Postgraduate Educational Programme - myESR.org

Postgraduate Educational ProgrammeA-189 16:51C. Portal vein embolisation before surgeryA. Denys, P. Bize; Lausanne/CH (Alban.Denys@chuv.ch)Portal vein embolisation (PVE) is performed before hepatectomy. Portal branchesof segments that will ultimately be resected are embolized. This embolisationproduces local per-portal inflammation and reroutes the portal flow towards segmentsthat will be left in place by the surgeon inducing liver regeneration of thesesegments. Indications are mainly hepatectomies removing more than 70-80% ofthe functional liver in healthy liver of more than 50-60% when the liver has beenharmed either by a chronic liver disease or cirrhosis or by chemotherapy or steatosis.The procedure is done percutaneously and different embolic agents can be usedfor PVE, such as embolic particles, coils and plugs. Results from experimentalworks suggest that PVE is more efficient when embolic agent occludes smallportal branches and produces significant periportal inflammation. PVE indicationsas well as results are evaluated by CT volumetry of the liver either manually orautomatized by dedicated algorithms.Learning Objectives:1. To become familiar with imaging strategies and indications for embolisation.2. To understand embolisation methods.3. To learn about results, complications and follow‐up strategies.Author Disclosure:A. Denys: Advisory Board; Bayer. Grant Recipient; Biocompatibles, Cook,Terumo. P. Bize: Advisory Board; Bayer. Grant Recipient; Biocompatibles, Cook,Terumo.Panel discussion:How to allow for more patients with HCC to be treated? 17:1416:00 - 17:30 Room PRadiographersRC 714Clinical audit: from EURATOM to the clinicalenvironmentModerators:E.J. Adam; London/UKD. Pronk‐Larive; Middelburg/NLA-190 16:00A. Clinical audit: from the EURATOM treaty to EU guidelines: clinicalaudit RP 159P. Wood; Helsinki/FI (paivi.wood@suomenrontgenhoitajaliitto.fi)The EC directive 97/43/EURATOM introduced the concept of Clinical Audit forthe assessment of radiological practices. The Member States were required toimplement clinical audits in accordance with national procedures. This conceptis of high importance for the improvement of the quality of imaging practices.In the past years, the implementation of clinical audits has been commenced ina number of varying “national procedures”. Need for guidance was obvious toachieve meaningful results. In 2007-2008, the EC conducted a project to prepareguidance on clinical audit. The purpose of the project was to provide clear andcomprehensive information on existing procedures and criteria for clinical auditsin radiological practices. The final European Guidelines were published in June2009. The EC guideline is to provide guidance on clinical auditing in order toimprove implementation of Article 6.4 of Council Directive 97/43/ EURATOM. Theguideline provides comprehensive information on existing procedures and criteriafor clinical audit in radiological practices: diagnostic radiology, nuclear medicineand radiotherapy. Clinical audit is not research, quality system audits nor regulatoryinspections and it is systematic and planned activity. Clinical audit is a systematicreview of medical radiological procedures which seeks to improve the quality andthe outcome of patient care through structured review. Clinical audit should be amulti-disciplinary, multi-professional activity. Follow general accepted rules andstandards which are based on international, national or local legal regulations,or on guidelines developed by international, national or local medical and clinicalprofessional societies.Learning Objectives:1. To understand the background to the publication of RP 159 along withits purpose and scope.2. To become familiar with the principles and prerequisites of clinical audit asoutlined by RP 159.3. To become familiar with the relationship between clinical audit and regulatorycontrols.4. To gain an insight into potential national, regional and international issuesassociated with clinical audit.Author Disclosure:P. Wood: Advisory Board; European Commission project 2007-2008 ContractN TREN/07/NUCL/S07. 71512, Panel of Experts Member. CEO; Society ofRadiographers in Finland. Consultant; Qulitor Ltd, clinical audits.A-191 16:30B. Implementation in practice: a comparison of different modelsS. Geers‐van Gemeren; Utrecht/NL (s.geers@nvmbr.nl)The Dutch Society of Medical Imaging and Radiotherapy (NVMBR) has implementedclinical audit in 1999 for the fields radiology, nuclear medicine and radiotherapy.In the Netherlands, clinical audit is since 2010 obligatory for healthcare professions,regulated by law, to be able to practice. With clinical audit the quality of the provisionof care by professionals is assessed by peers. In 1999, the NVMBR startedwith clinical audit. The NVMBR audit radiographers working in the Radiology andNuclear Medicine departments every five years on request. For the radiotherapy,a multidisciplinary audit is developed since 2003. Pilots of multidisciplinary auditshave been performed for radiology in 2004 and for nuclear medicine in 2010 and2012. The evaluation of the pilots shows a benefit for the department and for theprofessional groups. Implementation: in 2008, the NVMBR started with a webbasedtool ADAS (General Digital Audit System) to support the audit. The use ofADAS is evaluated amogst the members of the audit team and the departments.The development of professional standards is a prerequisite to start clinical audit.The use of ADAS in multidisciplinary audits is a requirement to be able to auditdifferent professions and focus on the content and the quality of their contributionto patient care. Clinical audit is a good tool to improve the quality of patient care.Important are the professional standards, the culture of learning and willing toimprove by the professionals. „Every defect is a treasure“.Learning Objectives:1. To understand the key components required to allow clinical audit to be implementedin practice.2. To gain an insight into different implementation models.3. To be informed about the key considerations that must be made prior toimplementing an audit model: organisation, auditors, process, financing, theroles of professional bodies, and outcomes.A-192 17:00C. A perspective on the impact and benefits of clinical auditS. O’Connor; Dublin/IE (s.oconnor@globaldiagnostics.ie)The purpose of this lecture is to demonstrate how systematic clinical audit can beembedded in a radiology department and to provide practical insight and adviceon audit selection and implementation and how to achieve critical buy in from amulti-disciplinary team to ensure that clinical audit remains an integral and selfsustainingcomponent of a modern radiology service. The importance of appropriateresources and training will be discussed in tandem with review of current literatureand guidelines available in this field. The findings, actions and outcomes will beevaluated to demonstrate the tangible and beneficial impact audits can have onpatients, the team and the service delivery. Clinical Audit remains one of mostimportant ways we have to ensure the quality of the service we provide. Whenimplemented properly, it will result in an effective and efficient quality-assured andsafe radiology service. The service must be delivered by a committed team ofinformed clinicians and will underpin an optimised patient journey.Learning Objectives:1. To gain an insight into the use of clinical audit from the perspective of a clinicalaudit lead in an international diagnostic imaging service provider.2. To become familiar with the challenges that may be encountered when undertakingclinical audit.3. To understand the significant impact that clinical audit can have from theperspective of the patient, the healthcare team and on service delivery.S48AB C D E F G