The European Congress of Radiology in Vienna just keeps getting better. Conference organizers celebrated an 11% increase in attendance at ECR 2002, including a total "professional" registration of 6,724, compared with 6,040 last year.
The figures do not include a roughly equal number of "nonprofessional" attendees, which included vendor representatives from 157 companies. Just four months earlier, organizers of the 2001 RSNA meeting in Chicago had reported an 11% decline in attendance, a drop that was widely attributed to fallout from last September's terror attacks in the U.S.
An informal poll of radiologists at this year's show yielded consistently positive comments about the meeting. More selectiveness in choosing presentations might have been one reason. Outgoing ECR president Philippe Grenier said a 24% increase in abstract submissions allowed evaluators to be choosier in selecting presentations. A 35% rejection rate for this year's submissions made ECR 2002 the most selective conference in the world, he said.
This year's congress featured a series of sessions on molecular imaging and the future of radiology, as well as the first European exhibition of the U.S.-based Integrating the Healthcare Enterprise information technology connectivity project.
Some of the more intriguing scientific studies highlighted new applications in MRI, ultrasound, and contrast agents, as well as advances in display technology. Ultra-low-dose CT techniques, always a European stronghold, produced good results in a wide variety of applications.
Equipment
ECR officials chided vendors for not displaying more big iron in their booths -- exhibitors tend to economize on exhibit space and transportation costs by leaving large gantries such as CT and MRI scanners at home. Nevertheless, exhibits were packed with attendees throughout most of the show.
And while ECR isn't renowned for its product introductions, this year's show saw several major launches. Meanwhile, the Matrix (formerly the Golden Mile) drew attendees with displays of cutting-edge computer-aided imaging technology.
Siemens Medical Solutions of Erlangen, Germany launched a new multipurpose flat-panel digital radiography system, Axiom Aristos FX. The system features a ceiling-suspended x-ray tube and detector to provide additional flexibility when imaging patients.
Best, Netherlands-based Philips Medical Systems focused on 3-D imaging with its launch of a new ultrasound scanner: ATL HDI 4000. Equipped with both mechanical and freehand 3-D modes, Philips said HDI 4000 is more versatile than dedicated 3-D scanners currently on the market.
GE Medical Systems of Waukesha, WI, chose the occasion to add a new entry-level dual-slice scanner to its CT line. The offering, called HiSpeed CT/e Dual, will sell for about 350,000 euros. And from GE's recent acquisition of South San Francisco, CA-based Imatron comes C300, the next generation of electron beam tomography scanning.
Scottish 3-D-software developer Voxar introduced a new calcium-scoring software package, Calscreen, which automates the calculation and reporting of calcium scores. Calscreen highlights potential calcifications based on size and tissue radiation attenuation. The software also creates a 3-D view of the heart, with calcifications marked and color-coded based on the artery in which they appear.
Scientific presentations
Studies in CAD breast imaging featured results from CADx Medical Systems of Montreal, Canada. A U.S. study found that mammography without CAD had sensitivity of 75.4%. With CAD, the sensitivity rose to 91.4%. This translates to 21,200 extra cancers detected for every 100,000 women diagnosed with cancer, the researchers said. Another study found that breast CAD had drawbacks, including a high false-positive rate for masses, and lower performance for less-common carcinomas.
In ultrasound, better software and high-powered transducers were the order of the day. Researchers from Kings College Hospital in London, U.K., found a robust correlation between primary testicular cancer and a criss-crossing vascularity pattern, imaged using high-frequency color Doppler ultrasound. The researchers used a 15L8w multifrequency (8-13 MHz) linear-array probe (Acuson, Mountain View, CA).
In a study of 2,032 patients, researchers found 53 testicular abnormalities in 44 patients, with the criss-crossing vascular pattern seen in 95% percent of the cases. The statistically significant result could assist in the selection of patients for biopsy, researchers said.
