2008-Issue01

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EFSUMB Newsletter

EFSUMB Newsletter European Federation of Societies for Ultrasound in Medicine and Biology

Editorial

Dear friends Welcome to yet another year with your favourite ultrasound society - EFSUMB. As probably known by now the 2007 EUROSON meeting in Leipzig was very successful and we are now looking forward to another great experience in beautiful Timisoara in Romania and the EUROSON2008 meeting.

Elections for all committees and the executive bureau take place every second year and the meeting in Leipzig brought several changes to all as you can see elsewhere in the Newsletter. Personally I have been in the Publications Committee for two terms serving under Dr. David Pilling who has now resigned as Editor of the Newsletter and Chairman of the Committee. I would like to take this opportunity to thank David very much for all the work he has put into the Newsletter and the committee. It has always been a pleasure to work with him. Additional two members are now leaving the committee, Juoko Pir-

honen and Francesco Drudi, I wish you all the best.

So far it looks like I will be the one who takes over the responsibility of the Newsletter. I always enjoyed reading David's Editorials; one of the reasons was his beautiful English language. In comparison I must confess right away that my vocabulary in English is limited, but I hope you will not mind too much.

Because of the deadline to the publishers the new Publications Committee has not yet met at the moment of finishing this editorial. However, several new ideas have already been launched and you can see one of them in the current issue: the start of a new series where the Newsletter meets different ultrasound societies. I think this is a great opportunity for the members to learn about the other membership countries and I am very grateful that Romania and Sweden volunteered for the first issue. Hopefully there will be one or two interviews in each issue in the coming years.

The EFSUMB webpage now includes a case of the month, so please drop in regularly to check. If you do you will notice that www.efsumb.org has being completely redesigned and thoroughly updated.

Michael Bachmann Nielsen EFSUMB Newsletter Editor

Contents Editorial ......................... .......................89 EFSUMB Officers and Thouts of the new President............90 EFSUMB Officers and Committees..91 Honorary Secretary's Report . ..........91 Honorary Treasurer's Report . ..........92 Introduction to the “2008 Update of EFSUMB Contrast Agent Guidelines“ ................................ ..........93 Education and Professional Standards Committee Report ..........93 Minimum Training Requirements for the Practice of Medical Ultrasound in Europe: ...................... ..........94 - Appendix 12: Musculoskeletal Ultrasound ...............96 Report from Publications Committee ................................. ..........98 Report from ECMUS Safety Committee .................. .......................98 - Clinical Safety Statement 2007........98 Report EUROSON 2007 Leipzig.... ....99 Report from Ultraschall in der Medizin/European Journal of Ultrasound .........................................100 Young Investigator Award 2007....100

Prof Francesco Drudi, Prof Lucas Greiner, Prof Christoph Dietrich, Prof M Bachmann Nielsen, Dr David Pilling

EUROSON School ..............................102 EFSUMB Newsletter meets Romania .............................................102 EFSUMB Newsletter meets Sweden................................................103 EUROSON 2008 – Timisoara, Romania.........................104 Future Congress................................104 Ultraschall in Med 2008; 29

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Thoughts of the new President You can have a look at the Minimal Educational Requirements in several areas that have been produced by the Education and Professional Standards committee on our website (www.efsumb.org <http:// www.efsumb.org>). The website has a new design and we will continue to improve this information and communication medium.

The office of EFSUMB has moved from Bromley in the periphery of London to the centre of London. We have rented an office from the British Institute of Radiology at a reasonable cost and I want to thank David Evans for his successful negotiations with BIR. The annual Euroson meeting in Leipzig that was held in conjunction with the German speaking countries saw a change in the composition of the Executive Bureau (ExB) of EFSUMB .

Kurt Jäger, Lucas Greiner and Pietro Pavlica finished their term on the board. All of them did an excellent job over the past two years. I would like to thank all of them for their collaboration and their dedication to EFSUMB. I would like to welcome the new members of the ExB, Christian Nolsoe from Denmark as President-elect, Christoph Dietrich from Germany as Honorary Secretary and Ian Sporea from Romania as Treasurer.

David Evans is the Past-President and the continuing role of our General Secretary Gianna Stanford has to be highlighted.

Without her efforts the work of all of us and of the committees of EFSUMB would be much more difficult. As you may know the term of office for the ExB and all our committees has been reduced from three to two years. We have to face the fact that Gianna will retire after this next two year term, so we have to find a new General Secretary. This will not be an easy task at all, since a General Secretary has to have really multitasking functions and Gianna has done much more that can be expected from a General Secretary. Also the committees of EFSUMB were newly elected and major changes happened. I want to thank all retiring members for the work they provided to our society and want to welcome the new members.

Ultraschall in Med 2008; 29

EFSUMB today is in a healthy and stable position. The membership of EFSUMB increases steadily and will soon reach 20.000 members, so EFSUMB is one of the biggest interdisciplinary medical societies. Also our financial condition allows us to support further educational activities.

One major aim is to concentrate on the individual benefits of being an EFSUMB member.

The combined Euroson/Dreiländertreffen in Leipzig this October was really a big success; nearly two thousand participants from 41 countries attended the congress.

Mainly through the enormous efforts of Volker Keim this meeting was the most successful interdisciplinary ultrasound congress in Europe to date. As we know Ultrasound congresses are going to have a more and more educational background.

But also new science was presented especially dealing with contrast agents. In this area ultrasound gets a giant boost. However US machines have decreased in price significantly during the past years, this is very much appreciated by the users, but for congress organizers it becomes more and more difficult to obtain a balanced budget since industry sometimes decreases their support. New cooperation forms with industry have to be found.

Euroson 2008 will be held in Timisoara from 31th May to 3 rd of June in the western part of Romania. Timisoara has good flight connections often via Vienna. I am sure that Ioan Sporea and his team toge-

ther with our society will provide a top educational and scientific program with many well known international speakers.

Furthermore it is really interesting to visit a country at a time when many changes are happening. During our visit there last May we were all pleased by the hospitality of the local organizers. I think all our constituent societies should support this congress and the science and education in an eastern country by turning up in large numbers at this interesting congress. Both the Romanian ultrasound society and EFSUMB will support young authors. To encourage young scientists to present innovative papers the congress fee will be waived for all accepted first authors below 35 years.

Another success story is our scientific journal „European Journal Ultrasound /Ultraschall in der Medizin“. Due to the efforts of Editors, the Review Board and mainly due to the publishing scientists, the impact factor of the journal continues to rise and is now 2.1, the highest figure for a multidisciplinary ultrasound journal. I really hope that we can continue with this success and EFSUMB will support the journal whenever possible. Also the newsletter of UiM will be in new hands; Michael Bachmann from Denmark will take care of this publication and communication medium. The style of the newsletter of EFSUMB will change and a case of the month will be introduced in the homepage of the EFSUMB website.

One important goal will be to optimize the communication with our members, so the National Societies are asked to provide email addresses of all their members. EFSUMB offer a membership certificate to all the member of the National Societies each year.

