clinicians jus- for ECR 20201, free access to all con-
the role of strategic planning for tify examinations, and it’s already tents of the ESR e-learning plat-
more cooperation between the ESR showing results in Egypt. Coop- form Education on Demand, the
and African radiology societies. eration with the ESR works on option to participate in the Euro-
“There have been proactive our side, so why not in the rest of pean Diploma in Radiology (EDiR) Prof. Dina Husseiny Salama from Prof. Hassen Gharbi from Tunis,
actions in Africa to improve the Africa?” Prof. Husseiny Salama and all the activities of the Euro- Cairo, Egypt will highlight the role Tunisia, will co-chair the ‘ESR meets
situation and enhance the imple- said. pean School of Radiology (ESOR), of strategic planning for more Africa’ session with ESR President
mentation of radiation protection The process for a stepwise imple- and many more. cooperation between the ESR and Lorenzo Derchi.
in several countries, however fur- mentation of the ESR iGuide was Both memberships are com- African radiology societies in today’s
ther actions and joint activities started last year at four centres pletely free of charge. ‘ESR meets Africa’ session.
are needed to enhance the process. of excellence in Cairo. A recently A 92% increase in abstracts from
Local initiatives work, but we need performed audit showed that the Africa was registered for ECR 2019, that ‘ESR meets Africa’ will be the Ultrasound can play a major role
to accelerate things through coop- number of inappropriate referrals as a result of inviting Africa to the right place and moment to get to in promoting radiation protection,
eration with the ESR. Africa needs declined significantly, especially ‘ESR meets’ programme. The num- know each other better,” he said. as it provides easy access to sophis-
free, evidence-based tools, which a in the emergency setting. “So far, ber of African ESR members also African radiologists have high ticated diagnostic methods for the
global player like the ESR can pro- we’ve had 15% fewer inappropri- rose from 3% to 5% in just over a hopes regarding their cooperation poorest patients. “Two thirds of the
vide,” she said. ate referrals, which is quite impor- year. The benefits of joining the with Europeans, according to Prof. global population have no access to
The ESR launched the EuroSafe tant for patient radiation protec- ESR must be made even clearer Gharbi. medical imaging. Ultrasound must
Imaging campaign three years ago tion and the financial budget of the south of the Mediterranean, so “Medical imaging is advanc- play an important role in radiation
to promote the safe use of ionis- radiology department,” Prof. Hus- that African radiologists can enjoy ing rapidly in Africa but we want protection and in tropical diseases,
ing radiation in medicine, and is seiny Salama said. all the support the ESR can offer, things to develop in the utmost for example hydatid disease, a sce-
now developing a EuroSafe Imag- The ESR is also supporting Afri- according to ESR President Prof. safety conditions and in respect nario we are commonly faced with
ing Star assessment scheme for can radiologists by offering the Lorenzo Derchi. with our guidelines. Africa hopes in Africa,” Gharbi concluded.
low and middle-income coun- opportunity for non-European “We hope this is just the start. It the ESR can help with radiation
tries (LMICs), to recognise imag- radiological national societies to is only a matter of making us visi- protection, and also to help pro-
ing departments that embody best become Associate Institutional ble and making the advantages of mote, advance and homogenise 1 Provided that ESR 2019 membership is activated and
practice in radiation protection. Members. The ESR has ten Asso- ESR membership known. We hope training,” he said. approved by August 31, 2019.
New Frontier: Predicting Breast
Cancer through Artificial Intelligence
Leaders in breast cancer detection will share
their clinical experience with ProFound AI™
for digital breast tomosynthesis and clinical
research on risk assessment.
Networking. Cocktails. Food.
When: Friday, March 1st, 18:00 CET
Where: DO & CO Hotel Vienna
Space is limited, advanced RSVP required.
Please visit X1, booth AI-17 to register and be
entered to win an Apple Watch.
#ECR2019 myESR.org
ECR TODAY | THURSDAY, FEBRUARY 28, 2019 HIGHLIGHTS 5
BY MÉLISANDE ROUGER
A new beginning in cancer imaging
O
NC IC
OLO G
has just begun, says Beets-Tan
Professor Regina Beets-Tan is chair of the department of radiology at The Netherlands
Cancer Institute in Amsterdam, full professor of radiology at the University of Maastricht
and adjunct professor of abdominal and oncological radiology at the University of
Southern Denmark. She will present the Wilhelm Conrad Röntgen Honorary Lecture,
entitled ‘Oncologic imaging: a new beginning has just begun’ at ECR 2019.
