Download - myESR.org

e are
roud
f you

ecause ESR
currently has
35,596 members
14,391 full members
3,922 corresponding members
2,121 others (retired, associate and honorary members)
15,162 in process

Editorial
Dear Readers,
Another ECR has come and gone and the European Society of Radiology together with the ESR Office
would like to take this opportunity to cordially thank all our guests; delegates, moderators and lecturers,
our partners from the industry and the media, and all cooperating companies. Your and our common
efforts were well appreciated and contributed to one more chapter in ECR's story of success.
In this issue of the ESR Newsletter we present to you a review of some of the meeting's highlights, from
remarkable scientific sessions to outstanding prize winners and impressive statistics, from our distinguished
honourees to pictorial impressions.
So, let's browse together through our ECR 2008 memories. We are already looking forward to welcoming
you to Vienna again in March 2009 to the world's most innovative medical meeting.
Apropos welcoming, a special salute goes to all new members of the European Society of Radiology; we
are now more than 35,500 strong and still growing … Thank you for your confidence!
Your ESR Newsletter Team
Contents
04 ESR Survey
05 The ESR President
ECR 2008 REVIEW
06 Scientific Presentation Prizes
07 ECR 2008 beats all records
08 Awards Shower at ECR 2008
09 ‘ESR meets’ drew crowds of delegates
12 Innovation drives growth of hybrid imaging
13 Experts outline pros and cons of functional MR and PET in clinical arena
15 Radiation worries must not inhibit cardiac CT
ESR NEWSLETTER is an official organ of ESR
17 NSF avoidance triggers debate
19 CAD emphasis shifts to diagnosis
ESR Executive Council
Iain W. McCall, Oswestry/UK
ESR President
Christian J. Herold, Vienna/AT
ESR 1 st Vice-President
Maximilian F. Reiser, Munich/DE
ESR 2 nd Vice-President
Borut Marincek, Zurich/CH
Congress Committee Chairman
Małgorzata Szczerbo-Trojanowska, Lublin/PL
1 st Vice-Chairperson of the Congress Committee
Yves Menu, Le Kremlin-Bicêtre/FR
2 nd Vice-Chairman of the Congress Committee
Adrian K. Dixon, Cambridge/UK
Publications Committee Chairman
Gabriel P. Krestin, Rotterdam/NL
Research Committee Chairman
Éamann Breatnach, Dublin/IE
Education Committee Chairman
Luís Donoso, Sabadell/ES
Professional Organisation Committee Chairman
Fred E. Avni, Brussels/BE
Subspecialties Committee Chairman
Guy Frija, Paris/FR
National Societies Committee Chairman
Luigi Solbiati, Busto Arsizio/IT
Communication & International Relations
Committee Chairman
András Palkó, Szeged/HU
Finance Committee Chairman
Peter Baierl, Vienna/AT
Executive Director
Managing Editor
Julia Patuzzi, Vienna/AT
Contributing Writers
Andrea Alcala-Galiano, Madrid/ES
Katharina Ebner, Vienna/AT
Paula Gould, Holmfirth/UK
Monika Hierath, Vienna/AT
Wiro Niessen, Rotterdam/NL
Mélisande Rouger, Vienna/AT
Vera Schmidt, Vienna/AT
Cagin Senturk, Madrid/ES
Maria Tutschek, Vienna/AT
Philip Ward, Chester/UK
Daniela Zimmermann, Essen/DE
Sub-Editor
Simon Lee, Vienna/AT
Layout
Cover: Petra Mühlmann, Vienna/AT
Body: Nina Ober, Vienna/AT
Marketing & Advertisements
Erik Barczik
E-mail: erik.barczik@myESR.org
Contact the Editorial Office
ESR Office
Neutorgasse 9, 1010 Vienna, Austria
Phone: (+43-1) 533 40 64-16
Fax: (+43-1) 533 40 64-441
E-mail: communications@myESR.org
ESR Newsletter is published 5x per year
ISSN 1994-4357
Circulation: 22,500
Printed by Angerer & Göschl, Vienna 2008
Date of printing: April 2008
myESR.org
20 Impressions from the congress
22 500 delegates swinging at the ECR Party
23 Guests greeted with glamour
28 ECR 2008 Quiz Winners
28 Roles in radiology, research, plus a private life
30 Imagine at ECR 2008
10 EIBIR News
11 ESOR – European School of Radiology
29 Radiology Trainees Forum
industry news
25 Industry at ECR 2008: on the rise again
26 Thank you to all ECR 2008 Exhibitors & Sponsors
ECR 2009 PREVIEW
31 Eminent Swiss radiologist to lead next year’s ‘summit of science’
European radiology
32 News from the Editor-in-Chief
33 New articles from European Radiology
34 Subspecialty Society News
The Editorial Board, Editors and Contributing Writers make every effort to ensure that no inaccurate or misleading data, opinion or statement
appears in this publication. All data and opinions appearing in the articles and advertisements herein are the sole responsibility of the contributor
or advertiser concerned. Therefore the Editorial Board, Editors and Contributing Writers and their respective employees accept no liability whatsoever
for the consequences of any such inaccurate or misleading data, opinion or statement. Advertising rates valid as per January 2008.
Unless otherwise indicated all pictures © ESR – European Society of Radiology / Harry Schiffer.
35 Congress Calendar
3 myESR.org

ESR Newsletter 02/08
ESR Survey
Radiology finds itself at a turning point. Recent
advances in CT and MR technology have expanded
the roles of these modalities into cardiac imaging.
Highly promising results, particularly in coronary
CT angiography, fuel the demand for 64 or more
detector row CT and dual source CT equipment.
At medical conferences the number of scientific
lectures and exhibits on cardiac imaging is continuously
increasing. The submission of abstracts
on cardiac imaging at the European Congress of
Radiology (ECR) 2007 grew by 50% in comparison
to 2005 and has more than quadrupled since
2004. All these developments ultimately demand a
redefinition of the core services of radiology.
Following a survey conducted by the European
Society of Cardiology, mainly about the practice
of cross-sectional cardiac imaging, the Executive
Council of the European Society of Radiology
(ESR) decided to analyse the current situation
more deeply. A survey on cardiac imaging
conducted by the ESR, as part of its mission to
promote the exchange of information between
radiologists in Europe and beyond, would help
to identify strategies to strengthen the position of
European radiologists working in this field.
In April 2007, the ESR Office sent an online questionnaire
to 637 academic and non-academic
radiological institutions across Europe that were
potentially performing cardiac imaging. An
address list of institutions known to be involved
in cardiac imaging did not exist. All radiologists
who were sent the questionnaire by e-mail were
informed about the purpose of the survey in a
cover letter.
The electronic questionnaire assessed the general
characteristics of the radiological institutions
surveyed, including country, affiliation and type
(university, regional or private hospital, private
institution), volume of radiological examinations,
and number of employees. Then, fourteen
cardiac imaging parameters were studied, including
access to various imaging modalities, imaging
services, radiologists’ training in cardiac imaging,
joint reporting with cardiologists or nuclear medicine
physicians, number of scientific publications
and grants received. Finally, the surveyed institutions
were asked to determine the importance of
several key criteria for cardiac imaging to succeed
in a radiology department.
A total of 138 (21.7%) of the 637 surveyed institutions
responded to the questionnaire.
Like other sample surveys, this one also has limitations:
the low
return rate could
imply possible
non-response
bias. However,
one has to bear
in mind that
the locations of
European radiological
institutions
performing
cardiac imaging
were hitherto
unknown and
therefore the ESR
Office used the
database at hand
for mailing the
questionnaire.
ESR today presents for the first time the results
of this survey, and thus a general view of cardiac
imaging activities in Europe.
ESR
Survey
on Cardiac
Radiology
By
Prof. Borut Marincek, Zurich/CH
Prof. Maximilian F. Reiser, Munich/DE
107 (78%) of the respondents were from university
hospitals, 19 (14%) from regional hospitals, and 12
(8%) from private hospitals or other private institutions.
The majority of the responding institutions
were located in hospitals with 200–500 beds,
performed 100,000–200,000 examinations per
year and had on average around 100 employees.
The 138 institutions had access to one or more
imaging modalities, with the most commonly
used being 64 row MDCT and 1.5 Tesla MRI.
71 (51%) of the respondents offered a cardiac
imaging service during daytime and 42 (30%) over
24 hours/7days; 25 (18%) institutions were not
involved in cardiac imaging. An emergency cardiac
CT service for patients with acute chest pain
was available in 49 institutions. The mean number
of trained staff members or residents providing
cardiac imaging services was 3 and 2, respectively.
Two thirds of these radiologists had undergone
structured cardiac imaging training for up to 12
months, a third had been
trained for more than 12
months.
The reports of cardiac
CT studies were issued
jointly with cardiologists
or nuclear medicine physicians
in 54% and 9% of
cases, respectively; with
regard to cardiac MRI the
corresponding figures for
joint reporting with cardiologists
or nuclear medicine
physicians were 52%
and 9%, respectively. However,
the revenues of cardiac
imaging studies were
shared with cardiologists
in 36% of cases and with nuclear medicine physicians
in only 4%.
Between 2001 and 2006, the peak number of grants
received in a radiological institution had increased
from 5 to 9 and the peak number of peer-reviewed
scientific publications from 20 to 50.
According to respondents, focused training of
radiologists in cardiac imaging was the most
important criterion for cardiac imaging to succeed
in a radiology department, followed by
political interventions at local, national or European
level. Other criteria also stated were costeffectiveness
aspects and integration with hospital
environments. The least important criteria were
negotiations with hospital management concerning
workflow and utilisation of cardiac imaging
equipment, and marketing of cardiac imaging.
In conclusion, in 2007 cardiac imaging by radiologists
in Europe was performed mainly in university
hospitals. Because of a lack of trained radiologists,
cardiac CT and MR studies were carried
out primarily during daytime. The radiological
community is increasingly involved in scientific
research and publishing on cardiac imaging. Due
to the rapidity of change and the complexity of the
techniques in cardiac imaging, many radiologists
feel intimidated and fear that they will lose the
turf battles with other specialties. The obstacles
that radiologists face when they want to become
experts in cardiac imaging are lack of clinical
training and inadequate exposure to cases during
residency.
Thus, it is gratifying to note the enormously
increased attendance of the 2007 Annual Scientific
Meeting of the European Society of Cardiac Radiology
(ESCR) in Rome. With 470 delegates – among
them over 100 residents in radiology – the number
of participants increased by more than 50% in
comparison to last year’s meeting in Athens.
Excellence begins with education and training, as
the ability to acquire and interpret cardiac CT and
MR studies is only as good as one’s skill. This is
why in 2007 the ESR took the initiative to offer
a training programme for trainees in radiology
with a special interest in cardiac imaging. The
ESR Cardiac Imaging Fellowship is supported
by the ESCR and integrated with the European
School of Radiology (ESOR). It will be continued
in 2008 and 2009. Further information is available
at www.myESR.org.
A total of 138 (21.7%)
of the 637 surveyed
institutions responded
to the questionnaire.
Respondents by country
France 21
Switzerland 12
Turkey 11
Austria 10
Belgium 10
Spain 10
Germany 9
Italy 8
Sweden 8
Netherlands 6
Serbia 6
United Kingdom 5
Estonia 4
Albania 3
Czech Republic 3
Hungary 3
Norway 3
Greece 2
Bulgaria 1
Finland 1
Iceland 1
Poland 1
Most frequntly used modalities
MDCT 16 row 71 (51%)
MDCT >16 and

THE ESR PRESIDENT
New ESR President says
communication is the key
Introducing Prof. Iain W. McCall from Oswestry/UK
By Mélisande Rouger
On Monday March 10, 2008, Prof. Iain McCall
became President of the European Society of
Radiology, reaching the climax of a successful
career dedicated to the development of European
radiology.
Finally, radiologists should multiply contacts and
communications with the European Commission
to increase their influence on political institutions
and secure radiology’s place in the European
medical system.
Prof. Iain W. McCall, ESR President
“I’m extremely proud and honoured to be elected
president. I’ve been involved with European radiology
for many years now,” he said.
McCall, Professor of Radiology at the University
of Keele in Staffordshire, United Kingdom,
witnessed the birth of the Viennese European
Congress of Radiology at the dawn of the 1990s
by taking part in a categorical course presented
at ECR in 1993. He played a major role in the progression
of radiology in Europe, notably during
his Vice-Presidency of the European Association
of Radiology (EAR), the predecessor of ESR, from
2003 to 2006.
During his 37 years as a radiologist, he has become
convinced of the importance of the specialty’s
visibility, and he intends to make this issue a top
priority in his ESR agenda.
“We need to involve ourselves with the patient
so that he or she understands what diagnostic
imaging is and what treatment options radiology
provides,” he explained. Patients have no idea
what the radiologist does, and the development
of a more and more computerised technology
alienates the specialist even more, he believes.
“There is a danger in retreating behind our PACS
machines and computers,” he warned.
To increase patient awareness of imaging, McCall
plans to boost clinical communication on the primary
care level, notably by providing GPs with
joint documents approved by both specialties.
Inviting GPs to ECR 2008 was a luminous idea,
he believes. “It is a great beginning, we could do
the same with nuclear medicine,” he suggested
regarding future meetings with partner disciplines
at ECR.
“ESR should provide support and encourage radiologists
in Europe in terms of continuing education,”
he summarised. “We want to stimulate
radiologists to keep doing more research in order
to continue to be leaders in imaging, and support
and advise our members on a number of issues,
including political issues.”
McCall, a muskuloskeletal radiologist, graduated
in 1967 from Birmingham University and started
his residency in 1971 at United Bristol Hospitals
under the leadership of Sir Howard Middlemiss.
He has been working as a consultant radiologist
at the Robert Jones and Agnes Hunt Orthopaedic
Hospital in Oswestry, Shropshire, since 1976, and
at the University Hospital of North Staffordshire
in Stoke-on-Trent since 1996.
During his time as Vice-President of EAR, he
authored policy documents on risk management,
teleradiology, good radiological practice,
benchmarking of radiological services in Europe
and continuing professional development. He
also contributed to the Charter for Radiological
Training, the Instigated European Training
Assessment Programme and the European Computer
Based Self Assessment.
He has been Registrar and Vice President of the
Royal College of Radiologists, as well as President
of the International Skeletal Society. He is
an honorary member of the Société Francaise de
Radiologie, the Greek Radiological Society, the
Deutsche Röntgengesellschaft, and a fellow of the
Faculty of Radiologists of the Royal College of
Surgeons in Ireland.
McCall is the author of 95 peer-reviewed papers,
and 33 articles and chapters. He has served as
Deputy Editor of Clinical Radiology, and Editor of
both Skeletal Radiology and ECR Today.
5 myESR.org

