RANZCR Inside News December 2024

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Quarterly publication of The Royal Australian and New Zealand College of Radiologists

Creating Connections

A recap of RANZCR's 2024 ‘gathering under the stars’ in Perth

Also inside Cultural Context Global Indigenous perspectives on cancer care Access All Areas Highlighting the important work of Road2IR

Managing COIs Guidelines for recognising conflicts of interest

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EDITORIAL STAFF

Editor-In-Chief

Dr

In-House Editor Arizona

Dr Wayne Wai-kung Wong, Fellow, NSW

Dr David Tay Sang Fong, Fellow, NSW

Prof

Bhuta reports on

Dr

Lau welcomes a new

RANZCR acknowledges the Traditional Owners of Country throughout Australia. We recognise the continuing connection of Aboriginal and Torres Strait Islander people to the sky, lands, waters and culture and we pay our respect to their Elders past and present and emerging. RANZCR acknowledges Māori as tangata whenua and Treaty of Waitangi partners in Aotearoa New Zealand.

All rights reserved. No part of this publication may be reproduced or copied in any form or by any means without the written permission of the publisher. Publication of advertisements and articles submitted by external parties does not constitute any endorsement by The Royal Australian and New Zealand College of Radiologists of the products or views expressed.

© 2024 The Royal Australian and New Zealand College of Radiologists® (RANZCR®)

Radiology, Radiation Oncology and the Distant Future

Looking at what’s ahead in 2025, and beyond.

“It’s difficult to make predictions, especially about the future.
Yogi

The above, perhaps humorous, quotation about the difficulty of predicting the future has been attributed to two radically different individuals. The first, a baseball player famous for redundancy in his comments (e.g. “It ain’t over till it’s over”) and the second, famous in physics for advancing theories with uncertainty as the cornerstone of the fabric of reality.

As the end of the year approaches, and acknowledging the difficulty even experts have with prediction, I propose to move away from everyday considerations, briefly review likely sources of change in radiology and radiation oncology, and speculate about developments we may see as the future unfolds.

By way of background, our two disciplines have repeatedly benefitted from discoveries in sciences such as computing, physics, biology, chemistry and engineering. These have resulted in the arrival and increasingly rapid evolution of new technologies with breathtaking increases in our ability to detect, assess and treat disease. Our patients have been worthy beneficiaries, and our clinical roles have increased because we have been willing to grasp the opportunities such

technologies have provided, explore their potential, and implement them with patient care in mind. It therefore seems likely that discoveries in the sciences will continue to impact upon our future.

AI seems poised to exert significant influence and promises to alter multiple aspects of our workflow, such as booking studies, planning radiation therapy, protocolling radiology examinations, triaging studies for reporting and lesion assessment to name a few. If implemented appropriately, AI could streamline our workflows and reduce workload, allowing us to engage in other higher value activities. At least, in the short to medium term, we will need to maintain a supervisory role, and if needed, overrule AI given our greater understanding of context. Understanding of failure modes or ways that human use of AI may lead to errors will be critical to safe care.

At present, AI is focused on single tasks but will likely progress, combining assessment of all relevant features on a given imaging study. As a result, provision of autonomous interpretation of imaging studies may feature in the more distant future. In the shorter term, imaging reports will be converted to language that

Prof John Slavotinek
Berra, New York Yankees baseball player and Niels Bohr, Nobel prize-winning quantum physicist

patients understand, but there will always be a need to demonstrate imaging findings and place them in perspective during patient consultation. Some centres have already trialled radiologists in this role, as a means of achieving greater patient contact and enhancing our value.

In parallel with advances in diagnostic imaging, there has been an equivalent and rapid rise in understanding of, and capacity to utilise knowledge in genetics and gene technology as well as within other fields of molecular biology.

The manifestations of this are protean but non-image based precision diagnostic techniques such as liquid biopsy (e.g. the ability to detect molecular signs of cancer via small fragments of DNA or mRNA) that will reduce but not replace the role of imaging during diagnosis, staging and follow-up. It has been said before, but radiologists who limit themselves to standard image interpretation alone are likely to be the most affected. Therefore, in the long-term future we will need to find additional ways of contributing to healthcare. Integration of imaging with non-imaging diagnostic information derived from pathology, proteomics, metabolomics, genomics and other laboratory and clinical information, likely with the assistance of AI, will become increasingly important.

If managed appropriately, radiologists might take on part of this integrative role, thereby reducing our dependence upon image interpretation as the principal basis for our clinical value. If these

opportunities arise, it will be essential to steadily evolve our practice and our training programs to provide necessary skills to radiologists and radiation oncologists of the future. Our methods of diagnosis and treatment will evolve and in the more distant future, smart contrast agents will likely target aspects of biochemistry, immunohistochemistry and genomics. Within radiation oncology, the future is likely to see proton (and perhaps even alpha particle) therapy becoming more accessible. Flash radiation therapy promises rapid dose delivery, reduced toxicity and fewer, shorter treatments. Aside from ongoing technical advancement, use of radiation oncology to treat benign diseases such as keloids, osteoarthropathy and Dupuytren’s contracture will likely increase. Additionally, treatments such as brachytherapy may lead to pursuit of further interventional techniques in radiation oncology.

The reach and capability of interventional devices will advance and robotics and augmented reality will likely play a part in interventional suites of the future. It is important that interventional radiologists of all kinds adopt these technologies and engage more closely in patient consultation and care, if such technologies are to be retained and not lost to other specialties.

Theranostics is another area of great importance that is likely to see rapid expansion in its scope and ability to target disease. Advantages include the ability to detect and localise disease, select patients for treatment and monitor response to

therapy. The combination of imaging with radionuclide treatment will play a vital role, but the future will likely also see other agents such as drugs, antibodies and small molecules (e.g. peptides) being utilised. Beyond oncology, inflammatory and autoimmune conditions may also benefit from such technology.

I have speculated about the future, but to successfully negotiate the above opportunities and associated challenges we will need to think and plan ahead. For example, as emphasis on value-based care grows we will increasingly need to demonstrate our clinical impact and value. More than ever, we will need to focus on what is best for patients and remaining a valued part of the clinical team. Provision of therapies that increase our relevance to patients and other clinicians will be vital as will environmental sustainability, research that provides evidence of our value, and collaboration with other specialists and allied health practitioners.

In my next article I intend to return to a more immediate and directly relevant focus by considering recent changes in Australian and New Zealand healthcare, the expedited IMG pathway and its likely impacts.

As the year draws to a close, I would like to wish all of you and your families a pleasant Christmas period and I hope you have the opportunity to take a break and recharge over the summer period. IN

Conflicts of Interest

Recognising a conflict of interest is crucial for maintaining ethical standards and public trust, says CEO Duane Findley. Here are some guidelines to recognising and managing COIs at RANZCR.

We’ve all seen this scenario. A high-profile and well-connected pillar of society faces accusations of having a potential conflict of interest (COI) on something that everyone else can see is a potential or actual conflict, but that they appear either unable or unwilling to concede. And in refusing to accept that there may be a COI, they damage their reputation in the eyes of their colleagues and other stakeholders. Strangely, these people are often able and willing to point out potential or actual COIs in other people.

The recent media attention on politicians from all sides receiving Qantas Chairman’s Lounge access and free flight upgrades is a case in point. Any politician receiving such largesse from a dominant market player could be seen as having a potential or actual conflict when making decisions that may impact on Qantas’ business model… and yet they all solemnly deny such a thing. Maybe they should be asked why they think that Qantas is offering these benefits to them and not others

Understanding Conflict of Interest: Recognition of Potential Conflict

In today’s complex social, professional and political landscapes, the concept of a conflict of interest has become increasingly pertinent. A conflict of interest occurs when an individual’s personal interests be they financial, familial, or otherwise compete with their professional responsibilities or obligations. This situation can compromise the integrity of decisions made in various sectors, including business, government and healthcare.

Recognising a conflict of interest is crucial for maintaining ethical standards and public trust. Here are key indicators to identify when a conflict of interest may exist:

Financial Gain: If an individual stands to benefit financially from a decision made in their professional capacity, a COI may arise. For instance, a Board, council, or committee member advocating for a vendor in which they have a financial stake presents a clear conflict.

Personal Relationships: Close relationships can cloud judgment. For example, if a hiring manager is responsible for selecting candidates and one of the applicants is a close friend or family member, the potential for bias exists, jeopardising the fairness of the hiring process.

Duane Findley, CEO
“A culture of openness and responsibility can help mitigate the risks associated with COIs, reinforcing and promoting ethical practices across all sectors.”

Multiple Roles: When an individual occupies multiple positions that may have competing interests, conflicts can emerge. A board member of a non-profit who also serves on the board of a competing organisation may face dilemmas in decision-making that could favour one organisation over the other.

Loyalty and Duty: A situation may arise where personal loyalties conflict with professional duties. For example, an elected member or College executive could be asked by another member (who they have a longstanding friendship with) to bypass chains of command to alter a decision, or ‘ignore’ College policies or legal obligations to deliver that member a desired outcome.

Undisclosed Information: If individuals have access to confidential information that could be used for personal gain, a conflict of interest is likely present. This could include using confidential

government briefing information to benefit a person or an organisation that they have an interest in.

Managing Conflicts of Interest

To effectively manage conflicts of interest, RANZCR has published clear policies and training that emphasise transparency and ethical behaviour. Disclosure is a vital step; individuals must report any potential conflicts to their manager or committee Chair within their organisation. RANZCR encourages staff and members to raise potential COIs even if they are not sure if it is a COI, so the issue can be discussed and a decision made on how to manage the situation

If others are aware of a potential COI, they should be encouraged to raise it with their manager or Chair, who can then speak with the person involved to better understand the situation. A few of our RANZCR staff, including me, have a wealth of experience in governance issues, including COI. We would welcome any approach from members or

staff seeking more information about potential COI situations. Conflicts of interest are an unavoidable reality in many fields. By learning to identify and address them proactively, individuals and organisations can safeguard integrity, ensuring that decisions are based on fairness and ethical considerations rather than personal gain. Ultimately, a culture of openness and responsibility can help mitigate the risks associated with COIs, reinforcing and promoting ethical practices across all sectors. IN

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Under the Stars A Gathering

Highlights from the 2024 RANZCR ASM in Boorloo Perth, WA.

Thank you to everyone who attended the 74th RANZCR Annual Scientific Meeting in Perth all 1,312 delegates! For those who weren’t able to attend, here’s a recap of the threeday event.

The Perth Convention and Exhibition Centre was abuzz on Thursday morning, with delegates picking up a coffee en route to the Riverside Theatre for the opening plenary session. Ingrid Cumming, a proud Whadjuk Balardong Noongar woman from Fremantle, carried out the Welcome to Country before introducing Indigenous group Corroboree for Life, who performed moving spirit dances and encouraged audience participation with recitals of words and phrases from the Noongar language. The Haka for Life group then delivered a roof-raising performance of the Haka, before we were introduced to our 2024 Nisbet Orator, Dr Natasha Hurley-Walker.

In keeping with the event’s theme, ‘A Gathering Under the Stars’, radio astronomer Dr Hurley-Walker spoke about her work in outback Western Australia developing ever-more-powerful radio telescopes that can help to reveal the secrets of our universe. She also spoke about the correlations between her work and the field of medical imaging, and the broader issues of equity and inclusion, asking attendees to consider who was missing from the room.

A panel discussion brought together leaders in clinical radiology, interventional radiology and radiation oncology: Dr Geraldine McGinty, Dr Mathias Prokop, Dr Katharine Halliday, Prof Alda Tam, Dr Charlotte Coles and Dr Sushil Beriwal. Dr McGinty spoke about benefits of collaborating with other specialties and encouraged delegates to “get in the room where decisions are being made”, while Dr Halliday spoke about the regional workforce challenges in the UK and the potential capabilities of AI.

