2009-Issue01

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EFSUMB Newsletter

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

EFSUMB Officers and Committees

Editorial

Executive Bureau 2007-2009

Michael Bachmann Nielsen

officers and committees and information about the host cities for the next congress - Edinburgh hosts EUROSON in December and Sydney hosts the WFUMB congress in September. Also my friend Lucas Greiner will introduce you to a new word: sonopsychology.

Dear friends

If you still are eager to learn more about EFSUMB or perhaps take a look at the case of the month please do not hesitate to visit our website www.efsumb.org which we expect will grow considerably during 2009.

This issue of the Newsletter is just filled with information. We have interviews, training recommendations, reports from

Michael Bachmann Nielsen, EFSUMB Newsletter Editor Chairman of Publications Committee

Contents Editorial...............................................79

Report Education and Professional Standards Committee...........................86

EFSUMB Officers and Committees .........79

President: N Gritzmann (Austria) President Elect: C Nolsøe (Denmark) Past-President: D H Evans (UK) Honorary Secretary: C F Dietrich (Germany) 3 Honorary Treasurer: I Sporea (Romania) 3 3 3 3

ECMUS - European Committee for Medical Ultrasound Safety 3 Chairman: G ter Haar (UK) 3 Members: 3 M Delius (Germany) 3 L Doležal (Czech Republic) 3 C Kollmann (Austria) 3 K Salvesen (Norway) 3 L Valentin (Sweden) 3 Co-opted: A van Wamel (The Netherlands) 3 Ex-officio:D H Evans (UK)

Education and Professional Standards Committee 3 Chairman: O H Gilja (Norway) 3 Secretary: H Strunk (Germany) 3 Members: 3 F Drudi (Italy) 3 G Mathis (Austria) 3 J Tuma (Switzerland) 3 Co-opted: B Brkljacic (Croatia) 3 Ex-officio: C Nolsøe (Denmark)

Welcome to Edinburgh and EUROSON 2009.....................................81

Minimum Training Requirements for the Practice of Medica Ultrasound in Europe............................88 -Appendix 10: Cranial Ultrasound in Infants..............................................90 -Appendix 11: Thoracic Ultrasound.......91

EFSUMB Calendar.................................81

Report Publication Committee..............92

EFSUMB Newsletter meets ICUS The International Contrast Ultrasound Society ..............................82

Report Ultraschall in der Medizin /European Journal of Ultrasound...........92

EFSUMB Newsletter

Report ECMUS (Safety Committee).......93

Secretariat

EFSUMB Newsletter meets the United Kingdom...................................80

Thoughts of the President....................84 EUROSON 2010.....................................93 Report Honorary Secretary...................85 Sono-psychology..................................94 Report Honorary Treasurer..................86

Publications Committee 3 Chairman: M Bachmann Nielsen (Denmark) 3 Members: 3 J Bamber (UK) 3 L Greiner (Germany) 3 J Y Meuwly (Switzerland) 3 Ex officio: C Dietrich (Germany) 3 Editor: M Bachmann Nielsen (Denmark) 3 Mrs Gianna Stanford, EFSUMB General Secretary 36 Portland Place, London W1B 1LS, U K Email: efsumb@efsumb.org Website: www.efsumb.org

Welcome to Wfumb 2009 Sydney ........96

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EFSUMB Newsletter meets the United Kingdom Dr Grant Baxter

Grant Baxter was the President of British Medical Ultrasound Society (BMUS) from 2004 to 2006 and for the last two years he has been the delegate at EFSUMB. Interview by Professor Michael Bachmann Nielsen December 2008.

Grant is radiologist at The Western Infirmary in Glasgow; he has served the BMUS council since 1993. "I have always liked practical work, this was probably how I ended up being involved in ultrasound and guided intervention and when colour Doppler came around many years ago I started doing a lot of vascular examinations". Since that the organisation within radiology departments has changed from being modality based into being area based. "Nowadays my main work is within oncology and transplants."

BMUS - 40 years in ultrasound Originating in 1969 as an informal ultrasound group the society took its present name in 1977 when it became affiliated with the world federation WFUMB. BMUS is multidisciplinary and has approximately 2.500 members. Of these sonographers have the greatest number but there are also many radiologists and physicians.

The president of the society serves for 6 years: 2 year as President Elect, 2 years as President and 2 years as Past President. At the council meeting during the BMUS meeting in Liverpool in December 2008 Ms Julie Walton took over as President and the previous Honorary Secretary Colin Deane, a physicist from London, became President elect.

In the BMUS council six seats are reserved: two for medical doctors, two for physicians and two for sonographers, the rest of the seats any member can be elected. In Ultraschall in Med 2009; 30

3 Population:60 million 3 Area: 244.820 km2 3 Capital and largest city: London (7 million) 3 Area:1,579 km2 3 EFSUMB members:2,517 3 Host city for the next EUROSON Congress Edinburgh - Population 468,000 the current council the majority of medical doctors are radiologists. "Many clinicians tend to go to their own societies, but the BMUS is now encouraging them to come to BMUS meetings by having special topic sessions that can attract e.g., urologists, OB/GYN etc."

BMUS meetings and study days BMUS has its annual meeting in December. In 2008 it was in Liverpool and attracted 7-800 participants and had a scientific programme with 5 parallel sessions. The next annual meeting will be in Edinburgh in December 2009 and will be held together with the EUROSON meeting.

Apart from the annual meeting BMUS have 1-day courses, called BMUS Study Days. They are held between 6 and 8 each year. The topics from recent study days have been "Essential Ultrasound for Nephrologists", "Contrast ultrasound", "DVT", "Musculoskeletal Ultrasound" and upcoming events are gynaecological as well as obstetric ultrasound. For more details please visit www.bmus.org.

Generally 60-80 people attend the BMUS Study Days but often many more. The meetings are not arranged according to the three levels of competences described in EFSUMB, instead they focus on a specific topic.

Training in ultrasound in the UK Radiologists have their own training programme decided by the Royal College of Radiologists (www.rcr.ac.uk). "It takes 5 years to complete the training programme and after that you are eligible for consultant ship. You have to pass an exam between the 3rd and 4th year, this exam is in all imaging modalities and topics. Sonographers have their own training programme, which takes 2 years to complete.

After this some will continue with a MSc project. Also some physicists will be involved in patient examinations, mainly vascular Doppler and there are training programmes for them also".

Website and official journal The BMUS Newsletter is electronic and available at the website. "Ultrasound" the official BMUS journal is published quarterly. "The journal which used to be called The BMUS bulletin has now changed into being a scientific journal and we are still hoping to be approved for impact factor." It publishes a mixture of review articles, current research, and descriptions of new techniques and equipment.

The Editor is Dr. Emma Chung from Leicester.

Welcome to Edinburgh - everyone is invited to wear a kilt In December 2009 BMUS will host the EUROSON meeting for the second time in Edinburgh. "Edinburgh is a great city; it's a fantastic tourist city and has a fantastic conference centre."

The meeting starts on Sunday the 6th of December. "We hope many participants and delegates will take the opportunity to arrive early in the weekend to enjoy the historical city which is particularly beautiful in the Christmas time" "We will do our best to make a first class programme both scientifically and socially. There will be traditional dance and dinners, and everyone is invited to wear a kilt if they want to. It is also the only change for a man to wear a skirt and look smart," Grant Baxter says with a smile.

The website for the meeting www.euroson2009.org is now online greeting you with "FĂ ilte gu DĂšn Eideann - Welcome to Edinburgh".

Dr Grant in a kilt

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EFSUMB Newsletter Edinburgh Panorama

Welcome to Edinburgh and Euroson 2009

The Edinburgh International Conference Centre, the venue for Euroson 2009, is a large, state of the art facility in the city centre close to many shops, hotels and restaurants.

Edinburgh Castle the best known and most visited tourist attraction in the Scottish capital. Visitors can also gain panoramic views over the city and the Firth of Forth. Royal apartments and the ancient Honours of Scotland - Crown, Sceptre and Sword of State - can all be viewed.

Palace of Holyroodhouse the Queen's official residence in Scotland nestles at the foot of Arthur's Seat and Salisbury Crags.

The extinct volcano is a favourite of tourists, providing views of the city and the Kingdom of Fife and East Lothian.

National Gallery the oldest of the city's five galleries, it is home to Scotland's greatest collection of European paintings and sculpture, from the Renaissance to postimpressionism.

Winter Wonderland in winter the city is also a special place to be as Princes Street Gardens become a Winter Wonderland. With an ice rink, German market and a big wheel, the Wonderland is one of the most popular attractions in December.

Ceilidh traditional Scottish entertainment with live music and flamboyant dancing. Come along to the conference Ceilidh and experience a Celtic party at its very best! It is a night to remember.