On demand each national society can obtain a bulk supply of personalized certificates for all their members.

I am open for every new constructive idea and can be easily reached.

Norbert Gritzmann President EFSUMB email:norbert.gritzmann@bbsalz.at

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EFSUMB Officers and Committees

Honorary Secretary’s Report Executive Bureau 2007-2009 3President: N Gritzmann (Austria) 3President Elect: C Nolsøe (Denmark) 3Past-President: D H Evans (UK) 3Honorary Secretary: C F Dietrich (Germany) 3Honorary Treasurer: I Sporea (Romania)

EFSUMB to improve the management of patients. They are also other ultrasound applications to reflect future advances in scientific knowledge and the rapidly evolving field of ultrasound technology which could be harmonised in a similar European way.

ECMUS - European Committee For Medical Ultrasound Safety

The new Honorary Secretary of our federation presents, therefore, with aims for the next two years including an EFSUMB course book written by contributors of all over Europe to strengthen the identity of our federation. The initiation and managing of European multicenter trials also with respect to effectiveness of patients care and costs are other goals for the next two years. The good relationship to the industry should be also strengthened as partners for improved patients care and technology.

3Chairman: G ter Haar (UK)

Members: 3M Delius (Germany) 3L Doležal (Czech Republic) 3C Kollmann (Austria) 3K Salvesen (Norway) 3L Valentin (Sweden) 3Co-opted: A van Wamel (The Netherlands) 3Ex-officio: D H Evans (UK)

Education and Professional Standards Committee 3Chairman: O H Gilja (Norway) 3Secretary: H Strunk (Germany)

Members: 3F Drudi (Italy) 3G Mathis (Austria) 3J Tuma (Switzerland) 3Co-opted: B Brkljacic (Croatia) 3Ex-officio: C Nolsøe (Denmark)

Publication Committee 3Chairman: M Bachmann Nielsen (Denmark)

Members: 3J Bamber (UK) 3L Greiner (Germany) 3J Y Meuwly (Switzerland) 3Ex officio: C Dietrich (Germany)

EFSUMB Newsletter 3Editor: M Bachmann Nielsen (Denmark)

Secretariat 3Mrs Gianna Stanford, EFSUMB General Secretary 36 Portland Place, London W1B 1LS, U K Email: efsumb@efsumb.org Website: www.efsumb.org

This letter is to introduce the new Honorary Secretary in harmony with the reports and letters of our President Prof. N. Gritzmann and the other (new) members of the EFSUMB Executive Bureau. This is, therefore, also to announce the XXth Congress of European Federation of Societies for Ultrasound in Medicine and Biology, in conjunction with the XIth Romanian Conference of Ultrasound in Medicine and Biology and to refer to the letter of Joan Sporea in the same issue.

First of all I like to thank Lucas Greiner, the past Honorary Secretary, for all his excellent contributions and activities for EFSUMB and personally even more for his friendship.

The warm welcome by the EFSUMB Executive Bureau and by the brilliant and charming Gianna Stanford was outstanding. In the past few years the identity of EFSUMB was strengthened by the efficacious work of all the national societies of EFSUMB. The importance of our multinational watchdog group on ultrasound safety and important role of our education and publications committees have been previously highlighted.

The publication of the EFSUMB-guidelines for the use of ultrasonic contrast agents in the liver in the August 2004 edition of Ultraschall in der Medizin / European Journal of Ultrasound was one of the cornerstones of EFSUMB activities. The 2008 revisited and expanded new version include recommendations for other applications as well, e.g., kidney, vesico-ureteric reflux, pancreas, trauma and cerebral circulation.

These guidelines are based on comprehensive literature surveys including results from prospective clinical trials and experience of many active members of the

In collaboration with Michael Bachmann Nielsen we initiated the "Monthly case reports" which is actually displayed on the EFSUMB website including videos (http:// www.efsumb.org/). Please participate actively and submit your cases of the month to efsumb@efsumb.org.

Please also note the website announcements for actual and future activities including EUROSON School and do not hesitate to contact EFSUMB for comments, considerations and improvements.

Yours sincerely, Christoph F. Dietrich EFSUMB Honorary Secretary

EFSUMB is moving Offices to 5 EFSUMB 36 Portland Place London W1B 1LS, UK E-Mail: efsumb@efsumb.org Phone numbers will change therefore Please check the EFSUMB website www.efsumb.org

Ultraschall in Med 2008; 29

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Honorary Treasurer’s Report shows a positive balance as in the last few years. We are happy to have this positive balance because the organization needs supplementary founds for the relocation of the EFSUMB office in the central London and also for educational projects.

In my position as new Honorary Treasurer, I like to inform you on the financial balance of 2006 (year ended on the 31 December 2006), which was accounted and

Concerning the balance of 2007, the final report shall be done in the future and published in another Newsletter, because the accounting year ended on the 31st December 2007, before publishing this material. But the preliminary data show again a positive balance.

Looking to the structure of the recent past budgets and also to the budget of 2008, we can see that the most important financial support arrived from membership, and I believe that is very important to try to keep or to improve the number of the members of EFSUMB. Like a conclusion of the financial balance of the last years we must know that EFSUMB has a healthy financial status.

More precise information about the accounts, 2008 budget can be found on the EFSUMB web-site, www.efsumb.org.

Ioan Sporea EFSUMB Honorary Treasurer MEMBERSHIP STATUS AT 31 DECEMBER 2007 Country

Number of members

AUSTRIA

853

BELGIUM

241

BULGARIA

135

CROATIA

65

CZECH REP

37

Membership fee (20000 x 8 €)

€ 160,000.00

DENMARK

573

Euroson School

€ 1,000.00

FINLAND

332

Euroson Congress

€ 1,000.00

FRANCE

291

Bank deposit interests

€ 2,000.00

GERMANY

6798

TOTAL INCOME

€ 164,000.00

GREECE

285

HUNGARY

48

EXPENDITURE

ISRAEL

111

WFUMB fee (20000 x 1.5 $) €1.30

€ 26,000.00

ITALY

1873

Newsletter

€ 28,700.00

LATVIA

158

Meetings, Executive Bureau

€ 15,000.00

MACEDONIA

11

EFSUMB Expenditure on EUROSON Congress

€ 10,000.00

NETHERLANDS

65

Educational Projects

€ 5,000.00

NORWAY

242

Meetings, Committees

€ 20,000.00

POLAND

340

Prizes etc

€ 1,000.00

PORTUGAL

70

Website

€ 2,000.00

ROMANIA

546

Wages

€ 30,000.00

RUSSIA

163

Printing, postage, stationery

€ 1,200.00

SLOVAK REP

30

Auditors

€ 2,600.00

SLOVENIA

128

Office expenses

€ 17,500.00

SPAIN

177

Computer equipment

€ 1,000.00

SWEDEN

115

Bank charges

€ 1,000.00

SWITZERLAND

2649

Depreciation

€ 1,000.00

TURKEY

252

Printing ID certificates

€ 2,000.00

UK

2517

TOTAL EXPENDITURE

€ 164,000.00

TOTAL

19105

BALANCE

€ 0.00

Ultraschall in Med 2008; 29

EFSUMB BUDGET FOR 2008 IN EURO

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2008 Update

EFSUMB Contrast Agent Guidelines published in this edition of Ultraschall!