The panel leaders were joined onstage by the 2024 ASM Convenors, Dr Lisa Sorger, Dr Susanne Guy, A/ Prof Suki Gill and Dr Jonathan Tibballs, with Dr Guy highlighting that conferences such as the ASM help clinicians “lift our heads out of the black boxes of reporting rooms” to learn from others. “We’ve got to learn from each other first before we can then go out and help patients,” she said.

The next three days of sessions featured an unprecedented line-up of international speakers presenting across three streams. Session topics were varied, covering both clinical subject matters and broader professional development themes.

The popular Women in Leadership breakfast returned

Melbourne 23–25 October 2025

for 2024, featuring inspiring talks from Dr Katharine Halliday and Dr Laura Dawson who shared insights into their own leadership journeys and offered advice on how to bounce back from failures and empower the next generation of female leaders. RANZCR CEO Duane Finley and ASM Convenor Dr Lisa Sorger also chaired a Diversity, Equity and Inclusion session, discussing the gender pay gap and Medicare gender audit.

The College introduced the new Clinical Radiology and Radiation Oncology Training Site Accreditation Standards, hosted a Research session discussing finding a supervisor, getting published and reviewing for journals, and facilitated robust discussions in the Faculty Forum debates. There was a dedicated session on the new Lung Cancer Screening Program and Occupational Health Imaging, and an IR Committee update on specialty recognition, where a tripartite Memorandum of Understanding (MoU) was signed between RANZCR, the Interventional Radiology Society of Australasia (IRSA) and The Australian and New Zealand Society of Neuroradiology (ANZSNR).

The Annual Ceremony saw 70 new Fellows grace the stage, with RANZCR President John Slavotinek’s speech

painting a picture of a bright future in clinical radiology and radiation oncology. He encouraged new Fellows to value and maintain their relationships, be curious, ask for help and remember that humour is a valuable ally. Touching on the conference theme, he reminded the audience that “delivering value is a collaborative effort” and that “our disciplines are well positioned to face future challenges”.

In the social events, Perth put on the perfect weather for the annual Targeting Cancer Fun Run. Competitors ran five kilometres along the glistening foreshore, with exhibitor Michael LeSouef and RANZCR member Dr Alexandra Stanislavsky taking home the first-places prizes.

Saturday night’s Gala Dinner saw the venue’s ballroom transformed under a canopy of twinkling lights. Prize winners were celebrated, including Branch of Origin trainee presentation winner Dr Richard Kelly, FROGG Prize winner A/Prof Wee Loon Ong and Varian Prize winner Dr Shanuka Samaranayake. The live band had the dancefloor thrumming in no time, while the photo booth provided lasting memories of another successful Annual Scientific Meeting. We look forward to welcoming you all in Melbourne next year! IN

2024 College Honour Recipients

College Honours celebrate the significant contributions clinical radiologists and radiation oncologists make to the health of patients across Australia, New Zealand and internationally. Congratulations to our 2024 recipients.

The Roentgen Medal

The Roentgen Medal is awarded to Fellows of the College who have made a valuable contribution to the College over a significant period of time. In 2024 the Roentgen Medal has been awarded to Dr Nicholas Ferris of South Melbourne, Victoria.

Dr Ferris trained in medicine, and then in radiology, at the Alfred Hospital (Monash University), attaining RANZCR Fellowship in 1992. After post-Fellowship training in neuroradiology at Duke University, North Carolina, he assisted with the introduction of MRI at the Alfred. He later worked in several public hospital radiology departments in Melbourne and Geelong. Dr Ferris was Chair of the College’s MRI (2000–2017) and eHealth (2009–2021) reference groups. He now works part-time at the Peter MacCallum Cancer Centre, and in private practice. He continues to be active on RANZCR’s Digital Radiology Committee.

Clinical Radiology Educational Service Award

The Clinical Radiology Educational Service Award acknowledges an outstanding level of commitment, participation and leadership in the area of training and education in clinical radiology over an extended period of time. The Clinical Radiology Educational Service Award in 2024 was awarded to Dr Shaun Gallagher of Mount Ommaney, Queensland.

Dr Gallagher trained in medicine at the universities of Cambridge and Oxford. He trained in general medicine and subsequently in radiology at Addenbrooke’s Hospital, Cambridge. Dr Gallagher moved to Queensland in 2006, training registrars at Ipswich Hospital where he is a consultant radiologist, and regularly holds weekend pre-Part II sessions for southeast Queensland FRANZCR.

The Gold Medal

The Gold Medal honours a Fellow who has rendered outstanding service or benefactions to the development, teaching or practice of clinical radiology or radiation oncology in Australia, New Zealand and Singapore. In 2024, the Gold Medal has been awarded Dr Keen Hun Tai of Melbourne, Victoria.

Dr Keen Hun Tai graduated from the University of Melbourne and trained in radiation oncology at the Peter MacCallum Cancer Centre. He has been a clinician, administrator, researcher and involved in training. He was the Chair of the Faculty of Radiation Oncology Genito-Urinary Group for 10 years. Elected to the Faculty of Radiation Oncology Council for six years, he was Chair of the Research Committee for five years; and then Dean of the Faculty 2021–2022. Having retired, he is a member of the FRO Mentoring Working Group and the interim Chair of the Māori, Aboriginal and Torres Strait Islander Empowerment Committee.

Life Membership

Life Membership is awarded to Fellows aged 65 and over who have made an outstanding contribution to their profession over the course of their career. In 2024, Life Membership has been awarded to Dr Wayne Lemish of Malvern, Victoria, Dr John Gunn of Auckland, New Zealand, and Dr Alan Klevansky of Molendinar, Queensland.

Denise Lonergan Educational Service Award

The Faculty of Radiation Oncology developed and introduced an Educational Service Award to acknowledge those members who have demonstrated an outstanding level of commitment, participation and leadership in the area of training and education in radiation oncology over an extended period of time. In 2013, the award was renamed to honour the late Dr Denise Lonergan for her outstanding contribution to the College. The 2024 recipient was Dr Tanya Holt of Brisbane, Queensland.

Honorary Fellowship

An Honorary Fellowship recognises individuals who have contributed to the advancement of clinical radiology or radiation oncology and allied sciences, either through original research or by special services to the College. In 2024, Honorary Fellowships have been awarded to Dr Geraldine McGinty and Prof Roland Bammer.

Educational Fellowships

The College offers a variety of Fellowships each year, to support members in their continuing education and to further their knowledge and expertise. Congratulations to the following recipients of Educational Fellowships for 2024.

Thomas Baker Fellowship

The history of the Thomas Baker Fellowship is as long as that of the College itself. The Fellowship enables a clinical radiology or radiation oncology member up to six years post-Fellowship to further their knowledge by studying abroad for between three and 12 months. The College would like to extend its special thanks and appreciation to the Baker Foundation for sponsoring this prize. The recipient for 2024 is Dr Cristian Udovicich of Ontario, Canada.

Dr Cristian Udovicich completed his registrar training in Melbourne, primarily at Peter MacCallum Cancer Centre. He was the inaugural Victorian Gamma Knife and NeuroRadiation Oncology Fellow from 2022–2023 and was the first author on the first Australian series of neoadjuvant stereotactic radiosurgery in brain metastases. He is undergoing a GU and CNS Fellowship at Sunnybrook Odette Cancer Centre, University of Toronto from 2024–25. Dr Udovicich’s main research projects in Toronto include prospective trials of prostate SBRT and HDR brachytherapy monotherapy as well as spine SBRT and dose intensification for meningiomas.

Windeyer Fellowship

The Windeyer Fellowship provides a 12-month position for a trainee (post Phase 2 Examinations) or junior Fellow in radiation oncology to undertake a Clinical Research Fellowship at the Mount Vernon Cancer Centre, Northwood, London, UK. The Fellowship involves a wide-ranging clinical experience working with several senior clinical oncologists in subspecialty sites. The position is under the broad supervision of Prof Peter Hoskin. The recipient for 2024 is Dr Tracy Lim of Lennox Head, New South Wales.

Bill Hare Travelling Fellowship for Clinical Radiology

The Bill Hare Fellowship supports a clinical radiology Fellow more than five years post-Fellowship for a period of intensive or overseas study (three to 12 months) or for attendance at an international short course (two weeks to one month). The primary purpose of the Fellowship is to enable the recipient to further their knowledge of an acknowledged subspecialty or skill, in which there is a recognised shortage. The award is named after the late Prof William Hare AO for his outstanding commitment and service to the College. The Bill Hare Fellowship for 2024 is awarded to A/Prof Craig Hacking of Grange, Queensland.

A/Prof Hacking is an emergency and trauma radiologist at the Princess Alexandra Hospital in Brisbane and a forensic radiologist at Forensic Pathology and Coronial Services, Queensland Health. He is the current Academic Lead for Clinical Radiology at the University of Queensland Medical School and has held several senior editorial positions at Radiopaedia.org. A/Prof Hacking has held past positions including founding executive committee member for the Australian and New Zealand Emergency Radiology Group (ANZERG), lead anatomy examiner and Viva examiner for RANZCR, and Medical Director of Medical Imaging at the Royal Brisbane and Women’s Hospital.

Dr Lim was born in Mauritius and moved to Melbourne in 2008. She completed a Bachelor of Medicine, Bachelor of Surgery and Bachelor of Medical Science at the University of Melbourne. She relocated to NSW for radiation oncology advanced training and has spent most of her training time in rural NSW in Lismore. She is passionate about advocacy and leadership and has been involved in various College committees as a trainee representative. She has a keen interest in GU malignancies, brachytherapy and thoracic malignancies.

ASM Hall of Fame 2024

2024 ASM Organising Committee

A/Prof Suki Gill, Radiation Oncology Convenor

Dr Susanne Guy, Clinical Radiology Co-Convenor

Dr Lisa Sorger, Clinical Radiology Co-Convenor

Dr Jonathan Tibballs, Interventional Radiology Convenor

Dr Riche Mohan, Radiation Oncology Trainee

Representative

Dr Joy Kim, Clinical Radiology Trainee Representative

Dr James Waldron, Clinical Radiology Trainee

Representative

2024 Keynote Speakers

Clinical Radiology

Dr Nishat Bharwani, UK

Dr Katharine Halliday, UK

Dr Geraldine McGinty, US

Dr Philip Robinson, UK

Prof Mathias Prokop, NED

Radiation Oncology

Prof Laura Dawson, CA

Professor Charlotte Coles, UK

A/Prof Piet Ost, BE

Prof Matthias Guckenberger, CH

Dr Joost Nuyttens, NED

Prof Billy Loo, US

Dr Sushil Beriwal, US

2024 International Guests

American Society for Radiation Oncology – ASTRO

Asian Oceanian Society of Radiology – AOSR

Hong Kong College of Radiologists – HKCR

Japan Radiological Society – JRS

College of Radiology, Academy of Medicine of Malaysia – CoR

Royal College of Radiologists – RCR, UK

Faculty of Radiologists – RCSI, Ireland

Society of Interventional Radiology – US IR Society

Taiwan Radiological Society – TRS

ASM in Numbers

Delegate Numbers: 1,312

Exhibitors: 70

Speakers: 268

International Keynote Speakers: 134

International Guests from Societies: 8

Oral Presentations: 395

Sessions: 81

Posters: 130

New Fellows: 70

ASM Prizes Awarded: 8

Targeting Cancer Fun Runners: 106

RANZCR Workshops, Courses and Events 2024

15-16

15-17 MAR 2025

Harry Perkins Institute of Medical Research, Nedlands, WA

Join us for an enriching experience at the WA Branch 2025 ASM. Explore new insights, expand your network, and contribute to advancing the field of diagnostic imaging in Women and Children. Register Now: www.trybooking.com/events/landing/1257363

AUG 2025

Tākina Wellington

NZASM (www.ranzcr2025.co.nz)

REMEMBER: EVENTS ARE A GREAT WAY TO GAIN CPD HOURS

VOCO Hotel, Brisbane, QLD

SMART Workshop theme this year is “Evidence Appraisal Skills”.

Register Now: Registration — TROG 2025 ASM (trogasm.com.au)

23-25 OCT 2025

Melbourne Convention Exhibition Centre

CPD Hours calculated once program is finalised. Save the Date!