The world of cancer medicine is colleagues on a 20-minute journey ing technology (functional MRI, acts. As much as we learn from cli-
changing rapidly. Major steps for- towards their future. molecular imaging) together with nicians, we need to be willing to
ward have been taken. Advanced ECRT: Your field of research is endoscopy brings us very far. Yet teach back. We cannot monopo-
imaging and computing technol- abdominal and oncologic imaging, some problems remain unsolved, lise knowledge. We can invent and
ogy, screening programmes; these especially MRI of rectal cancer. like the accurate assessment of investigate, but after that we need
all will result in the early detection What are the latest developments nodal disease. There is still a lot to share. By sharing our knowl-
of more tumours. Minimally inva- in rectal cancer medicine? of work to do and investment in edge we gain respect. It is with-
sive treatment, including inter- Regina Beets-Tan: Colorectal research investigating the role of out doubt that imaging technology
ventional therapy, will have an cancer screening programmes and modern imaging and computing and diagnosis remain the main-
increasingly important role. Tar- modern technology in imaging and imaging in colorectal cancer man- stay of radiology. These are skills
geted therapy, which specifically endoscopy have resulted in the agement is much needed. that are truly ours, for which our
hits the cancer genes, and immu- detection of early and smaller rec- ECRT: What are the challenges clinical colleagues really need us
notherapy, which uses the patient’s tal tumours. Multimodality treat- facing radiologists today and and, above all, respect us. I am con-
own immune system to kill can- ment of advanced rectal cancer that tomorrow? vinced that by combining the tech-
cer cells, will result in prolonged combines radiotherapy with che- Regina Beets-Tan: Radiology nological and digital progress with
Prof. Regina Beets-Tan from Amster- survival of patients who are in motherapy, or even with immuno- surely has challenges lying ahead, a thorough understanding of the
dam will talk about future aspects the final stage of metastatic dis- therapy, has resulted in more com- but challenges create new oppor- disease and treatment options, we
of oncologic imaging in today’s ease. It will be ‘precision medicine’; plete responses, which brings the tunities. Imaging technology and will strengthen our role in the mul-
honorary lecture. we do not want to give the wrong need for surgery in these cases into computational imaging are used tidisciplinary team.
treatment to the wrong patient. question. The focus will be on qual- not only in our own discipline There could not be a more excit-
As advocated by Prof René Ber- ity of life. It is going to be more min- but also in the clinical specialties ing time for the oncological radiol-
She shared a few thoughts with nards, a respected leader in can- imal invasive treatment and local around us. We should not be pro- ogist, because a new beginning in
us on the future of her specialty in cer research at the Netherlands tumour excision rather than rectal tective. Fear should not dictate our cancer imaging has just begun.
an interview ahead of the congress. Cancer Institute: ‘Within 15 years, amputation. We are going for active
ECR Today: You have chosen cancer will become a chronic dis- surveillance (Watch and Wait) for
quite an iconic and broad topic ease’. And I believe this is true. complete responders after treat-
Wilhelm Conrad Röntgen Honorary Lecture
for this honorary lecture. What This transformation will change ment. It will be paramount to per-
points will you cover exactly? the way we will practice oncologic form accurate selection and fol- Thursday, February 28, 12:15–12:45, Room A
Regina Beets-Tan: The audience imaging. This will require us to rec- low-up of patients, and accurately
Oncologic imaging: a new beginning has just begun
will get a glimpse of the future of reate our discipline. With this lec- predict who will truly benefit from
cancer care and the role of imaging. ture, I would like to take my young organ preservation. Modern imag- Regina G.H. Beets-Tan; Amsterdam/NL
Dive into
interventional
radiology at the
Cube 2.0
Open 8:30-17:30
February 27 - March 2
at the DC Tower, ECR City
For more information visit The Cube is located
www.myESR.org/cube in the cuboid annex
of the DC Tower.
myESR.org #ECR2019
ET2019
EUROPEAN CONFERENCE ON EMBOLOTHERAPY
EARLY BIR
FEES UNTI
MARCH 21
D
L
!
EMBOLOTHERAPY
The latest addition to the CIRSE conference family
focusing exclusively on a key area of interventional radiology:
embolisation in all its applications.
June 26-29 | Valencia | Spain
M A S T E R I N G E M B O L I S AT I O N
Some highlights from the ET 2019 programme
Special Topic Sessions
Examining the current evidence on new or controversial developments
in embolotherapy.
Technical Focus Sessions
Highlighting the latest trends in specific embolic materials, delivery
systems and advanced guiding modalities.
Case Remedy Sessions
Featuring case discussions including therapy options, technical aspects,
outcome and follow-up.