ESR Newsletter 02/08
ECR 2008 – Review
ECR 2008 Scientific Presentation Prizes
The best scientific papers and scientific/educational exhibits have been identified by the subcommittee members and session moderators. The selection criteria
comprised abstract, onsite performance, and images. The presenting authors of the best papers and magna cum laude exhibits will now be awarded the prize of
€ 1,500 each, and offered free registration for ECR 2009. Congratulations to all winners!
Best Scientific Presentations
Scientific Papers
Diffusion weighted imaging (DWI) in MR-mammography
(MRM): Comparison of echo planar imaging (EPI)
and half-Fourier single-shot turbo spin echo (HASTE)
diffusion techniques (B-614)
P.A.T. Baltzer, D.M. Renz, K.-H. Herrmann, J. Böttcher,
J.R. Reichenbach, W.A. Kaiser; Jena/DE
Dose reduction strategies for CT cardiac imaging
(B-654)
R. Raupach 1 , H. Bruder 1 , A.N. Primak 2 , X. Liu 2 ,
C.H. McCollough 2 , T.G. Flohr 1 , C. Leidecker 3 ;
1
Forchheim/DE, 2 Rochester, MN/US, 3 Malvern, PA/US
Cardiac MR (CMR) detection of intramyocardial
haemorrhage (IMH) following primary percutaneous
transluminal coronary angioplasty (PTCA) and rescue
PTCA (R-PTCA) (B-682)
M. Francone, F. Calabrese, M. Mangia, P. Lucchesi,
L. Agati, F. Fedele, C. Catalano, R. Passariello; Rome/IT
Prospective comparison of colonoscopy, CT
colonography, and stool tests in an average risk
population: Results from the Munich colorectal cancer
prevention trial (B-472)
A. Graser, P. Stieber, D. Nagel, C.R. Becker, H. Kramer,
S. Geisbuesch, C. Schaefer, H. Diepolder, A. Lottes,
A. Wagner, M.F. Reiser, B. Goeke, F.T. Kolligs; Munich/DE
In utero tractography of fetal brain pathologies (B-406)
G.J. Kasprian, P.C. Brugger, E. Krampl, C. Lindner,
F. Stuhr, D. Prayer; Vienna/AT
Health economic evaluation of three imaging
strategies in patients with suspected colorectal liver
metastases: Gd-EOB-DTPA (Primovist)-enhanced MRI vs.
extracellular contrast media-enhanced MRI and 3-phase
MDCT in Germany, Italy and Sweden (B-352)
C.J. Zech 1 , L. Grazioli 2 , E. Jonas 3 , M. Ekman 3 ,
R. Niebecker 4 , S. Gschwend 4 , J. Breuer 4 , L. Jönsson 3 ,
S. Kienbaum 4 , A. Guo 5 ; 1 Munich/DE, 2 Brescia/IT,
3
Stockholm/SE, 4 Berlin/DE, 5 Montville, NJ/US
Influence of the contrast agent iodine concentration on
the visualization of coronary arteries using automated
and manual segmentation methods in dual-source CT
angiography (B-797)
A. Kuettner 1 , K. Anders 1 , S. Busch 2 , C. Becker 2 ;
1
Erlangen/DE, 2 Munich/DE
Treatment monitoring in patients with pulmonary arterial
hypertension (PAH) using quantitative 3D MR pulmonary
perfusion (B-818)
S. Ley, E. Gruenig, F. Risse, N. Ehlken, D. Mereles,
H.-U. Kauczor; Heidelberg/DE
Pedicle screw placement in trauma patients with
unstable fractures of the thoracic spine
using CT assistance (B-457)
M.G. Mack, B. Maier, C. Ploss, K. Eichler, J. Frank,
I. Marzi, T.J. Vogl; Frankfurt a. Main/DE
Three-dimensional delayed gadolinium enhanced MRI of
cartilage (dGEMRIC) at 3 Tesla for in vivo differentiation
of normal hyaline cartilage and reparative tissue in
patients after different cartilage repair procedures:
Preliminary results (B-576)
S. Trattnig 1 , T.C. Mamisch 2 , K. Pinker 1 , P. Szomolanyi 1 ,
S. Marlovits 1 , S. Kutscha-Lissberg 1 , G. Welsch 1 ;
1
Vienna/AT, 2 Berne/CH
New frontiers of vascular imaging – dynamic MRI
derived models for morphologic and functional
evaluation of thoracic aorta: Clinical application in EVAR
patients (B-776)
M. Midulla 1 , R. Moreno 1 , L. Veunac 1 , F. Nicoud 2 ,
B. Marcheix 1 , V. Chabbert 1 , F. Joffre 1 , H. Rousseau 1 ;
1
Toulouse/FR, 2 Montpellier/FR
Diffusion tensor imaging (DTI) in HIV-positive patients
at 3.0 T MRI: Assessment of regional differences in the
axial plane within normal-appearing cervical spinal cord
(B-203)
C. Mueller-Mang 1 , T. Mang 1 , C. Plank 1 , A. Rieger 1 ,
E.-M. Law 2 , M.M. Thurnher 1 ;
1
Vienna/AT, 2 New York, NY/US
Molecular profiling of tumor neovascularisation by
multi-target molecular ultrasound imaging (B-030)
M. Palmowski 1 , J. Huppert 1 , G. Ladewig 2 , P. Hauff 3 ,
M. Reinhardt 3 , M.M. Mueller 1 , M. Maurer 2 ,
W. Semmler 1 , F. Kiessling 1 ; 1 Heidelberg/DE,
2
Erlangen/DE, 3 Berlin/DE
Excretory MR-urography at 1.5 and 3 Tesla: Comparison
with MDCT-urography (B-487)
M. Regier, C. Nolte-Ernsting, G. Adam, J. Kemper;
Hamburg/DE
A novel robust and dose efficient tube current
modulation for ECG-gated cardiac spiral CT imaging
(B-293)
R. Raupach 1 , H. Bruder 1 , C. Becker 2 , B. Schmidt 1 ,
T.G. Flohr 1 ; 1 Forchheim/DE, 2 Munich/DE
Diffusion-weighted MRI for nodal staging in patients with
head and neck squamous cell carcinoma: A comparison
with conventional MRI in correlation to histopathology
(B-172)
V. Vandecaveye, F. De Keyzer, V. Vander Poorten,
E. Verbeken, P. Dirix, S. Nuyts, R. Hermans; Leuven/BE
Automatic detection of atherosclerotic carotid plaque
from combined magnetic resonance angiography and vessel
wall images (B-078)
I. Isgum 1 , R. van ’t Klooster 1 , P.J.H. de Koning 1 , F. Jabi 2 ,
K. DeMarco 2 , J.H.C. Reiber 1 , R.J. van der Geest 1 ;
1
Leiden/NL, 2 East Lansing, MI/US
Magnetic resonance elastography: A new quantitative
tissue characterization parameter for differentiating
benign and malignant primary liver tumors (B-267)
S.K. Venkatesh 1 , M. Yin 2 , N. Takahashi 2 , J.F. Glockner 2 ,
J.A. Talwalkar 2 , P.A. Araoz 2 , R.L. Ehman 2 ;
1
Singapore/SG, 2 Rochester, MN/US
Scientific and
Educational Exhibits
Magna Cum Laude
The spaces of the retroperitoneum: A pictorial review
(C-071)
A. Almeida, M. Castro, J. Loureiro, B. Viamonte,
J.M. Pereira; Porto/PT
Percutaneous management of aggressive vertebral
haemangiomas: How, when and why (C-542)
X. Buy, T. Moser, J.-L. Dietemann, A. Gangi;
Strasbourg/FR
Direct MR arthrography using the standard arthroscopic
portals (C-639)
F. Idoate 1 , P. Golano 2 , T. Fernandez-Villa 1 , A. Marques 1 ,
J. Achalandabaso 3 , J. Bruguera 1 ;
1
Pamplona/ES, 2 Barcelona/ES, 3 San Sebastian/ES
Tips and tricks for interpreting and reporting a cardiac
CT study: A step-by-step instruction (C-166)
S. Leschka 1 , H. Alkadhi 1 , F.T. Schmid 2 , P. Stolzmann 1 ,
L. Husmann 1 , B. Stinn 2 , B. Marincek 1 , S. Wildermuth 2 ;
1
Zurich/CH, 2 St. Gallen/CH
Magnetic resonance elastography of liver: Technique and
clinical application (C-016)
S.K. Venkatesh 1 , M. Yin 2 , R.L. Ehman 2 ; 1 Singapore/SG,
2
Rochester, MN/US
The role of ultrasound in Crohn’s disease: A radiologic
review with pathologic correlation (C-445)
L.R. Williams, D. Kasir, S.A. Sukumar; Manchester/UK
Cum Laude
Magnetic resonance imaging assessment of small bowel
Crohn’s disease activity: Literature review and personal
experience (C-447)
R. Girometti, L. Cereser, G. Brondani, A. Furlan,
A. Linda, C. Zuiani, M. Bazzocchi; Udine/IT
Primer of cardiovascular pharmacology for radiologists
(C-162)
B. Graca, R. Teixera, A. Pereira, P. Donato,
F. Caseiro-Alves; Coimbra/PT
Getting to the heart of the matter: An illustrative look at
cardiomyopathies (C-194)
S. Harris, A. Misselt, P. Araoz, E. Williamson;
Rochester, MN/US
What is your differential diagnosis Characterization of
gastric submucosal tumors (C-453)
J. Kim, J. Lee, H. Park, J. Choi, S. Kim, J. Han,
B. Choi; Seoul/KR
The anterior pontomesencephalic-anterior medullary
venous system and its bridging veins communicating to
the dural sinuses: Normal anatomy and drainage routes
from dural arteriovenous fistulas (C-730)
H. Kiyosue, S. Tanoue, Y. Sagara, J. Kashiwagi, Y. Hori,
M. Okahara, Y. Kondo, S. Matsumoto, H. Mori; Oita/JP
Various cystic lesions of gastrointestinal tract:
Radiologic findings with pathologic correlation (C-462)
J. Lee, C. Park, K. Kim, C. Lee, J. Choi, S. Lee, B. Shin;
Seoul/KR
High-resolution MRI of the cervical arterial wall
(C-912)
C. Oppenheim, O. Naggara, E. Touzé, J.-F. Toussaint,
J.-L. Mas, J.-F. Méder; Paris/FR
Trapped on the “whirl”: Diagnostic sign on emergency
CT (C-482)
V.M. Suárez-Vega, M. Martí, E. Alonso,
V. Pérez-Dueñas, C. Palacios; Madrid/ES
Fat in the heart: Causes and meaning (C-193)
G. Tardaguila de la Fuente, F. Tardaguila, J.A. Aguilar,
R. Prada, D. Castellon, G. Fernandez; Vigo/ES
The accuracy of diffusion weighted imating (DWI) for the
diagnosis of residual breast cancer after neoadjuvant
chemotherapy (C-116)
R. Woodhams, S. Kakita, H. Hata, M. Ozaki,
H. Nishimaki, S. Kan, K. Hayakawa; Sagamihara/JP
Certificate of Merit
Neuroradiological findings in epilepsy patients with
hemispheric syndromes (C-714)
N. Bargalló, A. Radosevic, M. Carreño, A. Donaire,
J. Setoain, M. Squarzia, S. Capurro, F. Calaf, N. Sigritz;
Barcelona/ES
Brain poisoning: Accidental and intentional exposure (a
review) (C-708)
A. Domingo 1 , M. Andreu 1 , J. Vives 1 , A. Camins 2 ,
E. Salvadó 1 , A. Ramos 1 , A. Saurí 1 ;
1
Tarragona/ES, 2 Barcelona/ES
Complications following pediatric liver transplantation
through 64-slice computed tomography:
A wise approach (C-804)
G. Gallardo-Madueño, M. Parrón, I. Pastor, C. Prieto,
R. Rodríguez-Lemos, M. López-Santamaría; Madrid/ES
Coronary calcium scoring: How to avoid pitfalls (C-164)
K. Gruszczynska 1 , M. Rengo 1 , F. Pugliese 1 ,
W.B. Meijboom 1 , A.C. Weustink 1 , A. Rossi 1 ,
M.L. Dijkshoorn 1 , J. Baron 2 , N.R. Mollet 1 , A. Laghi 3 ,
P.J. de Feyter 1 , G.P. Krestin 1 ; 1 Rotterdam/NL,
2
Katowice/PL, 3 Latina/IT
Color Doppler twinkling artifact in various conditions
during abdominal ultrasonography:
Pearls and pitfalls (C-863)
H. Kim, D. Yang, W. Jin; Seoul/KR
Diagnostic value of PET/CT with contrast enhancement
for the staging and restaging of
pediatric tumors (C-838)
M.A. Kleis 1 , H.E. Daldrup-Link 2 , K.K. Matthay 2 ,
R.E. Goldsby 2 , E.J. Rummeny 1 , T. Schuster 1 ,
R.A. Hawkins 2 , B.L. Franc 2 ;
1
Munich/DE, 2 San Francisco, CA/US
Role of endoscopic ultrasound and MDCT for diagnosis
of gastric submucosal tumors according to the revised
pathologic classification of GIST (C-454)
J. Lim, M.-J. Kim, J.-H. Kim, K. Kim; Seoul/KR
Detection of cardiac allograft vasculopathy by multidetector
CT and whole-heart MR
coronary angiography (C-170)
H. Machida, S. Nunoda, M. Fujimura, E. Ueno,
S. Morita, K. Suzuki, K. Otsuka; Tokyo/JP
Fat only and water only gradient echo MR imaging of the
abdomen.
Part I: Basic concepts and imaging findings in the liver
(C-078)
E.M. Merkle, D.I. Schulz, D.T. Boll, D. Marin;
Durham, NC/US
Fat only and water only gradient echo MR imaging of the
abdomen.
Part II: Extrahepatic imaging findings (C-079)
E.M. Merkle, D.I. Schulz, D.T. Boll, D. Marin;
Durham, NC/US
Hemangiomas and vascular malformations: A practical
approach based on MR findings (C-910)
M.E. Nazar, A. Nápoli, D. Sarroca, C. Morales,
H. Di Nunzio, C.H. Bruno; Buenos Aires/AR
Solid components in endometriotic cysts: The role of MR
imaging in detection and diagnosis (C-327)
H Y. Okajima, Y. Matsuo, A. Tamura, Y. Onoda, S. Fuwa,
M. Matsusako, K. Suzuki, Y. Saida; Tokyo/JP
Arteriovenous fistulas (C-922)
S. Baleato, R. Garcia-Figueiras, J.C. Vilanova,
C. Villalva, C. Seoane, J.M. Pumar;
Santiago de Compostela/ES
The role of imaging in facial paralysis (C-529)
N. Satogami, T. Koyama, Y. Miki, K. Togashi; Kyoto/JP
Development and congenital abnormalities of the portal
venous system (C-924)
R. Shuto, H. Kiyosue, R. Takaji, S. Tanoue,
S. Matsumoto, H. Mori; Oita/JP
European Society of Radiology
6

ECR 2008 – Review
ECR 2008 beats all records
with a historic
18,000 participants
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
Country
By Mélisande Rouger
Professional
medical delegates
GERMANY 1,123
AUSTRIA 1,016
ITALY 989
UNITED KINGDOM 487
SPAIN 413
POLAND 391
RUSSIAN FEDERATION 387
SWEDEN 341
GREECE 336
FRANCE 315
NETHERLANDS 298
DENMARK 277
HUNGARY 276
USA 271
TURKEY 257
CHINA 256
BELGIUM 254
NORWAY 249
FINLAND 239
SWITZERLAND 238
JAPAN 219
ROMANIA 186
CZECH REPUBLIC 169
KOREA, Republic of 119
SERBIA 117
Continuing its long tradition of setting records,
the ever-expanding ECR has once more proven
its supremacy in the science world, by attracting
crowds of knowledge-hungry delegates from all
over the globe.
Exactly 17,837 radiology professionals from 95
countries registered to the second biggest radiological
event worldwide and the second largest
medical event in Europe, ensuring packed
audiences during conferences as well as massive
attendance of the technical exhibition.
Almost 11,000 professional delegates attended
the congress – 2,000 more than last year – including
over 8,400 radiologists. Roughly 7,000 company
representatives travelled to Vienna for the
occasion.
A total of 1,123 German delegates registered for
the congress this year – 16% more than in 2007 –
closely followed by Austrian, Italian, British and
Polish participants. China was also well represented
at ECR, with 256 delegates, increasing its
presence by 10% in comparison with 2007.
But by raising their number of delegates by half,
Turkey and Russia took the spotlight this year.
No less than 257 Turkish delegates turned up at
ECR 2008 – 53% more than last year – whereas
a 387-strong Russian delegation visited the congress
– a 57% rise from 2007.
Creating another landmark in the history of
ECR, reception to the scientific programme significantly
improved. Attendance in lecture rooms
went up by 5% in comparison with 2007.
7 myESR.org

ESR Newsletter 02/08
ECR 2008 – Review
Nicholas
Lizbeth M. Kenny,
Gourtsoyiannis,
President of the Royal
Professor and Chairman
Australian and New
Awards
shower at
ECR 2008
of the Department
of Radiology of the
University of Crete,
was honoured with
the Gold Medal of
the European Society
of Radiology for his
exceptional achievements,
particularly in the field of
gastrointestinal imaging,
R. Gilbert Jost,
immediate past president
of the Radiological Society
of North America (RSNA)
as well as Professor
and Director of the
Mallinckrodt Institute of
Frederick S. Keller,
Director of the Dotter
Interventional Institute
of the Oregon Health
and Science University
(OHSU), was awarded
Honorary Membership
of the European Society of
Radiology in recognition
of his untiring efforts in
Zealand College of
Radiologists (RANZCR)
and Director of Cancer
Services for the Central
Area Health Service,
Queensland, was awarded
Honorary Membership
of the European Society
of Radiology for her
exceptional achievements,
as well as his leadership
Radiology (MIR), at the
the field of radiological
especially in emphasising
By Mélisande Rouger
and pivotal role in the
Washington University
education, training and
the clinical role of
creation of ESR. He was
School of Medicine in St.
research. Prof. Keller,
radiology in cancer
President of ECR in 2003,
Louis, was presented with
Cook Professor of
care. Dr. Kenny, a senior
President of the EAR
Honorary Membership
Interventional Therapy,
radiation oncologist at
ESR and ECR once more
paid tribute to prominent
researchers who have
contributed, with their
exceptional scientific
achievements, to turning
radiology into the refined
discipline it is today.
from 2004 to 2007, and
was the first President of
the European Society of
Radiology. He is also the
founder and scientific
Director of the European
School of Radiology.
of the European Society of
Radiology in recognition
of his prominent work,
and particularly his
commitment to improving
information technology in
the practise of radiology.
is also Medical Director
of the Department of
Interventional Radiology,
Professor of Surgery and
Chair of the Department
of Diagnostic Radiology
at OHSU.
Cancer Care Services,
The Royal Brisbane and
Women’s Hospital, has
previously been the Dean
of the Faculty of Radiation
Oncology, RANZCR.
Albert L. Baert,
Jürgen Hennig,
Christiane K. Kuhl,
James H. Thrall,
Ernst Pöppel,
Professor Emeritus met
co-Chairman and
Professor of Radiology
Radiologist-in-Chief at
Head of the Institute of
opdracht, and former
Scientific Director of the
and Vice Chairman
Massachusetts General
Medical Psychology, and
Professor of Radiology
Department of Radiology
of the Radiological
Hospital and Juan M.
of the Human Science
and Chairman of the
at the University
Department, as well as
Taveras Professor of
Centre at Munich
Department of Radiology
Hospital Freiburg, as
Director of the Division
Radiology at Harvard
University, presented
of Leuven University,
well as Professor of
of Oncologic Imaging and
Medical School, was
the Inaugural Lecture
received a Lifetime
Radiology, presented
Interventional Therapy
invited to present the
‘Images in the brain
Achievement Award.
the Wilhelm Conrad
at Bonn University, was
Josef Lissner Honorary
– pictures in the eyes’
Prof. Baert has been
Röntgen Honorary
invited to present the
Lecture entitled ‘The
in recognition of his
highly acclaimed for his
Lecture entitled ‘Pushing
Peter E. Peters Honorary
coming of age of imaging
exceptional achievements
work in both peripheral
the speed limits in MR
Lecture entitled ‘New
in biomedical research’
and his leadership in
angiography and
imaging’ in recognition
paradigms in breast
in recognition of his
neurosciences as well as
abdominal CT, and his
of his outstanding
imaging’ in recognition
outstanding career and his
in research and teaching.
great contribution to the
accomplishments in
of her outstanding
contribution to radiology.
Prof. Pöppel, Professor
development of radiology
the field of MRI. Prof.
contributions to basic
Prof. Thrall currently
of medical psychology,
in Europe. He was ECR
Hennig has been Scientific
and applied research
serves as a trustee of the
previously worked at
President in 1993 and
Director of the European
in medical magnetic
Massachusetts General
several Max-Planck-
1995, ECR Gold Medallist
Institute for Biomedical
resonance, particularly in
Physicians Organization
Institutes and at the MIT
in 1999 and President of
Imaging Research (EIBIR)
breast imaging.
and chairs the Executive
in Cambridge/US.
the European Association
since 2006.
Committee of the
of Radiology (EAR) from
Harvard Departments of
1995 until 1997.
Radiology.
European Society of Radiology
8