CPD Hours calculated once program is finalised. WA BRANCH ASM WOMEN’S & CHILDREN’S IMAGING UPDATE RANZCR NZ ASM RANZCR ASM 18 MARCH 2025 SMART

RANZCR/ACR EDUCATION CENTRE COURSES 2025

Sydney CBD - Venue TBC

Details coming soon!

Find details on these events and many more on our website: www.ranzcr.com/whats-on/ events. For regular updates, in addition to the website listing, please “like” and “follow” our RANZCR social media accounts:

If you have any questions relating to any College events, please contact the Events team at events@ranzcr.edu.au

Knowledge Sharing

An overview of MATEC’s Cultural Session at the 2024 RANZCR ASM in Boorloo.

Themed ‘A Gathering Under the Stars’, this year’s event showcased the importance of collaboration, cultural diversity and continuous learning.

A key highlight of the event was the Friday morning Cultural Session hosted by the Māori, Aboriginal and Torres Strait Islander Empowerment Committee (MATEC), chaired by Dr Keen Hun Tai, interim MATEC Chair. This session, themed ‘knowledge sharing’, offered insights into how Indigenous perspectives on knowledge can influence modern educational practices in medicine.

We were fortunate to have in attendance the RANZCR ASM’s Artist-in-Residence, Hayley Thompson, Noongar/ Yuggera yorga (Djooken Djilba Art), whose beautiful artwork was featured on the conference website. This piece resonated with the event’s vision, symbolising the connection between knowledge, culture and community under the stars. To explore more of Hayley Thompson’s work, visit @djookendjilba_art on Instagram.

The session’s keynote speaker was Dr Lynne Kelly AM, a distinguished academic, author and researcher known for her work on memory systems. With over 40 years of teaching experience and 21 published books, Dr Kelly has significantly influenced how we understand memory, especially in Indigenous cultures. She currently serves as an Adjunct Research Fellow at La Trobe University and an Honorary Fellow in the School of Physics at the University of Melbourne. Dr Kelly was awarded the Order of Australia for her contributions to science education and is also the current Senior Australian Memory Champion.

Dr Kelly’s presentation delved into the memory systems developed by Indigenous cultures, particularly the First Nations of Australia and the Māori of New Zealand. These systems, using oral communication techniques like storytelling, songlines, music, dance and art, have preserved the history, traditions and knowledge of these

cultures for generations. Dr Kelly emphasised how these memory techniques, which manage complex information without written records, could be applied in modern educational settings, including medical specialist training.

Following Dr Kelly’s talk, I had the opportunity to demonstrate how these ancient memory techniques could be integrated into radiology education. Using the concept of a ‘memory palace’, I guided the audience in encoding key information about neurofibromatosis type 1 into specific locations within the lecture theatre. By mentally walking through the space, trainees could easily recall critical details about this Category 1 condition.

This hands-on example provided a glimpse of how First Nations memory techniques—refined over millennia— could help improve memory retention and learning in medical education, and help trainees prepare for their phase 1 and phase 2 exams.

Dr Keen Hun Tai then provided the audience with an update regarding the initiatives and future direction of MATEC. His update highlighted the ongoing commitment of the Committee to fostering educational opportunities, cultural exchange and empowerment of First Nations trainees, patients and the wider community.

The MATEC Cultural Session was not only an exploration of knowledge-sharing but also a reflection on how we can integrate Indigenous wisdom into our professional practices.

Gathered in Boorloo, Dr Kelly’s message was a timely reminder that the traditional memory methods of First Nations peoples can inspire and enhance modern learning approaches, especially in the medical field.

As we continue to learn from these time-honoured techniques, radiologists, radiation oncologists and trainees are reminded that effective memory strategies, both ancient and modern, can make learning easier, meaningful and even enjoyable. IN

First Nations Medical Educationalist

I am honoured to have been recently appointed as a First Nations Medical Educationalist at RANZCR. I will be working closely with the First Nations Trainee Liaison Officer, Bridie Searle, whose role provides dedicated support and advocacy for trainees. With the assistance of MATEC and the College, we will be working together to ensure First Nations perspectives are included in the development and evaluation of RANZCR curriculum, assessment, education and training processes. Together, we are committed to fostering an inclusive environment that acknowledges and values Indigenous knowledge systems and perspectives, ensuring our educational pathways reflect the rich diversity of First Nations peoples.

Dr Portia D’Anverrs, FRANZCR, MBBS First Nations Medical Educationalist, RANZCR

IAn Open Book

An interview with Prof Gail Garvey AM, lead editor of a new book, Indigenous and Tribal Peoples and Cancer, offering global Indigenous perspectives on cancer care.

nside News recently interviewed Prof Gail Garvey AM, lead editor of the book, Indigenous and Tribal Peoples and Cancer, a comprehensive publication offering global Indigenous perspectives on cancer care.

Prof Garvey is an NHMRC Research Leadership Fellow, and Professor of Indigenous Health Research in the Faculty of Medicine at the University of Queensland. She has established an extensive and targeted research program focused on cancer and the wellbeing of Australia’s First Nations people. Here she discusses the inspiration behind this project and what she hopes clinicians can take from it.

What was the impetus for the publication?

It began 10 years ago when I attended the World Cancer Congress in Melbourne, an international conference focused on providing greater equity in cancer care.

I noticed at that meeting, and in various international publications such as The Cancer Atlas, that Indigenous and tribal peoples were missing from the global cancer agenda.

This sparked the idea for the book which aims to stimulate the international audience and people working in cancer care to enhance global efforts to improve cancer outcomes for Indigenous and Tribal populations.

I wanted this book to be strengths based, so it was really important to me that each of the chapters prioritised Indigenous ways of knowing, being and doing. They focus on what has worked, rather than reporting on the disparities which tend to dominate the narrative about Indigenous peoples.

“Community engagement is really important... taking time to listen to and hear these perspectives offers valuable opportunities to provide holistic and culturally appropriate care.”

Who is this book for?

Researchers, people working in cancer care, policy makers and government and non-government organisations who support cancer patients can benefit from reading this book. It was important that we embedded the voices of Indigenous people affected by cancer right up front. So, the foreword features an excerpt from an interview which Uncle Archie Roach gave at the 2016 World Indigenous Cancer Conference.

His story reflects all the important components of the book and the essential elements for clinicians and others engaging with Indigenous people affected by cancer: taking time, listening, not rushing through things, building trust and relationships.

What was involved?

The book has 77 chapters and is written by 223 authors from eight countries, including Peru, India, Africa, Aotearoa New Zealand, Canada, the US and Australia, which reflects the level of interest and need for this resource.

I’m very proud of the fact that we attracted participants from so many countries who offer a much broader representation of Indigenous perspectives than is usually the case.

As the lead editor I’ve been involved in, read and re-read each chapter, supported by co-editors

from Canada, Aotearoa New Zealand and the USA, each of whom are Indigenous researchers with international reputations in health and cancer research.

The book includes all aspects of the cancer continuum, from prevention through diagnosis, treatment, end-of-life care and death and dying. Indigenous leadership is crucial in cancer care, and it was also essential in bringing together this book. We employed a co-design approach in creating every chapter, with Indigenous leadership, community engagement, partnerships and strengths-based approaches as the must-haves for those wishing to contribute.

We accepted reports, case studies and some personal stories from people with lived experience of cancer. It was important that we presented the information in a way that respected contributors’ cultures and ways of storytelling, so there are lots of images. We didn’t want to put any limitations around this. We’ve included a broad range of topics, and have documented lots of community programs, making them widely available for the broader audience. It was interesting to me to see how people approached things differently, and yet how there are also many similarities in the ways we are addressing cancer inequities within and across countries.

The book includes many practical examples which can enable clinicians and cancer services to extend their knowledge and understanding of how to provide more accessible, culturally responsive and appropriate care and, critically, how to communicate effectively with Indigenous patients and their families around diagnosis and treatment.

For example, we could really learn some lessons in Australia from Indigenous patient navigation programs that are working very well in other countries.

I’m really proud of this piece of

work, although it’s much bigger than I had thought. I also think that the time is right, and that people are ready to engage, listen and learn. We’ve really moved forward in the Indigenous and cancer space in the past decade.

What

has shifted over the past 10 years?

In Australia, it’s been a real struggle to get cancer in Indigenous populations high on the agenda, despite the growing disparities between Indigenous and nonIndigenous peoples. We are not alone in this.

It’s been a case of chipping away over the years at local and government levels. In 2015 we developed the first National Aboriginal and Torres Strait Islander Cancer Framework, and last year, the Federal Government provided significant funding to the National Aboriginal Community Controlled Health Organisation (NACCHO) to focus on cancer. We now have the Australian Cancer Plan, which has a strong focus on equity and Indigenous populations, something which is also occurring in Canada, Aotearoa New Zealand and the US.

The time is perfect for this book, not only here but internationally.

What do you hope that clinicians, or anyone who is working in this space, would take from this book?

First of all, I would encourage them to read the book and take on board the ways of engaging with Aboriginal and Torres Strait Islander people and creating a culturally safe environment.

This means building an Indigenous cancer care workforce, something which is really missing in Australia. In Aotearoa New Zealand, Canada and the USA, they have a much larger Indigenous cancer workforce including oncologists, radiation oncologists, radiation therapists and nurses.

Community engagement is really important and can be as simple as reaching out and introducing yourself to Indigenous staff within your organisation or including an Aboriginal Liaison Officer in multidisciplinary team discussions about an Indigenous patient.

Taking time to listen to and hear these perspectives offers valuable opportunities to provide holistic and culturally appropriate care.

What has this project meant for you personally?

I’m glad that we’re at this point and am very excited about it. I was very excited about it 10 years ago!

I’ve gained so much culturally out of this process myself it was really strength building for me as well as being integral to the book.

I’m really most proud about the 223 authors, how we’ve all collaborated and learned from each other, and come together as a collective with the same goal of trying to address the inequities in cancer care for Indigenous and tribal peoples.

We don’t have all the answers in Australia no country does yet we can come together and share what is working and then think about how that might work in our local context.

I hope that this book can help move the conversation about Indigenous cancer care from a deficit to a strengths base that emphasises collaboration, Indigenous leadership, local community partnerships and engagement, whatever the location. IN

on 4 October 2024 and is available on Springer.

Scan the QR code to view a video introducing the book. Indigenous and Tribal Peoples and Cancer was published

TOPGEAR Findings Take Centre Stage

An interview with Prof Trevor Leong on his TOPGEAR study and its implications.

In September, RANZCR member Prof Trevor Leong presented the Australasian Gastro-Intestinal Trials Group (AGITG) TOPGEAR findings at the European Society for Medical Oncology (ESMO) Congress in Barcelona, while the study was simultaneously published in The New England Journal of Medicine (NEJM). Worldwide, gastric cancer is the fifth most common cancer and fourth leading cause of cancer death. In Australia, the survival rate is below 40 per cent. The TOPGEAR (Trial of Preoperative Therapy for Gastric and Esophagogastric Junction Adenocarcinom) study evaluated the addition of preoperative chemoradiotherapy in the treatment of gastric cancer. Reflecting on the TOPGEAR results, Faculty of Radiation Oncology Dean Dr Gerry Adams commented on Prof Leong’s great leadership and dedication towards his research career and thanked him for his efforts “helping to contribute to the high level of respect RANZCR and our Faculty attract around the world”. Here, Prof Leong shares more details about the study.

The trial provided an answer to what has been a burning question in gastro-oesophageal cancer care for the past 20 years. What was the aim of the trial and how many patients were involved?

In many Western countries, the standard of care for resectable gastric cancer is perioperative chemotherapy (chemotherapy before and after surgery). There is keen interest in preoperative chemoradiotherapy, which has been adopted by some centres particularly as it is a standard of care for oesophageal cancer. However, comparison to perioperative chemotherapy is lacking. The TOPGEAR trial investigated whether adding preoperative chemoradiotherapy to perioperative chemotherapy would improve pathological complete response rates, and ultimately overall survival compared to perioperative chemotherapy alone. The role of radiation therapy in the management of resectable gastric cancer has been a topic of debate for more than 20 years. When recruitment to the trial closed in May 2021, 574 patients had been

enrolled from 70 participating sites across 15 countries in Australasia, Europe and Canada.