In another study, Russian researchers found that adding 3-D to power Doppler ultrasound improved prostate cancer detection. Among the 97 patients, B-mode transrectal ultrasound (TRUS) found 68 focal lesions, which resulted in 33 cancer diagnoses. B-mode plus power Doppler found an additional 29 lesions (n=62) and yielded an additional 14 cancer diagnoses (n=47).
The addition of 3-D power Doppler to the two previous modes added the visualization of 17 focal lesions (n=114) and yielded 16 additional histologically proven cancer diagnoses (n=63). Three-dimensional power Doppler TRUS provides more information than power Doppler TRUS for the detection of prostate cancer, the researchers concluded.
An innovative MRA study from the U.K. found that spiral blood-flow patterns predicted renal deterioration. The study evaluated 86 patients with chronic renal failure who were imaged using a standard 3-D contrast-enhanced MR angiography technique, and blood-flow pattern visualization. At follow-up one year later, patients with spiral flow deteriorated less than patients in whom spiral flow could not be detected.
German researchers have made important progress in whole-body MRI screening, which is actually a series of four scans including cerebrovascular MRI, whole-body 3-D MRA, cardiac MRI, and MR colonography. The whole-body 3-D MR angiography portion of the exam, now in its third year of clinical use, produces a complete vascular assessment in about 15 minutes.
A French study found that MRI was useful for monitoring cardiac sarcoidosis, whose first symptom is often sudden death. MRI revealed cardiac abnormalities in patients who corresponded to clinical worsening, stabilization, or improvement following prednisone anti-inflammatory therapy.
In ultrasound contrast media studies, Optison (Mallinckrodt, Hazelwood, MO) beat Levovist (Schering, Berlin) in a face-to-face challenge. In a linear-based enhancement study, Optison showed longer enhancement, higher peak response, and less variability than German competitor Levovist.
Experimental contrast agents are also an important area of research. At ECR 2002, two separate studies found good results using superparamagnetic contrast media with MRI for diagnosing lymph node metastases. Using a variety of new gadolinium-based agents such as DOTA, P760 and P792 with MRI, another group of researchers was able to distinguish inflammatory from normal lymph nodes in animal studies. A surface-imaging technique, known as near-infrared fluorescence imaging, used in tandem with enzyme-sensitive optical probes, was also used successfully for the preoperative evaluation of lymph nodes.
In a CT-PET fusion study, Swiss researchers found that the combined systems have a measurable impact on the ability of radiologists to identify and locate pathology, while at the same time reducing scan times and increasing patient throughput. Exam time decreased by 33%, and throughput was doubled, the researchers concluded.
Italian researchers found excellent results with ultra-low-dose virtual colonoscopy, compared to conventional colonoscopy. In 27 patients with clinical indications for colonoscopy, low-dose virtual colonoscopy detected 9 of 9 cancers, and 12 of 14 polyps discovered on conventional colonoscopy. Radiation dose and cost are two key issues that will determine the viability of widespread virtual colonoscopy screening. And while a lower radiation dose may reduce the detection rate of extracolonic pathology, low-dose protocols are probably adequate for the screening population.
In anticipation of next year's congress, outgoing ECR president Grenier passed the leadership reins to Dr. Nicholas Gourtsoyiannis of Greece. Gourtsoyiannis has promised a number of new features for ECR 2003, to be held March 7-11, 2003 in Vienna. One such initiative, "ECR meets...", is designed to encourage participation by national radiology societies by highlighting the home country of the congress president.
Also beginning next year, the ECR will require all scientific exhibitions to be submitted and displayed in electronic format rather than on posters. A number of exhibits were displayed on computers at this year’s show, and going 100% digital will facilitate the development of a database of scientific exhibits that can be distributed online or via CD-ROM, Gourtsoyiannis said.
Articles on many of the scientific studies and equipment launches mentioned in this article can be found right here on AuntMinnie.com. Just type "ECR" into our search tool.
By Eric Barnes and Brian Casey
AuntMinnie.com staff writers
April 4, 2002
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