Numerous restaurants across the city serve traditional Scottish food, while a number of familiar chains also cater for the less-adventurous. It is often claimed that Edinburgh has more restaurants per capita than London and a brief stroll around its myriad of cobbled streets and back alleys make this a tough claim to disprove.

Please do join us in Edinburgh in December 2009 for Euroson, where you can enjoy some Scottish entertainment and be sure of a great Scottish welcome.

Website: www.euroson2009.org

Winter wonderland night in Edinburgh

The city is alive with activities and attractions throughout the entire year. It is a perfect destination for a weekend of both cultural and retail occupation. Rich in history, visitors to the city will find places to explore literally around every corner: -

Shopping Edinburgh is increasingly becoming a shopper's paradise; all budgets are catered for, from the high street stores on Princes Street to the more upmarket stores on the elegant George Street. The arrival of Harvey Nicholls, has cemented the city's reputation as one of the UK's best shopping cities.

Shopping in Princess Street

The host city, Edinburgh, is a thriving, dynamic city with every modern amenity, as well as many fine historic buildings. It has been the capital of Scotland since 1437 and is the seat of the Scottish Parliament.

The Old Town and New Town districts of Edinburgh were listed as a UNESCO World Heritage Site in 1995 with over 4,500 listed buildings within the city.

Pipers and Edinburgh Castle

Euroson 2009 will be a great opportunity to see and hear the latest in ultrasound technology, clinical applications and practice, through our programme of expert reviews, research sessions and technical exhibition. You can also enhance your practical knowledge and skills through our extended programme of hands-on workshops and training sessions. We will again be working closely with all major manufacturers to provide the latest equipment to delegates, as well as our traditional technical exhibition.

EFSUMB Calendar EUROSONS, EUROSON Schools and WFUMB Meetings 3 3 3 3 3 3 3 3 3

6 - 8 December 2009 - EUROSON Congress in Edinburgh, UK 15 May 2009 - Contrast Enhanced Ultrasound. Bucharest, Romania 22-23 May 2009 - Thoracic and Small Parts Ultrasound. Kosice, Slovakia 30 August - 3 September 2009. WFUMB Congress. Sydney, Australia 17-19 September 2009 - EUROSON School Contrast Enhanced Ultrasound In Liver, Biliary, Pancreatic And Gastrointestinal Disease. Bologna, Italy 15-18 October 2009 - EUROSON School Vascular Ultrasonography. Opatije, Croatia 13-14 November 2009 - EUROSON School Doppler and CEUS Ultrasound. Kosice, Slovakia 27-29 November 2009 - EUROSON School CEUS. Hannover, Germany 21-25 August 2010 - EUROSON Congress in Copenhagen, Denmark

Committee Meetings in 2009 3 3 3 3

21 March 2009 ExB Meeting in Palma 23- 24 March ECMUS Committee Meeting in France 19 June 2009 Education Committee Meeting in London 29 May 2009 Publication Committee Meeting in Lausanne

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EFSUMB Newsletter meets ICUS -The International Contrast Ultrasound Society New International Contrast Ultrasound Society (ICUS) founding member and CoPresident, Dr. Steven Feinstein, interviewed by Professor Michael Bachmann Nielsen December 2008.

Steven Feinstein is a cardiologist specializing in prevention and noninvasive diagnosis of cardiovascular abnormalities.

He also serves as director of the echocardiography laboratory at Rush University Medical Center in Chicago. Dr. Feinstein has worked in the contrast-enhanced ultrasound (CEUS) field for approximately 26 years and developed the first two FDAapproved ultrasound contrast agents, Albunex and Optison. He currently coordinates international research teams using CEUS to investigate vessel wall biology and identify early CV disease using surrogate markers of atherosclerosis, including myocardial perfusion, carotid IMT, and neovascularization (intra-plaque and adventitial vasa vasorum).

ciated with cumulative radiation, radionuclides or iodinated X-ray contrast agents. By enhancing ultrasound images, CEUS often helps pinpoint medical abnormalities with greater accuracy and with superior spatial and temporal resolution.

CEUS also helps some patients avoid unnecessary, potentially riskier downstream testing. "

FDA restrictions created the need for ICUS "The need for ICUS was first recognized last fall (2007), in the wake of the FDA's decision to impose new restrictions on the use of CEUS agents. Those new restrictions were largely reversed a few months later, in large part due to the emergence of a multi-specialty international grassroots movement that collaborated with industry and other professional societies. This collaboration produced powerful new safety data that were persuasive to the FDA and resulted in the reversal of most of the new restrictions."

The idea behind ICUS The International Contrast Ultrasound Society (ICUS; www.icus-society.org) is the only international multi-disciplinary medical society that is exclusively focused on the use of CEUS to improve patient care worldwide. "ICUS brings together physicians, scientists, and other ultrasound imaging professionals from around the world, representing such diverse specialties as cardiology, radiology, vascular imaging, gastro-intestinal imaging, oncology, OBGYN, hepatology, etc. ICUS members are committed to working together across geographical and medical boundaries in order to help expand CEUS applications and improve the diagnoses of diverse clinical abnormalities. The organization also intends to be a strong, scientifically-principled voice for the field."

"Soon, it became clear that the CEUS field needed a strong and focused voice and to compliment the efforts of existing organizations worldwide. The grassroots movement grew into ICUS, and in a few short months the organization has garnered members in 25 countries worldwide and established its own newsletter and website (www.ICUS-Society.com), which foster communication about CEUS across continents and professional disciplines."

ICUS meetings and educational/regulatory outreach

Advantages of CEUS - safety, accuracy, lower cost

ICUS is organizing an international congress in Chicago October 21-23, 2009 (www.bubbleconference.com), and is developing plans to help educate regulatory officials, payors, the public and colleagues regarding the clinical value and benefits of using CEUS to improve the diagnostic accuracy across varied medical specialties.

"ICUS members are committed to the expansion of CEUS because contrast-enhanced ultrasound often provides a safer, more accurate, and more cost efficient diagnostic exam than other imaging systems. In particular, ultrasound contrast agents do not have the side effects asso-

The first ICUS international congress will correspond with the 24th Annual Advances in Ultrasound-ICUS meeting. The ICUS organization was launched in September at the 23rd Annual Advances in Ultrasound meeting.

Ultraschall in Med 2009; 30

Members of ICUS Executive Board are pictured just after the organization's launch. Top row: Brian Fowlkes, Fuminori Moriyasu, Maria Cristina Chammas, Stephanie Wilson, Petros Nihoyannopoulos, Michael Main. Bottom Row: Lennard Greenbaum, Paul Grayburn, David Cosgrove, Steven Feinstein, Barry Goldberg.

Not pictured: Kurt Jaeger, Shintaro Beppu, Mark Monaghan, Wilson Mathias,

ICUS also would like to arrange a session during the WFUBM meeting in Sydney in 2009 devoted to the new organization's mission and advances in the field.

International guidelines EFSUMB has published its recommendations for the use of ultrasound contrast agents, can we expect the same from ICUS? "Yes, as one of our first initiatives we plan to prepare a guideline that focuses on quality assurance and accreditation issues for physicians and sonographers in echocardiography laboratories, with a specific focus on the appropriate use of ultrasound contrast agents for cardiac chamber enhancement.

Contrast agents in the US Optison and Definity have been approved in the United States for use in cardiac indications since 1997 and 2001, respectively. Other contrast agents are undergoing clinical trials aimed at gaining FDA approval for other clinical indications (e.g., SonoVue/Bracco, and Imagify/ Acusphere).

Relation to other societies "Although ICUS is an independent organization, it seeks collaborative and liaison relationships with other medical societies, WFUBM included."

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No fee for ICUS membership or newsletter ICUS membership is free, and its newsletter and informational updates are distributed to members via email at no cost.

Anyone with an interest in the contrastenhanced ultrasound field may join the new organization by visiting the ICUS website (www.ICUS-society.org) and signing up for membership.

Volunteer board, pro bono assistance from law firm ICUS is run by an all-volunteer board of directors, committees and liaisons with other professional societies. They include the world's experts in the field of contrastenhanced ultrasound, and represent diverse medical specialties and geographic regions. (Their names follow at the end of this article.)

with public policy, regulatory strategies, health care issues, communications, and corporate and organizational matters, and recently hosted the first ICUS industry roundtable in the firm's Sears Tower/Chicago offices.

Founding sponsorships, volunteers sought ICUS plans to solicit founding sponsorships and financial support from industry to assist with operational costs and the cost of sponsoring the annual ICUS international congress ("www.bubbleconference.com"). ICUS also welcomes volunteers for its committees and liaison positions. To contribute or volunteer, please contact the ICUS Co-Presidents (stevebfeinstein@aol.com; barry.goldberg@jefferson.edu).