ECR 2008 – Review
‘ESR meets’ drew crowds of
knowledge-hungry delegates
to ECR 2008
01
By Mélisande Rouger
02
The popular ‘ESR meets’ programme – formerly ‘ECR meets’
– once more attracted packed audiences at ECR 2008,
between Saturday 8 and Monday 10 March. This year the initiative,
which traditionally invites three countries to present
their latest scientific achievements, also welcomed general
practitioners (GPs) to discuss the challenges in diagnosis
and treatment brought by atherosclerosis. This feature was
the first in a new series on partner disciplines at ECR, a
move designed to improve the ongoing dialogue between
radiology and other medical disciplines.
Germany opened the proceedings on Saturday morning with
a session entirely dedicated to computer aided diagnosis
(CAD), under the aegis of ESR President Prof. Andy Adam,
ECR President Prof. Maximilian Reiser, and German Radiological
Society (DRG) President Prof. Michael Laniado. “German
radiology is very much technology-driven, with a high
standard of equipment, and many German papers presented
at ECR every year have demonstrated the benefits of using
it. With CAD, we have chosen a topic that may highlight
the ‘pros and cons’ of cutting edge technology,” Laniado
explained.
The lectures ranged from CAD in mammography and virtual
colonography to CAD of the lungs and of the liver. Renowned
German radiologists Prof. Ulrich Bick from Berlin, Prof. Hans-
Ulrich Kauczor from Heidelberg, Prof. Andrik J. Aschoff from
Ulm and Prof. Heinz-Otto Peitgen from Bremen presented
the session and, together with an active audience, weighed
the benefits of CAD in its various uses.
In the afternoon, GP delegates met with their radiologist
colleagues for the first time at ECR, in a session presenting
current diagnosis and treatment options of atherosclerosis.
Atherosclerosis, which affects arterial blood vessels,
is the most important underlying cause of strokes, heart
attacks, various heart diseases including congestive heart
failure, and most cardiovascular diseases. Prof. Christos
Lionis from Iraklion focused on the assessment of coronary
artery disease together with radiologist Dr. Nico R. Mollet
from Rotterdam, while Prof. Manfred Maier from Vienna
and Dr. Marcus Treitl from Munich presented a lecture on
patients with peripheral arterial obstructive disease in primary
care.
The session was introduced and presided by both Prof.
Reiser and Prof. Igor Švab, President of the European Society
of General Practice/Family Medicine (WONCA Europe).
On Sunday, a six-strong Israeli delegation reported views
and impressions from radiology in Israel, in a session presided
by Prof. Moshe Graif, Chairman of the Israeli Radiological
Association (ISRA), as well as Prof. Adam and Prof.
Reiser. Israel’s great contribution to innovation in radiology
was expounded by Dr. Yael Inbar from Tel Hashomer and
Dr. Tamar Gaspar from Haifa during their lecture on the
hi-tech environment in Israel. National experience in emergency
radiology was also stressed during a lecture on CT
utilisation in emergency medicine. The latter, presented by
both Prof. Ahuva Engel from Haifa and Prof. Graif from Tel
Aviv, especially focused on CT use in the aftermath of mass
casualty events, such as terror attacks or during wars, situations
in which Israeli radiologists have gained knowledge
over the years. Finally, large-scale radiological projects and
surveys comparing local and international data were presented
by Dr. Dorith Shaham and Dr. Jacob Sosna, both
from Jerusalem.
Last but not least, Indian radiologists offered a whole session
on tuberculosis, presided by Prof. Nadhamuni Kulasekaran,
President of the Indian Radiological and Imaging
Association (IRIA), and both Prof. Adam and Prof. Reiser.
Tuberculosis (TB) has been endemic in India for a long time,
and Indian radiologists have acquired extensive know-how in
how to diagnose the disease in its most unusual instances.
With the re-emergence of TB in many western countries,
those lectures resonated strongly among the ECR international
guests, who poured in during the lectures. The session
focused on TB in its various forms, from its unusual
appearances in intracranial infection to atypical radiological
appearances in the chest, as well as peritoneal, intestinal,
and spinal TB. Presenters included Prof. Hanuman Satishchandra
from Bangalore, Dr. Deepak P. Patkar from Mumbai,
Dr. Rajesh Kapur and Dr. Shyam S. Doda, both from New
Delhi, and Dr. Prabhakar R. Kundur from Hyderabad.
03
04
01: Prof. Antonio Chiesa, Prof. Moshe Graif, Prof. Maximilian Reiser
02: Prof. Maximilian Reiser, Prof. Nadhamuni Kulasekaran, Prof. Andy Adam
03: Prof. Igor Švab, Prof. Maximilian Reiser
04: Prof. Michael Laniado, Prof. Andy Adam
9
myESR.org

ESR Newsletter 02/08
EIBIR
EIBIR’s prominent booth pulled in
the crowds at ECR 2008
By EIBIR Office
The prominent EIBIR Lounge in the entrance hall
of ECR 2008 was one of the most popular booths,
not only because of the attractive young ladies
servicing it, excellent coffee and comfortable armchairs,
but above all due to the importance of biomedical
imaging in state-of-the-art research.
The EIBIR Research Fund was launched at this
year’s ECR, in line with EIBIR’s mission to coordinate
the development of biomedical imaging
technologies and to foster research training
within Europe. Contributions to the Research
Fund can be made by individuals and institutions.
Donations will be used to support research training
in the field of biomedical imaging in order
to disseminate knowledge and to secure attainment
of the ultimate goal of improving diagnosis,
treatment and prevention of disease. Successful
advances in biomedical imaging research can
only be achieved if excellent training is available
to future generations.
EIBIR would like to thank those who were among
the first to make a donation and will ensure that
the funds will be used to benefit the future of
research in Europe. Information on the fund and
the possibility of donating online will shortly be
available on the EIBIR website www.eibir.org,
with regular updates on the use of the donations
received.
Prof. Hennig, EIBIR’s Scientific Director, was
present at the EIBIR Lounge and took the time to
answer scientific questions from delegates as well
as membership-related enquiries. Furthermore,
EIBIR was able to enlist many new international
institutes of excellence as members, which have
already received their access to the restricted
EIBIR members’ area on our website.
EIBIR held various meetings at ECR 2008, including
the General Meeting, the meeting of the Scientific
Advisory Board and the Industry Panel, as
well as meetings of various project groups, where
the roadmap for the months ahead was discussed
and a review was presented of the remarkable
progress the network has made since its establishment.
The Scientific Advisory Board meeting
also included a meeting of the partners of the FP6
project supporting the establishment of the structure
of EIBIR. At the meeting, Prof. Carrió of the
European Society of Nuclear Medicine (EANM)
was welcomed as a new member of the EIBIR Scientific
Advisory Board.
The consortium of the FP7 project on cell imaging,
entitled ENCITE (European Network for Cell
Imaging and Tracking Expertise), is currently
gearing up for the project start on April 1. EIBIR
will act as coordinator of the project.
EIBIR’s other successful EU project submitted by
the Biomedical Image Analysis Platform, called
HAMAM (Highly Accurate Breast Cancer Diagnosis
through Integration of Biological Knowledge,
Novel Imaging Modalities, and Modelling),
is scheduled to start in September of this year.
The objectives of the project are to set up spatial
correlation information data-sets, to develop preprocessing
tools, to build adaptability for integration
of other sources, and to build tools integrating
modalities into a single interface. EIBIR will
also be the co-ordinator and the administrative
partner of this project.
During the EIBIR Industry Panel Meeting, the
EIBIR Managing Director presented the business
plan for 2008 to 2010. Bracco, GE Healthcare,
Philips Medical Systems and Siemens Medical
Solutions agreed to continue their support of
EIBIR in 2008 and 2009. Close collaboration with
the pharmaceutical industry, system manufacturers
and information technologies is a key element
in translating new insight gained through
biomedical imaging research into biomedical and
clinical applications. EIBIR would like to express
its gratitude towards its industry partners for their
support!
EIBIR is also proud that besides the existing coshareholders
COCIR (European Coordination
Committee of the Radiological, Electromedical
and Healthcare IT Industry) and ESMRMB (European
Society for Magnetic Resonance in Medicine
and Biology), two new associations are already in
the process of becoming co-shareholders. We are
looking forward to fruitful future cooperation
with EANM and EFOMP, the European Federation
of Organisations for Medical Physics.
As you can tell, EIBIR successfully weathered the
second European Congress of Radiology since its
launch in 2006 and is now waiting in the wings of
many exciting new activities!
www.eibir.org
European Society of Radiology
10

ESOR, the European School of Radiology
is an initiative of ESR, the European Society of Radiology
made possible by an unrestricted grant from Bracco
ESOR
ESOR
European School of Radiology
Education in
partnership
ESOR releases its 2007 Annual Report and publishes
a number of brochures on its activities in 2008
After almost a year and a half of organising educational programmes, ESOR has published its
Annual Report 2007, which highlights last year’s activities for radiologists in training and the excellent
response received from the participants. In 2008 ESOR continues to help young radiologists to
achieve the knowledge and skills to fulfil tomorrow’s requirements by offering a number of established
activities and launching new ones.
The activities of ESOR include at present:
Visiting Schools
GALEN Foundation Courses (in partnership with GE Healthcare SCE)
GALEN Advanced Courses (in partnership with GE Healthcare)
School of MRI (in partnership with ESMRMB)
AIMS Advanced Imaging Multimodality Seminars (in partnership with Bracco)
ESOR establishes new advanced
courses on cross-sectional imaging
For 2008 ESOR will host a new course series on advanced cross-sectional
imaging, aimed at residents in their 4 th or 5 th year of training
in radiology and board-certified radiologists. The so-called GALEN
Advanced Courses include Cardiac, Women’s, Abdominal and Musculoskeletal
Cross-Sectional Imaging, starting in early summer with
the following courses:
Cardiac Cross-Sectional Imaging
June 20–21, 2008
Rome/IT
Women’s Cross-Sectional Imaging
July 4–5, 2008
Berlin/DE
Further information on the courses and the registration form are
available at myESR.org/esor.
Visiting Scholarship Programme (in partnership with Bracco)
Cardiac Imaging Fellowship Programme (in partnership with ESCR)
Tutorials (in partnership with Agfa and Siemens)
Virtual School
Relaxed ECR visitors at the ESOR lounge
Further information and brochures on the activities are available to download at myESR.org/esor.
ESOR 2008
European School of Radiology
Introduction
of Activities
Education partnership in
ESOR 2008
European School of Radiology
GALEN
Advanced Courses
Visiting School
Education partnership in
ESOR 2008
European School of Radiology
Cardiac Cross-Sectional Imaging
Women’s Cross-Sectional Imaging
Abdominal Cross-Sectional Imaging
Musculoskeletal Cross-Sectional Imaging
Rome/IT, June 20–21, 2008
Berlin/DE, July 4–5, 2008
Stockholm/SE, October 10–11, 2008
Amsterdam/NL, November 7–8, 2008
ESOR
GALEN
Foundation Courses
Visiting School
Abdominal/Genito-Urinary Radiology
Neuro/Musculoskeletal Radiology
Paediatric Radiology
Oncologic Imaging
Chest/Cardiovascular Radiology
Education partnership in
European School of Radiology
Alexandroupolis/GR, May 16–18, 2008
Lublin/PL, June 27–29, 2008
Prague/CZ, September 5–7, 2008
Bucharest/RO, October 17–19, 2008
Budapest/HU, October 31 – November 2, 2008
Education partnership in
ESOR 2008
European School of Radiology
Annual Report 2007
AIMS
Advanced Imaging
Multimodality Seminars
Visiting School in China
Spring Seminars
April 10–14, 2008
Summer Seminars
July 20–24, 2008
Chest and Musculoskeletal Radiology
Beijing · Changsha · Dalian
Abdominal and Urogenital Radiology
Education partnership in
ESOR 2008
European School of Radiology
CARDIAC IMAGING
Fellowship Programme
Education partnership in
ESOR 2008
European School of Radiology
Visiting
Scholarship Programme
Breast Imaging
Cardiac Imaging
Musculoskeletal Radiology
Neuroradiology/Head and Neck
Education in partnership
At this year’s ECR, the ESOR lounge in the entrance hall of the Austria Center was highly welcomed
by the busy congress visitors as a place to relax after sessions. The comfortable lounge
invited delegates to have a rest and read through the many brochures published by ESOR.
Many ECR participants took the chance to inform themselves about the variety of new and
established ESOR activities and to register for one course or another. After a very successful
ECR 2008, ESOR looks forward to presenting its activities in a similar relaxing way at ECR
2009.
An ESR initiative, in co-operation with GE Healthcare
An ESR initiative, in co-operation with
GE Healthcare Medical Diagnostics South Central Europe
Shanghai · Hangzhou · Chengdu
Oncologic Imaging
Urogenital Radiology
An ESR initiative, in co-operation with CSR, the Chinese Society of Radiology,
MRI Protocols
ESOR, the European School of Radiology
is an initiative of ESR, the European Society of Radiology
An initiative of the ESR, in co-operation with
the European Society of Cardiac Radiology (ESCR)
Multidetector CT Protocols
An ESR initiative, in co-operation with Bracco
11 myESR.org

ESR Newsletter 02/08
ECR 2008 – SCIENCE
Innovation drives growth
of hybrid imaging
By Paula Gould
Prof. Liselotte Højgaard from Copenhagen/DK.
Prof. Torsten Kuwert from Erlangen/DE.
Prof. Angelika Bischof Delaloye, Lausanne/CH.
Interest in multimodality imaging shows no sign
Højgaard now wants to see the evidence base catch
SPECT/CT could alter diagnoses in 30% of cases.
“Our integrated PET/MRI system is a completely new
of abating. New tracers are opening up the range
up with PET/CT practice. Many meta-analyses
In other words, 700,000 patients in Europe could
machine,” he said. “You simply cannot do this type of
of clinical applications, whilst novel technological
demonstrating the clinical efficacy of PET have
benefit from the switch.
hybrid imaging with an existing PET system.”
solutions are paving the way to yet more modality
been published, but no such studies have been con-
marriages, according to speakers at ECR's special
ducted into the value of PET/CT.
Kuwert has been using SPECT/CT in Erlangen
One of the main challenges posed by the inte-
focus session on hybrid imaging.
since 2005. He presented several examples show-
gration of PET and MRI is photon attenuation.
She would also like to see data on the cost-effec-
ing the advantages of hybrid imaging over sepa-
Components for the PET scanner must also be
Prof. Liselotte Højgaard, director of clinical physi-
tiveness of PET/CT. Such analyses should be per-
rate scans. For example, in the case of patient with
MR-compatible.
ology, nuclear medicine and PET at Rigshospitalet,
formed by health economists, who would provide a
metastatic thyroid cancer, neither SPECT nor CT
University of Copenhagen, described the impact
rigorous and comprehensive assessment, not radi-
alone could pinpoint the site of malignancy. Fusing
Fusing MRI with SPECT would pose additional
that PET/CT can make on clinical practice.
ologists, she said.
the two datasets revealed exactly where the surgeon
technical difficulties, Krieg said. Lead collimators
should operate.
are an integral part of SPECT scanners. Alternative
“Getting a PET/CT system in a nuclear medicine
“We have seen an almost exponential rise in the use
collimation technology would need to be devised
department is a little like getting a tiger instead of
of PET/CT,” she said. “I think we are now on the
SPECT/CT is not just beneficial in oncology,
for a SPECT/MRI machine.
a dog,” she said.
change of a curve in diagnostic imaging as a whole.
though. It can also be used as a ‘one-stop-shop’ for
In some areas, such as CT, this rise looks likely to
certain orthopaedic investigations.
The majority of today’s hybrid systems are still
PET/CT has already proven itself to be particularly
continue. But some of the other techniques will
essentially two separate technologies that have been
valuable in oncology. Imaging with the radiotracer
demand cost-effectiveness proof of what we are
“The combination of SPECT and spiral CT has
joined together, said Prof. Angelika Bischof Dela-
fluorine-18 FDG can identify areas of abnormal
doing. We will have to think cautiously about how
revitalised conventional scintigraphy,” Kuwert said.
loye, session moderator and chief of nuclear medi-
metabolic behaviour, and the addition of CT homes
to spend our money.”
cine at the University Hospital Vaudois, Lausanne,
in on the site of malignancy. Indications include
One concern with hybrid systems is that half of the
Switzerland. She questioned whether entirely new
malignant melanoma and lymphoma, and cancers
Prof. Torsten Kuwert, chair of nuclear medicine at
scanner will always be lying idle. This is not neces-
concepts would be needed to realise more substan-
of the head and neck, oesophagus, breast, lung, and
the University of Erlangen in Germany, agreed that
sarily the most cost-effective use of expensive imag-
tial improvements to image quality.
colon.
cost-effectiveness is an important consideration.
ing equipment. Why buy a 64-slice CT scanner if it
He pointed out that if a hybrid imaging modality
is going to be welded to a gamma camera and only
The low resolution of PET images is one area that
The development of new tracers may help PET/
can improve diagnostic uncertainty, then addi-
used for part of each imaging investigation Hospi-
could benefit from a new way of thinking. One
CT gain a stronger foothold in more clinical areas.
tional follow-up studies or invasive tests may not
tal accountants may query whether this investment
promising option is a technique known as virtual
For example, imaging with copper-64 ATSM may
be necessary, and money could be saved.
is truly worthwhile.
pin-hole PET, Bischof Delaloye said. A description
allow practitioners to identify hypoxic tumours
This issue should be less of a concern with PET/
of this approach was published in the online Jour-
that are more difficult to treat with radiation. This
SPECT/CT could potentially make a significant
MRI, according to Dr. Robert Krieg from Siemens
nal of Nuclear Medicine in February.
information may be critical to radiotherapy plan-
difference to clinical practice, according to Kuw-
Medical Solutions. He outlined details of a proto-
ning. Dementia is another area where PET/CT
ert. Approximately two million SPECT examina-
type PET/MRI system, now installed at the Univer-
“Over the past few years, major progress has
looks set to play a greater role. The tracers car-
tions are performed every year in Europe, making
sity of Tübingen, Germany, which acquires data for
been made in imaging on the CT side,” she said.
bon-11 PIB and fluorine-11 PIB look set to make
SPECT the ‘imaging workhorse’ of nuclear medi-
the PET and MRI studies simultaneously.
“Now we need to improve our nuclear medicine
this possible.
cine. Evidence suggests, however, that moving to
instruments.”
Find more coverage of ECR’s scientific programme at www.myESR.org/publications/ECR_Today.
European Society of Radiology
12