This was a multidisciplinary study that involved collaborative efforts. Can you tell us more about the people and organisations involved in this research?

TOPGEAR was a multidisciplinary effort on many levels. Firstly, preoperative gastric irradiation was a new technique that was unfamiliar to most radiation oncology departments. Therefore, a multidisciplinary radiation oncology committee was formed comprising radiation oncologists, radiation therapists and medical physicists to develop detailed radiation oncology guidelines for the trial, and to oversee the comprehensive radiation therapy quality assurance (RTQA) program that formed an integral part of the study.

Secondly, TOPGEAR was a trial investigating adjuvant

therapies in patients with resectable and curable gastric cancer. As such, the trial required active engagement by all three medical disciplines normally involved in the management of these patients: surgical oncology, medical oncology and radiation oncology. Without this commitment from all groups, particularly surgeons, the trial would not have succeeded. The International Trial Management Committee comprised representatives from all three disciplines across the three continents participating in the trial.

Thirdly, we knew from the outset that in order to manage such a complex trial, and achieve the required sample size of 570 patients, TOPGEAR needed to be a major international collaborative effort involving multiple cancer trials groups. The trial was led by AGITG, coordinated by the NHMRC Clinical Trial Centre (NHMRC CTC), with the Trans Tasman Radiation Oncology Group (TROG) overseeing global RTQA. Internationally, the trial involved the collaborative efforts of the European Organisation for Research and Treatment of Cancer (EORTC) and the Canadian Cancer Trials Group (CCTG).

As an academic (non-industry sponsored) trial, TOPGEAR was funded by three successive NHMRC grants as well as competitive grants in Canada, Europe and New Zealand.

The study showed there was no significant benefit of chemoradiotherapy on the long-term survival of patients with cancer of the stomach or oesophagus/ stomach junction What’s the good news for radiation oncology?

Although the results are a little disappointing for radiation oncology, we have no control over the data. The purpose of conducting large randomised phase 3 trials is to answer questions and uncover the truth. All of the investigators are very proud that the trial has provided a high-quality answer to a long-standing question with implications for clinical practice.

Although chemoradiotherapy did not meaningfully improve cancer control or extend survival, TOPGEAR did provide us with important new knowledge to improve our understanding of gastro-oesophageal cancer. Patients receiving chemoradiotherapy were found to have higher rates of complete response of their tumour at the time of surgery, compared with standard care (17% versus 8%). The doubling of pathological complete response rates and the absence of incremental moderate to severe toxicities when chemoradiotherapy was used provide important data to guide the future exploration of radiation therapy in the management of gastric and gastro-oesophageal junction cancers.

The results of the study are globally significant. Can you explain some of the potential implications for clinical practice in Australia and internationally?

We now know that with high-quality surgery and perioperative chemotherapy, preoperative chemoradiotherapy should not be used in management of patients with resectable gastric and gastro-oesophageal junction cancers. The results will be practice changing as some centres, particularly in the USA, currently employ preoperative chemoradiotherapy as standard treatment for gastric cancer, which has also been the standard of care in Europe, Canada and Australia for patients with gastro-oesophageal junction cancers who comprised one-third of the TOPGEAR patient cohort. National and international guideline committees will need to reconsider the current role of chemoradiotherapy in this setting.

Having an Australian radiation oncology trial published in NEJM is quite an achievement what advice do you have for other researchers?

The NEJM paper is recognition that TOPGEAR is a highquality, well-designed trial with practice-changing results that are generalisable to a global population. It was a large academic trial that involved the tireless efforts of hundreds of people around the world over many years. The takehome message is that research requires persistence and dedication but can be very rewarding, so be prepared for the long haul. IN

Local Cancer Care

A new radiation oncology centre in Albany, WA, is having a positive impact on patients who no longer need to travel great distances for treatment.

Targeting Cancer has long advocated for more accessible radiation therapy treatment in regional and rural Australia. And a new public-private radiation oncology treatment centre in Albany, Western Australia, is proving why more localised services for cancer sufferers in regional areas are so important.

The centre opened last May after years of campaigning by Albany residents for cancer treatment options closer to home. Operated by GenesisCare, the centre is part of the local hospital at Albany Health Campus and has treated over 375 local cancer patients in just 18 months.

Local radiotherapists, patient support staff and cancer nurses are based at the centre and supported by the medical oncologists, physicians and allied health professionals at the hospital. Radiation oncologist consultants work on a rota system, flying in and out of Albany from other locations in Western Australia.

Perth-based consultant Dr Qurrat Van Den Blink is one of about 10 doctors who work at the treatment centre in this way, staying in temporary accommodation when in Albany. “I can’t emphasise enough how important this treatment centre is to local patients,” said Dr Van Den Blink. “It is even helping cancer patients from further afield than Albany, including Esperance. Without the centre in Albany, patients would have to get to Perth for treatment [420 kilometres away].”

Radiation therapy is used at the centre to treat patients diagnosed

with a range of cancers, including breast, prostate, skin, lung, pancreatic and lymphoma. “Many of our cancer patients are elderly, and the trip would cause a great deal of stress both physically and mentally,” explained Dr Van Den Blink. “By being treated nearer to home, patients get to stay in their households, close to loved ones and carers, and near facilities they know and use regularly. This can make a world of difference to their treatment outcomes, including how they react to any potential side effects.”

One patient who has nothing but praise for the centre is 75-yearold Hilary Jenkins, a local Albany pensioner who has been receiving treatment for oesophageal cancer. “I had 28 rounds of radiation therapy at the new centre for my cancer earlier in the year, and I can’t fault the place,” said Hilary, who is a retired baker. “The centre staff were all wonderful, especially Dr Van Den Blink. Going all the way to Perth for treatment would have been a huge

ask at my age, and in all honestly, I’m not sure if I could have done it. My daughter has been caring for me in Albany, and it was important during my treatment we both stayed as local as possible as she had other commitments, including my grandson. It wasn’t frightening at all, and I had no pain or discomfort.”

Targeting Cancer Co-Chair Dr Lucinda Morris added: “It is heartening to hear about the Albany Treatment Centre and from Qurrat and Hilary on how it is having such a positive impact on cancer patients in regional WA. Targeting Cancer and RANZCR strongly support and advocate for equity of access for all Australians living with cancer, no matter where they live.

“The Targeting Cancer website features an interactive treatment centre map to help patients find their nearest radiation therapy treatment centre across all of Australia and New Zealand,” said Dr Morris. “The campaign welcomes all news of new treatment centres opening.” IN

(above left) Dr Van Den Blink; (right) Hilary with centre staff during her treatment.

2025 IRSAASM

29 July - 01 August 2025 Grand Hyatt, Melbourne

Please join us for a one-day Interventional Oncology Symposium followed by the three-day Annual Scientific Meeting (ASM)

SAVE THE DATE

Early bird registrations open January 2025 For more information, www.irsaasm.com

Early Bird Registration open

Register by 6th January to go in the draw to win the early bird prize - dinner for two at 3 chef hat restaurant Wildflower, Perth CBD

It Starts With A Nephrostomy

Vascular and Interventional Radiologist Dr Mihir Desai highlights the work of Road2IR, a group dedicated to developing IR services in East Africa, and shares details of his recent posting at the Mulago National Referral Hospital in Uganda.

Interventional radiology (IR) has become integral to the delivery of modern healthcare, but currently only half of the world’s population has access to it.

This is particularly apparent in Sub-Saharan Africa, where postpartum haemorrhage, trauma and oncology are a disproportionate health burden.

Road2IR is a program developed by Fabian Laage Gaupp in 2018 to train African interventionalists and develop local infrastructure to provide a long term, selfsufficient system. At its core are high frequency, two-week teaching trips by international IR consultants, nurses and radiographers to provide in-country clinical training.

The program commenced in Dar es Salaam, Tanzania, at the Muhimbili National Hospital, and has resulted in 16 graduated Fellows to date. The unit now performs the full spectrum of IR including complex vascular and oncological interventions. It has been developed as a regional training hub and the program has recently been expanded to neighbouring Uganda, where the Mulago National Referral Hospital (MNRH) became the second Road2IR training site.

The almost 50 million strong population of Uganda currently has no formally trained interventional radiologists. The first intake at MNRH’s Road2IR training site consists of three Fellows and consultant radiologists who have entered the newly established two-year program. Led by Eva Nabawanuka, the team has already developed a mature clinical service with a busy out-patient clinic,

inpatient services and long term follow-up. Specialised equipment is currently donated by visiting teams while local supply chains are being developed.

Patients often present with advanced stages of disease, not commonly encountered in Australia. Despite this, the clinical work is rewarding as even the simplest procedure can result in life-altering benefits. A memorable example involved a bed-bound six-year-old boy with metastatic pelvic sarcoma and bilateral obstructed kidneys. Due to his renal failure, he was unable to qualify for chemotherapy to control his symptoms. Inserting nephrostomies led to a remarkable clinical improvement.

There is an ever increasing number of referrals from both within the hospital and around the country, with some patients travelling over 24 hours to receive care. We performed an array of procedures, including biopsies, drains, nephrostomies and complex biliary reconstructions. The department is rapidly evolving and

new treatments are being offered as soon as they become feasible. Recently a paediatric vascular malformation service has been established, aiding patients who were otherwise without effective treatment options.

The success of the program demonstrates that this model can lead to sustainable services, resulting in exponential growth as local units become regional training hubs for Fellows from neighbouring countries. An enormous amount of administrative work is being done at an organisational level to develop the infrastructure to support IR in East Africa, however, despite this, clinical training lies at the foundation of its mission. This meaningful work is deserving of support from our community in Australia and NZ. IN

For further details about the program and how to join, visit www.road2ir.org or you can contact Dr Desai via email desai.mih@gmail.com

Dr Alex and Dr Sam in the newly established Uganda Cancer Institute.

Leading the Charge

The latest news on the National Lung Cancer Screening Program (NLCSP).

The introduction of the National Lung Cancer Screening Program (NLCSP) marks a significant advancement in Australian healthcare, particularly for radiologists and those in cancer care. This program focuses on early detection and treatment outcomes for lung cancer, placing RANZCR at the forefront of a transformative healthcare initiative.

Lung cancer remains Australia’s leading cause of cancer-related deaths, claiming over 8,000 lives annually. Often diagnosed at an advanced stage, the survival rates for late-stage lung cancer remain low. The NLCSP aims to change this by utilising low-dose CT (LDCT) scans to detect lung cancer in its early, more treatable stages. Studies show that early detection through LDCT could potentially save over 500 lives each

year, sparing families from the loss of loved ones to this disease.

Enhancing Clinical Practice

The NLCSP integrates advanced evidence-based tools, the PanCanadian Early Detection of Lung Cancer (PanCan) risk model and Lung-RADS, to improve patient care by stratifying risks and managing lung nodule findings accurately. This approach supports precision in diagnosis and treatment, leading to better patient outcomes.

A multidisciplinary team (MDT) model is also a key component of the program, encouraging collaboration among specialists to provide holistic care. This model not only improves patient outcomes but also fosters a collaborative learning environment among healthcare professionals, enriching the quality of clinical practice.

Public Health Impact

The NLCSP is a significant public health effort with the goal of reducing lung cancer mortality on a national scale. Clinicians participating in this program contribute directly to Australia’s broader mission to improve public health. Furthermore, the program integrates smoking

cessation support, addressing the leading cause of lung cancer. This dual approach targets both prevention and treatment, improving outcomes for patients and reducing other smoking-related diseases.

Professional Development

RANZCR members will have access to extensive resources, training and the latest research findings through the NLCSP. This enhances professional development by keeping radiologists at the cutting edge of lung cancer screening and treatment. The data collected will support quality assurance and contribute to future research, allowing members to play a vital role in advancing cancer care. IN

How to Get Involved

RANZCR members are uniquely positioned to lead the change by joining our Special Interest Group, the Australian and New Zealand Society of Thoracic Radiology (ANZSTR). ANZSTR is open to all radiologists who report thoracic imaging, and will be providing rolling updates as we approach screening launch in July 2025.

