2008-Issue02

EFSUMB Newsletter

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

Introduction In January the Publications Committee had their first meeting since new members were elected in October. The meeting was held in very untraditional and informal settings in Copenhagen, anyone familiar with Copenhagen and the part of town called Christiania will know what I mean by this. The Newsletter now differs from what it used to be and we hope you like it.

We hope to bring you up-to-date informa-

Michael Bachmann Nielsen entering a strange part of Copenhagen

tion about important issues in EFSUMB and also information from and about the member societies.

Stay tuned for the latest in ultrasound.

Michael Bachmann Nielsen

EFSUMB Calendar 31 May - 3 June 2008 EUROSON 2008 in Timisoara, Romania.

During EUROSON 2008 there will be: 5

Christoph Dietrich, Michael Bachmann Nielsen and Jeff Bamber in an even stranger place in Copenhagen

3 Executive Bureau meeting: Saturday 31 May 3 Education and Professional Standards Committee meeting: Saturday 31 May 2008 3 Board of Directors meeting: Sunday 1 June 2008 3 Safety Committee meeting: Monday 2 June 2008 3 Publications Committee meeting: Monday 2 June 2008

15 or 16 November 2008

Lucas Greiner in a typical Danish meeting room

The Publications Committee and the Education and Professional Standards Committee will have meetings in Rome during the national meeting of the SIUMB.

The Guidelines and Good Clinical Practice Recommendations for Contrast Enhanced Ultrasound (CEUS) Update for 2008 with accompanying appendices can be downloaded from www.efsumb.org

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News from the web The new exciting website of EFSUMB is now launched and has been updated with the latest information from the committees. Please note that the Safety Committee has its own microsite within the EFSUMB website with important information about the committee and its work.

The monthly new cases should be of interest for everyone. There are some excellent images and video clips to be found.

Please come back regularly to make sure you do not miss anything.

Professor Jean-Yves Meuwly will be the one who is responsible for the WebPages to be kept attractive and ever-changing, please send comments and suggestion to him (jean-yves.meuwly@chuv.ch), or to the Publications Committee (mbn@dadlnet.dk), or to the EFSUMB office (efsumb@ efsumb.org).

Michael Bachmann Nielsen

What has been done so far?

5 Multicenter studies using contrast enhanced ultrasound have been recently successfully published in the field of contrast enhanced techniques. The recently published EFSUMB-guidelines and recommendations summarise the data and provide general advice for the use of ultrasound contrast agents to improve the management of patients [Michel Claudon, David Cosgrove, Thomas Albrecht, Luigi Bolondi, Maurizio Bosio, Fabrizio Calliada, Jean-Michel Correas, Kassa Darge, Christoph Dietrich, Mirko D'Onofrio, David H Evans, Carlo Filice, Lucas Greiner, Kurt Jäger, Nico de Jong, Eddie Leen, Riccardo Lencioni, David Lindsell, Alberto Martegani, Stephen Meairs, Christian Nolsøe, Fabio Piscaglia, Paolo Ricci, Gunther Seidel, Bjoern Skjoldbye, Luigi Solbiati, Lars Thorelius, François Tranquart, Hans Peter Weskott, Tony Whittingham]. Italian multicenter trials have shown the very impressive advantages of local ablative treatment of malignant liver lesions in comparison to surgical strategies.

Case of the month February

Multicenter research trials Definition 5 The modified definition of multicenter research trials includes clinical trials conducted at more than one medical center, clinic or medical practice. The benefits of multicenter trials include a larger and therefore more representative number of participants, different geographic locatiUltraschall in Med 2008; 29

ons, the possibility to include a wider range of population groups, and the ability to compare results among centers. All these points increase the generalizability of the study. In many cases, efficacy will vary significantly between population groups with different genetic, environmental, and ethnic or cultural backgrounds ("demographic" factors); normally only geographically dispersed trials can properly evaluate this [modified to Wikipedia 2008].

Recently more than 1000 histological proven liver lesions have been prospectively examined by contrast enhanced ultrasound to characterize liver tumours by initiation of DEGUM and the convincing data have been submitted for publication.

A similar study has been performed in France as well. The power of the mentioned studies and many other similar activities are derived by the multicenter and sometime also interdisciplinary approach.

Other multicenter studies including different organ systems have been initiated so far, e.g. in the differentiation and differential diagnosis of pancreatic and splenic lesion, the lung and many other fields of contrast enhanced ultrasound and other techniques, e.g., Sonoelastography. Many

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successful multicenter studies have been initiated by individual researchers but ultrasound societies have also started to create a platform for the international community to collect, analyse and publish data. The EFSUMB platform might be particularly helpful for the smaller EFSUMBcommunities to point out their impressive expertise.