ICUS Officers and Directors In addition, ICUS receives pro bono (i.e., free) assistance from the law firm of Sonnenschein Nath & Rosenthal LLP, an international firm with offices in numerous cities throughout the United States and Europe. Through its pro bono program, Sonnenschein contributes attorney and staff time and other firm resources to select organizations that serve the public interest.

Sonnenschein added ICUS to its list of pro bono clients in 2008 and the law firm's strategic communications group now produces the ICUS newsletter, website, and a weekly email blast with CEUS news summaries. Other Sonnenschein attorneys and staff members also assist ICUS

3 Directors: Shintaro Beppu, Osaka (Japan), Cristina Chammas, Sao Paolo (Brazil), David Cosgrove, London (UK), Brian Fowlkes, Ann Arbor, MI (US), Paul Grayburn, Dallas (US), Wilson Mathias, Jr., Sao Paolo (Brazil), Mark Monaghan, London (UK), Fuminori Moriyasu, Tokyo (Japan)

3 Co-Presidents: Steven Feinstein, Chicago (US), Barry Goldberg, Philadelphia (US) 3 Vice Presidents: Kurt Jaeger, Basel (Switzerland), Petros Nihoyannopoulos, London (UK) Stephanie Wilson, Calgary (Canada) 3 Secretary: Lennard Greenbaum, Oviedo, FL (US), 3 Treasurer: Michael Main, Kansas City (US)

The annual ICUS "bubble conference" in Chicago offers numerous opportunities to exchange information, test ideas, build collaborations and socialize. The 2008 conference also provided opportunities to celebrate the launch of ICUS. Pictured here are ICUS members Petros Nihoyannopoulos (London), David Cosgrove (London), Lennard Greenbaum (Florida), Steven Feinstein (Chicago), and Francesco Pizzuto (Rome)

www.thieme.de Noch mehr Auswahl.

Noch mehr Neues.

Noch mehr Infos.

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Norbert Gritzmann

Thoughts of the President Despite the worldwide financial crisis EFSUMB looks back to a successful year.

5

hope that we can continue with this success and EFSUMB will support the journal whenever possible.

Last year the office of EFSUMB has moved from Bromley at the periphery of London to the centre of London. We have rented an office from the British Institute of Radiology at a reasonable price and I want to thank David Evans for his successful negotiations with BIR.

Another major event was the presentation of the new version of the guidelines for contrast enhanced sonography in the first issue of UiM/EJU by the EFSUMB study group for USCA. It was decided to re-evaluate the guidelines at least every three years. President elect Christian Nolsøe will steer this group.

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.

At the end of May Euroson 2008 was held in Timisoara in the western part of Romania. With a total number of more than 2000 participants this congress which was held in conjunction with the meeting of the Romanian Ultrasound society was a tremendous success. Ioan Sporea and his team really organised a remarkable event.

I want to thank him and all of his team for doing such a great and successful job.

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. We all were impressed be the generous hospitality of the Romanian organisers. Both the Romanian ultrasound society and EFSUMB have supported young authors. To encourage young scientists to present innovative papers the congress fee was waived for all accepted first authors below 35years.

Another big success 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 2.3, the highest number for a multidisciplinary ultrasound journal. I really

Ultraschall in Med 2009; 30

President of EFSUMB

The style of the newsletter and the homepage of EFSUMB have changed and a case of the month was introduced in the EFSUMB website. This all has been often visited by our members. Michael Bachmann from Denmark takes care of this important publication and communication medium. Michael also chairs the Publication committee.

The next Euroson congress will be held in conjunction with the British Medical Ultrasound Society in Edinburgh from 6th9th of December 2009 . I am sure that we are going to organise an interesting congress with educational and scientific highlights. I want to encourage all groups to present their new results and to present high quality education sessions at Euroson 2009. Again EFSUMB wants to support young scientists to present their papers by reducing or waiving their congress fee and by the young investigators award at the Euroson congress.

One important goal will be to optimise the communication with our members, so the National Societies are asked to provide email addresses of all their members. EFSUMB offers a membership certificate to all the member of the National Societies each year. On demand each national society can obtain a bulk supply of personalised certificates for all their members.

Another important task is the replacement of our General secretary Gianna Stanford. She will retire after the Edinburgh congress. Therefore we have to search a person with really multitasking abilities. It is well known that Gianna did an excellent job and that she did much more for our society that could be expected.

EFSUMB introduced a new series of Euroson schools regarding contrast enhanced ultrasound. H.P. Weskott organised the first course of this series in Hannover. This high end educational course proved to be a big success with more than 80 participants. This new type of courses is supported by Bracco.

Building up a European Ultrasound Community is a very important task for all of us and we try to do our best in promoting science and education.

The Education and Professional Standards committee was very active last year so that guidelines and recommendations for education in nearly all areas of ultrasound have been published.

The continuous work of the safety committee (ECMUS) reviewing the literature regarding safety aspects of ultrasound is of significant importance to all of us using this useful and safe technique. However since new techniques like contrast techniques are spreading into daily routine, we have to be even more alert to potential side effects.

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

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

EUROSON 2009 Abstract submission deadline 21 August 2009

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Christoph F. Dietrich Honorary Secretary EFSUMB

Report Honorary Secretary The task of the Honorary Secretary was both satisfying and challenging in the last period especially to keep in touch with the member national societies. I worked with friends of the Executive Bureau, the Board of Directors, and the various EFSUMB committees (being also a member of the Publication Committee), and with individual members of the member societies.

The importance of our multinational watchdog group on ultrasound safety and the more and more important role of our education and publication committees have to be highlighted.

The good relationship to the industry was also strengthened as partners for improved patients care and innovative technology.

Development of Membership

As a whole, EFSUMB is a flourishing enterprise with actually 19804 members, with the following distribution Austria

790

Belgium

241

Bulgaria

135

Croatia

32

Czech Rep

45

Denmark

573

Finland

331

France Germany Greece Hungary

291 7212 285 48

Israel

111

Italy

2095

Latvia Macedonia Moldova Netherlands

158 11 281 242

Poland

276

Portugal

70

Romania

560

Russia

266 30

Slovenia

128

Spain

180

Sweden Switzerland Turkey UK total

On behalf the Executive Bureau, we kindly ask (again and again) all members as a whole and especially the secretaries of each national society to provide us with active email member addresses.

Finally, a society as well as a federation is as much alive as are its members - so please do not hesitate to communicate with us (www.efsumb.org).

Moldova a new member society Applications for membership of the EFSUMB family were approved by the Board of Directors from the Moldova Society who faced a friendly and warm welcome.

20th EUROSON Congress in Timisoara, Romania (31st May - 3rd June) Since the very successful EUROSON congress in Timisoara organised by Prof. Ioan Sporea and Dr. Alina Popescu with the Board of Directors (BoD) meeting there was quite a lot of work to be done which will be discussed shortly.

Executive Bureau (ExB) meeting in Leicester The recent Executive Bureau (ExB) meeting was in Leicester, organised by Prof.

David Evans. Good news was reported by the organisers of the BMUS meeting in Edinburgh 2009 who presented their well advanced status quo. The ExB expressed their willingness to strengthen the identity of EFSUMB and to encourage you to actively participate in our society.

activities with Gianna Stanford, our well known Secretary better known as the heart and soul of EFSUMB.

Newsletter Michael Bachman and his team from the publication committee worked hard on interesting topics. One of these new topics is the interview with one of our member societies.

European Journal of Ultrasound (Ultraschall): Impact Factor 2.3 The Impact Factor of our European Journal of Ultrasound (Ultraschall) has reached 2.3. Congratulation to all researchers who participated in this success story and to the Editors and Reviewers.

Improved website The website improved over the last year significantly. Be curious and hit on www.efsumb.org.

Case of the Month The case of the month on the EFSUMB website (http://www.efsumb.org) was implemented some month ago. About 10.000 EFSUMB-website visitors have hit so far this new modality. Please feel free to submit "your image (or technique) of the month" to christoph.dietrich@ckbm.de.

The revised EFSUMB guidelines on the use of Ultrasonic Contrast Agents were published in the 1st edition of Ultraschall in 2008 (Claudon et al, Ultraschall in Med 29: 28-44, 2008).

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Norway

Slovak Rep

Some national societies, however, develop better than others with respect to their number of individual members, their scientific and educational activities and their representation within EFSUMB.

115 2649 252 2316

EFSUMB General Secretary, new Office EFSUMB new office is now situated in central London [EFSUMB General Secretary, 36 Portland Place, London W1B 1LS, Tel: +44(0)207 0997140; Fax: +44 (0) 207 436 7934. Email: efsumb@efsumb.org] in the same building as BMUS is located. The Honorary Secretary had the opportunity to visit this exciting place in the heart of London to discuss and prepare future EFSUMB

The revised EFSUMB guidelines 2008 on the use of Ultrasonic Contrast Agents were published in the 1st edition of Ultraschall in 2008 (Ultraschall in Med 29: 28-44, 2008).