Morbidity and Mortality Conferences
Looking at the “bad days” as well as the “good days” in the angiosuite.
www.ETconference.org
Cardiovascular and Interventional Radiological Society of Europe C RSE
ECR TODAY | THURSDAY, FEBRUARY 28, 2019 HIGHLIGHTS 7
BY VIVIENNE RAPER
3D printing makes steady
IN
FO C PH
S
R M AT I Y SI C S
transition from laboratory bench
to patient bedside
Three-dimensional printing has spread from craniomaxilliofacial surgery to a wide range
of medical disciplines, and can help demonstrate the value of radiologists in a future with
artificial intelligence and machine learning. That’s the view of Dr. Philipp Brantner, joint
head of the 3D Printing Lab at the University Hospital of Basel, Switzerland.
tines because it lies at the cross- phantoms to help them find and the hospital where clinicians from In general, the benefits of 3D
roads of many disciplines and takes quantify distortions and artefacts multiple specialties can discuss printing still need to be proven
the technological lead within hos- in CT and PET. However, one of the ideas and get feedback on projects. in some specialities, according
pitals. Surgeons need radiologists biggest challenges to implementing Because the lab is integrated into to Brantner. He is running tri-
to advise them on the limits of 3D a 3D printing lab is securing fund- the hospital PACS, surgeons can als to see whether the technology
printing and to choose the correct ing, he continues. easily commission 3D print jobs for brings quantifiable benefits to sur-
imaging protocols for 3D printing “We rely on research grants to work – or for training purposes – gery – an important step to secur-
because the accuracy of the under- have staff, we don’t have the hos- via a centralised form. ing acceptance and funding. He is
lying image controls the fidelity pital pay somebody to do the 3D Yet, despite the benefits, Eley also looking at whether, for exam-
of the resulting anatomical rep- printing process, because 3D print- said some people in the hospi- ple, a 3D model can reduce the time
resentation, he commented. ing in our centre is not institu- tal are still unaware of the 3D lab taken for orbital fracture surgery.
Advising surgeons on the appli- tionalised yet,” he explained, add- and its services. In addition, some Early results look promising. Print-
cations of 3D printing is part of Dr. ing that he is trying to establish clinicians feel it would be faster ing an orbital mesh before surgery
Francesco Moscato’s work at the 3D printing as part of the clinical to implement their own cheap can reduce by 30% the time spent
Medical University of Vienna. Mos- routine. printer rather than using the cen- in the operating room.
cato, who is an associate professor The challenge of ongoing fund- tralised lab.
at the Center for Medical Physics ing also affects Dr. Karen Eley, a
and Biomedical Engineering, coop- clinical lecturer in radiology and
erates with a wide variety of sur- lead on the project to establish a
geons and specialist radiologists centralised 3D printing lab located
to apply 3D printing to medical in the media studio at Addenbro-
problems. oke’s Hospital, Cambridge, U.K.
“Usually the clinician comes with “We were funded entirely by
3D printed models in the media a very diverse set of wishes and charitable money, which included
studio at Addenbrooke’s Hospital in thinks the technology can solve the initial salary costs of our dedi-
Cambridge. (Provided by Dr. Karen everything, and we have to spend cated 3D printing technician. Ongo-
Eley) a couple of meetings to understand ing salary costs are now having to
what they want and what we can be supplemented by him taking on
offer,” he explained. additional roles in the media stu-
“We don’t know what the future Moscato, who is primarily a uni- dio,” she explained.
will look like, but I think we will versity researcher, usually deals At today’s session, Eley will dis-
be faced with a very different way with difficult cases where a sur- cuss the benefits of setting up a
of working,” he said. “3D print- geon has a problem with a specific centralised 3D printing lab. Avoid-
ing might be a useful extension procedure or a desire to improve it. ing the high cost of duplicate equip-
to add value to existing imaging He has obtained a research grant to ment and consumables is the big-
B
techniques.” study patients at risk of thrombo- gest benefit, especially in the U.K.’s A photo of the main 3D printer used at Addenbrooke’s Hospital. (Provided by
His talk today will cover estab- embolic complications by using CT National Health Service. Another Dr. Karen Eley)
lished and emerging surgical appli- scans to create transparent silicon advantage of a centralised facility
cations of 3D printing. These include casts that can be used to visualise is having a dedicated technician
creating a 3D model of a fractured and study intracardiac flow. who specialises in 3D printing. Special Focus Session
bone or kidney to help plan mini- Among his cases was a patient “The 3D printing technician is
mally invasive procedures. with a hard-to-find paravalvu- the most valuable person in the Thursday, February 28, 16:00–17:30, Room G
“3D prints help surgeons get a lar leak around the mitral valve. lab,” she said. “If we lost him, the SF 8f The 3D printing lab from bench to bedside
closer understanding of the ana- The hole was hard to find and the service would be lost, because no
tomical situation they’re about to patient had an unsuccessful pro- one has any spare capacity to take »»Chairperson’s introduction
see,” Brantner noted. “In the oper- cedure to close it. “We printed a on these additional tasks.” F. Kainberger; Vienna/AT
ating theatre they don’t have the model and it turned out there were The technician saves radiologists »»Creating a 3D printing lab in radiology
field of view like radiologists do three possible holes, the largest of time doing routine image segmen- F. Moscato; Vienna/AT
with cross-sectional imaging, so a which was not a straight hole from tations, allowing them to focus on »»Cardiovascular applications of 3D printing
3D representation can give a better the atrium to ventricle,” Moscato the more specialist and complex M. Tam; Southend/UK
roadmap to a tumour, for example.” said. “The interventional cardiolo- parts of their job. He also ensures
The future role of radiology gists could then plan the procedure the equipment is maintained to a »»Supporting the surgeon with 3D printing
might be to expand existing imag- and finally successfully treat the high standard and keeps abreast of P. Brantner; Basle/CH
ing services to include the creation patient.” U.K. regulations. »»Challenges of centralised 3D printing
of 3D models, and radiology is per- He is also helping a colleague Other benefits include informa- K.A. Eley; Cambridge/UK
fectly positioned to incorporate who works in hybrid multimodal- tion sharing and easy commission-
this technology into clinical rou- ity imaging, by creating anatomical ing of services. The lab is a hub in »»Panel discussion: What are real advantages of 3D printing?