ECR 2008 – SCIENCE
Experts outline pros and cons of
functional MR and PET in clinical arena
By Philip Ward
Dr. Marko Essig from Heidelberg/DE.
Dr. Frank Berger from Munich/DE.
Prof. Hans Steinert from Zurich/CH.
Some tantalising glimpses into the future clinical methods and building of normal collectives, and
applications of functional MR and PET imaging transfer of the results from functional imaging
were provided at a densely packed New Horizons techniques into established or new therapeutic
session during ECR 2008.
concepts and monitoring strategies, he said.
Using innovative sequence design and modern
contrast media, most functional methods ogy at the University of Munich, explained that
Dr. Frank Berger, a clinical re searcher in radiol-
such as perfusion and diffusion MRI can now angiogenesis is the process by which new blood
be easily integrated into standard protocols, vessels are formed, and is the hallmark in the
facilitating a combined assessment in a single pathophysiology of tumour growth and metastases,
as well as being the target for many new
exam, explained the moderator, Dr. Marco Essig
of the department of radiology at the German treatments. In tumours with a diameter of more
Cancer Research Center, Heidelberg, Germany. than 2 mm, passive diffusion is no longer sufficient
to reveal the viability of malignant cells,
Although MR is still less sensitive than PET,
functional MRI tools are often used as a comparator
for some assessments.
beyond the occult stage can activate the “ang-
and neovascularisation is a necessity. Tumours
iogenic switch,” he added.
“The problem with MRI is that conventional
imaging is not able to fulfill all the requirements,” There are several vascular treatments of cancer.
Antiangiogenic agents block or inhibit the
he said. “Functional MRI combines morphology
and physiology/pathophysiology, and is a possible
solution”.
rupting agents destroy or compromise the func-
growth of new blood vessels, while vascular distion
of existing blood vessels by targeting more
He listed the indications for perfusion as stroke, mature vessels and the vessel wall. They are
oncology (whole body), diseases such as rheumatism,
and neurodegenerative diseases. Among modifying agents, on the other hand, change the
generally cytotoxic to endothelial cells. Vascular
the indications for diffusion MRI are neuroimaging
research, neurosurgical planning, neuro-
of other treatments.
vasculature in a way that is favourable for the use
degenerative diseases, oncology, and stroke.
“A considerable number of new vascular treatments
continue to fail at Phase III and beyond,”
The main requirements are rapid and reproducible
quantification of the functional datasets, he said. “There is a need for biomarkers that can
comprehensible presentation of the results in an improve the selection of candidate therapies.
interdisciplinary experimental or clinical context, Not every treatment is effective in every person.
comparison of the acquired data with established Also, there is a need for predictive tests that can
Find more coverage of ECR’s scientific programme at www.myESR.org/publications/ECR_Today.
aid selection of treatment in everyday clinical
practice.”
Angiogenesis is a complex process involving
many steps, defying a single-method approach,
he continued. Studying the individual molecular
process requires very sensitive methods, but
there is no gold standard and many imaging tests
are in the early stages of validation.
He noted that although CT perfusion is widely
available, quantification is straightforward,
and it is faster and easier to perform than MRI,
it suffers from poor anatomical coverage, low
sensitivity for detecting current contrast agents,
and additional radiation exposure.
PET and PET/CT, however, can provide essential
information in staging and grading of various
tumours, treatment monitoring, and detection
of recurrences. The acquisition of a whole-body
PET/CT from the head to the pelvic floor can
be obtained in less than 10 minutes, and soon
the resolution of PET will increase to 3–4 mm,
according to Prof. Hans Steinert, senior physician
at the Clinic for Nuclear Medicine, Zurich
University Hospital.
An exciting area for PET researchers is the development
of molecular imaging probes, including
specific tracers that can be used to detect hypoxia
( 18 F-misonidazole) and proliferative activity
( 18 F-thymidine). Hypoxia and tumour cell proliferation
contribute to resistance to radiotherapy
in head and neck tumour cells. Currently assessment
of these two tumour characteristics is performed
in biopsies using immunohistochemical
staining and subsequent analysis.
Evaluating new cytotoxic drugs is another
emerging field, and early identification of inactive
compounds and non-responding tumours
may become feasible.
“Many more ligands are under development for
imaging of angiogenesis, apoptosis, and reporter
gene expression,” he concluded.
CLARIFICATION
Concerning the article on page 4 of ECR
Today’s issue from 10/11 March 2008
(‘Awareness and avoidance of MR artefacts
raises quality’), Joseph Castillo has asked
us to stress the following points regarding
columns two and three of the text:
susceptibility-weighted imaging is a sequence
that uses the good effect of magnetic
susceptibility to show bleeding, and users
should always consult individual coil manuals.
We are sorry for any misunderstanding
caused by the original article.
13 myESR.org

© 2008 Philips Electronics North America Corporation.
Simplicity is the connection to your patient.
Philips Healthcare aspires to simplify medical care with solutions that are easier for
care providers and patients to experience. Insights from doctors, nurses, administrators,
and patients and their families factor into every technology and service we design.
Focusing on people just makes sense.
www.philips.com/healthcare

ECR 2008 – SCIENCE
Radiation
worries must
not inhibit
cardiac CT
By Paula Gould
Dr. Vicky Goh from Northwood/UK.
Dr. Joseph Schoepf from Charleston, SC/US.
Concerned about the level of radiation associated
with cardiac CT Fear not. The risk of patients
developing a radiation-induced cancer is actually
far lower than reports suggest, ECR delegates were
told in the scientific session ‘Advances in cardiac
CT’.
The good news came courtesy of Dr. Joseph
Schoepf, associate professor of radiology at the
Medical University of Charleston, South Carolina,
US. It follows a study of 104 consecutive patients
(64 men, 40 women) scheduled for cardiac CT on
a 64-slice scanner.
Organ doses were calculated using the ImPACT
dosimetry spreadsheet and then corrected for
patient weight. The risk of patients developing
radiation-induced cancers was then determined
using the BEIR VII approach, a method that draws
on data from Japanese atomic bomb survivors.
“It is sometimes forgotten that weight is an
important factor in radiation risk. The heavier
the patient, the lower the risk from radiation,” he
said.
Researchers found that the risk of an average
patient in their group developing cancer was
0.12%. The risk of mortality was put at 0.1%, with
lung cancer forecast to be the biggest killer (85% of
radiation-induced cancers).
These figures differ markedly with reports claiming
a 1 in 114 risk of contracting cancer from
cardiac CT, said Schoepf. This alarming statistic,
taken from a study published in the Journal of
the American Medical Association, was calculated
using presumed scan protocols for a 20-year-old
female patient.
In contrast, the calculations made by Schoepf and
colleagues are based on actual scan parameters
for a real life patient population. Their cohort was
predominantly male, median age 59 years old,
median weight 91 kg.
“It is always the most sensationalist numbers that
get repeated over and over again,” he explained.
“The vast majority of patients that undergo cardiac
CT are in their fifth to seventh decade of
life. That goes along with a significantly reduced
risk of seeing a radiation-induced cancer in their
lifetime. Also, our patient population was pretty
heavy, again a factor that significantly reduces the
risk of radiation-induced cancer.”
The cancer risk doubled for the most sensitive
patients in the study group. These patients were
younger than average, lighter than average and
scanned with a particularly high dose of radiation.
The 1 in 500 risk of contracting cancer faced
by these patients is still far lower than the headline-grabbing
1 in 114 figure, though.
“If appropriately indicated, the gain in diagnostic
information obtained non-invasively almost
always outweighs radiation risk,” Schoepf said.
“Appropriate patient selection and indication
are the most powerful tools for radiation
protection.”
The theme of radiation reduction was continued by
Dr. Vicky Goh, a radiologist at the Paul Strickland
Scanner Centre, Mount Vernon Hospital, London.
The evolution of CT technology means that
coronary artery anatomy, myocardial perfusion,
and left ventricular function can theoretically be
performed in a single, combined assessment. The
added dose required to quantify myocardial perfusion,
however, would take the patient’s radiation
burden well above acceptable limits.
The solution may be to use the test bolus performed
during routine coronary CT angiography to carry
out the desired quantification. A small-scale trial
has confirmed that the strategy is feasible.
The prospective study involved 14 patients (mean
age 66.5 years, eight male, six female) with suspected
coronary artery disease. All underwent
a retrospectively ECG-gated dynamic test bolus
acquisition at the mid-ventricular level prior to
combined coronary CTA and 82-rubidium perfusion
PET. The effective dose for the modified
test bolus acquisition was 1.4 mSv.
“Compare this to the 12 to 15 mSv for a standard
perfusion study,” Goh said.
The test bolus acquisition revealed normal resting
perfusion levels in 13 out of the 14 patients,
and evidence of an infarct in one patient. Interobserver
agreement was good. The CT perfusion
data tallied well with that from 82-Ru PET, also
from previously published perfusion studies using
a range of modalities.
“We have been able to show that the quantification
of perfusion is actually possible as part of a
gated CTA test bolus study. It is certainly useful in
a general setting, and it bodes well for combined
studies in the future in coronary artery anatomy
and myocardial perfusion,” Goh said. “Particularly
with the onset of prospective gated techniques
and greater cardiac acquisition, we now
should see greater integration of these techniques
together.”
Find more coverage of ECR’s scientific programme at www.myESR.org/publications/ECR_Today.
15 myESR.org

ESR Newsletter 02/08
ESR MEETS
What if workflow met
innovation at every turn
Our latest breakthrough technologies streamline your clinical
processes. Innovating every step of your workflow.
It’s time to change the way you work. For good. Our newest diagnostic and interventional imaging systems are
designed around your specific workflow needs. For the latest Siemens has to offer in speed, simplicity, versatility,
and diagnostic confidence.
www.siemens.com/radiology; +49 69 797 6420
Answers for life.
European Society of Radiology
16
CC-Z1039-2-7600

ECR 2008 – SCIENCE
NSF
avoidance
triggers
debate
By Paula Gould
Prof. Sameh Morcos from Sheffield/UK.
Prof. Pontus Persson from Berlin/DE.
The controversial topic of nephrogenic systemic
fibrosis (NSF) drew a large crowd to a dedicated
special focus session during ECR 2008. Delegates
queued to quiz speakers about their recommendations
for NSF avoidance, ensuring a lively panel
discussion.
NSF is a relatively new medical condition, and one
that has taken the medical community somewhat
by surprise. The systemic disorder, which results
in sclerodoema-like skin discolouration and hardening,
was first observed in patients in 1997. All
cases reported to date have involved patients with
advanced renal disease.
Radiologists’ avid interest in NSF is due to the
apparent link with gadolinium-containing contrast
media. The vast majority of patients developing
NSF had previously undergone imaging with a
Gd-based agent on one or more occasions.
The causal link between Gd-based agents and NSF
is far from straightforward, though. Two cases
have occurred in patients who have never received
a Gd-containing contrast agent.
“It seems that gadolinium is a very powerful trigger,
but NSF can also occur without the MRI
agents,” said Prof. Pontus Persson from the Institute
of Physiology, Charité Medical University of
Berlin.
The key question for radiologists is: How can we
prevent the continued occurrence of NSF The
first crucial step is to identify those patients who
are at highest risk, that is, those with impaired
renal function, said Prof. Sameh Morcos, professor
of radiology at the University of Sheffield, UK.
Regulatory bodies, including the UK Medicines
and Healthcare products Regulatory Agency
(MHRA) and the US Food and Drug Administration
(FDA), recommend that doctors obtain
an oral history and/or perform laboratory tests
prior to Gd-enhanced MRI studies to identify
any patients with renal dysfunction. Patients categorised
as high risk are those with a glomerular
filtration rate (GFR) lower than 30 ml/min. This
all-important level can be derived from serum
creatine measurements.
“As point-of-service techniques for measuring
creatine become more widely available, it will
become increasingly less easy to justify not doing
a finger stick test,” said Dr. Shawn Cowper, associate
professor in the department of dermatology
and pathology at Yale University, New Haven, US,
and a renowned authority on NSF.
For patients with a low GFR, radiologists must
decide if Gd-enhanced MRI is necessary. Studies
that are clinically justified should be performed
with a contrast agent that has a macrocyclical
chemical structure, and is less likely to release
free Gd into the body, Morcos said. Most NSF
cases have been associated with non-ionic linear
chelates, such as gadodiamide, which are less stable.
Just one case of NSF has been linked to a macrocyclic
agent.
“Molecules with macrocyclic structure are like a
birdcage. Once the gadolinium is inside the cage,
it is very difficult for it to come out,” he noted.
This strategy has already proved worthwhile at
University Hospital Herlev, Denmark. Radiologists
previously used gadodiamide when performing
contrast-enhanced MRI on renal patients, said
Prof. Henrik Thomsen, professor of radiology at
the Copenhagen-based hospital. A total of 28 NSF
cases were recorded after 370 contrast injections.
The team then switched to using a macrocyclic
agent with this patient group. More than 150 injections
later, no cases of NSF have been observed.
“The same observation is now being reported by
departments all over the world,” he said.
Delegates were instructed not to use prophylactic
haemodialysis as an NSF-prevention strategy. For
patients already scheduled for haemodialysis, it
may be prudent to carry that out shortly after the
MRI examination. Patients on peritoneal dialysis
are considered to be at greater risk of NSF. They
should be asked to do several rapid exchanges
after MRI.
It may be reasonable to avoid injecting Gd in
patients experiencing inflammatory events,
owing to a possible link with the pathophysiological
processes causing NSF, according to Morcos.
This issue remains contentious though.
Panellists rejected the suggestion that renal
patients should be injected with a chelate immediately
after contrast-enhanced MRI to ‘mop up’
any free Gd. This strategy has not been confirmed
in animal trials, and may cause more harm than
good. The ligand may deplete the patient’s natural
reserves of copper or zinc, and cause other
unwanted side effects.
“Once the gadolinium is in there, there is not a lot
you can do about it,” Morcos said.
Find more coverage of ECR’s scientific programme at www.myESR.org/publications/ECR_Today.
17 myESR.org

GE Healthcare
Isosmolar Visipaque:
Strong evidence1-7
Find out more at www.visipaque.com
References
1. Aspelin P et al. Nephrotoxic Effects in High-Risk Patients Undergoing Angiography.
[NEPHRIC study]. N Engl J Med 2003;348:491-9.
2. Chalmers N and Jackson RW. Short communication: Comparison of iodixanol
and iohexol in renal impairment. Br J Radiol 1999;72:701-3.
3. Davidson CJ et al. Randomized Trial of Contrast Media Utilization in High-Risk
PTCA. The COURT Trial. Circulation 2000;101:2172-7.
4. Hernandez F et al. Renal protection in diabetic patients undergoing
percutaneous coronary intervention: is contrast osmolality really important
Eur Heart J 2007; 28 (Abstract Supplement):Abs 463.
5. Jo S-H, Youn T-J, Koo B-K et al. Renal Toxicity Evaluation and Comparison
between Visipaque (Iodixanol) and Hexabrix (Ioxoglate) in Patients with
Renal Insufficiency undergoing Coronary Angiography: The RECOVER Study:
A Randomized Controlled Trial. JACC 2006;48:924-30.
6. Manke C et al. Pain in femoral arteriography. A double-blind, randomized,
clinical study comparing safety and efficacy of the iso-osmolar iodixanol
270 mgl/ml and the low-osmolar iomeprol 300 mgl/ml in 9 European centers.
Acta Radiologica 2003;44:590-6.
7. Tveit K et al. Iodixanol in cardioangiography. A double blind parallel
comparison between iodixanol 320 mg l/ml and ioxaglate 320 mg l/ml.
Acta Radiologica 1994;35:614-8.
Cardiac
Renal
Patient
comfort
PRESCRIBING INFORMATION VISIPAQUE iodixanol
Please refer to full national Summary of Product Characteristics (SPC) before prescribing. Indications and
approvals may vary in different countries. Further information available on request.
PRESENTATION An isotonic, aqueous solution containing iodixanol, a non-ionic, dimeric contrast
medium, available in three strengths containing either 150 mg, 270 mg or 320 mg iodine per ml.
INDICATIONS X-ray contrast medium for use in adults in cardioangiography, cerebral angiography
(conventional and i.a. DSA), peripheral arteriography (conventional and i.a. DSA), abdominal angiography
(i.a. DSA), urography, venography, CT enhancement, studies of the upper gastrointestinal tract,
arthrography, hysterosalpinography (HSG) and endoscopic retrograde cholangiopancreatography
(ERCP). Lumbar, thoracic and cervical myelography in adults. In children for cardioangiography, urography,
CT enhancement and studies of the upper gastrointestinal tract. DOSAGE AND ADMINISTRA-
TION Adults and children: Dosage varies depending on the type of examination, age, weight, cardiac
output, general condition of patient and the technique used (see SPC and package leaflet). CONTRA-
INDICATIONS Manifest thyrotoxicosis. History of serious hypersensitivity reaction to VISIPAQUE.
WARNINGS AND PRECAUTIONS A positive history of allergy, asthma, or reaction to iodinated contrast
media indicates need for special caution. Premedication with corticosteroids or H1 and H2 antagonists
might be considered in these cases. Although the risk of serious reactions with VISIPAQUE is
regarded as remote, iodinated contrast media may provoke serious hypersensitivity reactions. Therefore
the necessary drugs and equipment must be available for immediate treatment. Patients should
be observed closely for at least 15 minutes following administration of contrast medium, however
delayed reactions may occur. Non-ionic contrast media have less effect on the coagulation system in
vitro, compared to ionic contrast media. When performing vascular catheterization procedures one
should pay meticulous attention to the angiographic technique and flush the catheter frequently (e.g.
with heparinised saline) so as to minimize the risk of procedure-related thrombosis and embolism.
Ensure adequate hydration before and after examination especially in patients with renal dysfunction,
diabetes mellitus, paraproteinemias, the elderly, children and infants. Particular care is required in
patients with severe disturbance of both renal and hepatic function as they may have significantly
delayed contrast medium clearance. For haemodialysis patients, correlation of time of contrast media
injection with the haemodialysis session is unnecessary. To prevent lactic acidosis in diabetic patients
treated with metformin, administration of metformin should be discontinued at the time of administration
of contrast medium and withheld for 48 hours and reinstituted only after renal function has been
re-evaluated and found to be normal. (Refer to SPC). Special care should also be taken in patients with
hyperthyroidism, serious cardiac disease, pulmonary hypertension, patients predisposed to seizures
(acute cerebral pathology, tumours, epilepsy, alcoholics and drug addicts), and patients with
myasthenia gravis or phaeochromocytoma. One should also be aware of the possibility of inducing
transient hypothyroidism in premature infants receiving contrast media. All iodinated contrast media
may interfere with laboratory tests for thyroid function, bilirubin, proteins, or inorganic substances (e.g.
iron, copper, calcium, and phosphate). An increased risk of delayed reactions (flu-like or skin reactions)
has been associated with patients treated with interleukin-2 up to two weeks previously. PREGNANCY
AND LACTATION The safety of VISIPAQUE in pregnancy has not been established. Contrast media are
poorly excreted in breast milk and minimal amounts are absorbed by the intestine. Breast feeding
may be continued normally. UNDESIRABLE EFFECTS Intravascular use: Usually mild to moderate, and
transient in nature. They include discomfort, general sensation of warmth or cold, pain at the injection
site or distally. Serious reactions and fatalities are only seen on very rare occasions. Nausea and
vomiting are rare, and abdominal discomfort is very rare. Hypersensitivity reactions occur occasionally
with symptoms such as rash, urticaria, erythema, pruritus, dyspnoea or angioedema (immediate or
delayed). Hypotension or fever may occur. Severe reactions such as laryngeal oedema, bronchospasm,
pulmonary oedema and anaphylactic shock are very rare. Neurological reactions such as headache,
dizziness, seizures, and transient motor or sensory disturbance (e.g. taste or smell alteration) are very
rare. Also reported very rarely: vagal reactions, cardiac arrhythmia, depressed cardiac function,
ischaemia, and hypertension. “Iodide mumps” is a very rare complication. Arterial spasm may follow
injection into coronary, cerebral or renal arteries. A minor transient rise in S-creatinine is common.
Renal failure is very rare. Post phlebographic thrombophlebitis or thrombosis is very rare. Arthralgia is
very rare. Severe respiratory symptoms and signs (including dyspnoea and non-cardiogenic pulmonary
oedema), and cough may occur. Intrathecal use: Meningism, photophobia or chemical
meningitis. Transient motor or sensory dysfunction. Confusion. Paraesthesia. Seizures. EEG changes.
Local pain. Headache, nausea, vomiting or dizziness. Use in body cavities: Endoscopic Retrograde
Cholangiopancreatography (ERCP): Elevation of amylase levels, pancreatitis. Oral use: diarrhoea,
nausea, vomiting, abdominal pain. Hysterosalpingography (HSG): Transient pain in the lower abdomen.
Vaginal bleeding/discharge, nausea, vomiting, headache, fever. Arthrography: Pressure sensation and
post procedural pain. PHARMACODYNAMIC PROPERTIES In 64 diabetic patients with serum creatinine
levels of 115 - 308 µmol/L, VISIPAQUE use resulted in 3% of patients experiencing a rise in creatinine
of ≥ 44.2 µmol/L and 0% of the patients with a rise of ≥ 88.4 µmol/L.The release of enzymes (alkaline
phosphatase and N-acetyl-ß-glucosaminidase) from the proximal tubular cells is less than after injections
of non-ionic monomeric contrast media and the same trend is seen compared to ionic dimeric
contrast media. VISIPAQUE is also well tolerated by the kidney. INSTRUCTIONS FOR USE AND HAND-
LING Like all parenteral products, VISIPAQUE should be inspected visually for particulate contamination,
discolouration and the integrity of the container prior to use. The product should be drawn into
the syringe immediately before use. Containers are intended for single use only, any unused portions
must be discarded. VISIPAQUE may be warmed to body temperature (37°C) before administration.
MARKETING AUTHORISATION HOLDER GE Healthcare AS, Nycoveien 1-2, Postboks 4220 Nydalen,
N-0401 Oslo, Norway. CLASSIFICATION FOR SUPPLY Subject to medical prescription (POM). MARKETING
AUTHORISATION NUMBERS PL 0637/0017-19 (Glass vials/bottles and polypropylene bottles with
stopper and screw cap). PL 0637/0026-28 (Polypropylene bottles with a twist-off top). DATE OF
REVISION OF TEXT 19 October 2007. PRICE 320mgI/ml, 10x50ml: £228.81
Information about adverse event reporting can be found at www.yellowcard.gov.uk.
Adverse events should also be reported to GE Healthcare.
GE Healthcare Limited, Amersham Place, Little Chalfont, Buckinghamshire, England HP7 9NA.
www.gehealthcare.com
© 2008 General Electric Company – All rights reserved.
GE and GE Monogram are trademarks of General Electric Company.
Visipaque is a trademark of GE Healthcare Limited.
02-2008 JB3054/MB002665/OS UK