Following on from the success of the 2004 EFSUMB Guidelines for the use of contrast agents in ultrasound, EFSUMB has produced a new updated and expanded version which is published in this edition of Ultraschall. Once again these guidelines were drawn up by a group of experts from many European countries, with much of the initial work being done at two special consensus meetings held in Bologna in Sep-

tember 2006 and Rotterdam in January 2007. The section dealing with contrast agents in the liver has been updated and expanded, and new sections have been introduced for applications in the kidney, in vesico-ureteric reflux, in the pancreas, in trauma, and in the cerebral circulation.

We are very grateful to the many contributors to this document and especially to Michel Claudon and David Cosgrove for their excellent work in editing the final document. We are also grateful to the several manufacturers (acknowledged in the document) who kindly provided educational grants to make the consensus meetings possible. We do hope members of EFSUMB will find the new guidelines to be of value.

David H Evans EFSUMB Past-President

Report From The Education & Professional Standards Committee dership of the Committee and for the work he has done for the best of EFSUMB and ultrasound education.

Dear ultrasound friends, In the last meeting in the Education & Professional Standards Committee (EPSC) in December, I was elected as new chairman of the committee. I feel greatly honoured to be selected for this important task and will work to promote European education in the field of ultrasonography. I will also take the opportunity to extend my gratitude to Dr. David Lindsell, the previous chairman of the EPSC, for his inspiring lea-

Ultrasound is the safest imaging modality there is in medicine. There is only one danger: Incompetence. The pitfall of ignoring obvious pathology or making the wrong diagnosis is much closer to the incompetent poorly educated. Accordingly, it is of great importance to ensure quality in education and sustain high professional standards in ultrasound scanning.

One way of working towards this aim has been over the last years to establish guidelines in ultrasound education for the different medical disciplines. The present EPSC will continue this work by completing already undertaken guidelines and stimulate new guidelines to be produced.

The EPS Committee has agreed to focus on the following tasks for the coming period:

1. Promote more Euroson Schools to be arranged throughout Europe. The first Euroson School of EFSUMB was arranged in 1992 and since then 39 courses have been held. We encourage all the National Societies and ultrasound groups all over Europe to consider establishing a post-graduate course under the umbrella of a Euroson School. The EFSUMB secretariat and EPSC will do their best to support the new initiatives of Euroson Schools. A dedicated "start package" is being established to help the organisers of Euroson Schools. For more specific information look at www.efsumb.org., where the by-laws (these are under continuous improvement) of the Euroson School can be found. Do not hesitate to consider a Euroson School in your area of expertise or to take contact with EFSUMB or EPSC for a discussion.

2. Promote production of educational material on the Web. An initiative to publish a case-of-the-month is already launched on our web-site. Furthermore, we will try to convert some of the educational CD-ROMs and DVDs to a suitable web format to increase its availability. Moreover, EPSC has the ambition to make the EFSUMB website an educational portal for ultrasound imaging. The idea is to establish an index of links to relevant web-sites which contain good and relevant educational material (text, images, videos). To be able to fulfil this task, EFSUMB will need dedicated people to search for and organise these links. As a start, we encourage our members to e-mail relevant ultrasound web-links and information about educational material that can be published to our General Secretary, Gianna Stanford (efsumb@efsumb.org).

3. Explore the possibility of a common European course in basic ultrasound (level 1), where the course curriculum and content are made ready and standardised by EFSUMB. By providing a total course package, National Societies or local groups are enabled to run the courses.

We all need to keep in mind that if we think we have finished our education, we are not educated, but finished.

Wish you all a happy new year!

Prof. Odd Helge Gilja Chairman EPSC Ultraschall in Med 2008; 29

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Appendix 12

Minimum Training Requirements For The Practice Of Medical Ultrasound In Europe This curriculum is intended for clinicians who perform Musculoskeletal Ultrasound and it includes standards for theoretical knowledge and practical skills. EFSUMB purpose in preparing these recommendations is to achieve some level of training especially for level 1 but each country will need to follow their own regulations.

Musculoskeletal ultrasound comprises a wide range of different examinations increasingly performed by practitioners with different background (e.g. radiology, orthopaedic surgery, rheumatology or paediatric). This curriculum is intended for medical doctors who perform musculoskeletal ultrasound scans. It includes standards for theoretical knowledge and practical skills.

Ultraschall in Med 2008; 29

Training should be integrated in a 3-level system and modular, as some practitioners may need to be proficient in some specific areas of the musculoskeletal pathology according to their daily practice (e.g. shoulder surgery, hand surgery, paediatrics or rheumatic diseases). At least level 1 competence should be obtained by anyone performing routine unsupervised musculoskeletal ultrasound.

Level 1 5 Level 1: Theoretical Module Attendance in a basic course of at least 3 days (18 hours) including: 3 Ultrasound physics and instrumentation, ultrasound techniques and administration (see Appendix 2).

3 Normal musculoskeletal anatomy, normal musculoskeletal ultrasound findings, common pathological ultrasound findings in the musculoskeletal system.

Level 1: Practical Training competence requires: 3 To obtain level 1 status it is recommended that the trainee should perform a minimum of 300 examinations under supervision within a year.

3 Examinations should encompass the full range of conditions listed in the competency assessment sheet - level 1.

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3 A log book (or an illustrated log book) should be kept by the trainee, listing the number and type of examinations. Supervision of half of the 300 examinations can be achieved with approval of examinations in an illustrated log book.

3 The trainee should be supervised by a level 2 or 3 practitioner.

3 During the course of training a competency assessment sheet should be completed and signed by the supervisor, as this will determine in which area(s) the trainee can practise independently.

3 To maintain level 1 status the practitioner should perform at least 300 examinations each year.

Level 1: Competencies to be acquired At the end of training the trainee should be able to: 3 Perform common musculoskeletal ultrasound examinations (shoulder, elbow, wrist/hand, hip, knee, ankle/foot and common muscles) systematically, accurately, safely and with proper report and documentation.

3 Differentiate normal and pathological findings.

3 Perform dynamic examinations.

3 Recognise when referral for a second opinion is indicated (e.g. any diagnostic doubt, soft tissue tumours).

3 Acquire knowledge about advantages, disadvantages and indications of alternative imaging modalities (e.g. MRI).

3 Diagnose common abnormal ultrasound findings in shoulder, elbow, wrist/hand, hip, knee, ankle/foot and common muscles (e.g. effusion and synovitis, bursitis and cysts, tendon tears and tendinopathy, entesopathy, common muscle and bone pathology) (see competency assessment sheet - level 1).