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

19804

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clinical trials and experience of many active members of the EFSUMB to improve the management of patients.

Scientific corner The initiation of European multicenter trials or at least a discussion forum is another goal. The EFSUMB-platform might be particularly helpful for the individual member to find participants of their ideas. For example 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.

EUROSON School on CEUS EUROSON SCHOOLSs on CEUS have been implemented in 2008. Dr. Weskott welcomed to a successful course in Hannover.

Many colleagues could not participated due to the early completed course but future courses will be offered in many countries all over Europe (please contact our website www.efsumb.org). Please also note the website announcements for actual and future activities including the EUROSON School and do not hesitate to contact EFSUMB for comments, considerations and improvements.

Turning now to the future, we have the EUROSON 2009 in Edinburgh (6th of December - 9th of December, deadline of abstract submission 21st August 2009: and WFSUMB meeting in Sydney 2009 (30th of August- 3rd of September, deadline of abstract submission: Friday 23 January 2009), please submit your papers. I hope that many of you will be able to join us at one or all of these exciting venues.

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

The future still looks bright.

Cordially, Christoph F. Dietrich Honorary Secretary EFSUMB Email: christoph.dietrich@ckbm.de

EUROSON 2009 Abstract submission deadline 21 August 2009

Ultraschall in Med 2009; 30

Ioan Sporea Honorary Treasurer EFSUMB

Report Honorary Treasurer In my position of Honorary Treasurer, I shall present the EFSUMB financial report on 2008.

The financial results of 2008 show positive balance. This means that, like in the previous years, EFSUMB had had a good financial status.

The most important financial support arrived from membership fees, and I believe that is very important to try to maintain or to increase the number of members of EFSUMB. Despite the fact that some countries paid very late and with difficulty the membership fee, the number of paying members remained above 19,000.

We received 10% of the surplus from the last two Eurosons: 2007 Leipzig, Germany and 2008 Timi?oara, Romania, this means more than 10,000 Euro and represents a measurement of the financial success of these last two European meetings of ultrasound.

Concerning the expenditures, the new contract with Thieme, signed this year for EJU in quite good terms, maintains the expenses stable. The same situation is with WFUMB Membership. The expenses of ExB and different Committees are kept under balance.

Concerning the Budget of 2009, it was created in order to maintain the financial stability of EFSUMB, especially in a period of future difficulties in the economical and financial world.

Ioan Sporea Honorary Treasurer EFSUMB

Report Education and Professional Standard Committee Odd Helge Gilja Chairman EPSC

Dear ultrasound friend, In November I had the great pleasure to meet some of you at our first Euroson School on CEUS in Hanover. Under the excellent auspices of Dr. Weskott, about 75 participants experienced a successful postgraduate course with many state-of the-art lectures by experts from all over the world. There was broadcasting from Japan, USA and China to the audience with the possibility for online discussions with the speakers on the other side of the globe.

Dedicated hands-on sessions enabled close insight to the different manufacturers' tools for CEUS scanning. Some of the lectures are soon to be published on the web, so stay tuned on the EFSUMB web site (www.efsumb.org). I extend my sincere gratefulness to Dr Weskott and his local team for all the efforts they made to make this Euroson School a great success.

Euroson Schools The Education and Professional Standards Committee has as one of its main tasks to promote more Euroson Schools to be arranged throughout Europe. We have made a dedicated "start package", that can be downloaded from our website, to help new organisers of Euroson Schools getting started. Furthermore, as Europe is a leading force in clinical applications of CEUS, we are planning to arrange regular Euroson Schools on the subject of CEUS. We have now made a formal agreement with Bracco, securing practical and financial support for the CEUS courses in the future.

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EFSUMB Newsletter Upcoming Euroson Schools

It is a great pleasure for me to announce that 6 Euroson Schools are scheduled for 2009, of which 3 are dedicated for CEUS. These post-graduate courses are excellent opportunities for you to update you competence in many fields of Ultrasonography.

15 May

Title

Information/Contact

City, Country

Contrast Enhanced Ultrasound

SRUMB Secretariat

Bucurest, Romania

Email: isporea@umft.ro 22-23 May

Thoracic and Small Parts Ultrasound

Prof Jan Tuma and Prof Gebhard

Kosice, Slovakia

Mathis, Email: jan.tuma@hin.ch 17-19 September

Euroson School International

Dr Fabio Piscaglia, Bologna, Italy

Course In: Contrast Enhanced Ultra-

Email: Piscagl@med.unibo.it

Bologna, Italy

sound In Liver, Biliary, Pancreatic And Gastrointestinal Disease 15-18 October

IV Central European Vascular Forum

Prof. Dr. Boris Brkljacic, Zagreb,

International Educational Course

Croatia

and VI Adriatic Vascular Ultrasound

e-mail: boris. brkljacic@zg.t.-com.hr

Society Meeting about Vascular Ul-

Website meeting:www.novacon.hr

Opatija, Croatia,

trasonography 13-14 November

Doppler and CEUS Ultrasound

Prof Jan Tuma, Uster, Switzerland,

Kosice, Slovakia

Email: jan.tuma@hin.ch 27-29 November

CEUS

Dr. Hans Peter Weskott, Hannover,

Hanover, Germany

Germany. Email: weskotthp@t-online.de

Status of the Minimum Training Recommendations for the Practice of Medical Ultrasound in Europe The different guidelines and recommendations can be viewed online at the EFSUMB website. The minimum training recommendations on thoracic ultrasound was recently published on the web and more are to follow. The EPS Committee has decided also to have Minimum Training requirements on CEUS, including TIPS AND TRICKS to improve scanning.

This new committee is chaired by HP Weskott and is co-chaired by L Thorelius.

EFSUMB continuously works to expand our website with educational material.

We would like to invite you to send interesting ultrasound cases that can be published on the website. At the next EUROSON meeting in Edinburgh, the EPS Committee is planning to hold a session "Ultrasound on the Web", in which overview of ultrasound web resources will be given and also practical hints on how to design and publish ultrasound cases.

Dr Weskott from Germany holding the microphone for Dr Nolsøe from Denmark who is talking to Prof Burns from Canada, on the phone from Japan.

See you there!

Prof. Odd Helge Gilja Chairman EPSC Email:odd.gilja@helse-bergen.no

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Minimum Training Recommendations for the Practice of Medical Ultrasound in Europe The 2 latest additions to the list of minimum training recommendations are published on the following pages. All 12 appendices are available at www.efsumb.org

Appendix 10: Cranial Ultrasound in Infants 5 This syllabus is designed to include the whole of cranial ultrasound imaging in infants, not just the ultrasound skills needed on a neonatal intensive care unit. It does not include spinal ultrasound imaging.

Level 1: Training and Practice 3 Practical training should involve at least one session per week over a period of no less than 3 months, with approximately five scans per session performed by the trainee (under supervision of an experienced practitioner).

3 By the end of Level 1 training the trainee should be able to recognise all main pathologies that need urgent assessment on a neonatal intensive care unit.

3 Different trainees will acquire the necessary skills at different rates, and the end point of the training program should be judged by assessment of competencies, rather than by numbers of scans performed alone. As a guide, a minimum of 200 scans should be undertaken if this is the first practical training module undertaken. For those who are already competent at ultrasound in other body areas a reduced number of scans may be needed to achieve competency.

3 Examinations should encompass all pathological conditions listed below.

3 A logbook listing the types of examinations undertaken should be kept.

3 An additional portfolio containing an illustrated description of 20 cases with which the trainee has been personally involved is a useful record of performance and achievement and a useful educational aid.

3 Training should be supervised either by a practitioner who has obtained at least Level 2 competence in cranial ultrasound, or by a Level 1 practitioner with at least 2 years' experience of Level 1 practice.

Ultraschall in Med 2009; 30

3 Trainees should attend an appropriate theoretical course and should read appropriate textbooks and literature.

3 During the course of training the competency assessment sheet should be completed as this will determine in which area or areas the trainee can practise independently

Level 1: Knowledge Base 3 "Physics and technology, ultrasound techniques and administration (see Appendix 1) 3 "Issues of parental information and consent.