Mark Your Calendars

The countdown is on to the FROGG (Faculty of Radiation Oncology Genito-Urinary Group) Workshop in 2025.

The FROGG committee is gearing up for our upcoming FROGG Workshop in 2025, scheduled for 3-5 September in Brisbane. We have a line-up of exceptional international speakers, with the meeting’s focus being the use of stereotactic radiation therapy in localised prostate cancer. Stay tuned as we finalise the formal scientific program in the coming months.

FROGG would also like to extend our heartfelt congratulations to the organising committee of the recent RANZCR ASM for shaping a successful event. A special shoutout to A/Prof Wee Loon Ong for taking home the FROGG Prize.

In addition to the FROGG Workshop next year, the executive committee is actively working on several other initiatives, including registrar teaching webinars and ongoing work for the MSAC application to propose MRI planning for prostate radiation therapy. We would also like to take this opportunity to give a big thank you to outgoing FROGG Chair A/Prof Sarat Chander for all his hard work and commitment to the group as the Chair over the past 12 months. Thank you for your continued support. We wish everyone a Merry Christmas and Happy New Year and look forward to an exciting year ahead! IN

For the latest updates on the next workshop, visit www.frogg.com.au

New FROGG chair Dr Braden Higgs (right) presenting the FROGG prize to A/Prof Wee Loon Ong at the 2024 RANZCR ASM in Perth.

OGSIG on the Gold Coast

Updates on the OGSIG Executive, and a sneak peek of what to expect at the 2025 ASM.

Christchurch will now be co-Chair of OGSIG. Rachael is an experienced sub-specialist O&G radiologist, who been secretary of OGSIG since its inception. She is well placed to help steer OGSIG into the future.

We hope that everyone has recovered from the excitement of having an unprecedented five sessions of O&G Imaging at the recent RANZCR ASM in Perth. Thank you to the convenors for showcasing women’s imaging, along with so many wonderful talks on leadership and health equity.

Congratulations to Dr Lynne Brothers from Hobart, who received a Life Membership of OGSIG for her outstanding contribution to O&G imaging in Australia over many decades. Lynne can add this to her list of many achievements, which includes receiving an Excellence in Women’s Health Award from RANZCOG in 2019. Lynne has now retired from the OGSIG Executive her years of service are much appreciated.

We are excited to share some other updates regarding OGSIG. First, some news regarding the OGSIG Executive...

Dr Rachael McEwing from

We have also welcomed Dr Neil Caplin and Dr Paul Chou to the OGSIG Executive. Neil is a women’s imaging and paediatric radiologist from Sydney/Hobart who brings a unique perspective of all these subspecialties to OGSIG, adding balance to the committee. Paul is from the Gold Coast, and is an experienced radiologist with subspeciality interest in women’s imaging. Both Neil and Paul have been OSCER/Viva examiners for many years.

They join us, as well as Dr Virginia Saxton and Dr Ekaterina Alibrahim, in a strong Exec which provides bi-national and multi-state representation across both the public and private sectors.

We would also like to announce that we have a special superstar international speaker for OGSIG ASM 2025 A/Prof Mathew Leonardi, from Canada. A/Prof Leonardi is a gynaecologist with subspecialty interest in imaging and endometriosis. He is an incredible educator, whose talks and workshops are always enthusiastically received. A/Prof Leonardi will be supported by fabulous local, national and international speakers in a program that is geared towards the general

radiologist, to enhance and update their knowledge of O&G imaging. OGSIG ASM 2025 will be held on Thursday 6 March 2025, in the Gold Coast. This will, as usual, be just before the ARGANZ meeting. Registrations are now open via the OGSIG website or eecw.eventsair. com/ogsig25

We will be holding our AGM at the ASM this year. The Executive members are looking forward to meeting with you and answering any questions pertaining to O&G imaging in Australia and Aotearoa New Zealand.

On Friday 7 March, just after the OGSIG ASM, the inaugural School of OGSIG will join forces with the School of ARGANZ. We will be presenting a great program aimed at trainees, with tips and tricks from RANZCR O&G and abdominal examiners and international speakers. This is open to all. Thank you to ARGANZ for collaborating with us on what will surely be a great day for abdominal and O&G learning for trainees and Fellows.

We would also like to alert you all to a recent publication from the Society of Radiologists in Ultrasound (SRU) about a Lexicon for FirstTrimester Ultrasound a useful guide with modern terminology (e.g. “Fetal pole” be gone!! “Embryo” or “fetus” it is!). Visit https://pubs.rsna.org/doi/ full/10.1148/radiol.240122

We hope to see many of you in March in the Gold Coast. IN

A/Prof Emmeline Lee and Dr Rachael McEwing

Collaboration in Cambodia

APROSIG was recently part of a team visiting cancer hospitals in Phnom Penh. Here's a report from Dr Greg Wheeler, a radiation oncologist at Peter MacCallum Cancer Centre, Melbourne.

In August, four radiation oncologists (Dr Iain Ward, Dr Mei Ling Yap, Dr Sean Hassan and Dr Greg Wheeler), along with Kate Rogl (radiation therapist) and Sam Towns (medical physicist) visited Phnom Penh, Cambodia. We represented the College’s Asia-Pacific Radiation Oncology Special Interest Group (APROSIG), the ACPSEM Asia-Pacific Special Interest Group and the ASMIRT Global Medical Radiation Practitioner Reference Group (GMRPRG). The visit was supported by the RANZCR International Development Fund.

APROSIG has a longstanding relationship with Phnom Penh’s Calmette Hospital, including facilitating a 15-month placement undertaken by Kate pre-COVID, as a radiation therapist trainer.

Activities during this visit included tutorials and a discussion of difficult cases. We attended the newly established Multidisciplinary Meeting, where there was robust engagement of all specialties, reflecting the team’s desire to provide good care. We undertook meetings with the Ministry of Heath, the Australian Embassy, Australian Volunteers International and City Cancer Challenge. We also visited the private Orange Cancer Centre, the new Luang Mè cancer hospital, and Kantha Bopha Children’s Hospital.

With a population of almost 17 million and only three linacs, Cambodia has an urgent need to expand its radiation treatment

services. Calmette Hospital is purchasing a second linac and we were able to advise on specifications.

APROSIG and the GMRPRG have also been asked to support development of a formal radiation therapist training course. The national radiation oncology community is highly motivated and has made dramatic progress in recent years.

APROSIG will continue to support our Cambodian colleagues in line with our objective of supporting the safe and effective delivery of radiation therapy in low- and middle-income countries in our region. IN

“With a population of almost 17 million and only three linacs, Cambodia has an urgent need to expand its radiation treatment services.”
Dr Greg Wheeler gives a tutorial on paediatric radiation oncology to clinical oncology residents at Calmette Hospital.

2024 in Review

Reflecting on an eventful and productive year across the Faculty of Clinical Radiology.

The Faculty Council of Radiology is the peak bi-national body in radiology comprising of councillors predominantly elected directly by the membership and is responsible for a wide range of areas in radiology including overseeing training and exams, professional standards, CPD, policy and advocacy, IMG assessment, accreditation, Special Interest Groups and the advancement of knowledge in the profession.

It takes a concerted and collective effort of members and staff to progress our shared objectives, and those who volunteer their time and expertise deserve our heartfelt gratitude.

Below is a snapshot of FCR achievements in 2024...

The College achieved a key policy priority for clinical radiology with the deregulation of MRI services in MMM1 metropolitan areas from 2027, complementing the deregulation of licences for MMM2-7

rural and regional locations in 2022.

In response to a RANZCR proposal, Medicare was expanded to cover rectal MRI restaging and surveillance (currently, it is only for the first staging).

Indexation for nuclear medicine imaging was achieved, comprising a targeted schedule fee increase and the reintroduction of annual indexation (including non-PET imaging services).

Work continued on the National Lung Cancer Screening Program (NLCSP) (due to start on 1 July 2025) aimed at improving early detection of lung cancer and improved outcomes through structured screening.

RANZCR successfully advocated for mandatory Breast Density Reporting for Cancer Screening, a crucial factor in improving breast cancer detection rates (denser breast tissue can obscure cancer detection in mammograms).

RANZCR made significant strides in the integration of artificial intelligence (AI) within radiology. The AI Committee has been establishing best-practice guidelines and standards for the safe and ethical use of AI in medical imaging, critical for ensuring that AI augments, rather than replaces, the clinical judgment of radiologists. This has culminated in two new papers on generative and autonomous AI. It is noteworthy that RANZCR is a global front runner in AI.

Efforts to bridge the Indigenous healthcare gap have been strengthened by targeted policies to improve equitable access to

radiology services for Indigenous populations.

The MATEC now reports to both Faculty Councils and is doing some amazing work in bridging the gap. At the Joint Faculty Council meeting in August, MATEC had a name change now the Māori, Aboriginal and Torres Strait Islander Empowerment Committee, and both the Action Plan and Statement of Intent have been updated.

Cross-faculty engagement and networking offers many opportunities to collaborate, leverage shared knowledge and build consensus, strengthening each faculty and the College as a whole in advancing excellence in clinical practice.

In Other Developments:

The College received a contract from the Department of Health and Aged Care for the Silicosis Project

The bi-faculty Environment, Social and Governance Working Group (ESGWG) was established

Both Faculty Councils received training on Cultural Awareness comprising the topics of Māori health, equity and cultural safety, and on unconscious bias.

Highlights from Training and Professional Development include:

Refinements to the training programs via our Curriculum Assessment Committee (CRCAC).

2024 was the second year of delivering the new Phase 2 examination format, creating new resources for candidates in

Dr Rajiv Rattan, Dean (FCR)
“It takes a concerted and collective effort of members and staff to progress our shared objectives, and those who volunteer their time and expertise deserve our heartfelt gratitude.”

preparation for examinations, and offering more flexibility for sitting Phase 2 written examinations.

Following a three-year review process, the new clinical radiology Training Site Accreditation Standards have been approved, with the roll out commencing in January 2025.

There has also been progress on the IR and INR Grandparenting Pathway, with FIR and FINR postnominals endorsed in principle by the Council and sent for member consultation.

Regional and Rural Training Pathway (RRTP) funding was secured for eight additional funded training posts in Australia.

RANZCR received a Flexible Approach to Training in Expanded Settings (FATES) grant, which is supporting our goal of inclusive training, enabling the appointment of a First Nations Training Liaison Officer and a First Nations Medical Educationalist to provide culturally appropriate support for Aboriginal and Torres Strait Islander and Māori trainees.

In digital health, RANZCR is a founding member of Sparked, a collaborative community led by the CSIRO, DOHAC, ADHA and HL7 Australia. Sparked is driving major advances towards interoperability through the development and adoption of health data exchange standards. Additionally, the College has developed a standardised terminology for radiology procedures that will be adopted as part of the national electronic requesting capability for diagnostic imaging and pathology, to be launched in July 2025.

To cap it all, the RANZCR ASM at Perth was a resounding success thanks to the wonderful work done by our convenors.

Thank you!

Finally, huge thanks to all members who selflessly give up their time to sit on the Faculty Council, Committees, Working Groups, Reference Panels, Special Interest Groups, Branches etc, and to the terrific RANZCR staff. This collective effort contributes to the betterment of RANZCR and our profession as a whole.

Outgoing Councillors

Dr Mike Baker, NZ Rep (Jan 2022–Dec 2024)

Prof Dinesh Varma, Chief of Professional Practice (Jan 2019–Dec 2024)

Dr Ronny Low, WA Rep (Jan 2019–Dec 2024)

Dr Gabes Lau, NZ Branch Chair (Jan–Dec 2024)

Dr Sanjay Hettige, Trainee Rep (Jan 2023–Dec 2024)

Welcome to New Councillors

Dr Jash Agraval, NZ Branch Chair

Dr Pramod Phadke, Chief of Professional Practice

Dr Fiona Bettenay, WA Rep Dr Prashanth Sasidharan

NSW Trainee Rep

NZ Rep (TBC)

Continuing Councillors

I am delighted to be continuing as Dean of the Faculty of Clinical Radiology for another term and extend my congratulations to Dr Barry Soans on a second term as Chief Censor of the Faculty of Clinical Radiology. IN

Enhancing Trainee Support and Input

Reflections on the recent RANZCR ASM and DoT Workshop in Perth.