CLINICAL TRIALS Watch and listen to the results
at the SKY HIGH STAGE
IN RADIOLOGY
Wednesday to Friday
10:30 – 12:00
STRAIGHT FROM THE RESEARCH CENTRE …
… TO THE WORLD’S MOST INNOVATIVE IMAGING MEETING
Vienna
myESR.org #ECR2019
The Artificial Intelligence Exhibition (AIX) Making its grand debut at ECR 2019, the AIX brings the hottest topic in radiology to the heart of the technical exhibition. Meet the innovators applying machine learning, deep learning and big data to medical imaging, and take in illuminating sessions at the AIX Theatre. You can even start your own deep learning adventure thanks to self-paced training provided by Nvidia’s Deep Learning Institute in partnership with the ESR. Whether you’re exploring AI for the first time, researching it, or just want to chat about the future over a free juice at Algorithms Bar, the AIX is a must visit at ECR 2019! The AIX is located in the X1 hall. For more details, and the full AIX Theatre programme, visit www.myESR.org/ai
ECR TODAY | THURSDAY, FEBRUARY 28, 2019
CLINICAL CORNER 9
Is 7 Tesla MRI ready yet to go clinical? Discussion centres on imaging’s
10 12 13
Fierce debate continues over artificial
intelligence’s future impact on radiology And how can it make a difference? role in cases of pregnancy-associated
breast cancer
BY FRANCES RYLANDS-MONK
Can you do more to improve
communication of critical
information to patients?
The radiological community has done a great deal to quash the idea of ‘the invisible
radiologist’ who has little or no contact with patients, but some uncomfortable truths
remain. Anecdotally at least, some patients perceive radiologist presence to lag well
behind that of other specialists, and many medical universities still don’t incorporate
communication training into their curricula.
Nobody knows better about the but during the process, she allowed
importance of effective communi- what she saw on the screen to show
cation when receiving critical infor- in her face. She looked deeply wor-
mation than patients themselves. ried, stopped talking to Justich, and
Austrian-born Caroline Justich didn’t even come back later to say
was diagnosed with two tumours, goodbye.
a plexus papilloma and a pituitary With the increasing focus on
adenoma, in 2004 at the age of 27, early detection, demand for radi-
and she underwent drastic surgery. ologists’ communication skills will
She resumed her job in institutional also grow, she suggested. Therefore,
banking until she started a family certain techniques that don’t take
in 2009, returning to work after each too much time will be useful. She
maternity leave. pointed to the ‘BATHE’ technique,
Her back problems began dur- developed in 1999 by U.S. psychia- Radiologists helped Caroline Justich find the courage to choose to take the plunge into therapy rather than stand
ing her third pregnancy, and when trists Dr. Joseph A. Lieberman and hesitant and fearful on the sidelines. (Provided by Diego Artioli www.escapista.net)
the baby was seven months old in Dr. Marian Stuart. This psychother-
the summer of 2016, Justich broke apeutic method involves asking
a lumbar vertebra while water-ski- about patients’ current situation with incomprehensible examina- ogists towards their role as clini- or image-guided intervention and
ing. Doctors had put the recurrent (Background), how they feel (Affect), tion results, or receive a letter, which cally involved doctors has changed therapy.