ECR 2008 – SCIENCE
CAD
emphasis
shifts to
diagnosis
By Paula Gould
Find more coverage of ECR’s scientific programme
at www.myESR.org/publications/ECR_Today.
Computer-aided detection and diagnosis tools
were showcased at ECR’s ‘ESR meets Germany’
session. Speakers highlighted four key clinical
areas where advances in CAD could make a real
difference to diagnostic decision making.
The potential of CAD in breast imaging was first
noted back in 1967, said Prof. Ulrich Bick, professor
of radiology at the Charité Medical University
of Berlin. CAD algorithms have evolved considerably
since that initial report, leading to a steady
improvement in performance. He showed data
from a 2008 study revealing 100% sensitivity for
breast CAD in detecting microcalcifications and
91% sensitivity for malignant masses.
“Masses are easy to see, but difficult to interpret,”
Bick said. “Basically the entire breast parenchyma
is made up of masses. So if you look at a mammogram,
it is very difficult to tell which of these are
cancers and which are not. In addition, detection
of associated architectural distortion is difficult
for the computer.”
He predicts that future breast CAD systems will
be equipped with intelligent workstations that can
help determine if lesions are malignant or not.
This will be done by comparing key features seen
on the mammogram to those in a database.
Radiologists must also learn how to use CAD
appropriately. Given the large number of falsepositive
readings generated by breast CAD, a
measured approach is necessary, and he recommends
neither blind faith in the computer nor
complete scepticism.
Bick suggested that radiologists will gradually
come to regard CAD as a trusted second reader
for screening mammography, rather than a ‘spellchecker’.
No-one is yet obliged to use CAD when
reading screening mammograms, but if future
data demonstrates that CAD can reduce the mortality
of breast cancer, then this issue may need to
be re-visited.
“At some stage, CAD will be superior to radiologists,”
he predicted.
Chest imaging is another area where CAD is used
at present, but has the potential to do much more,
according to Prof. Hans-Ulrich Kauczor, Chairman
of the department of radiology at University
Hospital Heidelberg.
CAD is currently helping radiologists find pulmonary
nodules and early signs of lung cancer on
CT. Detection in itself is not enough though, he
explained. The ideal CAD system should also be
able to perform accurate volume measurements,
too. Suspicious lesions can then be monitored to
see if they change in size, and if so, by how much.
“You want to measure the tumour doubling time,”
he said. “But we also have to be aware that there is
a significant error in making volumetry measurements.
You really have to demonstrate an increase
in volume of more than 30% or 40% to be sure that
a nodule is actually growing.”
Kauczor would like to see chest CAD used to
assess a far greater spectrum of diseases related to
smoking. He envisages computerised systems that
could evaluate chronic obstructive pulmonary
disease (COPD). It should be possible to create
tools that can distinguish between emphysemapredominant
COPD and airway-predominant
COPD, a distinction that could influence treatment,
he said.
Other advances forecast by Kauczor include a
greater use of CAD for emphysema, 4D imaging
of lung hyperinflation, and the inclusion of vascular
imaging tools in chest CT work-up.
Continuing the theme of computer-aided analysis,
Prof. Heinz-Otto Peitgen of the Centre for
Medical Diagnostics and Visualization (MeVis)
in Bremen described a variety of state-of-the-art
tools that may assist liver imaging and intervention.
His presentation explored three different
aspects of computer-aided diagnosis and therapy:
response evaluation in chemotherapy, surgical
planning, and radiofrequency ablation.
Detection – rather than diagnosis – will remain
the primary role for CAD in the colon, said Prof.
Andrik Aschoff, associate professor of radiology
at the University of Ulm. Early identification and
removal of polyps promises to reduce the rate of
colon cancer, but if this type of screening is to
be performed with CT colonography, then CAD
may be needed to reduce variations in reader
sensitivity.
Aschoff outlined the three alternative paradigms
for using CAD: as an initial reader to filter out
‘normal’ cases, as an aid to the reporting radiologist,
and as an independent second reader. This
latter option tends to give the best sensitivity,
though at the cost of slightly extended reading
times, he said.
“CAD is very promising in CT colonography. It
has the potential to support radiologists in pro-
Prof. Hans-Ulrich Kauczor from Heidelberg/DE.
Prof. Ulrich Bick from Berlin/DE.
Prof. Andrik Aschoff from Ulm/DE.
viding the best possible detection rates of polyps.
This is extremely important. If we do CT colonography
on our patients, we want to give them the
assurance that they have no large polyps, and
they are not going to develop colorectal cancer,”
Aschoff concluded.
19 myESR.org

ESR Newsletter 02/08
ECR 2008 – IMPRESSIONS
European Society of Radiology
20

ECR 2008 – IMPRESSIONS

ESR Newsletter 02/08
ECR 2008 – Review
500 delegates swinging
at the
ECR Party
By Vera Schmidt
Once again, the ESR and the delegates of ECR 2008 proved that
medical professionals know how to party!
Inspired by the thirties and forties, the beautiful Art Nouveau interior
of Vienna Konzerthaus’ big hall was transformed into a swinging
ballroom from an era whose glitter and glamour continues to
fascinate audiences today. An enormous disco ball atmospherically
polka-dotted the room. All state-of-the-art scientific knowledge
was left outside for a night full of nothing but excellent entertainment,
and when the doors opened at 19:30, the guests flooded in to
the sold-out event.
The well-known Austrian actress, Claudia Martini, opened the
night, initiating the time travel and impressing with her splendid
solo show ‘Martini meets Marlene’. She then stayed for the rest of
the night to lead the audience through the other acts.
Swing, the fabulous American music of the 1930s, experienced a
remarkable rebirth with the help of the Swing Dance Orchestra. It
was founded in 1987 under the direction of ‘Swing King’ Andrej
Hermlin, and since then has developed into the most outstanding
and successful swing band in Germany. The orchestra has a multifaceted
repertoire containing many familiar but also rarely played
original American arrangements from the ‘30s. These include
melodies of Benny Goodman’s orchestra, Artie Shaw, Jimmy and
Tommy Dorsey, Duke Ellington, Cab Calloway, Glenn Miller and
many other stars of the swing era. The Swing Dance Orchestra is
authentic down to the finest details: the sound, the arrangements,
the microphones and music stands, the instruments and even the
musicians’ outfits are just like the American originals. Had there
been gangsters, you could have thought you were in 1930s’ Harlem.
Fortunately there were neither criminals nor prohibition and
drinks went down easy in the nicely lit vintage interior. The all-youcan-eat
Thai buffet was not vintage at all, but the guests indulged in
Asian flavours and enjoyed the excellent cuisine.
From hot 1930s North America, ESR then took their guests to sizzling
South America as the dancers of Extravadancas sprung into
action. After their performance the stunning artists mingled with
the crowd, tempting even the most reluctant guests to leave their
seats and hit the dance floor. Within minutes, enthusiastic people
filled up the space and were still dancing when DJ T-Jah resumed
his place at the turntables. “When I was hired to play at an event of a
medical congress I expected to put on some background music and
finish early, but I couldn’t believe my eyes when everybody from
19 to 89 was dancing together! They even had to clear the stage to
make room for medical dancers,” he said. An eclectic mix of Latin,
dance classics of the 70s, 80s and 90s, and house beats kept the
party going until dawn ...
See you again next year!
European Society of Radiology
22

ECR 2008 – Review
Guests greeted with glamour
The ECR 2008 opening ceremony was the perfect opportunity to pay tribute to an exceptional European
radiologist, Prof. Albert L. Baert, who has had a considerable influence on the development of radiology as
the backbone of healthcare. After it honoured one of its founding fathers, ECR started with music, carried by
the powerful voice of soul singer Dorretta Carter.
By Mélisande Rouger
Prominent radiologist
honoured at ECR 2008
In a moving tribute, Prof. Albert L. Baert received a Lifetime
Achievement Award, closing an incredible career
spent in the driving seat of European radiology.
From 1971 to 1997, Prof. Baert was Chairman of the
Department of Radiology of the University Hospitals
of Leuven, Belgium, a position which allowed him to be
intimately involved in the clinical introduction and application
of ultrasound, computed tomography and MRI;
imaging modalities that emerged during the 1970s and
1980s.
He used those new tools to their full potential, particularly
in the field of abdominal sectional imaging. Under
his aegis, the Leuven Department of Radiology soon
developed into one of the largest in Europe, and acquired
international fame for its clinical research.
Baert, a pioneer in peripheral angiography and abdominal
CT, is also one of the great architects of the modern
European Congress of Radiology, which he helped shape
with the late Josef Lissner. He was twice appointed ECR
President, in 1993 and 1995, and was President of the
European Association of Radiology (EAR), the precursor
to the European Society of Radiology (ESR), from 1995 to
1997. He also received the ECR Gold Medal in 1999.
After he retired, Baert remained extremely active, notably
by continuing as the editor-in-chief of European Radiology
until December 2007, a position he held for 13 years.
Under his leadership, ER became the second highest
ranked truly general radiological journal.
Baert’s name will remain among the most famous personalities
of European radiology.
ECR 2008 kickstarted
under the stars of soul
“You serious radiologists learning important stuff, you need to
relax!” Whether they did relax or heat up, the audience found
it hard to remain indifferent to the Dorretta Carter and HOT
POT show, which followed the Lifetime Achievement Award
ceremony in honour of Prof. Albert L. Baert on the first day of
the ECR.
With her strong and sensual voice, Carter infused electricity
into the industrious Austria Center Vienna, by paying tribute to
the ‘Godfather of Soul’, the legendary James Brown.
Carter, based in Vienna since 1988, accompanied her vocal
homage with a proper head-to-toe display of early sixties soul
fashion, wearing a tiny black dress, sparkling red ankle boots,
oversized eyelashes and the inevitable grand afro.
In a clever succession of tunes, she demonstrated the impressive
range of her powerful vocals. A vibrant ‘Papa don’t take no
mess’, followed a moving ‘This is a man’s world’, while her energetic
yet smooth performance in ‘Sex machine’ was worthy of a
rapturous applause.
Instead, the artist found herself confronted with a mixed
response. “I look at you and this is what I see,” she started, toying
with the auditorium. “Some of you are in shock, some look
pleasantly surprised, and some just look happy!”
If Carter is rather used to standing audiences, she is not afraid
of creating varied reactions to her performances. In December
1994, her portrayal of the Virgin Mary in a musical reading
directed by Willi Resetarits caused disarray and anger among
the Salzburg public, puzzled to see a black woman as Jesus’
mother.
Born to Jamaican parents in London, Carter’s musical repertoire
ranges from jazz to funk and soul. She has worked notably
with Working Week, Osibisa, Wayne Shorter, Bolo Bolo,
Jennifer Rush, Bingo Boys and Count Basic. She also sang with
musicians as distinguished as Rainhard Fendrich and Friedrich
Gulda, respectively Austropop and classical composers.
In 2007 she formed her current band, Dorretta Carter’s HOT
POT, with Thomas Lang (Guitar), Ivan Ruiz (Bass) and Eldis La
Rosa (Percussion). She composes and writes her own lyrics, and
she also sings in the formation Heavy Tuba.
23 myESR.org

ESR Newsletter 02/08
ESR MEETS
Hitachi Medical Systems:
Technology improves life.
Hitachi Medical Systems:
Wissen ist mehr
als nur ein Gefühl.
.artundwork designbüro
Hitachi Medical Systems is leading the way in the world of modern medical technology.
The strong will that drives us forward earns us the renewed confidence of our partners every
day. Combining our vision with innovation and creativity inspires new techniques such as
the advanced Hitachi Real-time Tissue Elastography (HI-RTE) modality.
As in the past, Hitachi Medical Systems remains true to its tradition of improving peoples’ lives –
at all times.
European Society of Radiology
Hitachi Medical Systems Europe Holding AG · Sumpfstrasse 13 · CH-6300 Zug
www.hitachi-medical-systems.com
24

ECR 2008 – Industry
Industry at ECR 2008:
on the rise again
By Katharina Ebner & Maria Tutschek, ESR Office
Another European Congress of Radiology, ECR 2008,
is over, and again the facts and figures of our technical
exhibition entitle us to be more than proud of the outcome.
This year we were able to expand the exhibition
space even further, to an unbelievable 26,000m². The
enormous enlargement of Extension EXPO A (which
now finally has the right to bear the name exhibition hall)
convinced the biggest exhibitor of ECR 2008, Siemens, to
give up their traditional position in EXPO D and move
to a top position in Ext. EXPO A. Not only did the total
exhibition space exceed last year’s level, but the number
of exhibitors and their countries of origin also showed
another increase: 285 exhibitors from 39 countries proved
that ECR was the place to be in March 2008.
ECR City
After encountering especially high demand for space,
ECR reused the successful concept of ECR City again this
year. Several exhibitors readily shifted their Hands-on
Workshops to these neighbouring towers, dedicated to
ECR 2008, to benefit from the well-equipped and modern
venues. The buildings – two of them appropriately
named cloud 19 and 21 – provide an amazing view over
the city, so this asset was played upon by holding corporate
evening events there. To complement our use of the
ECR City locations, restaurants in the nearby locations
were opened for the convenience of our delegates.
Free Publications @ ECR 2008
Introduced at ECR 2007, the ‘Free Publications’ initiative
– a collaboration between ECR and partners in the
publishing business – turned out to be outstandingly
successful and popular, so this initiative became an integral
part of ECR 08. Encouraged by last year’s success
we extended the project by again displaying a wide range
of professional medical journals. More than 35 publishers
have joined this initiative, presenting almost 60 print
media free to take away. For the convenience of congress
participants, we once again set up electronic terminals
dedicated to our partners’ online media, providing free
access to more than 50 online journals and catalogues.
Since the ‘Free Publications’ booth was especially well
received and highly frequented, several magazines were
out of stock within the first few days, as well as the bags
supplied to carry them. In total, around 22,400 copies
were distributed during the congress. We would like to
thank all publishers for being part of this initiative offering
congress delegates the opportunity to gain insight
into their journals.
ESR on tour
Japan, Iran, Spain, Italy, Switzerland, Morocco and
Korea – to name a few – are the destinations where ESR
will promote its activities and enhance cooperation with
national radiological societies during the next year. In
order to establish and strengthen the ties with radiologists
in these countries, ESR spares no effort to be present
at various national congresses worldwide.
Carestream Health has received this
year’s Exhibit Europe Award in recognition
of its commitment to innovation in
science and technology, its efforts in the
advancement of patient care and research,
and its support for ECR. In this photo,
ECR President Maximilian F. Reiser
presents the award to Chief Technology
Officer Holly M. Hillberg.
Huge advertisement banners displayed
throughout the congress
centre show the importance of
the increased involvement of our
industry partners.
25 myESR.org