As the actual Honorary Secretary of EFSUMB I am eager to challenge the scientific ultrasound community to perform more multicentre and interdisciplinary studies in the upcoming years to increase the influence of ultrasound techniques in daily practice. We have to prove all together that ultrasound is effective (and also cost

effective!) under many circumstances, including the emergency room and other accesses to the hospital, in the out patients care setting and under many other circumstances.

In addition imaging features of very rare diseases can only be characterised by collecting data of many centres. Therefore, EFSUMB offers combined activities of small and large ultrasound societies. We started our section "The case of the month" at our website [http://www.efsumb.org] and cordially invite you to join the EFSUMB-activities.

Additionally we could create a communicating multicenter platform if challenged by our members coming from so many European countries. Collecting data could

also include very rare liver diseases (e.g., storage liver disease, echinococcosis), intestinal disease (e.g., intestinal tuberculosis) and many other rare and more common entities regarding different organ systems. Monitoring biological antitumour therapy strategies in the view of time intensity curve analysis and sonographic application of antitumour agents might be of special interest.

Please refer to EFSUMB and the Honorary Secretary for support and discussion.

Cordially, Christoph F. Dietrich, EFSUMB Honorary Secretary and member of the EFSUMB Publication Committee

Pictures from EFSUMB old office in Bromley and new office in Central London

Pictures from EFSUMB old office in Bromley

Pictures from EFSUMB new office in Central London

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EFSUMB Newsletter meets Croatia Facts: 5

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3 Largest cities: Zagreb 1.000,000 (capital and largest city); Split 300,000; Rijeka 300,000 3 Population 4.3 million 3 The Croatian Society of Ultrasound in Medicine and Biology joined EFSUMB in 1994 Prof Boris Brkljacic, Vice President of the Croatian Society of Ultrasound and Medicine and Biology

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3 Professor Boris Brkljacic, (BB) Vice President of the Croatian Society of Ultrasound and Medicine and Biology is interviewed

by Michael Bachmann Nielsen (MBN).

Croatia hosted the successful EUROSON meeting in 2004 in Zagreb. Croatia is one of the societies who have joined bulk subscription for Ultrasound in der Medizine/ European Journal of Ultrasound.

3 3 MBN: First of all thank you for volunteering for this interview; I have been looking forward to talk to you. Could you tell us a little bit about what you work with?

3 BB: I am a radiologist and chairman of the Radiology Department at the University Hospital Dubrava in Zagreb. Approximately half of my time is devoted to ultrasound examinations, mainly vascular ultrasound, breast and urogenital.

3 MBN: I really enjoyed my visit to Zagreb in 2004 for the EUROSON meeting which was very successful. I did have the feeling that there were more members than the 65 currently listed in EFSUMB's homepage.

3 BB: Well we used to be over 100 members, I think 110 was listed a couple of years ago. Then we introduced bulk subscription of Ultrasound in der Medizine/European Journal of Ultrasound Ultraschall in Med 2008; 29

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and also increased our membership fee from approximately 20 â‚Ź to 60 â‚Ź. Probably because of this the membership number fell. This was surprising because we think that Ultrasound in der Medizine/European Journal of Ultrasound is an excellent journal and I don't know if that was the entire reason why we lost so many members. We hope they will eventually come back. There are approximately 4 million citizens in Croatia so we should have a potential for a much larger membership number.

MBN: Apart from Ultrasound in der Medizine/European Journal of Ultrasound, what are the potential benefits for member of the Croatian Society; do you have newsletters, website, low fee for courses?

BB: We don't have a national newsletter since we now have the Ultrasound in der Medizine/European Journal of Ultrasound. At present we don't have a website, some information about how meetings can be found on the radiology website and on the website of the Medical Faculty. Being a member of the Society will give a reduced fee for our courses and our national congress.

MBN: Could you tell us about your national meetings?

BB: We have a bi-annual national meeting. In 2004 it was together with the EUROSON congress. In 2006 it was in Umag and this year it will be in Zagreb.

We hope to have between 120-150 participants. It is the national meeting of

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Croatia but we have a lot of participants from Slovenia and also several speakers from Slovenia.

MBN: I apologize for not knowing very much about Slavic languages, but are Croatia and Slovenian language similar?

BB: No it is not the same language. Croatian is actually very close to Serbian and Bosnian.

MBN: Could you tell something about your courses in ultrasound?

BB: I am personal involved in two annual 3 week courses on Doppler which is a mix of both the lectures and hands-on.

The course has run for almost 10 years.