pain and fragility down to repeated their anxieties (Troubles), and their they might open at a time when patients’ expectations – and those “The shortage of clinicians
pregnancies, but two months later coping strategies (Handling), while they can’t contact anyone who of other specialists, according to in many countries is leading to
she could no longer move and she being Empathetic. could explain its contents, she rec- Prof. Christian Loewe, co-chair even heavier schedules in usual
was diagnosed in the October with Her own studies in industrial psy- ommended. Instead, wherever pos- of the session, along with Prof. outpatient services, and increas-
breast cancer, which had metasta- chology in the U.S., and her subse- sible a radiologist needs to be pres- Michael Fuchsjäger. ingly higher numbers of oncology
sised to the liver, L2 to L4 vertebrae, quent career in sales and corporate ent to discuss results and to prepare Besides the traditional need for patients asking for direct commu-
lymph nodes, and femur. Further- finance, as well as her direct expe- patients positively for further steps, precise written language, radiolo- nication with the radiologist right
more, there were two types of can- rience as a patient, has taught Jus- and they should give hope, show gists nowadays should be skilled in after staging CT. Consequently,
cer present. tich that a person can say the same empathy, and deal with this first direct communication with other radiologists need to find the right
She believes that without positive thing in many different ways, with stage of shock. clinical colleagues and, even more empathetic words,” Loewe said.
and clear messages from her radiol- varying impact. Justich advocates establishing importantly, with patients, said In his introduction today, he
ogist and other healthcare profes- “How information is transmitted one radiologist in each institute to Loewe, who is head of the Cardi- aims to remind delegates about
sionals, she would have been far less plays a major role in a patient’s med- provide patients with clarity and ovascular & Interventional Radi- the need to communicate directly
optimistic and more fearful when ical pathway. My situation was very support immediately after results, ology Department at the Medical with patients as well as highlight
starting her therapy. bad, but I had a smart oncologist. He though she admits that cost implica- University of Vienna. the possible problems, namely the
Speaking to delegates at today’s told me that they were already able tions needed to be weighed against Increasingly radiologists are the potential gap that may arise in
session, Justich, who recently to completely cure 3% of patients the increase in patient well-being. first doctors to inform patients some cases between what is said by
became a member of the ESR’s at the same clinical stage as myself, “In my case, it was my two radi- about a possibly unfavourable find- radiologists and what is heard by
Patient Advisory Group (ESR-PAG), and that in many cases they could ologists who gave me the hope and ing, particularly during ultrasound, patients.
will emphasise that radiologists transform the cancer into a chronic certainty that I could make it. In my
need to be mindful of their nonver- disease with patients living well for mind I thank them both every day
bal communication. five to 15 years. There and then I for their empathy during my first Special Focus Session
“As a patient, you always try to decided I would be a part of the 3%,” stage of shock and the way they
read the radiologist’s face, or study she noted. stopped me feeling so powerless,” Thursday, February 28, 16:00–17:30, Room O
how they talk to colleagues while She pointed to the flipside of how she said. SF 8c The art to transmit and to receive: how to communicate
your examination takes place. These the scenario could have played out. Justich believes that for trainee critical information to our patients
nonverbal clues lead to uncertainty “Imagine if he had told me that radiologists, education programmes
and misinterpretation that result in 97% of diagnosed patients die within should focus on communication, »»Chairpersons’ introduction
distress for the patient. This needs the first five years? My willpower and in hospitals, there should be a M.H. Fuchsjäger; Graz/AT
to stop,” she told ECR Today. would not have been so strong. I routine review of communication »»Chairpersons’ introduction (Part 2)
She believes that some doc- might not have started therapy at techniques every other year. Cru- C. Loewe; Vienna/AT
tors are overwhelmed by the fate all but rather spent the remaining cially, when radiologists deliver crit- »»How patients feel about communication
of their patients and may react time with my loved ones,” Justich ical information, patients shouldn’t C. Justich; Vienna/AT
strangely because they are trying said. be sent away or left to deal with it
to protect themselves or simply do Another problem patients face alone. »»Fundamentals of physician/patient communication
not know what to say. As a case in is the delay between diagnostic No doubt many of Justich’s L. Fallowfield; Brighton/UK
point, she revealed how the profes- findings until finally getting an comments will resonate with the »»How can we improve communication with our patients?
sional performing her lumbar CT appointment with the specialist. panel at today’s session. The con- F.J. Gilbert; Cambridge/UK
had been friendly before the exam, Patients should not be sent home tinuous transformation of radiol- »»Panel discussion: How to convey that we care
myESR.org #ECR201910 CLINICAL CORNER ECR TODAY | THURSDAY, FEBRUARY 28, 2019
BY VIVIENNE RAPER
Fierce debate continues over AI
artificial intelligence’s future
impact on radiology
Whether artificial intelligence (AI) will replace radiologists or make their jobs easier
continues to be a source of intense discussion, but is the speed of technological
development keeping pace with the hype surrounding AI, and what does the future hold?
Today’s Special Focus session will examine the evidence.
