ECR can help Asian and European Radiology

February 23, 2006
John Hoe, MD

Radiology in Asia is booming. The demand for radiology services is growing, and investment made by governments and private hospitals and companies in imaging equipment and radiology departments is increasing rapidly every year. This includes investments in PACS, RIS, and teleradiology networks.

Radiology in Asia is booming. The demand for radiology services is growing, and investment made by governments and private hospitals and companies in imaging equipment and radiology departments is increasing rapidly every year. This includes investments in PACS, RIS, and teleradiology networks.

Are the people who use and supervise the use of this equipment able to learn how to operate their scanners properly, and do they know how to tweak their protocols, as well as initiate research projects? Are the interventional radiologists able to perform the latest techniques safely and competently?

This is less of a problem in countries such as China, India, Japan, and Korea, which have many homegrown PACS and RIS vendors and networks. But in Asian countries that are less developed, scanners are often not used as well as they could be, in terms of both productivity and quality. The professional quality of radiologists takes years of learning and training, but this can be shortened with adequate good training and learning opportunities. The professional relationships of radiologists in Asian countries with their counterparts in other parts of the world make a difference.

On the radiological society and national levels, there are long-standing relationships between Asian and European countries. Many are historical and related to the influence of previous colonial powers. These relationships are often quite loose and informal, and there is little formal cooperation between the national societies to promote training and research.

Indonesian radiologists tend to train in the Netherlands and Germany, while Singaporean radiologists used to train in the U.K. More are now training and doing fellowships in Europe, especially France and Germany, as well as in the U.S. Training in interventional radiology also requires hands-on experience. To do this in a hospital in Europe requires overcoming medical registration and insurance hurdles. Most Japanese, Korean, and Chinese radiologists tend to do fellowships in the U.S., and this group could be encouraged to become more Eurocentric in outlook.

Over the past few years, many European radiologists have visited Asian countries to give talks, run seminars and workshops, and lecture at conferences. As an organizer of meetings, I know that European speakers are often very accommodating, generous with their time, willing to share their knowledge, and not demanding of meeting organizers and vendors. Many are invited back!

I believe the European Congress of Radiology can be used as a platform to promote cooperation and research between Asia and Europe. ECR allows the opportunity to establish stronger links and lines of communication between radiologists in Asia and Europe, on an individual basis as well as on a national radiological society level.

ECR already showcases the best of European radiology. As shown by the increasing attendance from Asia, ECR is firmly established as one of the meetings that one has to attend.

The "ECR meets" program is a clever move by the ECR Executive Committee, especially for Asian countries. In 2004, ECR met Korea, then Japan in 2005. This year, "ECR meets Singapore." Aside from bringing great honour to the Asian country and the national radiological society invited to participate, it also makes many more people in those participating countries aware of ECR. This has helped increase attendance.

One advantage of ECR over some of the other meetings, aside from its convenient location, is the quality and breath of the scientific program. The speakers are top notch, and having the talks in English helps Asian professionals. Having a perspective on radiology that is not solely North American is also important to give balance. Many Asian radiologists are only now finding out that the standard of radiology in Europe is as good as in the U.S.

Work still needs to be done in the technical exhibition, where the relationship of vendors with Asian customers is not good. An Asian customer is often ignored and not treated as a potential serious customer. Vendors are now realizing this, however, and the increased attendance of Asian radiologists is prompting them to have Asian salespeople on the floor at ECR and to promote equipment to their customers from Asia.

Of course, the RSNA meeting and its technical exhibition remains the main site for those making equipment purchases, but ECR is a close second and becoming a preferred alternative for many, especially since Sept. 11 and the difficulties of many Asian radiologists to get visas to enter the U.S. to attend the RSNA meeting or do radiology fellowships.

I have attended ECR for the past five years. By listening to the speakers from Europe, I have learned how to do cardiac CT. We were one of the first in Asia to start cardiac CT with a 16-slice scanner in early 2003 and have gone on to 64-slice CT cardiac scanning. Many of the tips and tricks on the difficulty of performing cardiac CT I learned by attending ECR. This allowed us to improve as well as reinvent ourselves to keep up with the new challenges of cardiac CT.

ECR has an International Relations Committee, which helps to promote international contacts and attendance from radiologists outside Europe. It shows foresight for ECR to aim for an audience beyond the European Union. ECR is already making a huge contribution to the relationship of Asian radiologists and European radiologists, on a national level as well as a personal level.

I would like to see ECR develop more formal relationships with the various Asian radiology societies such as Asian-Oceanian Society of Radiology, which is holding the AOCR congress in Hong Kong in August 2006, ASEAN Association of Radiology (AAR), and smaller societies such as Asian Musculoskeletal Society, Asian-Pacific Pediatric Radiology Society, and national radiological societies of Asian countries.

ECR could send representatives to speak at some of these meetings, perhaps in a special "... meets ECR" session. This would help raise the scientific content and level at the Asian meetings as well as promote awareness of ECR. The cooperation of vendors will be required, as they are usually the ones on the ground who know the local market. I would also like to see the various national societies and ECR share some of their contacts, especially training positions and fellowship opportunities and memberships, so that it will be easier to cross-promote the many meetings held in Europe and Asia. Many radiologists in Europe may not be aware of the many meetings held in Asia. Even simple things like linking Web sites can make a difference.

ECR is already making a huge contribution to the relationship of Asian radiologists and European radiologists, but more needs to be done to improve lines of communication. ECR is an ideal platform to help facilitate this. The influence of European radiology on the world should not be underestimated!

Some useful Asian radiology Web sites are listed below:

www.srs.org.sg

www.radiologymalaysia.org

www.hkcr.org

www.chinaradiology.org

www.radiology.or.jp

www.radiology.or.kr

www.rsroc.org.tw

www.philippineradiology.org/index.html

www.aospr.org

www.asianmsk.org

www.aocr2006.org

www.abda-breast.org

Dr. Hoe is clinical director of Medi-Rad Associates, Mt Elizabeth Hospital in Singapore, president of the Singapore Radiological Society, and vice president of the College of Radiologists, Singapore.