It was a pleasure to meet with potential trainees, current trainees, Directors of Training (DoTs) and other members at the recent Annual Scientific Meeting (ASM) in Perth. This provided an excellent opportunity to connect, reconnect, exchange ideas and focus on the ongoing development of our training programs. Events like these continue to showcase the collective strength of our medical education community and highlight the strides we’re making in supporting our trainees on their journey.

A significant highlight of the ASM was yet another impactful DoT workshop, led by our Medical Educationalist, Dr Ruth Sutherland, and Dr Jash Agraval, Deputy Chief Censor (Curriculum and Assessment). The workshop focused on ensuring our DoTs are well-equipped to guide and mentor the next generation of medical professionals. There was an emphasis on the importance of empowering our DoTs to provide more structured and meaningful support to trainees. This, in turn, allows us to foster an environment where our trainees feel both encouraged and supported throughout their training experience.

During my tenure as Chief Censor, I have seen first-hand how valuable it is to involve trainees in the decision-making processes. This has been enhanced by increased representation on our

official committees, but also the more informal working groups that are involved with reviewing aspects of training and the training program that will directly affect our trainees. Greater trainee input has led to making more informed decisions, particularly regarding the direction and focus of the training program. Trainees provide a unique perspective which may not always be visible to us. By engaging directly with trainees, we have been able to address specific concerns more effectively, leading to improvements in both the trainee experience and training outcomes.

As we continue to evolve the training program, this collaborative approach will remain a core focus. Wider stakeholder consultation, including input from trainees, clinical supervisors and DoTs, ensures that we are taking a well-rounded and inclusive approach to training.

I feel privileged to be able to serve another term as Chief Censor, and look forward to continue working closely with and collaborating with our Trainee Committee and all trainees.

I would like to express my gratitude to Dr Jash Agraval for his outstanding contribution to the Education and Training Committee (CRETC). Jash first joined CRTC as a trainee representative and has been a member of the Curriculum Assessment Committee (CRCAC) since 2018, becoming Chair in

2020. Jash has been intimately involved with the development of the new curriculum and training program, and has driven many other significant initiatives. We are all excited to see him take on the position of New Zealand Branch Chair, where his experience and expertise will continue to serve the broader medical community.

The new accreditation standards, effective from January 2025, introduce a more streamlined process with simplified documentation and faster turnaround times. This approach aims to reduce duplication while providing greater support, helping sites deliver high-quality training in a more efficient and encouraging manner. Looking ahead, we are committed to further improving the trainee experience. This includes exploring new ways to enhance training outcomes, refine the program structure, and provide even greater levels of support. By maintaining a strong partnership with our trainees and key stakeholders, we are confident that we can continue to build a worldclass training program that meets the needs of the next generation of healthcare professionals. IN

Dr Barry Soans, Chief Censor (FCR)

Change in Motion

Welcoming the incoming 2025 CRTC committee, and news of a RANZCR wellbeing initiative available now.

As we approach the end of the year, it’s important to reflect on the whirlwind months that have led to this point. For radiology trainees across the country, the demands of service delivery are ever increasing in an environment of strains on supervision and balancing this with exams, assessments, family and friends.

There are obviously system changes that need to happen to reduce burnout and improve the mental health of doctors-intraining. It’s also important that we take care of our own health. To help facilitate this, RANZCR

has recently partnered with CU Health, a virtual health provider, to offer four complimentary vouchers for psychology sessions. Visit the RANZCR Wellbeing website for more information and to register.

This is my last year as Chair of CRTC and it has been an honour to represent radiology trainees at the College and advocate for change to improve our training. Change is incremental and takes time but hopefully we’ve been able to change some things for the better and listen and respond to your concerns. I look forward to handing over the chair role to one of the great 2025

committee members and I’m sure they will serve you well.

I hope everyone has an excellent end of year filled with rest, relaxation and time with loved ones.

As always please feel free to reach out to CRTC at clinicalradtc @gmail.com and also feel free to contact me at sanjay.hettige @gmail.com or 0405 472 499 IN

Dr Sanjay Hettige, CRTC Chair

Passing the Baton

Prof Varma recaps some of the achievements and initiatives implemented over his past six years as Chief of Professional Practice.

As I reflect on my time in this role over the past six years, I am filled with gratitude and a deep sense of accomplishment. It's been an invaluable experience that has allowed me to implement a few changes, some critical, aimed at enhancing professional practice and ensuring that our members are supported in their continuous professional development (CPD). One significant milestone was overseeing the implementation of input into consultations from the Medical Board of Australia (MBA) regarding CPD Homes. This initiative was pivotal as we transitioned from a triennial CPD model to an annual program, a shift that recognises the evolving landscape of medical education and practice. I am proud to report that we moved from a point-based system to an hoursbased approach for CPD, which I believe provides our members with greater clarity and flexibility in meeting their developmental needs.

In our quest for quality, we achieved the accreditation of our College by the AMC as a CPD Home—one of the first Colleges to receive such recognition. This accreditation, extending until 2030, underscores our commitment to maintaining high standards in medical practice and education.

In 2022, we introduced the ePortfolio as a key component of our first annual CPD program, and I led the establishment of a CPD taskforce that took the time to gather member feedback. This allowed us to engage directly with our members and their experiences, leading to significant enhancements in the ePortfolio

system. I am excited to announce that the changes we’ve agreed upon will be implemented in 2025, aiming to provide a richer and more user-friendly experience. Additionally, my efforts extended to developing a robust Certification Policy that establishes a clear framework for any future credentialing programs. It was crucial to have a solid foundation to support our members and ensure that any new initiatives align with our overarching goals of professional excellence and patient safety.

In 2023, I was fortunate to lead discussions with the Cardiac Society of Australia and New Zealand and the Australasian Association of Nuclear Medicine Specialists. Together, we undertook the important task of reviewing the Training Guidelines for CT Coronary Angiography (CTCA). This extensive project spanned over 12 months and focused on ensuring that accreditation for those who had been practising for more than six years would depend on CPD rather than mere case numbers. I am proud say that this came into effect on 1 July 2024, enhancing the standards of training and continuous development in our field.

Throughout 2023 and 2024, I worked collaboratively with the Special Interest Groups (SIGs), the Faculty of Radiation Oncology and our College staff to address various concerns raised. Together, we made significant changes to the SIG manual to better reflect the operational needs of our members.

Another significant achievement was my role as Chair of the Tripartite Committee between RANZCR,

the Interventional Radiology Society of Australia (IRSA), and The Australian and New Zealand Society of Neuroradiology (ANZSNR). This committee was formed to foster clearer communication and collaboration among our organisations, allowing us to better advocate for interventional radiology and interventional neuroradiology. One of the outcomes of our collaboration was the signing of a Memorandum of Understanding (MoU) at the ASM, a moment that symbolised our commitment to working together for the benefit of our members and our patients.

I am invigorated by all that we have accomplished and the positive changes we have put in place. I am excited to pass the baton to my successor, Dr Pramod Phadke, knowing the foundations we’ve built will continue to support innovation and excellence in our profession.

I would like to thank all the Professional Practice Committee members for the hard work we have done together. Thank you, Chief of Professional Practice, Radiation Oncology and the Dean and Councillors FCR for the support you have provided. For any committee to deliver on its objectives you need an efficient and dedicated staff, and I have been very fortunate to work with Shellye Hanson and her team. I look forward to witnessing the continued growth and evolution of clinical radiology. IN

Prof Dinesh Varma, CHoPP (FCR)

REGISTER NOW

Join us in Canberra as we continue our journey exploring healthcare transformations in the Oncology landscape, fostering avenues to support improved workflows. Together we will embrace innovations to enhance efficiencies in this ever-changing environment, ultimately advancing patient and clinician outcomes and the pathways to truly comprehensive cancer care.

& ACPSEM CPD hours can be claimed for attendance of the Varian Australasian Oncology Summit 2025.

The Challenge of Geographic Inclusion

Why we need to challenge our attitudes and approach towards regional and rural training and practice.

As I come to the end of my term as Dean, I would like to share some important reflections which are the result of nine years’ serving on various College committees and two years in the role of Dean.

I believe it’s timely for each member of our Faculty to consider their personal role in demonstrably embracing diversity and inclusion across our profession, particularly when it comes to our perceptions about those who choose to train and practice in non-metropolitan centres.

Unfortunately, there is a prevailing attitude within medicine generally that those who work in regional or rural areas are only there because they can’t ‘make it’ in the city. These perceptions can influence trainees’ attitudes to regional rotations as something to be ‘gotten through’ and reinforce the notion that ‘the best jobs are in the city’.

Radiation oncology (RO) is not immune to this perception, which is not surprising in one sense given that until relatively recently, RO

services and training were mostly delivered in the big metro teaching hospitals. While most training is still metro-based, in recent years, service, and to a lesser extent training, has been more widely available in smaller, non-metro centres.

And there is certainly a need for this to continue. Government policy and strategy are focused on promoting and supporting a regional workforce in response to the well-documented poorer health outcomes for those living in regional and rural areas, compared to their city counterparts, particularly for First Nations people. New Zealand currently has a more metropolitan base for radiation therapy and its own additional troubles. But these issues are also important there.

Populations have increased in regional centres over the past 10-15 years with 30% of the population now living outside metropolitan locations. This exacerbates the demand for a specialist medical workforce and the environmental impact caused by mass travel for medical services. However, we struggle to recruit and retain ROs in these areas, not least because of our metro-centric (unconscious and conscious) bias.

Add to the mix our own professional aspirations to promote the benefits of RO for cancer treatment, and the ongoing challenge to improve cancer outcomes for our patients, regardless of their postcode.

While the College is stepping up to these challenges with changes to training accreditation, rural training posts, grants and awards

to encourage research, and some weighting towards regionality in training, there is still some resistance among members to these reforms.

We each have an opportunity to challenge our blind spots to broaden our perspectives, genuinely embrace diversity in every facet of training and demonstrably value regional training, trainees and the non-metro RO workforce.

RO has evolved and continues to do so, and as part of this, there are a range of skills, techniques and opportunities that the new generation needs to have to create a sustainable future for our profession and to serve all of our communities and our countries.

We therefore need to encourage new doctors with diverse interests and aspirations to join our community, and affirm that those whose desire is to train and work in non-metropolitan settings are not only accepted but encouraged because of the value they bring.

Changing our individual and collective attitudes and approach to rural and regional training and practice will help to address the maldistribution of ROs in the bush, attract a greater diversity of junior doctors to our community, and inform our decisions about the skills, techniques and training priorities for our future.

This issue won’t be resolved overnight, but as members we can each make a positive contribution to meeting this challenge.

The fact remains that the demand for ROs in the regions will continue to grow. It is our collective responsibility to support the ongoing efforts by the College, government and providers to address this.

I wish all members well for the future, and warmly welcome Dr Tuan Ha, the new FRO Dean, to this role. It has been a privilege to serve our Faculty. IN

Dr Gerry Adams, Dean (FRO)

HYPOFRACTIONATED RADIOTHERAPY IN THE ASIA-PACIFIC REGION

EXPERTS FROM SOUTH KOREA, Japan, Singapore and Australia assess current challenges and opportunities

Hypofractionated radiotherapy treatments deliver higher per-fraction radiation doses over fewer treatments than traditional radiotherapy. As reported in JCO® Global Oncology, hypofractionated radiotherapy has become the standard of care for breast and prostate cancer patients in the United States and Europe, with studies suggesting that outcomes are noninferior to conventional radiotherapy, while treatment durations are shorter and at a lower cost to health systems.1

“Hypofractionation—when it is indicated—is better for everyone. Better for the patients, whose treatment regimens end sooner; better for the health care providers, who can reduce the cost of treatment per patient and potentially serve more patients,” said Dr. Ricky Sharma, Vice President Clinical Affairs at Varian. “Unfortunately, the adoption of this approach has not been widespread across the Asia-Pacific region, as reflected in a global study that highlighted disparities across the region in the treatment of breast cancer and prostate cancer.2 And so, over a two-year period, we looked for ways to address this lack of access for patients in this region.”