In late 2016, Geoffrey Hinton was become more of a comprehensive differences between general image supervised learning algorithms Given these challenges for AI, van
famously quoted as saying it was collector, integrator and interpreter recognition and medical imaging. need to use images from multiple Ginneken expects radiology to sur-
obvious ‘we should stop training of information – and not just imag- Langs pointed out that radiologists sites. Langs, on the other hand, will vive at least another 50 years. Long-
radiologists’ because they’ll soon be ing information,” he told ECR Today. and machine learning researchers discuss weakly supervised learning, term predictions, however, are
replaced by AI. His words spurred “AI is helpful because this role must work closely together to over- which has more images available to always hard to make, he said. The
fierce debate among radiologists wouldn’t be possible without it.” come these problems and create train an algorithm because it uses invention of deep learning was a
and academics, which shows no Another participant at today’s truly novel approaches. imaging data and linked informa- surprise in his field, and nobody can
sign of disappearing today. That’s session is Prof. Polina Golland, the “When an algorithm for general tion generated during clinical rou- ever be sure when the next unex-
according to Prof. Bram van Gin- Henry Ellis Warren (1894) professor visual recognition is applied to med- tines to train AI software. pected breakthrough might be.
neken, a professor from the Depart- of electrical engineering and com- ical imaging as it is, it struggles to
ment of Radiology, Radboud Uni- puter science at the Massachusetts deliver clinically meaningful results
versity, the Netherlands, who will Institute of Technology in Cam- since the dominant variability it
explain the basics of deep and bridge, U.S. faces is just natural variability –
machine learning in today’s session. “Machine learning will free radi- everyone’s liver and lung are differ-
AI promises to automate simple, ologists from tedious work, so they ent – and most of the variability isn’t
repetitive tasks. Some work, such as can do more cerebral tasks,” she said. linked to disease,” he explained.
screening routine mammograms, “You could ask the question ‘how Another challenge is what Stieltjes
won’t need radiologists, unless an would a PC change how people do describes as the ‘dirtiness’ of medical
abnormality is found – which hap- accounting in business?’ Looking data. Data to feed into an algorithm
pens in 1–2% of cases, noted Van back, the answer is people stopped may be of low quality compared to
Ginneken. Thirona, a company he doing arithmetic by hand or on other non-medical fields, and are
co-founded in 2014, already has a a calculator – everything is done often mixed with free text that needs
product on the market that anal- automatically by a spreadsheet.” interpretation. This is an issue that
yses CT scans to check if patients Although specific tasks can be hospitals and technological partners
are eligible for certain treatments done with software, AI has not can face quite often.
for chronic obstructive pulmonary delivered on all its early promise, The technology to develop algo-
disease (COPD). according to some observers. rithms also faces challenges. In his
“We have hundreds of hospitals “You can see Google Health, etc. talk, Stieltjes will discuss his two-
worldwide sending us CT scans,” he struggling in medicine, whereas year study to develop an algorithm
explained. “Our customers are pul- they’ve been successful in other to classify tumours. The study
monary physicians, and they used fields,” says Dr. Bram Stieltjes, head annotated 4,000 lesions for super-
to ask a radiologist to look at certain of research at University Hospital vised learning, where an algorithm
things, but now they send the scans Basel, Switzerland. is trained using images where the
to an external company and the Some technologies, such as deep lesion is manually labelled.
radiologist is out of the loop.” learning, haven’t made much pro- “I think this is one of the largest
Algorithms might help radiolo- gress after initial breakthroughs, studies ever done, but it’s – by far –
gists make predictions about the says van Ginneken, and hospital not good enough to do the job, basi-
likely prognosis of a disease or the IT departments are often slow to cally,” he commented.