3 "Sectional and ultrasonic anatomy of the brain: 3 Sagittal anatomy 3 coronal anatomy 3 basic transfontanal and near-field scanning 3 Pathology in relation to ultrasound: 3 intracranial haemorrhage 3 hypoxic ischaemic change (in full term and premature infants) 3 ventricular dilatation 3 common congenital malformations

Level 1: Competencies to be acquired 3 To be able to: 3 perform a thorough ultrasound examination of the brain in different scan planes 3 recognise normal anatomy, common normal variants and varying appearances of normal anatomy with gestational age 3 recognise varying presentations of pathological processes with gestational and post-natal age 3 measure ventricular size and assess variation from normality 3 assess obstructive hydrocephalus and monitor progression 3 and describe intracranial haemorrhage and assess its extent 3 recognise common congenital malformations and refer for appropriate further investigation 3 recognise when other imaging modalities are more appropriate than ultrasound 3 recognise abnormalities which need referral for scanning by a more experienced practitioner and/

3 or further investigation 3 To be able to use ultrasound in the assessment of patients presenting with: 3 prematurity 3 fits/apnoea/collapse 3 meningitis 3 hydrocephalus 3 asphyxia (full term and premature) 3 other congenital abnormalities

Level 2: Training and Practice 3 ractical training should involve at least 1 year of experience at Level 1 with a minimum of one session per week.

3 A significant number of further examinations should have been undertaken sufficient to encompass thefull range of conditions and procedures referred to below.

3 A logbook of all examinations undertaken should be kept.

3 Supervision of training should be by a practitioner who has achieved at least Level 2 competence in cranial ultrasound, has had at least 2 years' experience at that level, and who would normally be of a consultant or independent practitioner status.

3 A Level 2 practitioner will be able to accept referrals from Level 1 practitioners.

Level 2: Knowledge Base 3 Sectional and ultrasonic anatomy 3 Cerebellum and posterior fossa structures 3 the basic use of Doppler ultrasound, including spectral, colour and power Doppler 3 further applications of cranial ultrasound 3 use of trans-axial ultrasound 3 assessment of cerebral perfusion 3 Pathology in relation to ultrasound 3 an understanding of the role of ultrasound in the context of cerebral asphyxia, abnormal head circumference, congenital abnormalities, non accidental injury and systemic disease

Level 2: Competencies to be acquired 3 Competencies will have been gained during training for Level 1 practice, and then refined during a period of practice.

3 Vascular studies in asphyxia.

3 Role of ultrasound in the assessment of abnormal head circumference 3 Recognition of most identifiable congenital brain malformations.

3 Further assessment of antenatally suspected anomalies.

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3 Identification and location of surface collections.

3 Appearances of non-accidental injury and the limitations of ultrasound assessment.

3 Intra-operative ultrasound as appropriate.

3 Infants with systemic disease (e.g., post-operative or paediatric intensive care).

3 Competency in reporting results and communicating them to the clinical teams in an appropriate way

Level 3: Training and Practice 3 A Level 3 practitioner is likely to spend a significant proportion of his or her time undertaking cranial ultrasound, teaching, research and development and will be an 'expert' in this area.

3 Practical training should involve at least 2 years of experience at Level 2.

3 He or she will accept tertiary referrals from Level 1 and " practitioners and will perform specialised examinations.

Maintenance of skills: All Levels 3 Having been assessed as competent to practice at Level 1, there will be a need for maintenance of practical skills, by continuing to perform regular ultrasound and update skills. Such further ultrasound practice may be intermittent, but no more that 3 months should elapse without the trainee using his ultrasound skills and sufficient examinations should be performed per year to maintain competency.

3 In independent practice, a medical practitioner scanning at level 1 should continue to perform at least 100 examinations per year should have regular meetings with imaging colleagues and should have a designated ultrasound practitioner of Level 2 experience or above designated as their mentor.

3 Practitioners should: 3 Include ultrasound in their ongoing CME 3 Audit their practice 3 Participate in multidisciplinary meetings 3 Keep up to date with relevant literature (q Tab: Appendix 10, see page XX)

Appendix 11: Thoracic Ultrasound 5 This curriculum is intended for clinicians who perform diagnostic and therapeutic thoracic ultrasound. It includes standards

for theoretical knowledge and practical skills. At least level 1 competence should be obtained by anyone performing thoracic scans unsupervised

Level 1 3 It is recommended that the trainee should observe 25 thoracic ultrasound examinations and perform (under supervision) at least 100 examinations on normal patients, 50 ultrasound examinations on patients with pleural effusions and 25 thoracocenteses 3 A minimum of 200 examinations in total are required to acquire the necessary skills; the end point of the training programme should be judged by an assessment of competencies 3 Examinations should encompass the full range of pathological conditions listed below.

3 A logbook listing the types of examinations undertaken should be kept.

3 Training should be supervised either by someone who has obtained at least Level 2 competence in thoracic ultrasound or by a Level 1 practitioner with at least 2 years' experience of Level 1 practice.

3 Trainees should attend an appropriate theoretical course (at least 15 hrs) and should read appropriate textbooks and literature.

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

Knowledge Base Physics and technology, ultrasound techniques and administration Approaches to: 3 3 3 3

chest wall pleural space lung (direct intercostal, abdominal) mediastinum ( suprasternal, right and left parasternal, posterior paravertebral, supraclavicular, subcostal - approaches)

Sectional and ultrasonic anatomy 3 right and left hemidiaphragms 3 heart 3 superior and anterior mediastinum (with great vessels and oesophagus) 3 liver and spleen 3 chest wall 3 supraclavicular region 3 rib and intercostal spaces

Pathology in relation to ultrasound 3 pleural effusion 3 pleural thickening

3 pneumothorax 3 chest wall abnormalities 3 detection of pulmonary lung consolidation ( inflammation, atelectasis, embolism, neoplasm) 3 paralysed hemidiaphragm 3 pericardial effusion

Competencies to be Acquired To be able to: 3 Recognize the normal anatomy of pleura and diaphragm 3 Identify the heart, great mediastinum vessels, liver and spleen 3 Recognize pleural effusion, including the different echogenic patterns 3 Recognize pleural thickening and its differentiation from pleural fluid 3 Detection of pulmonary consolidation (inflammation, atelectasis, embolism, neoplasm) 3 Estimate the quantity of pleural fluid 3 Perform guided thoracocentesis

Level 2 3 Practical training should involve at least 1 year of experience at Level 1 with a minimum of two examinations performed per week.

3 A further 300 examinations should be undertaken in order to encompass the full range of conditions and procedures listed below.

3 Supervision of training should be undertaken by someone who has achieved at least Level 2 competence in thoracic ultrasound, has had at least 2 years' experience at that level.

3 A Level 2 practitioner will be able to accept referrals from Level 1 practitioners.

Knowledge Base Sectional and ultrasonic anatomy a full understanding of thoracic and diaphragmatic anatomy

Pathology in relation to ultrasound 3 "more detailed understanding of pleural disease ( differentiation of pleural thickening including diagnosis of pleural masses) 3 "differentiation/characterisation of peripheral pulmonary consolidation, lung abscesses and sequestration 3 differentiation of mediastinal masses ( solid vs. cystic vs. vascular)

Competencies to be Acquired To be able to: 3 Perform a comprehensive ultrasound examination of the thorax Ultraschall in Med 2009; 30

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•competency in reporting results and communicating them to the clinical team in an appropriate way

•intra-operative ultrasound as appropriate •infants with systemic desease (e.g. Post-operative or paediatric intensive care

• recognition of most identifiable congenital brain malformations • further assessment of antenatally suspected anomalies

Pathology in relation to ultrasound – an understanding of the role of ultrasoundin the context of cerebral asphyxia, abnormal head circumference, congenital abnormalities, non-accidental injury and systemic disease

• recognise abnormalities whic hneed referralfor scanning b experienced practitioner and/or further investigations

– hydrocephalus – asphyxia (full term and premature) – other congenital abnormalities • recognise when other imaging modalities are more appropriate than ultrasound

– fits/apnoea/collpse – meningitis

– prematurity

presenting with:

• use ultrasound in the assessment of patients

•identification and location of surface collections •appearances of non-accidental injury and the limitations of ultrasound assessment

Date

•vascular studies in asphyxia • role of ultrasound in the asssessment of abnormal head circumference

Competencies/Skills to be Acquired - Level 2

– assessment of cerebral perfusion

– the basic use of doppler ultrasound including spectral, colour and power doppler – further applications of cranial ultrasound – use of trans-axial ultrasound – posterior fossa structures

Sectional and ultrasonic anatomy

Core Knowledge Base - Level 2

• common congeninital malformations including posterior fossa malformations

• obstructive hydrocephalus and monitor progression • intracranial haemorrhage, itx extend and complications

• varying presentations of pathological processes with gestational and post-natal age • periventricular leukomalacia (PVL) and full term asphyxia (FTA) • ventricular size and assess variation from normality

• normal anatomy, common normal variants and varying appearances of normal anatomy with gestational age

• transfontanelle ultrasound examination in different scan planes

To be competent to perform/diagnose etc the following:

Trainer Signature

Cranial ultrasound techniques

Competencies/Skills to be acquired Level 1

Sectional and ultrasonic anatomy Cranial pathology in relation to ultrasound

Practical instrumentation/use of ultrasound controls

Date Administration and image recording

Trainer Signature

Trainer

Physics and technology

Trainee Core Knowledge Base – Level 1

Trainer Signature

Trainer Signature

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APPENDIX 10: Cranial Ultrasound in Infants Training Competency Assessment Sheet

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3 Use Doppler ultrasound, including colour and power Doppler in the study of pulmonary , pleural or mediastinal lesions 3 knowledge about the use if contrast agents 3 Undertake diagnostic interventional procedures including lung, pleural, mediastinal and supraclavicular nodal biopsy 3 Perform special therapeutic percutaneous US guided procedures such as catheter drainage of pleural effusion, pleurodesis and instillation of fibrinolytic agents 3 Recognise abnormalities which are outside his/her experience and refer to a more experienced ultrasound professional.