To assess the adoption of—and access to—hypofractionated radiotherapy in Japan, Australia, Singapore, and South Korea, renowned radiation oncologists from each country came together in a collaborative initiative, the Therapy Advancement Thought Leadership Council (TA-TLC), supported by Varian.

One of the key objectives of this international group of experts was to explore ways to enhance the adoption of advanced therapies across the Asia-Pacific region, including ultrahypofractionated methods, such as stereotactic radiosurgery (SRS) and stereotactic body radiation therapy (SBRT).

The TA-TLC collaborative initiative also gave participating experts the opportunity for cross learning on clinical, reimbursement and administrative best practices, as well as identifying barriers to adoption and potential solutions. By reaching consensus on the key issues, the group published their expert opinions in the ASTRO journal, Advances in Radiation Oncology.3

In the paper, entitled “Challenges and Opportunities with the Use of Hypofractionated Radiation Therapy in Cancer Care: Regional Perspectives from South Korea, Japan, Singapore, and Australia,” the experts focus on brain, breast, lung, and prostate tumor sites and share their perspectives on ways to improve adoption. One of the main barriers identified is

reimbursement models used by payers, which vary by country but are often still based on traditional per-fraction models that have not kept up with technical and clinical advances in number of fractions and treatment schedules that can be used to benefit patients.

For instance, the authors note: “Pay-per-fraction models in countries such as Japan disincentivize physicians to choose shorter treatment schedules and remove the physicians’ flexibility to choose the optimal treatment platform and the number of fractions best suited to the patient.”

Another key hurdle identified by experts is the referral pathways, with general physicians and surgeons often acting as gatekeepers for patient referrals to radiation oncologists, which can limit information about radiation therapy options available to the patient and hinder a broader multidisciplinary approach to cancer care.

The authors state: “In our experience, surgeons often present limited information to patients about radiation therapy and do not always refer patients to radiation oncology specialists, indicating discrepancies in hospital policies and referral pathways.”

Other barriers discussed in the paper include limited resources, technology, and administrative capabilities, and concern about the potential toxicity and side effects associated with hypofractionation. In each case, the panel proposed solutions based on their own observations, from reworking remuneration models to increasing local clinical trial data, patient advocacy, and applying lessons from the COVID-19 pandemic.

The experts conclude: “It is critical to uphold the role of radiation oncologists within the multidisciplinary team in advocating for patients, educating peers on data, and facilitating effective treatment decision-making to ensure patients benefit from this significant advancement in modern radiation therapy.”

1 https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10166538

2 Rodin D, Tawk B, Mohamad O, et al. Hypofractionated radiother-apy in the real-world setting: An international ESTRO-GIRO survey. Radiother Oncol. 2021;157:32-39.

3 https://www.advancesradonc.org/article/S2452-1094(23)00120-3/fulltext

To view the complete article including a full list of references, please refer to:

Akimoto T, Aoyama H, Chua MLK, et al. Challenges and opportunities with the use of hypofractionated radiation therapy in cancer care: regional perspectives from South Korea, Japan, Singapore, and Australia. Adv Radiat Oncol. 2023;8(6):101291. doi:10.1016/j.adro.2023.101291

Perth Reflection

Personal highlights from the recent ASM and my gratitude for your opinions and feedback.

I’ve just returned from the wonderful ASM in Perth, and I’m filled with gratitude for our entire community. The hard work, dedication and impactful research from both trainees and Fellows were truly evident. It was a joy to reconnect with colleagues, trainees and friends—old and new alike.

One of the most valuable aspects of the ASM for me is the feedback I receive from all of you. While some of it can be challenging to hear, I genuinely appreciate every piece of input. I know I can’t always please everyone, but listening to your concerns and suggestions is a key priority for me. I truly believe that by fostering open and respectful communication within our community, we can enhance our training programs and create a more supportive environment for everyone. I hope you share my optimism about the meaningful progress we’re making together! Please continue to let us know what’s working well and what areas could use improvement.

A personal highlight of my role is the Fellowship Ceremony. Welcoming our trainees and International Medical Graduates (IMGs) into the College is a profound honour. This year was no exception, and I was thrilled to celebrate their remarkable achievements. For those of you taking on the vital role of DoTs and Clinical Supervisors, you should feel immensely proud of your contributions. You are shaping the future of our profession.

The DoT workshop and the radiation oncology trainee workshops were other standout moments at the ASM. Given the distances many travelled, I was delighted with the turnout.

These sessions were filled with inspiring discussions, shared experiences, live podcasts, and even Academy Award-worthy performances from some of our extraordinary examiners. A special shout-out to Dr Alex Tan for his exceptional contributions at the ASM and his countless hours of dedication during examinations. His commitment to creating highquality examinations, supporting our trainees and setting them up for success is truly inspiring. A heartfelt thank you also goes to Dr Riche

Mohan for organising the fantastic trainee workshop, as well as to the many trainees who participated.

Another key moment was the official launch of our new accreditation standards, set to take effect in 2025. These updated standards are the culmination of years of hard work, collaboration and vision. I’d like to extend my gratitude to Dr Vanessa Estall, Dr Anne Capp, Dr Matthew Seel and the College accreditation team for their efforts in making these standards a reality. Their dedication to refining our processes is something we can all be grateful for.

Looking ahead, I’m excited to see these standards put into action.

We anticipate a more streamlined, user-friendly approach to the accreditation process that will allow training sites to focus on delivering the highest quality education.

As we transition into 2025 and beyond, I’m confident that the changes we’re implementing will continue to strengthen our program and ensure the success of our trainees and departments.

Thank you for your ongoing dedication, and I can’t wait to see what we will achieve together in the years ahead! IN

“We anticipate a more streamlined, user-friendly approach to the accreditation process that will allow training sites to focus on delivering the highest quality education.”
Dr Lisa Sullivan, Chief Censor (FRO)

A Journey of Professional Growth and Collaboration

Dr Carol Johnson reflects on her term as Chief of Professional Practice and encourages other members to become involved with College initiatives.

Dr Carol Johnson, CHoPP (FRO)

As I approach the end of my term as Chief of Professional Practice chairing the Committee of Professional Practice Faculty of Radiation Oncology, I find myself reflecting on the incredible journey we have undertaken together. It has truly been a privilege to serve in this role, and I am proud of the strides we have made in enhancing our commitment to CPD and the broader issues surrounding professionalism within the healthcare community.

During my term, we have expanded our oversight of CPD and ongoing education, focusing on critical aspects of professionalism. This includes the exploration of a mentorship program aimed at fostering growth and development among practitioners, as well as facilitating access to professional leadership modules. Recognising the importance of ethical standards, we have also updated our College Code of Ethics, ensuring it remains relevant and reflective of current practices.

One of our significant initiatives has been the creation of a College working group dedicated to addressing bullying, harassment and discrimination within our profession. We believe a safe and respectful environment is pivotal for all clinicians, and we are committed to taking proactive measures to combat these issues.

In an effort to encourage our initiatives, we have fostered a close relationship with our colleagues in the Faculty of Clinical Radiology. This collaboration has allowed for more consistent changes across both faculties, and we are excited to maintain this relationship as we explore joint meetings in the upcoming year. Additionally, we are pleased to welcome a representative from MATEC to these discussions, further strengthening our collaborative efforts.

Support for Special Interest Groups (SIGs) has been identified as a priority. These dedicated clinicians consistently strive to maintain a high quality of care for our patients, often leading the way in best-practice

standards. They serve as the expert voice for the College, and we are committed to providing them with the resources and support they need to excel in their roles.

Throughout my term, I have had the immense pleasure of working alongside dedicated and passionate staff at the College. I have witnessed firsthand the enormous effort required to address the accreditation of the College as a CPD hub, along with managing annual CPD returns and audits. This experience in this role has enriched my professional network, allowing me to connect with colleagues I may not have met otherwise. I have seen the professionalism that underpins so much of what the College does, and it fills me with pride to belong to such an esteemed organisation.

As I reflect on my experiences, I encourage all members of the College to seize opportunities as they arise. Your involvement in the various initiatives can have a profound impact not only on your own professional growth but also on the collective strength of our community. Contributing your voice and expertise to our discussions will reap numerous rewards, both personally and professionally.

“I have witnessed the enormous effort required to address the accreditation of the College as a CPD hub, along with managing annual CPD returns and audits.”

As I conclude my term, I want to extend my best wishes to Dr Ziad Thotathil, who will be stepping into this role in 2025. I am confident that he will continue to advance our mission and uphold the values that define our College.

Thank you for the opportunity to serve as your Chair. Let us continue to work together to foster a culture of professionalism and excellence. IN

Member Rewards Program

As a member of the College, you can access a specially selected, member-only rewards program to deliver maximum value from your membership subscription fee. The program caters to a variety of needs with a range of financial, insurance, legal, travel and lifestyle products and services included.

THE ACCOMMODATION BROKERS

They say “memories last forever” and some of the best memories for us all are holiday memories. Our partner The Accommodation Brokers has been delivering holiday discounts to our members for more than three years and the ongoing feedback has been very positive.

“I am a RANZCR member and have used The Accommodation Brokers on six occasions, I just submit the best price I can find, and The Accommodation Brokers have always been able to secure a better deal,” said a College member from South Australia. Time to start planning your next break?

To discover your travel discounts, visit The Accommodation Brokers website, www.theaccommodationbrokers.com. au and register to become a member or email your request to bookings@ theaccommodationbrokers.com.au

KPMG Enterprise is a specialist division of KPMG Australia, dedicated to advising the emerging, private and mid-market. KPMG works with established and emerging entrepreneurs, family business, private clients, not-for-profit and fastgrowing companies to build successful organisations. College members can access the following benefits:

• An initial meeting with a Partner or Director free of charge;

• A minimum 40 per cent discount on KPMG standard rates for the engagement period with all College members;

• Access to a dedicated national KPMG Enterprise team to support your members, across all service areas.

This offer is available to the following services provided by KPMG Enterprise Australia, New Zealand and Asia: Audit and Assurance; Tax, Transactions, and Accounting; Advisory; Accelerating Business Growth. To access the offer, please complete the online form. You will then be connected with the appropriate contact. ranzcr.com/contact-kpmg

See all Member Rewards offers in:

New Zealand Australia

PETALS FLOWERS

Petals Network is one of Australia and New Zealand’s premier flower delivery services, proudly connecting customers with the world’s best local florists for almost 30 years.

All of Petals’ flower arrangements are artistically arranged and hand-delivered

using only the freshest flowers available through its network of talented local florists.

College members receive 20 per cent off the value of flowers purchased. This discount applies to the flower value only. An additional delivery fee will apply.

Please register your details by scanning the QR code to access the online catalogue and discount.

BMW Corporate offers Australian College members and their spouses the following benefits:

• A free Service inclusive for three years or 60,000kms*

• Benefits extended to your spouse or de-facto partner

• Reduced dealer delivery of $1,850 excluding taxes

• Access to a dedicated Corporate Sales Manager

This offer currently excludes electric cars.

*Complimentary basic scheduled servicing, including Vehicle Check, is valid from date of first registration for whichever comes first of 3 years/60,000kms, and is based on BMW Condition Based Servicing or Service Interval Indicator, as appropriate. Normal wear and tear items and other exclusions apply.

Servicing must be conducted by an authorised BMW dealer. Consult your preferred BMW dealer for further terms and conditions.