ESR Newsletter 02/08
ECR 2008 – Industry
Thank you to all ECR 2008
Exhibitors & Sponsors
2020 Healthcare Global, US
3mensio Medical Imaging, NL
3w-Informed, NL
A
AADCO Medical, US
Acceleware, CA
Adani, BY
Adimec Advanced Image Systems, NL
AFP Imaging/ QR, IT
Agfa Healthcare, BE
Albatross Projects, DE
Alliance Medical Group, UK
Alma IT Systems, ES
Aloka Holding Europe, CH
American College of Radiology, US
AngioDynamics, US
Apelem, DMS Group, FR
Apple, UK
Arcoma, SE
Array Corporation Europe, NL
A.T.S. (Applicazione Tecnologie Speciali), IT
Aycan Digitalsysteme, DE
Az Corporation, RU
B
B. Braun Melsungen, DE
Barco View, BE
Bard Europe, UK
Bayer Schering Pharma, DE
Biodex Medical Systems, US
BioOffice, NO
Bioptics, US
Biospace Med, FR
BMI Biomedical International, IT
Bracco, CH
C
Campden Publishing, UK
Candelis, US
Canon Europa, NL
Carestream Health, UK
CAT Medical Systems, IT
Celon medical instruments, DE
Chison Medical Imaging, CN
Codonics, US
Confirma Europe, US
ContextVision, SE
Control-X Medical, HU
Covidien, IT
CPI International, CH
D
Damgaard, DK
Dastor, IT
D.A.T.A Corporation Automed, AT
DEL Medical Imaging Corporation, US
Diagnostic Imaging Europe, US
DigiMed-mcs / Esinomed, DE
DIRA X-Ray, DE
DMS Group, FR
Dr. Goos-Suprema, DE
Dr. Sennewald Medizintechnik, DE
DRTECH Corporation, KR
DTM Medical, DE
Dunlee Medical Components, DE
E
Econet Medical, KR
Edge Medical Devices, IL
eIntegrity, UK
Eizo Display Technologies, DE
Eizo Nanao, JP
ELCAN Optical Technologies, CA
Elsevier, UK
EMD Technologies, CA
EMC Consulting Group, BE
Esaote, IT
Esaote - Ebit Aet Business Unit, IT
Etiam, FR
ETS-Lindgren, UK
European Hospital Verlags GmbH, DE
European Telemedicine Clinic, ES
Evorad, GR
E-Z-EM, US
F
Faxitron X-Ray, US
Fluke Biomedical, US
FOGALE Nanotech, FR
Fujifilm Europe, DE
G
Gammex-RMI, DE
GE Healthcare, UK
General Medical Italy, IT
General Medical Merate (GMM), IT
Georg Thieme Verlag, DE
Gilardoni, IT
GIT-Verlag / Hospital Post, DE
Globetech Publishing Corporation, US
Gruppo Soluzioni Tecnologiche, IT
Guerbet, FR
H
Health Professionals International, NZ
Hitachi Medical Systems Europe, CH
Hologic, US
Hoorn Holland, NL
I
I.A.E. Industria Applicazioni Elettroniche, IT
IBA Dosimetry, DE
iCAD, US
iCRco, DE
IEI Technology, CN
Image Diagnost International, DE
Imaging Diagnostic Systems, US
Imaging Management, BE
Imedco, CH
IMIX ADR, FI
IMS, IT
im3D S.p.A. Medical Imaging Lab, IT
Infinitt, KR
Innomed Medical, HU
Insight Agents GmbH, DE
Instrumentarium Imaging, FI
Integra, FR
Intermedical Italia, IT
International Hospital Equipment & Solutions,
BE
Intrasense, FR
Invivo, US
Italray, IT
ITEL Telecomunicazioni, IT
J
Jungwon Precision, KR
JVC Professional Europe, IT
K
Kiran Medical Systems, IN
Konica Minolta Medical & Graphic Imaging, NL
K&S Röntgenwerk Bochum, DE
European Society of Radiology
26

ECR 2008 – Industry
L
Landwind International, CN
Leidel & Kracht, DE
LINOS Photonics, DE
Lodox Systems, US
LukasSoftware, AT
M
Matrox Graphics, CA
McKesson, CA
Mecall, IT
Medavis, DE
Medecom, FR
Medex Loncin/ D3A Medical Systems, BE
Median Technologies, FR
Medical Econet GmbH, DE
Medicatech, US
Medicexchange, UK
Medicor Medical Supplies, BE
Medicsight, Rapier Group, UK
Medinvents, NL
Medis Medical Imaging Systems, NL
Medison, KR
Medrad Europe, NL
Medtron, DE
Mercury Computer Systems, US (now: Visage
Imaging, Inc., US)
Merge Healthcare, CA
Metaltronica, IT
Mindray, CN
Minerva, DE
MR-Schutztechnik, DE
N
NEC Display Solutions Europe, DE
NeoRad, NO
Neusoft Medical Systems, CN
Nical, IT
Ningbo Xingaoyi Magnetism, CN
Noras MRI products, DE
NordicNeuroLab, NO
O
Olympus Medical Systems Europa, DE
P
Pacioni & C. Snc, IT
Pacsgear, US
Palodex Group, FI
Pausch technologies, DE
PEHA Medizinische Geräte, DE
Perlong Europe, SK
Philips Healthcare, NL
Planar Systems, FI
Planilux Gerätebau Felix Schulte, DE
Planmed, FI
PrimaX International, FR
Protec Medizintechnik, DE
PTW - Freiburg, DE
Q
QStar Technologies, IT
Quantum Medical Imaging, US
R
Radcal, US
Radiological Society of North America, US
Radiology Onesource Europe, BE
RamSoft, CA
RAPID Biomedical, DE
Raymed, CH
Rein EDV, DE
Reichert, DE
REM, IT
Rendoscopy, DE
Rimage Europe, DE
Rogan-Delft, NL
RTI Electronics, SE
S
Sanochemia Diagnostics International, CH
Sapheneia, SE
Schiller Medical, CH
Sectra Imtec, SE
Sedecal, ES
Shantou Institute of Ultrasonic Instruments, CN
SharpView, SE
Shenzhen Emperor, CN
Shimadzu Europa, DE
Sidam, IT
Siemens Healthcare, DE
Siemens Healthcare OEM Solutions, DE
Sonoscape, CN
Sony Europe, UK
Soredex, FI
Springer Verlag, DE
Suinsa Medical Systems, ES
Swiss Medical Care, CH
Swissray Medical, CH
Synthes, CH
T
Technix, IT
Telemed UAB, LT
TeraRecon, US
Thales Electron Devices, FR
The Medipattern Corporation, US
Thieme & Frohberg, DE
Toshiba Electronics Europe, UK
Toshiba Medical Systems, NL
Totoku Electric, JP
TransLite, US
Trixell, FR
U
Ulrich medical, DE
Ultrasonix Medical, CA
Unfors Instruments, SE
V
VacuTec Meßtechnik, DE
Varian Medical Systems, NL
Vidar Systems, US
Villa Sistemi Medicali, IT
Visage Imaging, US
Visaris, RS
Visus Technology Transfer, DE
Vital Images Europe, NL
W
Wide, NL
Wiroma, CH
Wisepress Online Bookshop, UK
X
Xoran Technologies, US
Z
Ziehm Imaging, DE
Zonare Medical Systems, US
27 myESR.org

ESR Newsletter 02/08
ECR 2008 – Review
ECR 2008
Quiz Winners
The winners of the ECR
2008 Cases-of-the-Day
Quiz have been determined.
Out of 3,810
answers given 43%
were correct.
15 correct diagnoses out of 20:
Gema Medrano; Madrid/ES
14 correct diagnoses out of 20:
Alvaro Paniagua Bravo; Alcala De Henares/ES
Silvia Ossaba; Madrid/ES
Luis Curvo-Semedo; Coimbra/PT
Juan Jose Ciampi; Madrid/ES
13 correct diagnoses out of 20:
Juan Guzman de Villoria; Madrid/ES
Jarmila Halova; Ústí nad Orlicí/CZ
12 correct diagnoses out of 20:
João Filipe Costa; Coimbra/PT
Takashi Koyama; Kyoto/JP
Gonzalo Tardaguila de la Fuente; Vigo/ES
11 correct diagnoses out of 20:
Mustafa Secil; Izmir/TR
Oscar Pozuelo Segura; Barcelona/ES
Cyrillo Araujo; Anápolis/BR
Ignacio Gonzalez Garca; Madrid/ES
Filip M.H.M. Vanhoenacker; Antwerp/BE
Roles in radiology, research, plus a private life
Could anything be better
Professor Maria Cova is one of the
mainly with the aim of attracting more
my exams here, went to America and
the Radiographer’s Degree Course in
two female Board Members of the
young scientists.
returned here with my postdoctorate. I
Trieste. I also carry out research with
Italian Society of Radiology (SIRM),
became Assistant Professor, then Asso-
a focus on MRI and, within that, mus-
of which she was Vice President from
DZ: How many women do you sup-
ciated Professor and, in 2004, full Pro-
culoskeletal research, particularly on
2004–2006.
port in this way
fessor. That sounds easy, but it was hard
articular cartilage. Using MRI you can
MC: Actually, very few. The Board has
work and women must sometimes even
get morphological information as well
Apart from spending a year at Johns
only two. The problem is that, although
work a bit harder. You must always com-
as biochemical information. So the aim
Hopkins University Hospital, Bal-
there are a lot of female radiology resi-
bine the job with your private life. I’m
is to use MRI to see the changes that
timore, US, the professor has never
dents and a lot of women actually work
not married and have no children, but I
cannot be seen by changing morphol-
worked anywhere other than at the
as radiologists, only very few reach
do have a very active private life, which
ogy – biochemical changes. You can do
University Hospital of Cattinara, Tri-
top positions. So far there are few, but
naturally I don’t want to miss. So I’ve
it today. I’m also working on the tech-
este, where she is Chairman.
I hope in the future more and more
always done my best for work, but what
nical aspect of MRI, just optimising
women will be motivated to work hard-
I’ve borne in mind was that I wanted to
the technique. In this field I work with
In a return to ECR 2008’s spotlight
theme of Women in Radiology, Dan-
er to reach top positions in radiology.
preserve my inner self. I am very proud
to say this attitude has worked, so far.
physicists and with the Department of
Biochemistry, so there’s a very good,
Prof. Maria Cova from Trieste/IT.
iela Zimmermann, Managing Director
DZ: Are they held up because they
Of course I’m diplomatic, but I would
dedicated team. With the right techni-
of European Hospital, asked her about
marry or change professions
never change myself only to find a com-
cal sequence, we are aiming to get both
what women can achieve in this field,
MC: No, they stay in the profession, but
promise. The most important thing for
the morphological and biochemical
one-man-show: I strongly believe in
as well as the professor’s own multifarious
roles and research activities.
Daniela Zimmermann: What does
your role as a Board Member of the
Italian Society of Radiology entail
Maria Cova: The Society is subdivided
into many scientific sections for subspecialties
such as neuroradiology
vascular and interventional radiology
and so on. My function is to coordinate
the presidents of these subspecialties,
it’s very tough for them to coordinate
and manage everything.
DZ: How did you achieve this
MC: First, I really like my job – that’s
very important. Second, I am ambitious
– to succeed, you need to be. Third, you
also need to be feminine. Also, I’ve
always done my best to reach where I
wanted to reach and then, I have to add,
you must be lucky. In my case, things
always went right. I chose Trieste, did
me is to keep myself balanced.
DZ: What about your work at the
hospital
MC: I’m Chairman of the Radiology
Department at the University Hospital,
so I not only manage the department,
the patients and so on, but also have
various teaching functions. It’s really
what I like most! I would never give it
up. I am also Director of the Postgraduate
School of Radiology and Director of
data in a short time.
Using contrast media and molecular
imaging would be the greatest tool to
obtain this result.
DZ: Have you already reached the
professional level you want
MC: At the moment, I’m very happy
with my position because there are
still challenges, and managing a department
means you have to learn
something new every day. I’m not a
teamwork and I work with a wonderful
team. In a team everyone has the
chance to give his or her best and every
single person has a special quality that
can lead to perfect results.
Of course I’m always open to opportunities
that may arrive, but I’m totally
satisfied with all that I must deal with
every day. As a 47-year-old woman who
loves radiology, I cannot imagine anything
better.
© Daniela Zimmermann / EUROPEAN HOSPITAL Verlags GmbH
European Society of Radiology
28

Radiology Trainees Forum
© Radiology Trainees Forum
United and
forever young!
By Dr. Cagin Senturk and Dr. Andrea Alcala Galiano, RTF Board
Another ECR and ‘eine Wiener Woche’ have
passed and we are all now back home. Around
18,000 participants visited ECR 2008, with 270
scientific sessions from every field of radiology
and the highest ever resident attendance. Thanks
to the ‘invest in the youth’ programme and the
reduced fee for residents, we had less black or blue
suits and more colourful costumes at this year’s
ECR.
The Radiology Trainees Forum had its usual stand
at the congress, where residents gathered not only
to collect their RTF reception tickets but also to
discuss their professional experiences, problems
and ideas. As usual, reception tickets were completely
sold out before lunchtime on Saturday.
The most popular sessions among residents were
the interactive teaching courses, and of course a
classic from RTF; the RTF Highlighted Lecture.
This year we had three excellent talks covering
three different modalities. Prof. Michael Forsting
from Essen, Germany, explained different ethiologies
of intracerebral haemorrhage and endovascular
treatment strategies for arteriovenous malformations.
It was really exciting to witness the
potential of interventional neuroradiology in the
treatment of cerebrovascular pathologies. We
also had the chance to learn about the challenges
and opportunities for the future of interventional
radiology from Prof. Jim Reekers, who is the current
president of CIRSE. Finally Prof. Nigel Raby
from Glasgow, UK, enlightened us with his speech
regarding the approach to radiographic images in
a trauma patient. In this session three lucky residents
had the chance to win three books in a raffle,
with one of them being presented to the lucky
winner by the author, Prof. Raby.
After these enlightening lectures, Saturday night
fever was ready to start at our usual meeting point.
At the RTF party, various different nations came
together to share a delicious meal, Dionysian wine
and the rhythm of the protons. Many of us had to
be forced by our friends to leave this event unwillingly
and too soon. Well, of course we had to be
ready for our general assembly on Sunday.
At the GA, we welcomed Prof. András Palkó,
who was attending our meeting for the last time
as the chairperson of the national societies of
ESR. National delegates were informed about the
whole year’s activities in regard to exchange programmes,
surveys and political events in the field
of radiology in Europe. Following the revision of
the current European Training Charter for Clinical
Radiology, we performed a survey amongst the
national RTF representatives to provide a radiology
trainees’ perspective on their training programme.
Our impression prior to the completion
of the survey was that there was wide variation
in radiology training in Europe. To our surprise,
we found that the results, although not without
small discrepancies, showed more or less the same
positive aspects and deficiencies throughout the
whole of Europe. Most countries have a standardised
curriculum, with yearly assessment, regular
formal teaching and opportunities for scientific
research and publishing. However, many countries
are still lacking proper subspecialty training
and fellowships, and equipment in the training
centres is not always adequate.
Updated results on the teleradiology and outsourcing
questionnaire, which were published in
the previous ESR Newsletter, (completed by 85%
of the national representatives) once more show
that two thirds of trainees sense the level of teleradiology
and outsourcing have increased over the
past year. This has had a negative impact on their
training, mainly by reducing the routine work that
helps trainees gain confidence in recognising normal
findings and complicated cases. Outsourcing
seems to happen mostly in the MRI and CT
modalities. Clinicians are also reacting to this tendency,
with complaints about the lack of interaction
with radiologists or difficulties in contacting
the outsourcing site. With these results, we believe
further outsourcing may have a serious impact on
the quality of training in the future.
New ideas and suggestions from a lively discussion
will hopefully give birth to new RTF activities
in 2008. At the end of the meeting everybody was
happy not to wait too long until March 2009, and
to meet in November 2008, again in Vienna.
We hope to see you there!
The Radiology Trainees Forum would
like to say a big THANK YOU to the
ESR for the fantastic learning opportunities
offered through the European
School of Radiology! We hope the
great success will continue so that
more and more trainees throughout
Europe and abroad may benefit from
this unique initiative.
✻
Happy faces at the RTF booth: Dr. Pradeep Govender, Ireland, Dr. Peter R.
Kornaat, Vice-Chair, Netherlands, Dr. Cagin Senturk, Turkey, Dr. Christiane M.
Nyhsen, Chair, UK, and Dr. Andrea Alcala-Galiano Rubio, Spain (from left to right).
Representing the RTF’s motto: United and forever young!
✿
❀
❃
✾✽
❂
✼
✿
❀
❀
❋
RTF
INFO CORNER
29 myESR.org

ESR Newsletter 02/08
ECR 2008 – Review
By Prof. Wiro Niessen, Rotterdam/NL at
ECR 2008
There was a new addition to this year’s
IMAGINE exhibit, the ninth in a series of
high-tech specialty exhibits in the field of
diagnostic and interventional radiology at
ECR. For the first time, a dedicated special
focus session was held, which focused on
the question of whether novel image analysis
and modelling techniques, as showcased
at IMAGINE, are improving the diagnosis
and therapy of cancer. Four distinguished
lecturers, Anwar Padhani, Heinz-Otto Peitgen,
Mike Brady, and David Hawkes, gave
their views on the development of the field.
It became clear from the lectures that the
current criteria being used to diagnose cancer
and monitor therapy response are seriously
lacking. For example, as shown by
Dr. Peitgen, the RECIST criteria are prone
to errors, and have poor predictive value.
There is clearly a need for a novel class of
dedicated quantitative imaging biomarkers,
based on the richness of information
provided by novel imaging modalities and
contrast agents. In his talk, Dr. Padhani
outlined the practical steps that need to be
taken to develop a clinically useful imaging
biomarker. First and foremost, in developing
a biomarker, it should be clear which clinical
issues should be addressed by the imaging
biomarker, and there should be a close
biological link between the biomarker and
the underlying pathophysiological process.
After that, a long process of developing and
validating a biomarker should be initiated.
In the talks of Dr. Brady and Dr. Hawkes, the
need for precise pre-operative planning and
intra-operative guidance was addressed. Dr.
Brady showed that modern image analysis
tools are finally, after tens of years of
research, reaching the accuracy required
to be used in the planning of resection. Dr.
Hawkes showed how advanced motion and
deformation models can be used to improve
the accuracy of radiotherapy and interventional
radiology.
At the IMAGINE exhibit, eleven exhibitors
demonstrated the latest developments in
the field of diagnostic and interventional
radiology. Focal areas of IMAGINE were
quantitative image analysis, computeraided
diagnosis, interactive visualisation,
image-guided interventions and robotics,
and computer-assisted training, and exciting
developments were demonstrated in all
these areas. The unique feature of IMAG-
INE remains that it is the place where you
can actually meet the researchers who are
creating the novel developments.
It is difficult to discuss all that was shown
at IMAGINE, although a number of trends
could be observed. First, there was a lot of
interest in computer-aided detection and
diagnosis e.g. for breast lesions (CADMEI,
Definiens, GIFU University), Alzheimer’s
Disease and neuro imaging (Medical Delta,
MEDIS, Philips Healthcare), liver lesions
(Siemens), cerebro- and cardiovascular disease
(GIFU University, Medical Delta, Medical
Imaging Lab Singapore, MEDIS, Philips
Healthcare, Siemens), CT colonography
(ESGAR CTC Working Group) and ocular
diseases (GIFU University). Next, there was
increasing research in computational tools
for following therapy, especially in oncology
(MEVIS Research, Philips Healthcare). As
every year, the Austrian Image Processing
group showed their latest developments in
image-guided navigation, with the possibility
of hands-on experience. Finally, the integration
of multi-modal cardiac imaging data
(Medical Delta, MEVIS, Philips Healthcare,
Siemens) for improved visualisation and
diagnosis remains an active research area.
Abstracts of this year’s IMAGINE exhibitors
can be found at the ESR website
www.myESR.org → Research → IMAGINE
European Society of Radiology
30