Level 3 Training and Practice

Maintenance of Skills: All Levels

3 A medical practitioner scanning at Level 1 should perform at least 100 ultrasound examinations per year and have regular meetings with ultrasound /radiological colleagues Practitioners should: 3 include ultrasound in their ongoing CME 3 audit their practice 3 participate in multidisciplinary meetings 3 participate in basic, advanced or/and postgraduate thoracic ultrasound courses 3 keep up to date with relevant literature

• differentiation of mediastinal masses

• differentiation of peripheral pulmonary lesions

• more detailed understanding of pleural disease

Pathology in relation to Ultrasound

• a full understanding of thoracic and diaphragmatic anatomy

Sectional and ultrasonic anatomy

Competencies/Skills to be acquired at Level 2 To be competent to perform/diagnose etc the following:

• Pneumothorax • Subpleural lung consolidation • Pericardial effusion

• Pleural thickening

(lymph nodes, hematomas) • Rib fracture • Pleural effusion (volume estimation) • US-guided thoracocentesis

Trainer Signature

Date

3 Having been assessed as competent to practise there will be a need for continued medical education (CME) and continued professional development and maintenance of practical skills.

3 A chest physician specialist will need to continue to perform ultrasound scans throughout the remainder of the training programme. Such further ultrasound practice may be intermittent, but no more than 3 months should elapse without the trainee using his/her scanning skills.

• Soft tissue chest wall diseases

To be competent to perform/diagnose etc the following:

Competencies/Skills to be acquired Level 1

Ultrasound Techniques Administration Sectional and ultrasonic anatomy

Trainer Signature Physics and technology

Trainee Core Knowledge Base – Level 1

Appendix 11: Thoracic Ultrasound Training Compentency Assessment Sheet

Date

A Level 3 practitioner should spend the majority of their time undertaking thoracic ultrasound or teaching, research and development and will be an 'expert' in this area

3 He/she will perform special examinations at the leading edge of ultrasound practice (e.g. endoscopic ultrasound including endobronchial examinations) 3 He/she will accept tertiary referrals from Level 1 and 2 practitioners and will perform specialised examinations (e.g. the use of intravascular contrast agents in evaluating malignancy or pulmonary infarction) as well as performing advanced ultrasound-guided invasive procedures.

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Report Publications Committee

Advert Thieme Connect 1/3

The Publications Committee met three times during 2008: in January in Copenhagen, in June in Timisoara (during EUROSON) and in November in Rome (during the SIUMB meeting). The Publications Committee will meet twice in 2009, in May in Lausanne and in December in Edinburgh.

In 2008 the Newsletter contents changed.

A new interview series, "EFSUMB Newsletter meets ..." was introduced and brought the latest information about the status of ultrasound in Sweden, Romania, Latvia, Croatia, Italy, Spain and Turkey. Also ASUM - the Australasian Society and host of the next WFUMB congress - was interviewed. Technology update articles, literature reviews, information from the committees and training requirements were also to be found in the Newsletter in 2008. If you missed some of these then hurry to the EFSUMB website where the Newsletters are available as pdf-files for free download.

The Committee was very happy with the further increase in Impact Factor for the UiM/EJU. At the end of the year the contract with Thieme was renegotiated and signed for additional 5 years. As part of the

new contract the number of pages available for the EFSUMB Newsletter has increased.

The website changed its design and layout in 2008. A news flash was introduced to the front page. A case of the month was introduced with high quality images and video clips available for free download and has become of the most visited sides on the website. The latest newsletter and case of the month is always linked directly from the first page.

At the next EUROSON congress in Edinburgh in December 2009 the Publications Committee will be responsible for a scientific session.

I would like to thank the other members of the committee Christoph Dietrich, Lucas Greiner, Jeff Bamber and Jean-Yves Meuwly for their hard work in the committee and for all the fun hours we have spent together during the year. A particular thanks to Mrs Gianna Stanford for her outstanding work for EFSUMB and for helping with so many things during the year, I cannot see we can allow her to retire in 2009.

Michael Bachmann Nielsen Chairman Publications Committee

Report Ultraschall in der Medizin/European Journal of Ultrasound (UiM/EJU) The Ultraschall in der Medizin/European Journal of Ultrasound - which has been the official journal of EFSUMB since 2004 - is also the official journal of 9 national ultrasound societies (the German, Swiss, Austrian, Norwegian, Danish, Latvian, Flemish, Macedonian and Croatian) and from 2009 also of Romania. I would greatly recommend the remaining EFSUMB member countries to consider joining the bulk subscription.

Issue 1 is distributed to all 20,000 EFSUMB members, the remaining five issues are sent only to the approximately 13,000 subscribers. Because of an accumulation of accepted manuscript an additional issue was released in December 2008.

The Impact Factor for 2007 released in June 2008 showed another increase for the UiM/EJU - from 2.103 to 2.303. The journal is the highest-ranking interdisciplinary ultrasound journal.

More than 50 percent of the published articles are in English and the rest all have an extended English abstract and captions in English. During the last 12 months the five countries who submitted the highest number of manuscripts were Germany, Switzerland, Italy, Austria and France.

The EFSUMB Newsletter can be found in each issue of the journal, for those who do not receive the journal the Newsletter is also available at the EFSUMB website at www.efsumb.org. The Newsletters of all subscribing societies in their own national language are also in each issue.

Michael Bachmann Nielsen

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Gail ter Haar

Report ECMUS Safety Committee The Safety Committee met twice in 2008, once during the EFSUMB meeting in Timisoara, Romania, and once at the invitation of committee member Dr Christian Kollmann at the Centre for Biomedical Engineering & Physics, Medical University of Vienna. The current membership is Gail ter Haar (Chair (UK)), Michael Delius (Germany), Lil Valentin (Sweden), Kjell Salvesen (Norway), Ladislav Doležal (Czech Republic) and Christian Kollmann (Austria).

In addition we welcome Annemieke van Wamel as a co-opted member.

Four reviews of published literature have been agreed and made available through the newsletter, and on the EFSUMB website. The EFSUMB statement has been reviewed and updated, with a minor amendment that states that "It is important that ultrasound devices are ap-

propriately maintained". The safety of the use of Doppler Ultrasound in the first trimester of pregnancy has been widely discussed both within the committee, and in the wider community. A debate on this has been arranged for the 2009 Edinburgh EFSUMB conference. Existing safety guidelines are being examined with a view to their possible revision.

Past safety committees produced a hugely successful series of tutorial articles designed to provide information on a number of safety related topics. These can be found in the ECMUS area of the EFSUMB website. A number of new and updated tutorial articles are planned, and two, on cellular effects and on sonothrombolysis are already in draft form. These are intended to be accessible to clinical users of ultrasound.

ECMUS Committee Chairman

ECMUS will meet twice in 2009, in France in March and again at the EFSUMB meeting in Edinburgh. It is intended that there will also be a joint meeting with the BMUS safety committee at this conference.

ECMUS exists to serve the EFSUMB membership. If there is any area for concern or topic that could benefit from clarification please do not hesitate to let us know.

Prof Gail ter Haar ECMUS Committee Chairman

Anzeige euroson 2010 verkleinern auf 142 mm Höhe, linksbündig

Ultraschall in Med 2009; 30

93

E U R O S O N

2 0 1 0 Copenhagen

21 – 25 August 2010 www.euroson2010.org

INVITATION Dear Colleagues and Friends We are delighted to announce that the 22nd EUROSON Congress hosted by EFSUMB and the Danish Society of Diagnostic Ultrasound will be held in Copenhagen, Denmark 22-25 August 2010. The congress will take place at the School of Architecture of the Royal Academy of Fine Arts situated at the waterfront in downtown Copenhagen.

We are looking forward to seeing you in these excellent settings for the scientific programme. Furthermore, the social events will give you an adventurous experience of Wonderful Copenhagen.