The course is completed with a test. The gastroenterologists run a 4 weeks course in abdominal ultrasound and there are also courses in breast ultrasound and musculoskeletal ultrasound and others. It could also be arranged to have an individual based course coordinated by the medical faculty. For trainees in radiology, ultrasound is part of the curriculum. All the courses and certificates are under the auspices of Zagreb Medical School.

MBN: Your Society is probably multidisciplinary like in the rest of Europe?

BB: Yes, ultrasound is mostly performed by radiologist and gastroenterologists but also other specialities like cardiology and others are represented, probably like in most of Europe.

MBN: How is the health care system organized in Croatia?

BB: It is mostly financed by the state but because of increasing waiting lists private clinics are appearing like it is in many other countries.

MBN: Well thank you very much for taking your precious time to give this interview.

St. Mark Church of Zagreb

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EFSUMB Newsletter meets Latvia.

Facts: 5 3 Area: 64,589 km² 3 Capital (and largest city): Riga 3 Member state of European Union Dr Ilze Sedleniece, President of the Latvian Society

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3 3 since 2004 Dr Ilze Sedleniece (IS) President and Delegate of the Latvian Society is interviewed

by Michael Bachmann Nielsen (MBN), Editor of the EFSUMB Newsletter

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3 3 MBN: Could you start by telling your current position and how you use ultrasound in daily practice?

3 IS: Yes I am a radiologist. Recenly I moved from the Riga to a regional hospital 100 km from the capital, the city is called Valmiera. I work within all fields of diagnostic imaging also CT, MRI and mammography, but of course also a lot of ultrasound examinations.

3 MBN: The Latvian Society joined EFSUMB in 2004. Could you tell us a little bit of your Society and the number of members you have?

3 IS: I think we now have approximately 180 official members, which is the number of members that are also part of EFSUMB. We have some unofficial additional members who are only associated with our national Society, this sum up to approximately 300 members in total.

3 MBN: Do you think that is the correct number of doctors using ultrasound or could it be larger?

3 IS: Probably several more doctors use ultrasound and we hope that they will eventually join our Society. There are officially 2.3 million citizens in Latvia, when I say officially, it is because approximately 10% have moved to another country for economical reasons, a large number are in Ireland. Perhaps you

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have noticed that during the Eurovision song contest Ireland always give points to Latvia.

MBN: I know you have an official language, Latvian, but I would think that Russian is also spoken in your country?

IS: The official language is Latvian.

However, with one out of every 10 patients I see, I have to speak Russian. Doctors who work in the capital Riga meet more Russian patients - up to 40%.

MBN: So you speak several languages Razna Lake, the second largest in Latvia IS: Yes, personally I speak Latvian, Russian and English. I also speak a little of Swedish. I can read Swedish without problems and I have often translated from Swedish to Latvian.

MBN: Which medical specialities are represented within the Latvian ultrasound Society?

IS: Approximately half of them are radiologists and the rest are clinicians within different specialities.

MBN: Do you have any certification for performing ultrasound in Latvia or do you hold any courses?

IS: There are two centres that can provide certification for performing ultrasound in Latvia. There is a postgraduate course of either two or four months with a mix of lecture and supervised hands-on. After that you can go for a certificate after two years of clinical practice, where you have to pass an exam and afterwards you are approved by the government and by the radiological Society.

MBN: How about annual meetings and postgraduate courses?

IS: We have two annual meetings, each of one day and we have postgraduate courses, e.g., in Doppler.

MBN: How is the health care system in Latvia? Is it private or state financed?

IS: It is mostly provided by the state, there is a compulsory health insurance involving access to primary health care doctors and hospital for a standard patient payment which has been kept to a minimum. There are private health care clinics also, and they have contract with private insurance companies, but due to financial situation most of the patients goes through state clinics.

3 MBN: Do you have a web site for your Society or a newsletter?

3 IS: Currently we don't have a web site.

We have a newsletter we send out approximately four times a year to our members and, of course, we have the bulk subscription for Ultraschall in der Medizin/European Journal of Ultrasound 3 MBN: How do you think the future is for ultrasound in Latvia?

3 IS: It is looking good, treatment is getting better, level of equipment bought by health care companies increase, and doctors really care about education. Unfortunately there is a dramatically inflation rate of now 20% and the increase in salaries are of course lower.

3 MBN: It has been very nice talking to you and thank you very much for volunteering to give this interview and I am sure all the other EFSUMB countries will appreciate reading about your country and your Society.

Vidzemes slimnica - the Hospital in Valmiera

The latvian delegation in geneva during EUROSON 2005

Geneva is with an initial capital

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