ECR 2009 – Preview
Eminent Swiss radiologist to lead
next year’s ‘summit of science’ By Monika Hierath
As preparations for ECR 2009 are already well
ESRN: What will be the main focus of ECR
less than 50% of the countries, and subspecialty
underway, we would like to introduce to our read-
2009, and what will be the scientific highlights
training starts at a variable level of the training
ers the new ECR President. Prof. Borut Marincek,
regarding new technology presented
programme.
who will preside over ECR in 2009, is Full Profes-
BM: An important focus will be on cell imaging
We learned from this survey that in Europe there
sor of Radiology and Chairman at the Institute
and image-guided therapeutic interventions, and
are still many differences – there is still a lot to do
of Diagnostic Radiology at the Zurich University
there will be many highlights within the New
to achieve standard guidelines. ESOR is an ideal
Hospital in Switzerland. His interest in radiology,
Horizons Sessions, State-of-the-Art Symposia
instrument to compensate for this deficit in train-
in particular in computed tomography and mag-
and Special Focus Sessions. Another interesting
ing where it is required, and ESOR therefore is an
netic resonance imaging, is reflected in over 270
event will be the Professional Challenges Session
important structure within the ESR.
authored and co-authored scientific papers, 47
on the topic of radiation protection.
book chapters and over 180 lectures, orations and
ESRN: The University of Zurich celebrates
invited lectures in Europe and overseas.
ESRN: Will there be a new partner discipline in
its 175 th anniversary in 2008, themed ‘sharing
2009, as with the general practitioners this year
knowledge’. ESR has also started to raise pub-
ESR Newsletter: When was your first ECR What
BM: The partner discipline of the next congress
lic awareness about medical imaging, this year
have been the major improvements since then
will be emergency medicine, with the European
with a public campaign on women’s health – a
Prof. Borut Marincek: I attended my first ECR as
Society for Emergency Medicine as partner.
strategy worth being continued
early as 1983 in Bordeaux. It was the 5 th European
Emergency medicine is an important interface in
BM: I think that public health campaigning is an
Congress of Radiology and at that time I had fin-
the daily work of radiologists.
extraordinarily important assignment of ESR. In
ished my training in radiology and completed a
2-year research fellowship. Between then and now
ESRN: What may delegates expect in terms of
my opinion there are far more appropriate topics
than women’s health, where the health of men
Prof. Borut Marincek, ECR 2009 Congress President
radiological congresses are quite different. Today
the social programme – a Swiss theme
would not be disregarded, as for example the focus
we live in a digital world, and this fact has an enor-
BM: Most certainly it will be a theme with a Swiss
on youth to prevent and fight obesity or imaging
progress in biotechnology, nanomedicine and
mous effect on the set-up of ECR.
flavour, but I do not want to tell you more about it
adapted to the needs of elderly patients.
new innovative therapies fills me every day with
Compared with early congresses we can now
right now; after all it should be a bit of a surprise!
new enthusiasm. I believe that it is essential to
enjoy numerous technical improvements, such as
ESRN: How and when did you decide to become
acknowledge the importance of the multidiscipli-
PowerPoint presentations instead of slide shows,
ESRN: In addition to your numerous commit-
a radiologist
nary character of research and collaborate with
EPOS instead of customary paper posters, inter-
ments you serve on the steering committee of
BM: I knew very early that I wanted to become
other disciplines.
active sessions with electronic voting tools, and in
ESOR. The aim of ESOR is to extend teaching
a radiologist, at that time I was still in medical
addition, the entire organisation of the congress
resources worldwide and to raise standards in
school. I was always fascinated by the possibilities
ESRN: You are head of the Institute of Diag-
has changed, with online registration and other
the field of scientific radiology through glo-
to correlate imaging, morphology and function as
nostic Radiology at the University of Zurich,
electronic tools and documentation. We can also
bal e-learning initiatives. Has Europe already
well as to map non-invasively anatomy and dis-
you teach, are an active member of numerous
see structural improvements in the ever more
attained an equal level of educational standards
ease processes.
medical societies, such as the Swiss Society of
professional organisation of the congress, with a
in radiology
Looking back, to choose this profession was the
Radiology, you serve on the Executive Council
programme subdivided into New Horizons Ses-
BM: ESR has published a revised charter for
best decision I could have made in my life. I find
of ESR, and you are in the steering committee
sions, State-of-the-Art Symposia, Special Focus
training in clinical radiology, which had been
radiology still highly absorbing, because it plays
of ESOR. How much time is there left for things
Sessions, Refresher Courses and Workshops. All
elaborated by the former EAR and UEMS. Fur-
a central role in the healthcare system
outside of your professional life
these innovations have enabled the congress to
thermore, a survey was carried out about radio-
and is one of the fastest grow-
BM: Of course there is not much time left for activ-
open to the East and West.
logical training in Europe.
ing areas in medicine, both
ities beyond my numerous professional duties, but
This survey demonstrates the existence of
regarding the clinical set-
the satisfaction my work brings me compensates
ESRN: What were your favourites at ECR
a wide spectrum of diversity in terms of
tings and the R&D.
for that and makes every day of my life an extraor-
2008
requirements, training schemes, appraisal
This fascination
dinary experience.
BM: One of my favourites is certainly cardiac
and professional evaluation between the
with exciting
In my spare time I love to go mountain biking in
imaging, which underwent a significant upturn
various countries across Europe. The
advances in
the woods; I enjoy nature very much and I find it
during the past few years. The number of abstract
training curriculum is more or
functional
a very pleasant way to relax the mind and at the
submissions in this field has increased enormously,
less similar to the recommen-
and
same time to get some exercise. Another favour-
by 50% compared to 2005, and even quadrupled in
dations given in the EAR/
molecu-
ite sport of mine is rowing; it is a good way to get
comparison to 2004. This fact demonstrates that
UEMS Training Charter in
lar
in touch with the elements of nature and a nice
cardiac imaging is an important topic at ECR.
only 13 countries. In addi-
imag-
opportunity to spend time with friends. To cul-
Another field of interest is abdominal imaging,
tion, there are significant dif-
ing,
tivate friendship and social contacts is important
being my special subject from the beginning of my
ferences between the coun-
to be able to exchange thoughts, to learn from his-
professional career in radiology. I am acting presi-
tries regarding the number
tory, and to get new ideas. To quote Sir Winston
dent of the European Society of Gastrointestinal
of radiologists per million
Churchill, “The further backward you look, the
and Abdominal Radiology (ESGAR) and there-
inhabitants. Subspecial-
further forward you can see”. This is one of my
fore this area is of great importance to me.
ties in radiology are
personal guiding themes when trying to approach
officially
contemporary issues in our glo-
ESRN: What are your ambitions and expecta-
recognised
balised world.
tions for your term as President of ECR
in
BM: My ambitions are to achieve an extraordinary
satisfaction among the participants, which will be
shown by means of ratings and evaluations of the
sessions. Furthermore, it is important for me
that the speakers get good feedback and are
appreciated by the participants.
31 myESR.org

ESR Newsletter 02/08
European Radiology
European Radiology enjoyed another thoroughly
successful ECR in Vienna, making the most of some valuable opportunities to gather our esteemed
contributors and editorial advisors together for some rare face-to-face contact. It was also highly
encouraging to see the speed with which the complimentary sample copies of ER were snatched up
from the free publications booth, hopefully reaching a new troop of readers and prospective authors.
Almost as popular as the actual journal was the Editorial Board meeting, where last year’s progress was
presented to a packed room and the chance was taken to offer thanks to one especially distinguished
figure in the journal’s history.
ECR recognition of
Prof Albert Baert.
ECR 2008 marked the end of an era with Prof. Dr.
Albert L. Baert receiving a thoroughly deserved
Lifetime Achievement Award at the opening ceremony
of ECR. This was a happy occasion when his
wife, family members and his many friends and
colleagues from far and wide listened to his enormous
achievement in the field of radiology and
radiological publishing. Apart from his enormous
contribution to European Radiology, he has written
or edited a vast number of textbooks and overseen
the successful development of the electronic Euro-
Rad teaching museum.
Shortened reviewing time.
Since January 2008, all referees have been asked
to return their reviews within 3 weeks. It is very
pleasing that most do kindly achieve this abbreviated
turnaround time, which then facilitates
a much faster decision for the
authors – one way or the other. It is
inevitable that the rejection rate
has to be high – many authors
now choose to send their best
work in to European Radiology
as the first port of call (more
so given the healthy recent
further rise in the impact factor
to 2.554). It is important
that everyone recognises the academic contribution
provided by referees. Peer review is an essential
part of the scientific method. If scientists are
submitting papers, then they have an equal duty
to review papers. Furthermore it is an educational
endeavour. In time we need to think how this academic
work can be better recognised on curricula
vitae and by departmental chairmen.
Peer review confidentiality.
The New England Journal of Medicine suffered an
embarrassing breach of confidentiality concerning
a drug trial recently – a Lancet editorial made
some very pertinent points on this topic (The
pitfalls and rewards of peer review (2008) Lancet
371:447). The European Radiology review process
is kept confidential; the author will not know who
the referees are. However, sometimes it is inevitable
that, despite the hard work of ‘blinding’ the
paper by the editorial staff in Vienna, the host
institution from where the work emanated will
be apparent. For example the equipment may be
so unusual that the university or medical centre
will be obvious, or the reviewer may have heard
the work presented at a conference. Nevertheless
the paper is sent out to reviewers on the understanding
that they will maintain confidentiality
about the paper until it has been published electronically,
if it has been accepted, or forever if it
has been rejected.
European Radiology
Prizes at ECR.
As in previous years, certificates were awarded for
the most widely cited paper and for those submitting
the most correct answers in the Interpretation
Corner section. This year these were awarded to:
Most widely cited paper:
Ntziachristos V, Bremer C, Weissleder R
Fluorescence imaging with near-infrared light:
new technological advances that enable in vivo
molecular imaging.
Eur Radiol (2003) 13:195-208.
Interpretation Corner:
The winner (for the second year running) with 11
correct entries out of 12:
Dr. Annemie Snoeckx, Zandhoven, Belgium
The following all sent in over eight or more
correct replies:
Dr. Chidambaranathan, Chennai, India
Dr. Mustafa Kemal Demir, Ataköy, Istanbul,
Turkey (who deserves a special mention as he was
an author on one case)
Dr. Maniatis, Palini, Greece
Dr. Manubu Minami, Ibaraki, Japan
Dr. Ram Prakash Galwa, Chandigarh, India
Dr. Filip Vanhoenaker, Duffel, Belgium
ESR Molecular Imaging Grant
This is to announce the availability of a molecular imaging scholarship
grant accessible through the European Society of Radiology
(ESR). This scholarship is provided by the Memorial Sloan-Kettering
Cancer Center, New York, through an NCI R 25 training grant.
The scholarship starts on January 1, 2009 at the Department of Radiology
of the Memorial Sloan-Kettering Cancer Center, New York,
USA under the chairmanship of Professor Hedvig Hricak and is for
a period of 2 years. The scholarship grant for training in molecular
imaging depends on the scholar’s years of postgraduate training, and
starts at US$46,000 per year.
Description of training programme:
The training programme emphasises the development of molecular
imaging for oncology, and includes didactic training. The focus of
the training is on relevant molecular biology and research methodology
coursework, instruction in advanced imaging methods, and an
individualised research programme. Individual research will focus
on basic, translational, or clinical interdisciplinary research and
experience in advanced methods of nuclear, radiographic, optical,
and magnetic resonance imaging/spectroscopy.
Eligibility
• The applicant must be a member of ESR.
• The applicant must be a radiologist or associated scientist working
in a radiological department or molecular imaging laboratory.
• The applicant must be in training or have recently completed residency
training.
Application
Applications should be sent by e-mail to iris.kovacs@myESR.org
for the attention of the chairman of the ESR Research Committee,
Prof. Gabriel Krestin, and must include:
• a full CV of the applicant
• a letter from the applicant’s department head confirming that upon
the trainee’s return, he or she will be provided the opportunity to
pursue molecular imaging research in the department as well as a
description of how the applicant’s new skills will be used within the
institution’s infrastructure. The terms of the grant require that the
applicant returns to Europe to his/her activities in this field.
Deadline for application: May 30, 2008
The application form is available at www.myESR.org.
European Society of Radiology
32

European Radiology
New articles from
European
Radiology
This manuscript presented by a group from
Zurich considers 64 detector row CT as an outcome
predictor for cardiac events. The results
should be of interest to any representatives of the
cardiac CT community.
The authors of this paper from Ioannina, Greece,
compare the accuracy of multidetector CT and
MRI in the characterisation of ovarian masses
on a case-by-case basis. They demonstrate that
CT is a technique with great potential and the
This group of authors from Vienna report
on a well-conducted study on the use of a fast
sequence to quantify T1 changes on delayed contrast
enhance images reflecting CAG content.
results make some interesting advances on those
from former CT studies.
A selection by Adrian K. Dixon,
Editor-in-Chief
Coronary 64-slice CT angiography predicts
Comparative evaluation of multidetector CT
Differentiating normal hyaline cartilage from
Full-text articles are available
outcome in patients with known or suspected
and MR imaging in the differentiation of
post-surgical repair tissue using fast gradient
at Springerlink.com and freely
coronary artery disease
adnexal masses
echo imaging in delayed gadolinium-enhanced
accessible for members via
MRI (dGEMRIC) at 3 Tesla
www.myESR.org/MyUserArea
Gaemperli O, Valenta I, Schepis T, Husmann L,
Tsili AC, Tsampoulas C, Argyropoulou M,
Scheffel H, Desbiolles L, Leschka S, Alkadhi H,
Navrozoglou I, Alamanos Y, Paraskevaidis E,
Trattnig S, Mamisch TC, Pinker K, Domayer S,
Kaufmann PA
Efremidis SC
Szomolanyi P, Marlovits S, Kutscha-Lissberg F,
Welsch GH
DOI 10.1007/s00330-008-0871-7
DOI 10.1007/s00330-007-0842-4
DOI 10.1007/s00330-008-0859-3
Eur Radiol 2008, Epub February 20
Eur Radiol 2008, Epub January 12
Eur Radiol 2008, Epub February 2
Abstract:
Abstract:
Abstract:
The aim of this study was to assess the prognostic
The purpose was to compare the accuracy of
The purpose was to evaluate the relative
value of 64-slice CT angiography (CTA) in
multidetector CT (MDCT) on a 16-row CT
glycosaminoglycan (GAG) content of repair
patients with known or suspected coronary
scanner and magnetic resonance (MR) imaging
tissue in patients after microfracturing (MFX)
artery disease (CAD). Sixty-four-slice coronary
in the characterization of ovarian masses.
and matrix-associated autologous chondrocyte
CTA was performed in 220 patients [mean age
Preoperative CT examination of the abdomen
transplantation (MACT) of the knee joint with a
63 ± 11 years, 77 (35%) female] with known or
and MR imaging of the pelvis was performed
dGEMRIC technique based on a newly developed
suspected CAD. CTA images were analyzed with
in 67 women, with clinically or sonographically
short 3D-GRE sequence with two flip angle
regard to the presence and number of coronary
detected adnexal masses. The CT examinations
excitation pulses. Twenty patients treated with
lesions. Patients were followed-up for the
were performed on a 16-row CT scanner, and
MFX or MACT (ten in each group) were enrolled.
occurrence of the following clinical endpoints:
the protocol included scanning of the abdomen
For comparability, patients from each group were
death, nonfatal myocardial infarction, unstable
during the portal phase, using a detector
matched by age (MFX: 37.1 ± 16.3 years; MACT:
angina, and coronary revascularization. During
collimation of 16 × 0.75 mm and a pitch of 1.2. We
37.4 ± 8.2 years) and postoperative interval (MFX:
a mean follow-up of 14 ± 4 months, 59 patients
used a 1.5-T magnet unit to perform T1, T2 and
33.0 ± 17.3 months; MACT: 32.0 ± 17.2 months).
(27%) reached at least one of the predefined
fat-suppressed T1-weighted sequences, before and
The Δ relaxation rate (ΔR1) for repair tissue and
clinical endpoints. Patients with abnormal
after intravenous administration of gadolinium
normal hyaline cartilage and the relative ΔR1
coronary arteries on CTA (i.e., presence of
chelate compounds. The accuracy of multidetector
were calculated, and mean values were compared
coronary plaques) had a 1 st -year event rate of 34%,
CT and MR imaging in the differentiation
between both groups using an analysis of
whereas in patients with normal coronary arteries
between benign and malignant ovarian masses
variance. The mean ΔR1 for MFX was 1.07 ± 0.34
no events occurred (event rate, 0%, p < 0.001).
was evaluated, using histopathologic results
versus 0.32±0.20 at the intact control site, and for
Similarly, obstructive lesions (≥50% luminal
as the standard of reference. The sensitivity,
MACT, 1.90±0.49 compared to 0.87±0.44, which
narrowing) on CTA were associated with a high
specificity and accuracy of MDCT in the
resulted in a relative ΔR1 of 3.39 for MFX and 2.18
first-year event rate (59%) compared to patients
characterization of ovarian masses were 90.5%,
for MACT. The difference between the cartilage
without stenoses (3%, p < 0.001). The presence of
93.7% and 92.9%, respectively, and that of MR
repair groups was statistically significant. The
obstructive lesions was a significant independent
imaging 95.2%, 98.4% and 97.6%, respectively.
new dGEMRIC technique based on dual flip angle
predictor of an adverse cardiac outcome. Sixty-
Although MRI performed slightly better, this did
excitation pulses showed higher GAG content in
four-slice CTA predicts cardiac events in patients
not reach statistical significance. In conclusion,
patients after MACT compared to MFX at the
with known or suspected CAD. Conversely,
both MDCT on a 16-row CT scanner and MR
same postoperative interval and allowed reducing
patients with normal coronary arteries on CTA
imaging demonstrated satisfactory results in the
the data acquisition time to 4 min.
have an excellent mid-term prognosis.
characterization of ovarian masses.
Subscribe now
to ensure you keep up to date
with the latest advances
in science and research!
www.myESR.org/European_Radiology
33 myESR.org