Level 2 5 Level 2: Theoretical Module Attendance in one or more relevant advanced courses or congresses with a total of at least 3 days (18 hours).

Level 2: Practical Training competence requires: 3 To have achieved level 1 competence.

3 To have regular ultrasound clinics at level 1 and perform at least 500 examinations under supervision within a year.

3 Supervised by a level 3 practitioner or someone who has achieved level 2 competence and has at least 2 years of experience at that level.

3 To be able to recognise and correctly diagnose almost all musculoskeletal pathological conditions (or all conditions within a specific area of a musculoskeletal pathology).

3 To maintain level 2 status the practitioner should perform at least 500 examinations each year.

Level 2: Competencies to be acquired 3 To accept and manage referrals from level 1 practitioners.

3 To have knowledge of new ultrasound modalities.

3 To teach ultrasound to trainees and to level 1 practitioners.

3 To conduct some research (clinical or fundamental) in musculoskeletal ultrasound.

3 To recognize and correctly diagnose almost all pathology in the shoulder, elbow, wrist/hand, hip, knee, ankle/foot, muscles, bones and nerves (see competency assessment sheet - level 2).

3 To perform basic, non-complex musculoskeletal US-guided interventions (e.g. aspirations, injections, drainages, biopsies).

Level 3 5 Level 3: Theoretical Module Attendance in at least two advanced relevant courses or congresses with a total of at least 6 days during 2 calendar years.

3 To have regular ultrasound clinics at level 2 for at least two years (at least 500 examinations per year).

3 To be occupied mainly with musculoskeletal ultrasound.

3 To perform (or have knowledge about) specialised musculoskeletal ultrasound examinations 3 To perform advanced US-guided interventional procedures. competencies to be acquired 3 To accept and manage tertiary referrals from level 1 and 2 practitioners.

3 To perform specialised musculoskeletal ultrasound.

3 To perform all sorts of musculoskeletal US-guided interventions.

3 To conduct substantial research (clinical or fundamental) in the field of musculoskeletal ultrasound.

3 To teach musculoskeletal ultrasound to trainees and practitioners at all levels.

3 To be aware of and to pursue developments in musculoskeletal ultrasound.

Maintainance of Skills 5 Having been assessed as competent to practice there will be a need for continued medical education and maintenance of practical skills. Recommended numbers of examinations to be performed annually to maintain skills at each level are given in the text. Practitioners should: 3 Include musculoskeletal ultrasound in their ongoing continued medical education (CME) and continued professional development (CPD).

3 Audit their practice.

3 Participate in multidisciplinary meetings.

3 Keep up to date with relevant literature.

Level 3: Practical Training competence requires: 3 To have achieved level 2 competence.

Appendix 12: Musculoskeletal Ultrasound Training Competency Assessment

Ultraschall in Med 2008; 29

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Ultraschall in Med 2008; 29

_________________ _________________

··Normal musculoskeletal anatomy

·US examination of normal joints and muscles

_________________ _________________ _________________ _________________ _________________ _________________

·Shoulder joint effusion and synovitis

·Subacromial-subdeltoid bursitis

·Biceps tendon (tendinopathy, luxation, rupture)

·Hill-Sachs lesion

·Acromioclavicular joint pathology

·(Rheumatoid erosions)

_________________ _________________ _________________ _________________ _________________ _________________ _________________ _________________ _________________ _________________ _________________

·(Rheumatoid erosions)

Wrist and Hand

·Ganglion cyst

·Tenosynovitis

·Tendon rupture

·Joint effusion and synovitis

·Rheumatoid erosions

Common Muscles

·Large muscle rupture, hematoma

·Abscess

·Myositis ossificans

_____________

_____________

_____________

_____________

_____________

_____________

_____________

_____________

_____________

_____________

_____________

_________________ _________________

·Detection of foreign body

_________________ ·Fluid at prosthesis/osteosynthesis

·Identification of bone pathology

_________________

_________________

·(Rheumatoid erosions) Other

_________________

_________________

_________________

_________________

·Fasciitis plantaris

·Tenosynovitis

·Achilles tendinopathy and rupture

·Joint effusion and synovitis

_________________

_________________

·(Rheumatoid erosions) Ankle and Foot

_________________

_________________

_________________

·Collateral ligament strain

·Osgood-Schlatter

_________________

·Elbow joint effusion and synovitis

_____________

·Large Meniscus cyst

_____________

_________________

·Lateral and medial epicondylitis

_________________

_________________

·Quadriceps tendon rupture ·Identification of the menisci

_________________

_________________

_________________

_________________

_________________

_________________

Trainer Signature

·Patellar ligament tendinopathy

·Baker´s cyst (and rupture)

·Knee joint effusion and synovitis

Knee

·(Rheumatoid erosions)

Elbow

_____________

_____________

_____________

_____________

_____________

_____________

·Trochanteric bursitis

·Hip joint effusion and synovitis

_________________

·Rotator cuff calcifications (different types)

_____________

_________________

·Full-thickness rotator cuff tear

_____________

Hip

Date

_____________

_____________

_____________

_____________

Date

Trainer: ________________________________________________

Shoulder

To be competent to perform/diagnose the following: Trainer Signature

_________________

·Practical instrumentation / Use of ultrasound controls

Competencies/Skills to be acquired - Level 1

_________________

Trainer Signature

·Physics and technology

Core Knowledge Base - Level 1

Trainee: __________________________________________

_____________

_____________

_____________

_____________

_____________

_____________

_____________

_____________

_____________

_____________

_____________

_____________

_____________

_____________

_____________

_____________

_____________

_____________

_____________

_____________

_____________

_____________

Date

96

Appendix 12: Musculoskeletal Ultrasound Training Competency Assessment Sheet

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_________________ _________________ _________________ _________________ _________________

·Rotatorcuff interval pathology

·Frozen shoulder

·Nerve entrapment

·Identification of ant and post glenoid labrum

·US-guided interventions

_________________ _________________ _________________

·Ligament and pulley lesions

·Other tumours than ganglion

·US-guided interventions

_________________ _________________ _________________ _________________ _________________ _________________ _________________ _________________

·Identification of common muscle tumours

Other

·Withdrawal of foreign body

·Bone pathology (fracture, tumour)