Sincerely yours The Organising Committee

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Dr Lucas Greiner

Sono-psychology Introduction Medical doctors and psychology - a daily must, and most doctors like it: considering and reflecting their patient`s and their own behavior, reactions, emotions, interactions, and roles. Performance capabilities in doctors usually usually exceeds an amateur level - or is quite different to what is considered a "professional" psychological approach, whatever this might be.

The reader is invited to share some considerations on psychological implications before, during, and after ultrasound examinations and interventions - looking at an "inner" and at an "outer" scenario.

The main actors These are the patient/the fellow citizen, the doctor, and the ultrasound machine (q Tab.1). The latter has - as from a rationalistic point of view - no emotions nor affectations. However, in the perception of both the doctor and the patient, the machine maybe is gifted with sort of a perso-

nality as being the main mechanical tool in meeting and answering the questions, the main topic (q Tab.1) of the examination. And these questions of health and disease, of living and maybe even dying they might be considered as so to say the number four main actor.

Inner scenario Motivations to be with an ultrasound examination are zero for the machine (of course), but manifold and diverse for the patient as well as for the doctor. Spending a span of time together in a darkened (!) room means for the expectations, wishes, and fears of the patient and of the doctor only in part the same (q Tab. 2).

The patient - or the co-citizen and not-yetpatient in case of getting a "health check up" (sometimes a doubtful enterprise) first and chiefly wants to get a good result: situation improving, no new/additional findings or no abnormality detected at all, especially no signs of malignancy.

Table 1 Main components of "inner" and "outer" scenario, and their ranges "Inner scenario"

Outer scenario

the main topic

patient

relatives, friends

the main topic

doctor

colleagues

machine

internet, etc

weak victim - strong customer

attentive ones

health, disease, and the ques-

welcome watchdog

better/informed ones

tion of Hamlet

bearer of bad news

open sources

technical tool - mighty mediator

Table 2 Wishes and expectations of patient/citizen, and doctor Patient

Doctor

inferior position

"superior position

expectation and communication

expectation and communication

- verbalized

- verbalized

- non verbalized

- non verbalized

level of

level of

- role experience as a good patient

- role experience as a good doctor

- intellectuality

- intellectuality

- pre-information

- pre-information

fears of

fears of

- bad findings

- overlooking

- false diagnosis

- false diagnostic or therapeutic decisions,

- wrong diagnostic or therapeutic consequences Ultraschall in Med 2009; 30

under- or overreaction

Second and well understood is that the machine and the procedure - though harmless physically - may give uncomfortable (e.g. gallstones) or even dangerous results (e.g. malignancy).

Third, the patient knows that the examination with ultrasonography absorbs the doctor for some minutes, leaving the chance of undivided attention and allowing himself to grab hold of the examiner.

In this, patients/citizens understand that the examining doctor is dedicated and not reluctant to closely get into contact, both metaphorically speaking and physically.

The doctor, interpreter of findings and diagnostician, must make best use of a limited span of time in getting an idea of the patient`s problems, history, and personality. Patients must be addressed on an appropriate level of language and intellectuality (probably the most fascinating aspect at all in working in the medical field).

The doctor should meet all these requirements clearly, friendly, indefatigably, and completely - yes, and of course: including an ultrasonography examination high in competence and quality of performance, looking into the body without cutting it open (unlike a surgeon and patients of course appreciate this). The doctor is to some extent the master of the sequence of actions - either by speeding up the examination (with increasing fears of overlooking an important finding), or - in the case of too much speaking - giving an extra command on taking a deep breath and holding it as long as possible.

Having been in the patient`s role once himself can be a good help for the doctor to practice a more pronounced understanding of the scenario, and of the own position.

Room for magic moments Occult handlings including cold jelly on undressed skin, commands from the examiner, mysteriously moving pictures, and strange sounds in a dark room: all this

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is not so far away from a shamanic behavior of the examining doctor, communicating with supernatural forces via the competently ruled machine and monitor.

Moreover, the doctor being capable of his role of interpreter and "medium" is close up, touching the patient both manually and in the more figurative sense, exposing him/ herself directly and without restraint or escapement - a situation completely different to what patients experience with the "secondary" imaging modalities (computed tomography (CT), magnetic resonance (MR), etc.). All this and the underlying position of the patient contribute to the power of the doctor, whether patients like it or not. Those who do not like this type of mastery will sometimes start to offer sort of a graded resistance, more or less subconsciously - a well understandable type of reaction, which the doctor must have ways for, too.

And he must always remember the fact that his non-verbal communications and especially his face are under most attentive and maybe anxious observation. So in doubt - e.g., finding a mass suspicious of malignant origin - a pokerfaced concentration is needed for the examiner.

For the doctor, ultrasound examination is a routine work. The patients - experiencing the examination as a special event in their life - will however repeatedly recall all its details to their memory and re-evaluation.

All this means - that in an attempt to summarize the inner scenario -ultrasound examination is 3 loaded with a strong magic component in the triangular relationship of patient, doctor, and machine, 3 psychologically standardized by the underlying questions of health, disease, and even fatality - so in its performance, ultrasound examination can be 3 sort of a movie equivalent, harbouring both comedy and drama options.

Outer scenario: sonophilia, sonophobia, and others These interpretations of ultrasound examinations will be understood easily by those who perform it themselves, whatsoever medical subspecies they are from.

ents being too fat, too immobile, too meteoristic, and similar lame excuses for avoiding acceptance - or even self-performance - of the examinantion. The militants simply deny any use of ultrasonography.

Both feel better and relieved by ordering a CT- or MR-scan, which is a matter of a minute only.

It is remarkable how widespread sonophobia is. The reasons for this can be quite clear - ultrasonography means challenging work, direct exposure to a non-sedated patient, and a high degree of personal responsibility , with no personalized (e.g. financial) benefits for the examiner. And it means competition to more simple imaging modalities such as CT and MR - notwithstanding their limited additional information and limited local resolution capability.

This is especially true in abdominal indications, where most of CT- and MR-scanning is made superfluous by ultrasonography "only". Sonophobia is even found with gastroenterologists of the merely endoscopists type - an attitude which makes these gastroenterologists less than one-eyed and more than half-blind in gastrointestinal (GI) disease. Their view is limited to the mucosa perspective of the GI tunnel, they voluntarily avoid the rich information of abdominal and especially of intestino-sonography. The same holds true for hepatologists, only recently discovering e.g. nonalcoholic steatohepatitis by means of ultrasonography, and avoiding further ultrasound information about the liver. This close-your-eyes-policy is difficult to understand; maybe some jealousy concerning ultrasonography is in part a psychological explanation. The split and still highly ambivalent surgical attitude to ultrasonography will not be stressed in more a detail.

Clinical ultrasonography is a well established high-tech tool with a marked potential for further development (e.g., by contrast enhanced ultrasonography (CEUS) - however, as it is true for all morphological and functional imaging modalities, it is more useful for practical than for

scientific reasons. Building an academic career on "merely" ultrasonographical scientific work is considered less trendy, acceptable, and fundable than e.g. working with naked mice, clinical oncology experiments, or genetics.

Conclusions and recommendations The sonophilic and maybe even a bit sonomaniac reader of our EFSUMB Newsletter and of The European Journal of Ultrasound/Ultraschall in der Medizin having gone through all these considerations is met with appreciation and thankfulness, and comments and criticism are welcome as well as addenda and completion.

We know that ultrasonography is to be praised as a not yet fully detected jewel in practicing a doctor`s work, extending palpation, auscultation, and the knowledge of the patient`s history in an immediate and wholesome approach for quick further decision making.

The method is by far good enough to overcome the psychological obstacles for present users and non-users (q Tab.3) - especially since it is an ideal "soft" technology bearing just the adequate dosage of medico-technical armentarium awaited and well tolerated by our patients.

The fine art of clinical ultrasonography combining the skills of the doctor and of the machine for the patient in a very specific atmosphere - creates a good basis for a confidential cooperation between doctor and patient. The adequate use - underuse can be as much a problem as overuse -, and marketing of clinical ultrasonography is highly recommended, for the sake of our patients, and for the pleasure in work for the doctor, too (and maybe - who really knows - for the machine a little bit as well).

Prof Dr Lucas Greiner Email: lucas@prof-greiner.de; ultrasonography@flying-faculty.de

Table 3 Recommendations Recommendation don't be shy, rely in your method ultrasonography is high tech ultrasonography is one of the most sophisticated clinical tools

Such sonophilic colleagues, however, are usually met with skepticism by others: the sonophobics, presenting as either a tolerant or a more militant sub-subtype. The sonophobic tolerants complain about pati-

accept its limitations, including a limited value in scientific research CT and MR only when really needed perform daily case-related ultrasound meetings, e.g. combined with X-ray conference perform continuous education, training, teaching use the high "psycho- and confidentiality-index" of clinical ultrasonography Ultraschall in Med 2009; 30

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EFSUMB Newsletter Sydney Convention and Exhibition Centre

Welcome to WFUMB 2009 Sydney World Medical Ultrasound Congress Sunday 30 August to Thursday 3 September 2009 www.wfumb2009.com and www asum.com.au EMAIL info@wfumb2009.com

The Sydney Convention and Exhibition Centre, Darling Harbour is the largest and most technologically advanced facility in Australia. It has been purpose built to host a spectrum of conferences, international congresses, exhibitions, gala events, product launches and small meetings.

