Radiologists from 71 nations attended the 22nd International Congress of Radiology from July 1-5 in Cancun, Mexico. Most of them found opportunities to enjoy the warm turquoise waters, sparkling white beaches, and sizzling nightlife of this fabled Caribbean party town. And yes, the meeting was good too.
Some of radiology's best and brightest attended the congress, held nearly every two years since 1925 under the auspices of the International Society of Radiology. The Asian Oceanian Society of Radiology, American College of Radiology, InterAmerican College of Radiology, and the Mexican Federation of Radiology were also educational sponsors of the event.
Together, the ICR’s scientific papers, refresher courses, exhibits, and panel discussions at the congress covered the known universe of radiology, with each area represented by well-known experts in the field.
Among them, neuroradiologist Dr. Peter Corr from South Africa discussed the neurologic sequelae of HIV disease, which continues to roar unchecked through much of the world, and is now estimated to affect nearly 50 million people.
From this large population, about a third of patients with AIDS have neurological disease in some form, which causes significant morbidity and mortality, Corr said. Radiologists play an important role in managing disease, particularly in the early stages, when antiretroviral drugs can be administered and infections treated. Imaging is a critical cool for assessing the extent of disease and monitoring treatment response. Corr discussed the spectrum of neurological complications of AIDS, from acute encephalitis to peripheral neuropathy, beginning with early HIV infection of the brain.
In another ICR presentation, Cuban radiologists discussed the use of high-powered ultrasound to examine the head and neck, where the modality can accurately assesses blood circulation and cerebral perfusion, detect tumors and aneurysms, and measure blood-flow velocities in the cerebral vessels, according to Drs. Orlando Vals Perez and Silvia Fleitas Brague from Hospital Hermanos Ameijeiras in Havana, Cuba.
Ultrasound's advantages include noninvasiveness, zero radiation, and, of course, low cost compared to other imaging methods, the radiologists said.
Meanwhile, Dr. David Cosgrove from Hammersmith Hospital in London covered progress in noninvasive prostate cancer detection. Transrectal ultrasound (TRUS) is very popular, he said, but since it can't rule out cancer it leads to a lot of unnecessary biopsies. What really matters is the ability to distinguish aggressive prostate tumors from those that will probably never cause problems, he said. It is here that ultrasound, aided by new generations of microbubbles, is making progress.
In several studies at his institution, Cosgrove's group found that neovascularity is enhanced somewhat by the new generation of microbubble contrast agents. And color Doppler ultrasound probably adds specificity to the diagnosis of cancer with TRUS, he said. But the microbubbles work only moderately well. They either need to be made smaller, or some novel way to excite the microbubbles needs to be found, Cosgrove concluded.
And from the far-away U.S., breast imaging expert Dr. Edward Sickles from the University of California, San Francisco discussed reading mammograms: the good, the bad, and the suspicious. In a refreshingly clear refresher course, Sickles reviewed factors that don't affect the probability of malignancy, including a lesion's size and even its location. For while malignant lesions tend to be concentrated in certain areas such as the upper outer quadrant (45%), the ratio of benign to malignant lesions remains constant throughout the breast. The presence of fat and the abililty to compress are two other signs pointing to a favorable diagnosis, he said.
In the final session of the congress, Dr. N. Reed Dunnick from the University of Michigan in Ann Arbor said education and research are powerful weapons in the radiology turf wars. Together they can help radiologists save their practices from others who would corral imaging for their own purposes, he said. The good news is that radiology has become so important that patients cannot be cared for without it. The bad news is that the shortage of radiologists encourages entrepreneurial specialists in other fields to try their hand at imaging.
In a presentation on molecular imaging, Dr. James Thrall from Massachusetts General Hospital in Boston cited similar themes, urging radiologists to learn about and use the new techniques before other specialists take the business away. A comprehensive understanding of the underlying science is not a prerequisite for success in molecular medicine, he said, expertise in imaging is enough.
Also notable was a reading session -- featuring radiologists from five continents -- that packed the main hall with attendees and radiology star power. The American Roentgen Ray Society and the Radiological Society of North America sponsored a series of sessions on radiologic oncology, while the European Congress of Radiology sponsored presentations on radiologic-pathologic correlation, documented in a special edition of the European Journal of Radiology.
The ISR's highest award, the Beclere medal, was awarded to four presenters for outstanding contributions to world radiology. Recipients included Dr. Anne Osborn of Salt Lake City, UT; Dr. Peter Corr of Durban, Republic of South Africa; Dr. Joseph Marasco from Fernandina Beach, FL; and Dr. Jose Luis Ramirez Arias of Mexico City, Mexico. In absentia, Dr. Josef Lissner of Munich, Germany, also received the award, named for pioneering French radiologist Dr. Antoine Beclere.
From left to right: Incoming ISR president Dr. George Klempfner, ISR 2002 chairman Dr. Jose Luis Ramirez Arias, ISR 2002 president Dr. Carl Standertskjöld. Photos by Eric Barnes.
Organizers announced the site of the 2006 conference, Cape Town, Republic of South Africa, but have not yet provided a date. The 2004 conference will be held in Montreal, Canada, from June 24-28, hosted by the Canadian Association of Radiologists. In the August ISR newsletter, ISR president George Klempfner said the organization is still considering sites for the 2008 meeting.
"We have had several proposals to sponsor ICR 2008 and hope to make a decision by the summer of 2003," Klempfner wrote. "Any other society which is interested in being a sponsor for the international congress in 2008 may request consideration by writing to me at the ISR secretariat."
Klempfner, of Melbourne, Australia, was appointed ISR president at the Cancún meeting, succeeding Dr. Carl-Gustaf Standertskjöld-Nordenstam, of Helsinki, Finland.
By Eric Barnes
AuntMinnie.com staff writer
September 4, 2002