·Doppler examination of tendons, joints, …

·Entesopathy

·Identification of common nerves

·US-guided interventions

_____________

_____________

_____________

_____________

_____________

_____________

_____________

_____________

·US-guided interventions

_________________

·Late complication of muscle rupture

_____________

·Ligament strain

_________________

·Small muscle rupture

_____________

·Tarsal tunnel syndrome

·Morton´s neuroma

Ankle and Foot

·US-guided interventions

Muscles

_____________

_____________

_____________

·Cartilage lesion

_________________

·Tendon adherences

_____________

·Osteoarthritis

_____________

_________________

·Runner´s knee

_________________

_________________

_________________

_________________

_________________

_________________

_________________

_________________

_________________

_________________

·Meniscus cyst

·Meniscus tear

_________________

_____________

Knee

_________________

·US-guided interventions

·Carpal tunnel syndrome

_________________

·US-guided interventions

_____________

_____________

_________________

_________________

_________________

_________________

_________________

_________________

_________________

_________________

Trainer Signature

·Pathology of the Infant hip

·Groin pain

·Inguinal hernia

·Snapping hip

·Identification of iliopsoas tendon

·Identification of ant labrum

·Pathology of small tendons

_________________

·Nerve entrapment

_____________

_____________

_____________

_____________

_____________

_____________

Wrist and Hand

_________________

·Biceps and triceps tendinopathy and rupture

Elbow

_________________

·Ganglion

·Osteoarthritis

·Other bursitis than trochanteric

_____________

_________________

·Dynamic examination for impingement

_____________

_________________

·Partial-thickness rotator cuff tear

Date Hip

Trainer Signature

Trainer: ________________________________________________

Shoulder

To be competent to perform/diagnose the following:

Competencies/Skills to be acquired - Level 2

Trainee: __________________________________________

Appendix : Musculoskeletal Ultrasound Training Competency Assessment Sheet

_____________

_____________

_____________

_____________

_____________

_____________

_____________

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Report from EFSUMB Publications Committee

Report from the European Committee for Ultrasound Radiation Safety (ECMUS) safety related publications relevant to clinical usage, drafting of tutorial articles on safety aspects of souvenir scanning and contrast agents, and consideration of the generation of EFSUMB's own guidelines for safe use of diagnostic equipment. The reports and statements will be published on the EFSUMB web site and in the European Journal of Ultrasound. It is also intended to introduce a "safety corner" in the EFSUMB newsletter - so Watch This Space!

The Publications Committee has met twice during 2007. The first meeting was held in Copenhagen in April during the annual postgraduate course of the Danish Society. The second meeting was in October at the beginning of the EUROSON meeting in Leipzig. The next day a completely new committee was elected at the Board of Directors meeting, and they did not have a chance to meet until January 2008. The meeting in Leipzig was also David Pilling's last as he resigned from being the Editor of the Newsletter and chairman of the committee. He was thoroughly thanked for all his hard work and commitment.

The EFSUMB website is once again going to be updated both regarding the design and the contents. The design was presented at the BoD meeting in Leipzig. The new website should be up and running when you read this. The Committee will be looking into things to make the website more attractive and so far a case of the month has been introduced.

The membership of the European Committee for Ultrasound Radiation Safety (ECMUS) has changed during the last year.

At the Board of Directors meeting in Leipzig, Ladislav Dole탑al (physicist, Czech republic), Kjell Salvesen (OB/GYN, Norway and Lil Valentin (OB/GYN, Sweden) were elected on to the Committee to join existing members Michael Delius (biologist, Germany), Christian Kollmann (physicist, Austria) and Gail ter Haar (physicist, UK).

Annemieke van Wamel (biologist, the Netherlands) has also been co-opted into ECMUS to provide much needed and timely expertise on contrast agent safety.

Current ECMUS activities, apart from the annual re-affirmation of the clinical safety statements, include drawing up reviews of

There is currently very little information on the exposure levels used during ultrasound scanning in the clinic. ECMUS is therefore circulating a questionnaire about scanner settings in daily use to clinics in Europe, and asking them to complete one for every scan on one day. This follows a pilot study undertaken by BMUS in 2007. Once the results are in and analysed, they will be brought to the attention of the EFSUMB community. If you receive a request to fill in such a questionnaire please give serious consideration to completing it, or if feel able to participate please contact a member of ECMUS. Gail ter Haar

European Committee of Medical Ultrasound Safety (ECMUS)

The Committee was very happy with the increase in Impact Factor for the UiM/EJU. The matter of inclusion of subscription to the UiM/EJU in the registration for EUROSON Congresses has been discussed and there was no information regarding the 2008 and 2009 meetings, but it could take place in 2010 in Copenhagen.

This document is the 2006 EFSUMB Clinical Safety Statement and it has been reconfirmed with no changes applicable during the EFSUMB Board of Directors meeting in Leipzig on 24th October 2007. A Safety Statement has been published by EFSUMB annually since 1994.

harmful effects. The range of clinical applications is becoming wider, the number of patients undergoing ultrasound examinations is increasing and new techniques with higher acoustic output levels are being introduced. It is therefore essential to maintain vigilance to ensure the continued safe use of ultrasound.

In 2008 the committee will meet in January in Copenhagen as well as in Timisoara during the EUROSON meeting. A meeting in November is also under consideration.

Clinical Safety Statement For Diagnostic Ultrasound 5

Ultrasound examinations should only be performed by competent personnel who are trained and updated in safety matters.

Diagnostic ultrasound has been widely used in clinical medicine for many years with no proven deleterious effects. How ever, if used imprudently, diagnostic ultrasound could be capable of producing

Ultrasound produces heating, pressure changes and mechanical disturbances in tissue. Diagnostic levels of ultrasound can produce temperature rises that are hazar-

Michael Bachmann Nielsen

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dous to sensitive organs and the embryo/ fetus. Biological effects of non-thermal origin have been reported in animals but, to date, no such effects have been demonstrated in humans, except when a microbubble contrast agent is present.

The Thermal index (TI) is an on-screen guide to the user of the potential for tissue heating. The Mechanical index (MI) is an on-screen guide of the likelihood and magnitude of nonthermal effects. Users should regularly check both indices while scanning and should adjust the machine controls to keep them as low as reasonably achievable (ALARA principle) without compromising the diagnostic value of the examination. Where low values cannot be achieved, examination times should kept as short as possible. Guidelines issued by several ultrasound societies are available.

Some modes are more likely than others to produce significant acoustic outputs and, when using these modes, particular care should be taken to regularly check the TI and MI indices. Spectral pulse wave Doppler and Doppler imaging modes (colour flow imaging and power Doppler imaging) in particular can produce more tissue heating and hence higher TI values, as can B-mode techniques involving coded transmissions. Tissue harmonic imaging mode can sometimes involve higher MI values.

3D (three dimensional) imaging does not introduce any additional safety considerations, particularly if there are significant pauses during scanning to study or manipulate the reconstructed images. However, 4D scanning (real-time 3D) involves continuous exposure and users should guard against the temptation to prolong examination times unduly in an effort to improve the recorded image sequence beyond that which is necessary for diagnostic purposes.

Temperature rises are likely to be greatest at bone surfaces and adjacent soft tissues.

With increasing mineralisation of fetal bones, the possibility of heating sensitive tissues such as brain and spinal cord increases. Extra vigilance is advised when scanning such critical fetal structures, at any stage in pregnancy.

Based on scientific evidence of ultrasound-induced biological effects to date, there is no reason to withhold diagnostic scanning during pregnancy, provided it is medically indicated and is used prudently by fully trained operators. This includes routine scanning of pregnant women.

The power levels used for fetal heart rate monitoring (cardiotocography - CTG) are sufficiently low that the use of this modality is not contra-indicated on safety grounds, even when it is to be used for extended periods.