ESR Newsletter 02/08
Subspecialty Society news
ESGAR 2008
Istanbul/TR
June 10–13
ESGAR 2008 will offer numerous
lecture sessions, workshops and
lunch symposia. The Postgraduate
Course is devoted to abdominal
MDCT. Innovative features such
as the Research Corner will further
enhance the scientific content
of the meeting and enlarge the
choice for attendees. Furthermore,
an appealing social programme
will provide an insight into the
fascinating charm of Istanbul.
Registration for the meeting is
possible online until May 20, 2008
at www.esgar.org
Future ESGAR
CTC Workshops
September 11–13, 2008
Berlin/DE
February 2–4, 2009
Harrogate/UK
Future ESGAR
Liver Imaging Workshop
October 9–11, 2008
Munich/DE
EuroPACS
Following an extremely successful
joint congress with CARS
(Computer Assisted Radiology
and Surgery) in Berlin last year,
EuroPACS will again hold a
meeting with CARS in 2008, this
time in the wonderful and newly
‘hip’ city of Barcelona, Spain.
The meeting will be held
June 25–28, 2008. For information
on abstract submission and
registration, please go to
www.cars-int.org
MIR – Management in Radiology
This year’s annual meeting of MIR will take
place in Athens/GR from October 29–31,
2008, and aims to provide delegates with topics
relating to all aspects of management in
radiology today.
Abstract Submission is still possible until July
18 by e-mailing your work in Microsoft® Word
format with 350 words max. including methods,
results and conclusions to
Amanda.Jelley@imperial.nhs.uk.
Get to know the MIR Preliminary Programme
and seize the opportunity to benefit from
reduced registration fees now!
ESMRMB
Hands-On MRI
New Course Programme of ESMRMB
First course:
fMRI and DTI on GE Healthcare equipment
October 23–25, Rotterdam/NL
Especially designed for technicians and physicians
with a special interest in the field!
Learning objectives
• To understand the theoretical background of fMRI
and DTI data acquisition and analysis
• To become familiar with the user interface of the
scanner and post-processing tools
• To perform clinical fMRI and DTI examinations and
analyses
• To support fMRI and DTI examinations in a research
environment
Lecture topics (50% of the course)
Basics of fMRI and DTI, imaging sequences, technical
set-up, paradigms, principles of data analysis, quality
control, clinical and research applications
Hands-On topics (50% of the course)
Scanner interface, data acquisition, tricks and pitfalls,
instruction and preparation of subjects, data analysis
on GE Advantage Windows workstation as well as
freely available software (SPM and dTV).
The pilot course for this new programme is sponsored
by Bayer Schering Pharma AG.
Visit www.esmrmb.org for more information.
ESMRMB 2008
25 th Annual Scientific Meeting
October 2 – 4, Valencia / ES
Invitation to the Exhibition
For further information visit the MIR
website www.mir-online.org, or contact
office@mir-online.org.
M a n a g e m e n t i n R a d i o l o g y
MIR
ESCR – European Society of Cardiac Radiology
Registration for the annual meeting of the ESCR in Porto/PT from October 16–18,
2008, is already online. In order to benefit from the early registration fee, please visit
our website www.escr.org and register before August 15.
In cooperation with the Portuguese Airline TAP, ESCR can exclusively offer its congress
participants reduced fees for flights to Porto.
The discounts offered are as follows:
10% in economy class
20% in business class
For further information visit the website www.escr.org,
or contact office@escr.org.
The European Forum for MR research and clinical practice | www.esmrmb.org
CIRSE 2008
September 13–17, 2008
Copenhagen, Denmark
With the CIRSE 2008 second announcement being
sent to interventional radiologists from Europe and
around the world, it becomes clear: CIRSE has indeed
become Europe’s top interventional meeting. This
year’s 144 sessions, including 8 foundation courses, 39
special sessions and more than 50 workshops, will be
grouped around six major topics, enabling participants
to follow all sessions of a specific field without overlap.
Abstract submission has once again broken all previous
records with a rise of 15%, not counting late breaking
abstract submission, which will take place from
May 4 to May 14. For more information about CIRSE
2008 please refer to www.cirse.org
or contact us at info@cirse.org.
ESUR CALL FOR ABSTRACTS
Welcome to the 15 th symposium of the ESUR (European Society of Urogenital Radiology),
to be held in Munich/DE, September 11–14, 2008.
Abstract submission is possible until April 30, 2008 (midnight, CET). Abstracts submitted after this
date will not be considered by the review committee.
To access the Abstract Submission System and for any further information,
please go to www.esur2008.org
ESTI 2008
16 th Annual Meeting of the European Society of Thoracic Imaging
May 30 – June 1, 2008
Nice, France
The final programme is online.
Pre-registration is possible until May 16, 2008!
Have a look at our website www.esti2008.org
for further information.
European Society of Radiology
34

Congress calendar
ESR Congress Calendar
April – July 2008
This web tool guarantees simple usability and consists of view, search, detail and submitting areas, as well as a print feature, the possibility to send events by e-mail via Outlook and to save meetings in your
personal Outlook calendar. Also, past events stay online in the ‘past events’ area and can be viewed, printed and added to the ‘my events’ list.
Please feel free to submit your radiological events online at congresscalendar.myESR.org.
Date Event City Country Topic Website
April
28.04. – 29.04.2008 ESGAR – European Society of Gastrointestinal and Abdominal Radiology,
Buc France Gastrointestinal Tract www.esgar.org
GE Doctor to Doctor Training on CT-Colonography
30.04. – 03.05.2008 89 th German Radiology Congress 2007 (Deutscher Röntgenkongress) Berlin Germany General Radiology www.roentgenkongress.de
May
01.05. – 03.05.2008 8 th Annual MR Advances in Neuroradiology and Sports Medicine Imaging Las Vegas, NV United States Neuro radiologycme.stanford.edu/2008mradvances/
01.05. – 04.05.2008 CAR – Annual Scientific Meeting of the Canadian Association of Radiologists Ottawa, ON Canada General Radiology www.car.ca
03.05. – 09.05.2008 ISMRM Sixteenth Scientific Meeting and Exhibition, joint with SMRT Seventeenth Annaul Meeting Toronto, ON Canada Magnetic Resonance www.ismrm.org
05.05. – 09.05.2008 ACINR 2008 – 3 rd Anatolian Course of Interventional Neuroradiology, 5 th International Intracranial Ankara Turkey Interventional Radiology www.ics08.org
Stent Symposium (ICS), Joint Meeting
13.05. – 16.05.2008 10 th Annual International Sypmposium on Multidetector-Row CT Las Vegas, NV United States Computed Tomography radiologycme.stanford.edu/2008mdct/
14.05. – 17.05.2008 10 th International Symposium on Interventional Radiology & 37 th Annual Meeting of the Japanese Nagano Japan Interventional Radiology www.secretariat.ne.jp/isir-jsir2008
Society of Interventional Radiology
14.05. – 17.05.2008 IX Congresso Nacional de Radiologia Vilamoura Portugal Abdominal Viscera www.secretariat.ne.jp/isir-jsir2008
15.05. – 17.05.2008 MEDUOG 2008 – 5 th Congress of the Mediterranean Association for Ultrasound in Obstetrics and Ain Sokhna Egypt Ultrasound www.meduog.com
Gynecology
17.05. – 22.05.2008 ACR – American College of Radiology, Annual Meeting and Chapter Leadership Conference Washington, DC United States General Radiology www.acr.org
18.05. – 25.05.2008 Radiology in Prague and Vienna Prague and Vienna Czech Republic, Austria General Radiology www.radiologyintl.com
22.05. – 24.05.2008 Applied MR Techniques, Basic Course Basel Switzerland Magnetic Resonance www.school-of-mri.org
23.05. – 27.05.2008 43° Congresso Nazionale della Società Italiana di Radiologia Rome Italy General Radiology www.congresso.sirm.org
23.05. – 26.05.2008 SERAM 2008 – 29° Congreso nacional de la Sociedad Española de Radiologia Medica Sevilla Spain General Radiology www.seram2008.com
29.05. – 31.05.2008 95 th Annual Meeting, Swiss Society of Radiology St. Gallen Switzerland Magnetic Resonance www.radiologiekongress.ch
29.05. – 31.05.2008 Advanced Neuro Imaging – Diffusion, Perfusion, Spectroscopy Bern Switzerland Neuro www.school-of-mri.org
29.05. – 31.05.2008 The Leuven Ear Imaging Course Leuven Belgium Head and Neck www.headandneckimaging.be
30.05. – 31.05.2008 ESIR – Aortic Diseases Budapest Hungary Interventional Radiology www.cirse.org
30.05. – 01.06.2008 ESTI 2008 – European Society of Thoracic Imaging, 16 th Annual Meeting Nice France Education in Radiology www.esti2008.org
June
04.06. – 07.06.2008 ESPR – 31 st Postgraduate Course and 45 th Meeting of the European Society of Paediatric Radiology Edinburgh United Kingdom Pediatric www.espr.org
05.06. – 09.06.2008 8 th Asia and Pacific Congress of Cardiovascular and Interventional Radiology (8 th APCCVIR) & 31 st Kuala Lumpur Malaysia Interventional Radiology www.espr.org
College of Radiology Annual General & Scientific Meeting and Endovascular and Neurointerventional
Radiology Symposium III
05.06. – 08.06.2008 ICR 2008 – 25 th International Congress of Radiology Marrakesh Morocco General Radiology www.isradiology.org
08.06. – 14.06.2008 Egyptian Society of Women’s Imaging & Health Care; 3 rd Annual Meeting Cairo Egypt Ultrasound www.eswih.org
08.06. – 11.06.2008 SOUND, ULTRASOUND and HARMONICS – Updates in Clinical UltraSound Ravello Italy Ultrasound www.ecografiainterventistica.it
10.06. – 13.06.2008 ESGAR 2008 – 19 th Annual Meeting and Postgraduate Course Istanbul Turkey Gastrointestinal Tract www.esgar.org
14.06. – 18.06.2008 SNM 2008 – Society of Nuclear Medicine, 25 th Annual Meeting Honolulu, HI United States Nuclear Medicine www.snm.org
20.06. – 21.06.2008 ESIR – Varicose Veins Winterthur Switzerland Interventional Radiology www.cirse.org
21.06. – 23.06.2008 XIII AFIP Course Porto Portugal Musculoskeletal www.sprmn.pt
25.06. – 28.06.2008 CAD – 10 th International Workshop on Computerl-Aided Diagnosis Barcelona Spain Physics in Radiology www.sprmn.pt
25.06. – 28.06.2008 CARS 2008 – Computer Assisted Radiology and Surgery Barcelona Spain Physics in Radiology www.cars-int.org
25.06. – 28.06.2008 EuroPACS – 26 th International EuroPACS Meeting Barcelona Spain Management in Radiology www.cars-int.org
26.06. – 28.06.2008 5 th International Congress on Complications in Interventional Radiology Pörtschach Austria Interventional Radiology www.ccir.at
26.06. – 28.06.2008 XXIV. Congress of Hungarian Radiological Society Pécs Hungary General Radiology www.tensi-congress.hu
July
03.07. – 05.07.2008 Advanced MR Imaging of the Musculoskeletal System Moscow Russian Federation Magnetic Resonance www.school-of-mri.org
07.07. – 11.07.2008 30 th Anniversary Diagnostic Imaging Seminar Martha’s Vineyard, MA United States General Radiology www.uphs.upenn.edu/radiology/educ/CE/
cecourses/penncourse2189.html
08.07. – 11.07.2008 16 th Annual Summer Diagnostic Imaging Update Jackson Hole, WY United States Education in Radiology radiologycme.stanford.edu/2008jacksonhole/
11.07. – 19.07.2008 Cruising with the Masters: Cardiothoracic Imaging & Virtual Colonoscopy: State of the Art Review Barcelona Spain Education in Radiology www.ryalsmeet.com
18.07. – 19.07.2008 ESIR – Image-Guided Radiofrequency Tumour Ablation Iraklion Greece Interventional Radiology www.cirse.org
35 myESR.org

www.bracco.com
1 NAME OF THE MEDICINAL PRODUCT MultiHance, 0.5 M, solution for injection
2 QUALITATIVE AND QUANTITATIVE COMPOSITION 1 ml of solution for injection contains: gadobenic acid 334 mg (0.5M) as the dimeglumine salt. [Gadobenate dimeglumine 529 mg = gadobenic acid 334 mg + meglumine
195 mg]. Osmolality at 37°C: 1.97 osmol/kg. Viscosity at 37°C: 5.3 mPa.s. For excipients, see 6.1.
3. PHARMACEUTICAL FORM Solution for injection - Clear aqueous solution filled into colourless glass vials.
4. CLINICAL PARTICULARS
4.1 Therapeutic indications MultiHance is a paramagnetic contrast agent for use in diagnostic magnetic resonance imaging (MRI) of the liver and Central Nervous System (CNS). MultiHance is indicated, for the detection of focal
liver lesions in patients with known or suspected primary liver cancer (eg. hepatocellular carcinoma) or metastatic disease. MultiHance is also indicated for the MRI of the brain and spine where it improves the detection of lesions and
provides diagnostic information additional to that obtained with unenhanced MRI.
4.2 Posology and method of administration Liver: the recommended dose of MultiHance injection in adult patients is 0.05 mmol/kg body weight. This corresponds to 0.1 mL/kg of the 0.5 M solution. CNS: the recommended
dose of MultiHance injection in adult patients is 0.1 mmol/kg body weight. This corresponds to 0.2 mL/kg of the 0.5 M solution. The product should be administered intravenously either as a bolus or slow injection (10 mL/min.)
without dilution. Post-contrast imaging can be performed immediately following bolus injection (dynamic MRI). In the CNS the imaging window has been shown to be up to 60 minutes after the administration. In the liver delayed
imaging can be performed between 40 and 120 minutes following the injection, depending on the individual imaging needs. MultiHance should be drawn up into the syringe immediately before use and should not be diluted. Any
unused product should be discarded and not be used for other MRI examinations. To minimise the potential risks of soft tissue extravasation of MultiHance, it is important to ensure that the i.v. needle or cannula is correctly inserted
into a vein. The injection should be followed by a saline flush. The safety and efficacy of MultiHance have not been established in patients under 18 years old. Therefore, use of MultiHance in this patient group cannot be recommended.
4.3 Contra-indications MultiHance is contra-indicated in patients with hypersensitivity to any of the ingredients. MultiHance should not be used in patients with a history of allergic or adverse reactions to other gadolinium chelates.
4.4 Special warnings and special precaution for use The safety and efficacy of MultiHance have not been established in patients under 18 years old. Therefore, use of MultiHance in this patient group cannot be recommended.
Patients should be kept under close supervision for 15 minutes following the injection as the majority of severe reactions occur at this time. The patient should remain in the hospital environment for one hour after the time of injection.
Caution is advised in patients with renal impairment (creatinine clearance < 30ml/min). The accepted general safety procedures for Magnetic Resonance Imaging, in particular the exclusion of ferromagnetic objects, for example cardiac
pace-makers or aneurysm clips, are also applicable when MultiHance is used. Caution is advised in patients with cardiovascular disease. The use of diagnostic contrast media, such as MultiHance, should be restricted to hospitals or
clinics staffed for intensive care emergencies and where cardiopulmonary resuscitation equipment is readily available. Small quantities of benzyl alcohol (1/10,000, 1/100, 1/1,000, 12.5 (dog) Intraperitoneal administration:
26.1 (23.3-29,2) (mouse); 10 (8.9-11.3) (rat); Intracerebroventricular administration: 1.4 (1.3-1.6) (mouse); Intracisternal administration: >1.2 (rat) Intracarotid administration: 5.8 (4.64-7.25) (rat)
6. PHARMACEUTICAL PARTICULARS
6.1 List of excipients Trometamol, hydrochloric acid (d=1.18), water for injection
6.2 Incompatibilities Contrast media must not be mixed with other medicinal products, to avoid eventual incompatibilities.
6.3 Shelf life 5 years
6.4 Special precautions for storage Expiry date refers to the product stored correctly in intact packaging. Protect from light.
Although the sensitivity of iomeprol to X-rays is low, it is advisable to store the product out of reach of ionizing radiation. Parenteral products should be inspected visually for particulate matter and discoloration prior to
administration, whenever solution and container permit. Do not use the solution if it is discolored or particulate matter is present.
6.5 Nature and contents of container Type I or Type II glass vials or bottles with halobutyl stoppers and an aluminium crimp seal.
6.6 Instruction for use/handling Vial or bottles containing contrast media solution are not intended for the withdrawal of multiple doses. The rubber stopper should never be pierced more than once. The use of proper
withdrawal cannulae for piercing the stopper and drawing up the contrast medium is recommended. The contrast medium should not be drawn into the syringe until immediately before use and should not be diluted. Solutions
not used in one examination session or waste material, such as the connecting tubes, should be disposed. Any residue of contrast medium in the syringe must be discarded. Bottles of 500 ml should be used in conjunction
with an injector system. After each patient examination, the connecting tubes (to the patient) and relevant disposable parts should be disposed because could be contaminated with blood. At the end of the sessions, the left over
solution in the bottle and in the connecting tubes as well as any disposable parts of the injector system should be discarded. Any additional instructions from the respective equipment manufacturer must also be adhered to.
7. MARKETING AUTHORISATION INFORMATION
The Marketing Authorisation Holder, Number, and Date of Approval may be different in different Countries. Volumes, presentations, and indications may also differ.Refer to Local Summary of Product Characteristics. Please
contact Bracco Imaging SpA – Via Egidio Folli, 50 20134 Milano- Italy for further information.
8. DATE OF PREPARATION OF THIS DOCUMENT May 2006
Iodine concentration Osmolality Viscosity
MgI/mL MosmL/kg water MPa.s
(x ± s.t95)* (x ± s.t95)
37°C 20°C 37°C
150 301 ± 14 2.0 ± 0.2 1.4 ± 0.1
200 362 ± 17 3.1 ± 0.2 2.0 ± 0.2
250 435 ± 20 4.9 ± 0.4 2.9 ± 0.3
300 521 ± 24 8.1 ± 0.7 4.5 ± 0.4
350 618 ± 29 14.5 ± 1.1 7.5 ± 0.6
400 726 ± 34 27.5 ± 2.3 12.6 ± 1.1
Vasodilatation, cyanosis, circulatory collapse
Tremor, muscle spasms,confusion, loss of consciousness, visual field
defect, aphasia, convulsions, coma
Anaphylactoid reaction (characterized by cardiovascular, respiratory
and cutaneous symptoms)
Renal insufficiency, oliguria, proteinuria, blood creatinine increased
Cardiovascular (mainly after cardiovascular procedures/interventions)
Nervous System
Gastrointestinal system
Respiratory system
Skin and Subcutaneous Tissue
General
Renal and Urinary Disorders
Common
Uncommon
Bradycardia , tachycardia, hypertension, hypotension
Dizziness,paralysis, agitation
Vomiting
Wheals, pruritus, rash
Back pain, chest pain, rigors, injection site
haemorrhage, pyrexia, sweating increased
Rare
Asthenia, syncope,headache
Nausea
Dyspnoea, nasal congestion
laryngeal oedema
Injection site warmth
and pain, pallor

THE ACTIVE STUDY
A multicenter, randomized, double-blind, parallel-group study has shown that
the rate of post-dose increases in serum creatinine ≥ 0.5 mg/dL, as well as
mean changes in serum creatinine from baseline, were significantly (p

MAGNETIC RESONANCE
MR Angiography with MultiHance ® :
detection of significant steno-occlusive disease
of the abdominal or peripheral arteries
MultiHance ® is now also indicated for Contrast-enhanced MR-angiography where it improves
the diagnostic accuracy for detecting clinically significant steno-occlusive vascular disease in
patients with suspected or known vascular disease of the abdominal or peripheral arteries. (1)
The recommended dose of MultiHance ® injection in adult patients is 0.1 mmol/kg body weight.
This corresponds to 0.2 mL/kg of the 0.5 M solution. (1)
MH_MRA_3-03-08ADV
Reference: 1. Multihance Spc
Please consult locally approved information.

myESR.org

omised
&
elivered