effect of a treatment by exploiting install the software that is avail- Even with 4,000 labelled images,
information beyond known mark- able. He anticipates that in 5–10 the group’s dataset wasn’t big
ers, according to Dr. Georg Langs, years, radiologists will be able to enough to train the algorithm. Mean-
an associate professor heading the buy 10–30 software packages that, while, unsupervised learning, where
Computational Imaging Research if he’s optimistic, will replace 10–15% the algorithm learns about tumours
Lab at the Department of Biomed- of their most tedious tasks. The from random images, wasn’t good
ical Imaging and Image-guided hype around AI is being driven by enough to carry out tasks as com- Shown here is an ‘image feature’ assay that identifies clusters in large-
Therapy, Medical University of companies trying to secure money plex as staging tumours. scale medical imaging data of the lung. The clusters carry very specific
Vienna. The data generated by from investors, he argues. To increase the images available to clinical properties, suggesting that large-scale data can be mined for
unsupervised learning might then “They promise fantastic things train an algorithm, Stieltjes and his disease phenotypes and corresponding markers. It is an illustration of how
be used to create hypotheses for and make strong promises, but you colleagues are currently working to machine learning can be used to discover new patterns and make them
medical research, or to enable the can already see they’re not deliver- include annotation for AI as part of useful for diagnosis and prognosis. (Provided by Johannes Hofmanninger,
delivery of personalised medicine. ing,” van Ginneken said. the radiological workflow. Another Computational Imaging Research Lab, Medical University of Vienna)
“The role of radiologists will The relatively slow pace of devel- take-home message from his talk
change and I’ll speculate that they’ll opment can be attributed to the will be that projects to develop
Special Focus Session
Thursday, February 28, 16:00–17:30, Room B
SF 8a Artificial intelligence (AI): our future cannot be
predicted, but we have to be prepared
»»Chairpersons’ introduction
G. Langs; Vienna/AT
»»Basics of machine learning and deep learning
B. Van Ginneken; Nijmegen/NL
»»AI for lesion detection and characterisation
B. Stieltjes; Basle/CH
»»Machine learning in medical imaging going forward
P. Golland; Cambridge, MA/US
»»Which impact does AI have on medicine?
S.O. Schönberg; Mannheim/DE
»»Panel discussion: What is the future role of a radiologist in the
Examples of medical image analysis results that support interventions and enable clinical research. diagnostic process?
(Provided by Dr. Polina Golland and colleagues)
#ECR2019 myESR.orgECR TODAY | THURSDAY, FEBRUARY 28, 2019 CLINICAL CORNER 11
BY MÉLISANDE ROUGER
Deep learning and radiomics:
PH
Y SI C S AI
could future lie in combining
best of both?
In an exciting multidisciplinary session today, a panel of experts will highlight the powerful
potential of deep learning in medical imaging and introduce promising solutions, such as
distributed learning, which uses radiomics.
Maastricht, the Netherlands, who Collecting millions of images from with a predetermined signature that
now advises the university spinoff different countries remains an issue, needs to be validated in the study.
Oncoradiomics since data confidentiality legislation Software must then receive a CE
“There are not that many quanti- can affect data sharing. To overcome mark or FDA approval and must be
tative data in the radiology report. that challenge, Lambin and his team integrated into workflow. Very often,
Occasionally you have something propose to distribute learning from this means integration within an
on maximum tumour diameter. federated databases, i.e. to send the already chaotic hospital IT system.
Healthcare, in general, is a little late. learning modules to each hospital Reimbursement can prove difficult
Machines using AI screen your lug- database instead of having the hospi- even when added value has been
gage and perform facial recognition tal send their data into a centralised shown. “Using our radiomics signa-
at the airport, but healthcare lags system. ture, we can reduce the number of
behind the rest of the world,” he said. “The benefit is that hospitals keep useless interventions in kidney cysts,
With radiomics, five categories of their databanks within their systems, for example, but in some countries
quantitative and measurable infor- which are protected by firewalls, hospital managers argue that they
mation can be extracted: intensity; rather than centralising the multiple are paid per intervention. Financial
tumour shape; tumour texture; wave- databases from different countries,” incentives may go in the wrong direc-
length; and complex semantic fea- he said. tion,” Lambin said.
tures that can represent friction, such The researchers already tested the Today radiomics is in the valley of
as contact between the tumour and solution in various hospitals around death, a compelling metaphor that
the bone. the world, with results just as good as is often used to describe the gap
Radiomics can generate 15,000 to when data is centralised. between scientific validation and
20,000 quantitative image charac- Implementing a radiomics solu- application in clinical routine. But
teristics, which may indicate gene tion into clinical practice is a long and within five to ten years, every hos-
mutations, and enable the differenti- winding road. Quality research must pital will use a radiomics solution
ation of aggressive from non-aggres- be used and evaluated. A quality score because extracting information
sive tumours, or whether a tumour for assessing studies is available on from an existing image is cheaper
responds to immunotherapy or radi- the radiomics.world website, which and more attractive than a genomic
otherapy or not. All these tasks can makes sure there are enough patients signature, which requires a tissue
be done without using a single drop involved and no external validation. sample to be taken and sent to a
of contrast and one can determine The TRIPOD classification is lab, or a biopsy that may not repre-
Image from Radiomics: extracting more information from medical images the histological type of the tumour another resource for assessing the sent a tumour’s evolution over time,
using advanced feature analysis. Lambin P, Rios-Velazquez E, Leijenaar by mining the biological information quality of the biomarkers that are Lambin predicted. “All these issues
R, Carvalho S, van Stiphout RG, Granton P, Zegers CM, Gillies R, Boellard from a CT scan. used in a trial. Radiomics signatures disappear with radiomics, but it
R, Dekker A, Aerts HJ. Eur J Cancer. 2012 Mar;48(4):441-6. doi: 10.1016/j. DL covers pretty much the same must meet the TRIPOD level 4 crite- needs to be rigorously validated
ejca.2011.11.036. Epub 2012 Jan 16. applications as radiomics – auto- ria to be deemed worthy. Prospective and fulfil an unmet clinical need to
mated tumour segmentation, patient studies are sometimes also required, pay off,” he concluded.
