French radiologists call for better access to MR imaging

The French Society of Radiology (SFR) is stepping up its campaign for greater investment in MRI. The delay between patients being referred for an MRI examination and receiving a scan is just too great, and France is lagging behind its European neighbors in terms of implanting new technology, said Prof. Philippe Grenier, chair of diagnostic radiology at the Pitie-Salpetriere Hospital in Paris. Grenier has directed efforts to promote MRI during his year-long tenure as secretary-general of the SFR.

"We are not able to apply clinical recommendations for imaging in many domains of healthcare, particular neuroscience, cardiovascular disease, and oncology. We are not able to provide adequate training for young radiologists to participate in clinical research. We are not able to integrate innovations in imaging into clinical practice. For all of these reasons, the SFR is asking the French government to purchase more MR scanners," he said.

Purchase and installation of any MR system in France requires prior authorization from regional authorities. The growing number of indications for which MRI is recommended, however, has prompted the SFR to request an increase in authorizations.

In September, the society participated in a high-profile press conference to publicize waiting times for outpatient MRI. French residents wait an average of 35 days between referral and imaging. The SFR also used its annual October meeting, the Journees Francaises de Radiologie (JFR), to promote the clinical value of MRI to the French media. Applications highlighted to journalists included perfusion and diffusion techniques for stroke imaging, early diagnosis and monitoring of Alzheimer's disease, and breast imaging.

During the same month, private radiologists were knocked back by a reduction in their technical fees. This change was made because of an increase in the total number of MR and CT examinations.

Grenier will be taking a less active role in the SFR's campaigning from now on, having resigned as secretary-general at the end of JFR 2007. The post has been filled by Prof. Jean-Pierre Pruvo, a professor of neuroradiology at the Roger Salengro hospital, University of Lille.

Grenier had been expected to serve as secretary-general for four years. His predecessor, Prof. Guy Frija, chair of radiology at the European Hospital George Pompidou in Paris, held the reins of power for 12 years. Having accepted the role of medical director at his hospital, however, Grenier found he did not have sufficient time to devote to SFR leadership.

"The Pitie-Salpetriere is the largest hospital in France, so the position of medical director is a huge task. I have been doing both jobs since April, but I had to make a choice," he said.

His 12 months at the helm of SFR have been busy. Continuing medical education and professional practice assessments became compulsory in France at the end of 2006. The SFR has consequently become an official organization for the delivery of CME. It is also now involved with professional practice assessments in medical imaging and the accreditation of radiologists who practice interventional procedures.

The new obligatory CME scheme helped generate interest in JFR 2007, Grenier said. Attendance at the event once again topped 16,000, with more than 1800 delegates attending from outside of France. Preregistration figures were up 15% over 2006.

This year's congress included 169 hours of CME and offered 115 hours of workshops. Program highlights focused on new technological developments and the transfer of innovation to clinical practice in neuroscience, oncology, and cardiovascular diseases.

The Antoine Beclere lecture, "New horizons in oncologic imaging," was presented by Prof. Hedvig Hricak, chair of radiology at the Memorial Sloan-Kettering Cancer Center in New York City and honorary member of the SFR. Delegates were also invited to a plenary session on the role of imaging in osteoporosis. This was followed by several hands-on bone densitometry workshops to tie in with World Osteoporosis Day.

Topics of particular interest in the oncology sessions included functional imaging for the assessment of tumor response and tumor ablation using high-intensity focused ultrasound. The value of MRI for pretreatment evaluations of breast cancer and for screening women at high risk of developing the disease was highlighted as well. The potential role of CT colonography for the detection of colorectal polyps and cancers was discussed in a session organized jointly with the French Society of Digestive Endoscopy.

Sessions on neuroradiology pointed out the importance of MRI in the diagnosis and management of stroke and the role of MRI in diagnosing Alzheimer's disease.

French radiologists who were unable to get to JFR 2007 can still pick up CME credits online, Grenier said. All CME courses delivered during the meeting were recorded. The SFR will make a selection of these available on its website each week for the next 12 months (www.sfrnet.org).