Safety considerations for other sensitive organs 5

Ultrasound contrast agents (UCA) 5 These usually take the form of stable gas filled microbubbles, which can potentially produce cavitation or microstreaming, the risk of which increases with MI value.

Data from small animal models suggest that microvascular damage or rupture is possible. Caution should be considered for the use of UCA in tissues where damage to microvasculature could have serious clinical implications, such as in the brain, the eye, and the neonate. As in all diagnostic ultrasound procedures, the MI and TI values should be continually checked and kept as low as possible.

It is possible to induce premature ventricular contractions in contrast enhanced echocardiography when using high MI and end-systolic triggering. Users should take appropriate precautions in these circumstances.

The use of contrast agents should be avoided 24 hours prior to extra-corporeal shock wave therapy.

Particular care should be taken to reduce the risk of thermal and non-thermal effects during investigations of the eye and when carrying out neonatal cardiac and cranial investigations.

Report EUROSON 2007 Leipzig The joint meting of 19th EUROSON Congress and the 31st Dreil채ndertreffen took place between 24th and 27th October 2007 in the Congress Centre of the City of Leipzig. More than 2050 participants from 43 countries attended.

There we more than 800 lectures during the 4 days. The rented area in the industrial exhibition was over 1000 square metres.

The festive evening was attended by more than 650 people.

Prof. Dr. med. Volker Keim Joint President EUROSON CONGRESS 2007

Ultrasound exposure during pregnancy 5 The embryo/fetus in early pregnancy is known to be particularly sensitive. In view of this and the fact that there is very little information currently available regarding possible subtle biological effects of diagnostic levels of ultrasound on the developing human embryo or fetus, care should be taken to limit the exposure time and the Thermal and Mechanical Indices to the minimum commensurate with an acceptable clinical assessment.

Prof David H Evans, Mrs Gianna Stanford, Prof Volker Keim, Prof Norbert Gritzmann

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Report on Ultraschall in der Medizin/ European Journal of Ultrasound in 2007 category "Radiology, Nuclear Medicine & Medical Imaging". This is good news not only for those directly involved in the journal and for the contributors but also for EFSUMB.

Just like when I wrote the report one year ago I will have only nice things to say. The year 2007 was another good year for our journal. The Impact Factor increased once again, from 1.708 to´2.103. The journal is now ranked 32nd out of 85 journals in the

We also continue to see an increase in submitted manuscripts and this of course means greater competition for the journal pages. In the Editorial in issue 5-2007 some general tips and tricks can be found to make sure that your manuscript is the only that moves on to publication.

ger and Eberhard Merz for all the work that is put into making the journal what it is today. I would also like to thank everyone else involved in the process, the contributors, the reviewers, and the Thieme group.

The Ultraschall in der Medizin/European Journal of Ultrasound – the official journal of EFSUMB – is also the official journal of 9 national ultrasound societies (the German, Swiss, Austrian, Norwegian, Danish, Latvian, Flemish, Macedonian and Croatian).

Michael Bachmann Nielsen Co-editor of the Ultraschall in der Medizin/ European Journal of Ultrasound

In 2007 Professor Gerhard Mostbeck from Vienna joined us as co-editor in the journal and I would like to thank him and my other co-editors Karlheinz Seitz, Kurt Jä-

EFSUMB Young Investigator's Award 2007 Each year, each member society of EFSUMB is invited to nominate a member of their society to present a paper in the Young Investigator's Award session of the EUROSON Congress. Applicants must be under 35 years of age at the opening date of the Congress, and must be a paid up member of the nominating society. The member society must agree to sponsor their candidate for the cost of their travel and accommodation expenses, and the organising committee of the conference offer the candidates free registration at the meeting. One or two prizes of €1,000 are awarded to the candidates, judged by an ad-hoc committee to be best in terms of scientific content and quality of presentation. This year entries were received from 5 national societies (Germany, Italy, Norway, Poland, United Kingdom), and as always the quality of the presentations was excellent.

Two First Prizes were awarded on this occasion. Emma Chung, from Leicester, United Kingdom and Vito Cantisani from Rome, Italy. Their CVs and abstract are to be found here below. I would like to encourage all societies to consider nominaUltraschall in Med 2008; 29

ting one of their outstanding young members for the 2007 competition to be held in Leipzig in October of this year. I would also commend attendance at the Young Investigators session to the membership in general; for me it is one of the highlights of the meeting.

Since 2004, Emma has been working as a Medical Physicist at the University Hospitals of Leicester NHS Trust where she coordinates clinical and laboratory research aimed at improving Doppler ultrasound detection of cerebral emboli during carotid and cardiac surgery. She is currently Assistant Editor of 'Ultrasound'- the

CV Emma Chung 5 Dr Emma Chung was born in Tasmania in 1975 and moved to the England in 1980.

She received her Master of Physics (MPhys, 1st Class, Hons.) degree and SimsPortex prize for best undergraduate research project from the University of Kent in 1998. Emma gained her PhD from the Superconductivity and Magnetism Group of the Department of Physics at the University of Warwick in 2002. Following her PhD, Emma continued her research while living in Germany and the USA. She performed neutron scattering experiments at the Institut Laue-Langevin in Grenoble (France), where she was the first to observe two-dimensional magnetic scattering using neutron Laue diffraction.

Emma Chung

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journal of the British Medical Ultrasound Society. In 2007 she was one of eight short-listed nominees for a L'Oreal UK Woman in Science Award. Emma also holds a Wellcome Trust Value in People (VIP) Award and a David Watkin Award for overseas study leave.

Emma has a talent for identifying novel applications of Physics to problems in the Cardiovascular Sciences. Her latest research pioneers targeted microbubbles for enhanced detection of thrombus (Stroke 2007; 38:10:2726-32), and 'virtual patient' computer simulations for an improved understanding of stroke (Phys. Med. Biol. 2007; 52:7153-66). Internet website: http://www.le.ac.uk/cv/research/Ultrasound/Emma Emma_home.html

Results: Complete occlusion of the peripheral branch of the glass model revealed discrete knock-type signals caused by fluid flow in the occluded vessel. Imaging of the occluded vessel using Colour Doppler revealed forward and reflected components and two types of flow pattern.

Wall motion was investigated using a latex model and found to produce periodic bidirectional signals typically =100 ms in duration occurring during systole.

Conclusions: Our in vitro experiments suggest that transcranial Doppler ultrasound is capable of detecting blood-flow within an occluded side vessel. However, as similar knock-type signals are also produced by wall motion, careful interpretation of data for detection and classification of knock signals is required.

Abstract Title: Detection of small vessel occlusion using Doppler ultrasound; an in vitro study Authors: Chung E.1, Ramnarine K.V.1, Long C.V.1, Udommongkol C.2, Chambers B.R.2, 1University Hospitals of Leicester NHS Trust, Medical Physics Group, Leicester, United Kingdom, 2,Austin Hospital, Department of Neurology, Melbourne, Australia Aims: `Small vessel knock´ is a recently reported Doppler ultrasound finding detected in patients with acute ischemic stroke.

