ECR 2007

Few controversies in radiology have generated as much interest as that of whole-body imaging. But niche-specific indications for the technique may quell the controversy.

Imaging is poised to play a key role in the advancement of 21st century science and healthcare. This will happen only if the radiology community changes its view of imaging sciences, according to Dr. Elias Zerhouni, a radiologist and director of the National Institutes of Health. And if that means researchers adopting unconventional or innovative approaches, so be it.

Correct diagnosis of tumor character and stage is fundamental to lung-cancer therapy planning, but evaluating indeterminate solitary pulmonary nodules (SPNs) continues to challenge radiologists. In addition, it is vital to determine as soon as possible whether patients are likely to respond to treatment.

Technological advances to CT and MRI allow radiologists to perform whole-body examinations in mere seconds. This has changed the way radiologists use whole-body imaging in diagnostics, according to Dr. Maximilian Reiser, director of the Institute for Clinical Radiology at the Ludwig-Maximilian University in Munich and incoming 2008 president of the European Congress of Radiology.

Technical advances in MRI have paved the way for functional imaging of the abdomen, moving beyond simple morphological evaluation of disease and in some cases proving superior to multislice CT. With quantitative imaging tools at their disposal, radiologists are rethinking what they need to visualize with MR to answer new clinical questions.

ECR attendees tested their skills at diagnosing breast disease and learned how to create clear, concise breast imaging reports at Tuesday morning’s BI-RADS training in breast imaging session.

The combined functional and morphological approach to imaging afforded by PET/CT and SPECT/CT has far-reaching technical, diagnostic, and economic advantages, according to Dr. Gerald Antoch of the department of diagnostic and interventional radiology and neuroradiology at the University Hospital Essen in Germany. He moderated Monday’s state-of-the art symposium on the use of PET/CT and SPECT/CT for cardiac and oncologic purposes.

At last year’s European Congress of Radiology, research regarding 64-slice CT angiography was focused on its feasibility. This year, feasibility is no longer an issue. Rather, a wealth of evidence is being presented attesting to the fact that coronary CTA is a powerful and useful tool to evaluate patients suspected of coronary artery disease who are at intermediate risk. It is within this niche patient group -- those who would otherwise undergo invasive catheter angiography -- that coronary CTA is finding an affordalbe home.

Does software that flags malignancies on medical images help, hinder, or make no difference to patient management? That question has dogged radiology for years. Automated detection systems are undoubtedly becoming smarter, strengthening arguments for their use. But no system is perfect, and doubts remain, leading to a widespread policy of wait and see.

Around 10% to 15% of patients in the developed world die following acute stroke, 30% to 60% survive with long-term disabilities, and 20% to 25% require a hospital stay. These frightening statistics could be improved if radically different strategies were adopted for managing stroke patients, according to speakers at an overflowing state-of-the-art symposium.

MR imaging has great value in guiding treatment of breast cancer patients and is well worth the extra expense when used appropriately, according to radiologists speaking at an ECR session on Sunday.

Radiology must learn from the automotive and aviation industries to eliminate errors and improve patient safety. That is the view of Dr. William R. Brody, president of Johns Hopkins University in Baltimore, who delivered Saturday’s W.C. Roentgen Honorary Lecture.

Patients with compressive or entrapment neuropathies of the elbow, forearm, wrist, or hand may go straight to sonographic examination. In skilled hands, ultrasound can produce images that reveal pathology as well as MR images can. But while the diagnosis of a tendon rupture is a relatively simple matter with ultrasound, to assess specific neurological injuries, such as nerve entrapment and compression, the technique requires considerable experience, expertise, and patience, said Dr. Javier Beltran of the Maimonides Medical Center in Brooklyn, NY.

“I predict that lung radiofrequency ablation is going to be very big indeed,” said Dr. Alice Gillams at the beginning of her two presentations on Saturday examining factors influencing tumor recurrence and incidence of pneumothoraces.