To find out more: Visit www.bmw.com.au/corporate or www.mini.com.au/corporate

Phone: Call 1800 635 750

Email: Write to corporate@bmw.com.au When you’re ready to make a purchase, you will require an authorisation letter from the College to access the corporate benefits. Email the College to request this letter.

KPMG
BMW & MINI CORPORATE

MENTAL HEALTH SERVICES

CU Health psychologists provide a broad range of services from counselling through to long-term therapies. Whether it has simply been a tough week or something doesn’t feel quite right, their team are ready to support you.

Many of us struggle to prioritise our physical and mental health, whilst managing work pressures, engaging in family life, or pursuing personal wellness goals. These pressures may all influence psychological health.

CU Health Psychologists are certified to help you with managing a crisis and treatment for depression, anxiety and burnout using the most up-to-date evidence and resources. They understand the challenges of maintaining your health while managing demanding work schedules and responsibilities.

Complimentary Vouchers for Psychology Sessions

As part of our service to members, RANZCR is pleased to offer 4 complimentary vouchers for psychology sessions via CU Health, an entity that offers a variety of healthcare services. All other services offered by CU Health are at the cost of members.

Queries and Support

If you have any questions or concerns about using CU Health, please contact CU Health directly by calling 1300 284 325 or visiting their website at www.cuhealth.com.au.

Disclaimer

Please note that RANZCR does not provide medical or mental health advice, nor does it endorse the advice or treatment recommendations provided by CU Health or its clinical professionals. Members should act at their own discretion and seek independent advice if necessary. RANZCR will provide supplementary information about this service as part of your membership but does not influence or have responsibility for clinical decisions made by CU Health practitioners.

Final Call

The deadline for 2024 CPD activities is 31 December. Here’s a reminder of the requirements and categories.

If you haven’t started entering your CPD activities for 2024 yet, please be reminded that the deadline is 31 December 2024.

Note that the College will be required to report to AHPRA in the future on those who are non-compliant. If you are non-compliant with AHPRA or the Medical Council of New Zealand (MCNZ)'s CPD requirements, you are placing yourself at risk should you be selected for a random audit of your CPD.

To record your CPD activities, please log into the RANZCR ePortfolio and select the CPD Dashboard (2024).

Please also note the 2024 CPD requirements:

Professional Development Plan (PDP)

50 hours of CPD

• 12.5 hours of Educational Activities

• 25 hours of Reviewing Performance and Reflecting on Practice and Measuring and Improving Outcomes (minimum of five hours for each category, e.g. 20 hours in one and five hours in the other)

• remaining 12.5 hours distributed across any of the three CPD categories

Anaphylaxis training (2023–2025 once every three years, clinical radiology only)

MRI and mammography requirements (clinical radiology only)

Structured conversation (MCNZ requirement)

Cultural safety and health equity to be reflected in CPD activities (MCNZ requirement)

Meeting CPD Requirements

There are a variety of CPD activities that can be recorded to meet the CPD requirements. Please also refer to the CPD category list of activities.

You can enter up to 25 hours under Educational Activities, e.g. conference attendance, web-based learning, journal reading, supervision and/or assessment of trainees etc.

For Reviewing Performance and Reflecting on Practice (minimum of five hours) possible activities include:

• Review of Cases peer review activities

• Reflective Diary

• Professional Development Plan you can claim two hours for completing this

• Cultural Competence Activities please refer to the College website for suggestions

• Professional Practice Management staff training,

operational planning, equipment compliance etc.

• Participation in RANZCR governance e.g. Committees Multidisciplinary Team Meetings

For Measuring and Improving Outcomes (minimum of five hours) possible activities include:

• Multidisciplinary Team Meetings

• Audit of your own cases

• Patient Experience Survey

• M & M meetings.

Changes to the 2025 CPD Program

The 2025 CPD Program starts on 1 January 2025 and will be available in the CPD ePortfolio.

After consideration of user feedback regarding the ePortfolio and the CPD categories, the Chiefs of Professional Practice and the Professional Practice Committees, several changes were made to improve user experience.

Key changes include:

Redesign of the CPD Dashboard to make it more userfriendly

New layout of the CPD Program goals to make it easier to recognise completion

Implementation of Program Level Requirements (PLR) to enable recording and tracking of progress.

The introduction of the four categories of Program Level Requirements (PLR) is a requirement from the Australian Medical Council (AMC) for 2025:

1. Professionalism Practitioners’ conduct and attitudes aligned with standards and ethics. Includes integrity, accountability, communication, teamwork and upholding ethical principles.

2. Addressing Health Inequities Recognising and reducing disparities in health outcomes and access. Focuses on social determinants, policy advocacy and interventions for marginalised populations.

3. Cultural Safety Practice Healthcare that respects cultural perspectives and needs, creating an inclusive environment. Addresses power imbalances and promotes cultural safety.

4. Ethical Practice Morally informed decisions in healthcare, considering patient rights, values, autonomy and well-being. Informed consent, confidentiality, beneficence, nonmaleficence and justice are prioritised.

CPD Assistance

Please be reminded that College staff experience a high volume of enquiries at this time of year and response times may be longer than usual. The College office is closed from 20 December 2024 to 6 January 2025. Contact Freya or Leanne on +61 2 9268 9777 or email cpd@ranzcr.edu.au IN

Go to www.myranzcr.com and log into the ePortfolio to enter your 2024 CPD activities.

International Awards

Prof Sandeep Bhuta is a neuroradiologist, Director of Research and MRI Supervisor at Gold Coast University Hospital, and Professor of Neuroimaging at Griffith University and Menzies Health Institute. Here, he shares some news from the 2024 ASNR conference in Las Vegas.

The American Society of Neuroradiology (ASNR) held its annual scientific conference in Las Vegas, US, on 18-22 May 2024. I was invited as a faculty member for the conference. The ASNR conference is one of the most reputed and highly regarded scientific meetings in our specialty, showcasing new technology and cutting-edge research as well as having a huge focus on learning and education.

I was deeply humbled and honoured to receive two awards at this conference. ‘Summa cum laude’ was awarded to the educational exhibit, “Imaging Challenges and Understanding Complexities of Osteoradionecrosis in Head and Neck: Are We There Yet!”. ‘Summa cum laude’ is a Latin phrase that translates to ‘with highest honour’ or ‘with highest distinction’. It is an academic honorific used to signify an exceptionally high level of academic excellence.

The ‘International Recognition Award’ was offered to the educational paper, Imaging of Arnold Chiari Malformations, Neurosurgical Technique and Post-operative Appearance: Are We Any Wiser Now?

These projects were in collaboration with two departments in Gold Coast University Hospital. The first project had contributions from the Dept of Radiation Oncology and the second project had contributions from the Dept of Neurosurgery. I would like to extend my heartfelt thanks to my co-authors, Dr Ananya Prabhu (Radiology Registrar), Dr Eric

Khoo (Radiation Oncologist), Dr Gian Sparti and Dr Teresa Withers (Neurosurgery PHO and Consultant) for their hard work awards like this are always a team effort.

It is very satisfying to get recognised for the academic work we do here at Gold Coast University Hospital, and my affiliation with Griffith University as a Professor made this long trip all worthwhile. This is a matter of huge pride to our institute, as something on this scale has been achieved for the very first time in Australia. This opens doors to other top-tier institutions, research funding, and collaborative projects that can shape health policies and practices on a global scale.

The ASNR conference was

attended by more than 3,300 neuroradiologists from across the world, and typically receives up to 2,000 abstracts. I would like to thank the ASNR committee for recognising and validating our hard work. I am passionate and a strong believer in my subspecialty of neuroimaging, and as a Professor, I believe education and teaching are vital in imparting and sharing the knowledge with junior doctors and colleagues they are the future of healthcare. Receiving these awards inspires me to push the boundaries of what we can achieve together. It reinforces my belief in the importance of our work, and motivates me to continue striving for excellence. IN

Prof Bhuta at the ASNR conference in Las Vegas.

www.ranzcr2025.co.nz

End-of-Year Reflection

A letter of thanks, and a warm welcome to new Branch committee members and incoming Chair, Dr Jash Agraval.

Kia ora koutou. Firstly, congratulations to the America’s Cup team, the Constellation Cup-winning Silver Ferns, the All Blacks in the Bledisloe Cup (we won’t mention the Rugby Championship), the White Ferns in the T20 World Cup and why not include Anna Sawai (she was born in Wellington).

As my final term as NZ Branch Chair draws to an end, I would like to extend my heartfelt gratitude to all the Fellows, in their College and nonCollege roles, and College staff for their support and hard work during my tenure. Without you, I could not have fulfilled my role. It has been a privilege to have represented the New Zealand Branch.

I would also like to thank the outgoing members of the NZ Radiation Oncology Executive (Carol Johnson), NZ Branch Committee (Verity Wood, Missa Amin and Daniel Joh), MSK Working Group (Ian Best and Mark Coates), and FCR Councillor Mike Baker, and wish them all the best in

future endeavours. I would like to welcome our new incoming branch committee members, Lotte Steffens, Joel Dunn and Jash Agraval.

We have faced many challenges during my tenure, and this year has been no different, with the oftenperplexing decisions coming from the Beehive, some of them reverse ferreting. However, I am buoyed by the formation of the National Cancer Network and National Radiology Network and the appointment of their respective co-leads. I am sure Shaun Costello, the Chair of NZROE, as well as the incoming NZ Branch Chair, will continue to advocate for our Fellows and respective specialties. On that note, it is a great pleasure to introduce Dr Jash Agraval, the incoming NZ Branch Chair, although Chairman Agraval doesn’t have the same ring. For those who don’t know Jash, he is a Clinical Radiologist and Clinical Director at North Shore Hospital, Auckland. He has been involved with the College in many roles, most

recently as the Deputy Chief Censor of the Curriculum and Chair of the Curriculum Assessment Committee. For any who are concerned, he is well aware that we are a Branch and not a state, and he knows the Taku Taku verbatim.

RANZCR ASM

Congratulations to Dr John Gunn (clinical radiologist), who was awarded Life Membership of the College, and one of our clinical radiology registrars Dr Richard Kelly, winner of the Branch of Origin for his presentation on Utility of PET CT in CT Stage IA Non-Small Cell Lung Cancer: The New Zealand Te Whatu Ora Northern Region Experience Congratulations to Dr Ziad Thotathil (radiation oncologist) for winning the Chris Atkinson and the NZRET Radiation Oncology award. Once again, thank you all for your support, and I look forward to seeing you in the new year. Whatever your summer plans are, I wish you and your loved ones a relaxing break. IN

Dr Gabes Lau, NZ Branch Chair
Dr Richard Kelly presenting at Branch of Origin at the Perth ASM.

Postcard from ACT

A recap of September’s ACT Branch Educational Evening.

Winning Shot

Announcing the 2024 ASM Photo Competition Winner, Dr Ziad Thotathil.

Congratulations to Dr Ziad Thotathil for winning this year’s ASM photo competition. Here’s his description:

“The photo was taken at Ngarunui beach, Raglan, NZ. The foreground shows part of the Four Directions Māori sculpture. The hinuera stone carvings feature images influenced by the surroundings, like Hector's dolphins, music and Celtic knots, and Māori mythical beings with paua-shell eyes. In the background is the Milky Way core rising.

We gather at the ASM to gain knowledge that we will take back as we disperse in all directions. And the galaxy behind is a reminder that we are only a tiny part of the cosmos, and there is always more to learn.”

This year’s ACT Branch Educational Evening was a great success, bringing together radiologists and radiation oncologists from across the state All private practice groups were represented and registrars from both disciplines were in attendance. It was a chance to acknowledge A/Prof Murali Guduguntla for his valued contribution over the years as Branch Chair, and we wish him well as he takes up position of Councillor in the Faculty of Clinical Radiology.

We thank our speakers Dr Amy Shorthouse, Dr Tarun Jain, Dr Bijan Gattlin, Dr Rowan Stephenson, and Dr Shahroz Khan for an informative and entertaining evening. The Committee would also like to thank Mereana from the College for coming down to enjoy the evening with us. It was a fantastic night, keeping the ACT RANZCR community connected and learning from each other.

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