Knock signals are periodic, of short-duration (<100 ms), and localised within the head. Typically, signals have a unidirectional component in systole and a reflected component during diastole. Currently it is not known whether this signal arises due to occluded blood-flow, wall motion, or some other mechanism. The potential uses of Doppler ultrasound for location of small-vessel occlusion in stroke patients therefore remains controversial. The aim of this study was to determine the origins of knock-type signals by reproducing conditions for small-vessel occlusion in vitro.

Method: Synthetic bifurcations were moulded from latex and glass, artificially occluded, and placed in a closed-loop flow-rig mimicking physiologically realistic blood-flow conditions. Doppler signals associated with blood-flow and wall-motion were examined under controlled conditions using Doppler, B-mode and Colour Doppler Duplex imaging.

Acknowledgement: this project was funded by the Australian Society for Ultrasound in Medicine (ASUM) and British Medical Ultrasound Society (BMUS) as part of a British-Australian exchange visit to the National Stroke Research Institute in Melbourne, Australia.

CV Vito Cantisani 5 Department of Radiology, University "La Sapienza", Rome *Department of Radiology,University Campus Biomedico,Rome.

Born on August 20, 1974 in Lagonegro, Italy. Graduated in Medicine at University La Sapienza of Rome in 1999 cum Laude.

3 Visiting Fellow the Johns Hopkins Hospital in Baltimore and AFIP in Walter Reed in Washington. 2002 Fellowship in Abdominal Radiology at BWH, Boston, Medical University.

3 Chief Resident and completed in 2004 the Residency in Radiology at University La Sapienza cum Laude.

3 In 2002 and 2003 awarded at ECR with the EURORAD prizes.

3 From 2004 employed in the Department of Radiology, II Chair, University La Sapienza, as Full-Time Staff Radiologist and Instructor in Radiology.

3 From 2005 attending the PhD in Cardiovascular and Thoracic Fisiopathology and Imaging and Surgery at University La Sapienza.

3 From 2004 coordinator oF Color-Doppler sonography didactic Courses at the Department of Radiological Sciences at Policlinico Umberto I.

Vito Cantisani

3 From 2005 Professor at School of Residency in Diagnostic Radiology and at School for Radiological Technicians at University La Sapienza.

3 Co-coordinator of the TEMPUS project "US School in Tirana".

3 Research interest is mainly focused on US contrast media in abdominal and non-abdominal applications in correlation with multislice-CT and enhancedMRI. 3 2007 nominated secretary of Contrast media Group of SIUMB and SIRM. 3 Wrote as first author or co-author more than 40 papers published on Italian or International peer-reviewed Journals.

Co-author of more than 10 chapters of International Books. He presented more 60 oral presentations, 10 scientific exhibits, 5 invited lectures and 2 chairmanships. He took part to the organization commettee of more than 10 Italian or international Meetings.

3 Member of SIRM (Società Italiana di Radiologia Medica) from 2000, SIUMB (Società Italiana di Ultrasonografia in Medicina e Biologia) from 2004, ESR (European Society Radiology) from 2007, ESGAR (European Society of Gastointestinal Radiology) from 2007.

Member of the Editorial Board of Journal Ultrasound from 2006.

Abstract: Title: Detection of hepatic metastases from colorectal tumours: prospective evaluation of US versus sonoVue low mechanical index (MI) real time-enhanced US as compared with 64 slice-CT or BOPTA-MRI Ultraschall in Med 2008; 29

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Authors: V Cantisani, P Ricci, E Pagliara, M Erturk, U D'Ambrosio, G Alfano, C Catalano, FM Drudi, R Passariello. Department of Radiological Sciences, Policlinico Umberto I, University La Sapienza, Rome, Italy Purpose: To compare low-mechanical index(MI) contrast enhanced US, US and 64slice CT for the detection of hepatic metastases from colorectal tumors assuming the combination of 6 months follow-up with 64 slice CT and/or BOPTA-MRI and/or intraoperative US (IOUS) as referring imaging modalit Methods and Materials: From February to June 2006, 110 patients with colorectal tumors (55 males, 35 females; mean age 62 years; range 39-78) with suspected hepatic lesions were evaluated with US, CEUS and 64-slice-CT by two independent readers. Intraoperative ultrasonography (n=45) or a follow-up up for at least 6 months by using CT or BOPTA-enhanced MRI (n=50) was considered the gold standard. To compare the sensitivity and specificity of US, CEUS, and CT, McNemar test was employed.

Results: No side effects were observed.

Reference standards revealed 430 metastases in 110 patients. At patient-by-patients analysis CEUS improved US sensitivity from 74% to 95% (p<0.05). At lesion-bylesion analysis, CEUS improved the sensitivity of US for the detection of individual metastases, from 60.4% to 92.8%, respectively (p <.001). The specificity increased from 60% and to 84%, respectively; there were no significant differences between CEUS and CT. Contrast-enhanced US was significantly more accurate than baseline US, especially for small metastases (p<0.001) with an increase of sensitivity from 35% to 76.6% with no statistical difference if compared with 64-slice spiral CT (73.3%–75.8%).

Conclusions: CEUS is significantly more accurate than US and highly comparable with 64-slice spiral CT and BOPTA-MRI in the detection of liver metastases from colorectal cancer. Therefore, in the evaluation of patients with suspected hepatic metastases from colorectal tumour, US examination must be performed after contrast administration

Ultraschall in Med 2008; 29

Euroson School Future Euroson Schools 5 4–5 April 2008

Information/ Contact

Advanced Abdominal Ultrasound Course University Hospital Košice

PD Dr. med. Jan TumaPD Dr. Milan Kuchta Seilerweg 1LF UPJŠ v Košiciach CH 8610 Ustertrieda snp c. 1 SwitzerlandKošice, Slovakia Jan.Tuma@hin.ch kuchta@lf.upjs.sk Internet-Homepage:www.sgum.ch www.ultrasono.sk

24–25 October 2008 Gastroenterologic Ultrasound - University Hospital Košice

EFSUMB Newsletter Meets Romania Facts 5 Area: 238.392 km2.

Population: 22 million.

Capital: Bucharest.

Largest cities: Bucharest 1,9 million, Iasi, Cluj-Napoca, Timisoara, Constanta, Craiova, each 300-340.000.

EFSUMB members: 422

President of Romanian society of Ultrasonography in Medicine and Biology, Professor Ioan Sporea (IS) interviewed by Michael Bachmann Nielsen (MBN) November 2007.

5 The Romanian society during the past 6 years the Romanian society has organised successful European schools each year, in 2008 the Romanian society organizes the EUROSON congress in Timisoara. Per-

sonally I have known Ioan Sporea for the last 6 years serving at the Board of Directors and as a personal friend.

3 MBN: First of all congratulations for the election as honorary treasurer in the executive bureau. And also for joining this interview series in the Newsletter.