Artificial intelligence (AI) will pro- All these numbers can be collected classification, etc. – but it uses a radi-
foundly change medicine within and machines can learn from this cally different method. While in radi-
the next ten years, and radiologists information, using DL for a large omics one selects image character- EFOMP Workshops (European Federation of
and medical physicists have a role number of tasks, from image pro- istics with an already known image Organisations for Medical Physics)
to play in this process, according to duction to image reconstruction, signature, such as heterogeneity, this
Prof. Marco Brambilla from Novara, dose optimisation, image processing process is not transparent with DL, Thursday, February 28, 08:30–10:00, Room G
Italy and Prof. John Damilakis from and more. which also requires huge horsepower. EF 1 Big data and the big picture: deep learning in
Iraklion, Greece, both medical physi- Dose optimisation is paramount to “We don’t know what the image char- optimisation of medical imaging (part A)
cists who will co-chair the session at minimising radiation and maintain- acteristics are that can differentiate
the ECR. ing the highest possible quality. “At between a malignant and a benign Moderator: J. Damilakis; Iraklion/GR
Algorithms used in AI are based the moment this task is done manu- tumour with DL. DL is a super com-
»»Chairperson’s introduction
and trained on huge amounts ally, but AI could help adjust dose for puter. It is powerful but needs at least
of data to be able to distinguish every patient according to their size, 10,000 images to work. But it is a black J. Damilakis; Iraklion/GR
whether a tumour is malignant or weight, sensitivity and other parame- box; we do not really know how this »»Imaging and dose biobanks
benign. This is especially true with ters,” Damilakis suggested. works and this is annoying because E. Neri; Pisa/IT
deep learning (DL), which uses more Another area is justification, espe- doctors like to understand the pro- »»Statistical methods for analysis of multidimensional imaging data
horsepower than other methods. cially in examinations that use ion- cess,” Lambin said. K. Van Leemput; Copenhagen/DK
Whatever the AI solution, data ising radiation. Justification is cur- DL demands a lot of data to create
robustness must be checked. This rently based on information in books, learning databases and sometimes »»The use of radiomics in medical imaging
is, to a large extent, part of the med- but AI could very well help retrieve this means using synthetic data. “If P. Lambin; Maastricht/NL
ical physicists’ duties, Brambilla information from the literature or we can have a million data, I would
explained. “When it comes to data, refine tools that already exist, such as bet that DL would be better than Thursday, February 28, 10:30–12:00, Room G
we have the old saying of ‘garbage in, the ESR iGuide, the clinical decision traditional radiomics, but we would EF 2 Big data and the big picture: deep learning in
garbage out’. We medical physicists support system for European imag- still have the issue of an uninter- optimisation of medical imaging (part B)
have to check the consistency of the ing referral guidelines developed by pretable algorithm,” he said.
data that is provided. We are respon- the ESR. Current research combines the Moderator: M. Brambilla; Novara/IT
sible for the acceptance of all radiol- DL could also support research in best of DL – particularly automated
ogy machines and software,” he said. medical imaging to develop non-in- segmentation, which is very useful »»Chairperson’s introduction
Radiology departments are cur- vasive imaging-based biomarkers in clinical trials – with radiomics, by M. Brambilla; Novara/IT
rently flooded with information. for radiomics, a field that involves enforcing robust image characteris- »»Computer analysis in chest imaging: from rule-based to
Just for an image acquisition proto- the extraction and mining of a large tics on DL. “This looks like a promis- machine learning to deep learning
col, the medical team has to decide amount of data and quantitative fea- ing approach for the future,” he said. B. Van Ginneken; Nijmegen/NL
how the examination should be per- tures from medical images. Many conditions must be met
»»Deep learning in CT optimisation
formed and determine parameters Radiomics is a major advance for for this alliance to work. Data is
M. Kachelrieß; Heidelberg/DE
on tube potential, tube current, time, healthcare, as the information deliv- required for both approaches,
etc. These decisions generate a lot of ered by radiology is still based on so AI modules would need to »»From image quality to care outcome
numbers. “For each examination, we a qualitative and semi-subjective be constantly updated, as new M. Kortesniemi; Helsinki/FI
can have 100 or more values,” Dami- assessment, according to Philippe machines and treatments emerge
lakis said. Lambin, a radiation oncologist from continuously. These sessions are part of the EuroSafe Imaging campaign.
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