Sydney Convention and Exhibition Centre is unique because of its ideal location within the Darling Harbour convention area.

It is only five minutes from Sydney's city centre and within walking distance of restaurants, shops, and a range of accommodation and entertainment facilities.

Sydney Sydney is the Gateway City to Australia and home to the world's most beautiful harbour. Life in Sydney revolves around its spectacular harbour, its golden beaches, parklands and national parks. Visitors soon fall in love with the attractions, experiences and atmosphere. It is a cosmopolitan, stylish city with a reputation for being friendly, clean and vibrant. Attractions include world class art galleries, museums, parks, waterways that stretch into all parts of the city, wildlife parks, the majestic sails of the Sydney Opera House, luxury cruises, aquariums, beaches, The Royal Botanic Gardens, theatre, entertainment, shopping, culture and sport.

Australia Australia's landscape is a picture of amazing diversity, contrasts and natural wonder. From the ancient rock Uluru (Ayers Rock) to the Great Barrier Reef, Australia's Red Centre reaches out to a magnificent azure coastline. Scattered across this beautiful environment, our thriving cities bubble with sophistication and energy.

Brisbane, Queensland's vibrant sub tropical capital, Sydney and its magnificent harbour, and Melbourne with its heritage of arts, fashion and fine food, are just three Ultraschall in Med 2009; 30

of Australia's outstanding city destinations. Australia, the world's smallest continent and largest island, is like nowhere else on earth. It is as big as mainland United States but has only 20 million people.

It is adventurous, stylish and friendly, has unique flora and fauna and a fantastic climate. Aussies (as the locals are called) enjoy sport, beaches, music, performing arts, outdoor cafes, pubs, multicultural restaurants and good friends. A rich cultural blend of fashion, languages and cuisine colours the streets of Australia's major cities. Australia's diverse mix of environments and cultures offers an encounter like no other. Explore lively, sophisticated cities, experience the awe-inspiring beauty of Australia's natural wonders, discover the ancient mysteries of Aboriginal culture, and see and feel the rigours of life in the rugged Outback. Regardless of which path you take, Australia guarantees the experience of a lifetime!

Things to see and do in Sydney BridgeClimb

BridgeClimb

About the congress venue and destination 5 Sydney Convention and Exhibition Centre

Sydney

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BridgeClimb is a 3.5 hour adventure and an experience that will never be forgotten on one of the world's most modern wonders......The Sydney Harbour Bridge.

See all the Main Harbour attractions including the Opera House, Harbour Bridge and Fort Denison while enjoying morning tea and a personalised commentary.

The Bridge Climb experience begins with a comprehensive briefing and safety demonstration to prepare you for the Climb of Your Life!

You will also explore the magnificent upper reaches of Middle Harbour with its natural parklands, inner harbour beaches, marinas and palatial waterfront homes.

The exhilaration and personal satisfaction achieved by reaching the top of the Bridge is rewarded by the breathtaking view that lies before you as you scale up the Sydney Harbour Bridge.

There is so much more to discover outside of Sydney. Explore the World Heritage Blue Mountains or the delightful wine growing are of the Hunter Valley.

Important Dates There is no adventure like it in the world......no view like it.....no feeling like it!

Sydney Harbour Morning Tea Coffee Cruise Join us on Sydney's Award Winning Coffee Cruise.

3 Abstract Notification February 2009 3 Early Registration Fee Deadline March 2009 3 Registration Deadline July 2009 3 Late Registration From Saturday, 1 August 2009

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EFSUMB Newsletter

Program outline The Scientific Organising Committee is creating an innovative and unique program tailored to the needs of the ultrasound industry, medical users and scientist members. WFUMB 2009 in Sydney will be unique in that it will emphasize a wide range of opportunities from handson training at entry-level to specialist medical point-of-care procedures, such as Emergency Room and nerve block Anaesthetic monitoring. The program will also offer sessions on leading-edge technological developments, particularly in small portable scanning devices.

The WFUMB 2009 Organising Committee will prepare optimal programs and skills development workshops in all aspects of ultrasound imaging. The intention of the program will be to highlight the growth of the industry and emerging techniques.

As a fundamental aim of the WFUMB, this Congress is committed to providing assistance for education in the developing world, thereby helping to develop wider markets for the application of diagnostic ultrasound in medicine.

Some of the exciting program topics we hope to include are 3 Point of care 3 cutting edge ultrasound practice and technology 3 safety and quality assurance, medicolegal issues 3 3D and 4D ultrasound 3 echocardiography 3 ultrasound contrast 3 therapeutic applications 3 hands-on workshops and live-demonstration sessions 3 pediatrics 3 obstetrics and gynecology 3 musculoskeletal 3 emergency room and veterinary and other non-medical applications of ultrasound Delegates will have ample opportunity to meet with exhibitors who will be displaying their new, innovative and technical diagnostic and therapeutic equipment, supplies and services.

Back by popular demand interactive ASUM MDW multidisciplinary Ultrasound workshops will run every day on Sunday, Monday and Tuesday, 30 August to 1 September 2009.

Latest Point of Care, Critical Care Ultrasound workshops will run on Wednesday and Thursday 2- 3 September 2009

Details of these prizes will be published in the ASUM Bulletin.

Prizes/Awards Application Nuchal Translucency courses and WINFOCUS (Emergency Medicine Ultrasound )workshops and more...

Check out www.wfumb2009.com for regular updates to the program timetable.

WINFOCUS The 5th World Congress on Ultrasound in Emergency and Critical Care Medicine is being held as an official Satellite Meeting to the WFUMB2009 Congress 4 - 6 September 2009. For more information go to www.winfocus2009.org

Prizes/Awards Prestigious awards and prizes Papers submitted by registrants are generally eligible for a range of generous prizes offered by our sponsors. To be eligible for a poster prize a presenter must give permission for the content of the poster to be published in the ASUM Ultrasound Bulletin. An independent jury of sonographers and radiologists, grouped according to their expertise, will judge all scientific exhibits with regard to originality / educational value / scientific quality, visual impression and overall assessment.

The following prizes will be awarded at WFUMB 2009 Congress 3 Best Sonographer Research WFUMB2009 Presentation Award US$2,000 3 Best Medical Research WFUMB2009 Presentation Award - US$2,000 3 Best Clinical WFUMB2009 Presentation Award - US$1,000 3 Best Poster Presentation WFUMB2009 Award - US$1,000 3 Best Poster Presentation Award - to an AFSUMB member -US$1,000 3 Best Poster Presentation Award - to a MASU member - US$1,000 3 Best Poster Presentation Award - to a FLAUS member US$1,000 3 Best Poster Presentation Award - to a EFSUMB member US $1,000 3 Best Poster Presentation Award - to an AIUM member US$1,000 3 Best Poster Presentation Award - to an ASUM member US$1,000 3 50 Young Investigators scholarships total value US$500 each

Details of the application process will be available after abstract submission has closed and upon notification of your abstract acceptance email.

Photographic Competition - close 7 August 2009 5 A photographic competition has been organised by WFUMB 2009 Organising Committee. Individuals are invited to submit up to 3 photographs for each of the 2 prize categories 3 1. General Interest Photograph 3 The WFUMB 2009 Organising Committee is looking for all budding photographers to send in their favourite photographic work. This might be an artistic photo, a holiday snap or portraits of people. There are no specific themes for this category.

3 2. Historical Photograph (Ultrasound) Prizes will be awarded to the best historical photograph of ultrasound under the following 3 categories: 3 1. Interest 3 2. Technology 3 3. Occasion If you are interested in entering the competition please contact the Congress Office for further information. You will be sent guidelines and a form, to be returned with a 50 -100 word description of each of your photos.

Please note that submissions close on Friday, 7 August. By entering a photograph you are acknowledging that the photograph was taken by yourself, and is not from copyrighted sources. You also assign rights to use the photograph in any ASUM publication. The winners' photographs will be printed in large format and displayed at the Congress.

Dr Caroline Hong Chief Executive Officer Australasian Society for Ultrasound in Medicine (ASUM) Website: www.asum.com.au Email: carolinehong@asum.com.au ASUM is certified ISO 9001:2000 Quality Management Systems WFUMB2009 congress email: info@ wfumb2009.com

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