You have a very busy year ahead, don't you?

3 IS: Yes, the EUROSON congress in 2008 will take place in Timisoara. A lot of colleagues as well as myself have already been working hard with the preparation for a long time and we are sure it will be a very successful meeting.

3 MBN: Could you start by telling us your medical profession and were you work?

3 IS: I am a medical gastroentorologist and Head of the Department of Gastroenterology in the university hospital in Timisoara.

Ioan Sporea, President of SRUMB, and Viorela Enachescu, Honorary Secretary of SRUMB, in Craiova May 2007

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3 MBN: According to the EFSUMB web page the society has 422 members. Is that a true mirror of the number of ultrasound users in Romania?

3 IS: The last count was actually 573 and we have increased in membership number each year during the last 5 years. I will estimate that between two and three thousand use ultrasound in Romania, so we still have a way to go.

We are trying to teach ultrasound in several centres in Romania.

3 MBN: Could you tell a little more about your training programme?

3 IS: Ultrasound in Romania like in the rest of Europe is multidisciplinary. In Romania we have 7 university centres for ultrasound providing post-graduate courses several times a year. They all have basic courses and each of them also have different specialised courses.

In average all trainees have a 3-month stay at the department with a curriculum, theoretical courses, hands-on training and supervised patient examinations.

3 MBN: I know you are also involved in FAST. 3 IS: Yes we now have a special course for emergency ultrasound and FAST where trainees are trained during 2 weeks.

This is something that has been made mandatory by the Health Ministry for everyone involved with emergency and FAST ultrasound.

3 MBN: I have had the pleasure of being invited for the EUROSON School 2 times and attended the national meetings.

How many people do you think attend these meetings?

3 IS: At least 400 participants took place in the European schools, which is held entirely in English. The annual national conferences are in the Romanian language and 5–600 people attend 3 MBN: Do you have a newsletter you send to your members or do you have a national ultrasound journal?

3 IS: A newsletter is printed in our national journal. We have had a Romanian journal for ultrasound for the last approximately 10 years; there are 4 issues each year. The journal is in the Romanian language but we intend to change this entirely into English language in 2008.

3 MBN: Is there any change of the Romanian society will join bulk subscription for Ultraschall in der Medizin?

3 IS: We are currently looking into it and we will have to discuss it in the Romanian board. Also your offer of including

subscription of Ultraschall in der Medizin for everyone attending the EUROSON congress (except for those who already have bulk subscription) is something we will have to look into. Currently we have already decided on the congress fee, so your offer will to some extent depend on the size of a surplus from the congress.

3 MBN: I read about Timisoara in Wikipedia, could you tell me about the city.

3 IS: It is a beautiful baroque city, often named little Vienna because it belonged for a long time to the Hapsburg empire. The city is more than 700 years old and it has a beautiful historical centre and many charming places.

3 MBN: Thank you Ioan for agreeing to this interview. We will publish the interview in the EFSUMB web page and also in the newsletter in 2008. I am confident that you will make a very successful EUROSON meeting and I am looking forward to attend it myself.

EFSUMB Newsletter meets Sweden Facts: 5 Area: 449,964 km² Population 9.1 million Capital: Stockholm Largest cities: Stockholm 1 200 000, Gothenburg 510 000, Malmö 258 000 EFSUMB: members 115

President of the Swedish Society for Ultrasound in Medicine, Anders Nilsson(AN ) interviewed by Michael Bachmann Nielsen (MBN) November 2007.

5 The Swedish Society co-organized the EUROSON 2003 meeting in Copenhagen. To many EFSUMB delegates and committee members the past-president Lil Valentin as well as the current president Anders Nilsson will be well know. Personally I have know Anders Nilsson for 15 years, often attending or lecturing at the same meetings or inviting each other to lecture at courses and meetings.

3 MBN: Anders, first of all thank you for volunteering for this interview. Can you start by telling us about your medical profession and where you work?

3 AN: I am a chief-radiologist in charge of the ultrasound section in Uppsala.

3 MBN: Considering the size of Sweden, the number of members of the Swedish Society for Ultrasound in Medicine seems very small.

3 AN: Yes this is correct. In the past the Swedish society held an annual symposium and that was what connected the members. This has not happened for some years. Today, the radiologists, the gynaecologists and surgeons each have separate meetings, in the Swedish form these are 5-day meetings covering all aspects within the radiology, gynaecology/obstetrics and surgery, respectively. The Swedish "Radiology Week" is a huge meeting with up to 2,000 participants.

3 MBN: Do you host any courses in ultrasound?

3 AN: Well we used to, but to be honest it has been a while since we had any. We are currently planning some courses for Michael Bachmann Nielsen (left) and Anders Nilsson (right).

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2008 and also ultrasound symposia for the next radiology Week in August 2008. Currently we do not even have a Newsletter.

MBN: Sweden is a large country measured in square kilometres, but compared to other European countries it has a low population density (20/km2). Does that have anything to do with the problems AN: Probably yes. Until a few years ago it was cheaper to buy a return flight to New York than going from Malmö to Stockholm.

MBN: How do you consider the current status of the society?

AN: We will in the coming months try to reorganize the Society and look for some ideas as to how we can re-launch the Society as the interdisciplinary society we should be. This means we will need too have symposia and courses that can attract people.

MBN: I had some problems finding your correct telephone number and society details on the internet, how can that be?

AN: The Swedish homepage unfortunately has not been updated for several years, since we did not have any meetings or course to promote. Also we have had problems finding a webmaster. The information about the board members should have been sent to EFSUMB, but we will certainly check it again.

MBN: Thank you Anders for agreeing to this interview, which will be published on the EFSUMB webpage and in the Newsletter. Let's hope you will succeed in your plans for the Swedish ultrasound community.

31 May - 3 June 2008, Timisoara, Romania

EUROSON 2008 Important Dates

Why to come to EUROSON 2008

3 15 February 2008 Abstracts deadline

speakers

3 1 April 2008

3 All sessions of the Congress in

Early registration deadline 3 15 April 2008

English 3 Participants <35 years old with pa-

Hotel reservation deadline 3 10 May 2008

per accepted for oral presentation at Euroson 2008 can register to the con-

Final registration deadline

gress without payment of registration fee.

3 Meet the expert workshops 3 6 Postgraduate Courses 3 7 parallel sessions each day 3 All the information about the congress are available on the official website

www.euroson2008.ro

Future Euroson Congresses 3 XXIst EUROSON 2009 Congress in con-

3 XXIIIrd EUROSON 2011 Congress -

junction with BMUS (British Medical

Dreiländertreffen -

Ultrasound Society) - Edinburgh -

WFUMB 201–2011

December 2008 (Date to be decided)

August 2011 (Date to be decided)

3 XXIInd EUROSON 2010 Congress in conjunction with DSDU (Danish Society of diagnostic Ultrasound) Copenhagen - 22–25 August 2010

Ultraschall in Med 2008; 29

3 More than 100 international invited