Inside News June 2024

A Step Ahead

introduces

Inside News is published quarterly. For enquiries, feedback or to contribute to Inside News, email editor@ranzcr.edu.au

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AI and the Ground Beneath Us

RANZCR President Prof John Slavotinek reflects on the areas AI is destined to influence within radiology and radiation oncology, and the opportunities presented.

Prof John Slavotinek

It has been almost eight years since Geoffrey Hinton, a leading British-Canadian computer scientist and expert on deep learning, warned us to ‘stop training radiologists now’ because, as he believed, artificial intelligence (AI) would be better at our jobs within five to 10 years. His colourful, unsettling analogy was to compare our circumstance to Wile E Coyote running over the edge of the cliff, failing to look down and notice the ground was missing1

Academic researchers have been working on AI for at least 50 years, and the study of neural networks in biology (on which deep learning is based) is even older. Over that long period we have seen more science-fiction films about AI than actual progress towards a brave new world run by machines. Hence, a decade ago few seriously felt that R&D in AI had reached a point where we might soon see the last generation of human radiologists. However you view it, Hinton’s prediction got everyone’s

attention. Of course, many feel that his prediction has not aged well and, strictly speaking, that’s true because we’re still here, with much the same workflow as we had in 2016. Hinton’s story illustrates the difficulties even highly intelligent individuals experience when attempting to predict the future. But some are missing the salient point. AI, including the AI based on large language models (LLMs), is a technology many now believe is destined to disrupt and permanently alter practice in radiology and radiation oncology, at least as profoundly as any technology in the history of our professions.

Why? Radiologists and radiation oncologists have for decades benefitted from the efforts and skills of physicists, engineers and others in the sciences who have developed (and refined) new imaging and therapeutic modalities such as CT, MRI, IMRT and particle beam therapy. These have greatly advanced our ability to detect, stage, monitor and treat disease but these changes have largely remained specific to one area of our activities. AI differs because its impact and potential are much broader.

Specifically, AI may improve our efficiency and reduce human fatigue and error rates by taking on supervised activities such as measurement, writing of basic reports, segmentation and automated treatment planning. Beyond such activities, AI will impact upon multiple points of the radiology and radiation care

cycles. This includes booking and scheduling of patients, automatic protocolling and planning, more rapid image acquisition (e.g. in MRI), triage of cases for reporting and provision of results in language suitable for patient review.

We would be mistaken to ignore this potential, and not just because of the rewards we hope to reap in our own field. The world of work is changing all around us. With the likely widespread adoption of AI throughout healthcare and other sectors, radiation oncology and radiology without AI would be greatly diminished if not destined for extinction. While perhaps daunting to some, AI represents an opportunity that we must embrace in order to improve patient care and maintain the vital role that we currently hold within the practice of medicine.

In the past decade we have seen rapid growth in the number of AI-related products in clinical radiology, with the FDA now having cleared more than 700 healthcare algorithms, over 500 of which relate to radiology2

While growth is rapid and there is much interest from vendors, some reservations have been registered. In 2020, a Dutch research team surveyed the AI radiology products commercially available in Europe. Their survey listed 100 AI image analysis tools with EU medical device certification, primarily for use in detection, diagnosis and quantification3. They found that 64 of those 100 products lacked peerreviewed evidence of efficacy.

Having said this, the potential

“While perhaps daunting to some, AI represents an opportunity that we must embrace in order to improve patient care and maintain the vital role that we currently hold within the practice of medicine.”

downsides of AI cannot be ignored and it is important to understand them prior to implementation in practice. Modern AI algorithms based on deep learning are able to learn relevant features from large data sets without explicit definition and programming. Many such AI products are effectively ‘black boxes’ that do not understand context or the clinical situation. Supervision by humans adds value for many reasons including human appreciation of context and the ability to understand if AI outputs are inappropriate in a given clinical context.

Furthermore, AI systems are more likely to exhibit bias if the data used to train the AI system are not representative of the patient population on which the AI system will be used. Without validation using data representative of the patient population, we cannot assume a particular AI model is safe or accurate. Other types of bias include automation bias, the tendency for humans to favour AI decisions and ignore contrary data or conflicting contextual clinical information. There are also the needs of consumer groups and our patients who have expressed

concerns about privacy and the possibility of misuse of their data for inappropriate purposes without their consent. These are just a few of the issues, but we should not lose sight of the fact that AI has considerable potential if harnessed appropriately.

At a practical, everyday level, and in view of the above, we should not accept the claims of AI vendors without careful consideration and we need to be sure the tools on offer can be successfully integrated into existing clinical workflows and with local IT. The Dutch team that surveyed the available AI products in 2020 later found that adoption of these products by radiology departments in that country was being hampered by high purchase and implementation costs, as well as lack of internal resources or “dissatisfactory integration possibilities”.

I have barely scratched the surface of the matter at a time when there is expanding literature, multiple claims and variable publicity about AI and its value. Several important articles in the medical literature have addressed the practical issues. One such article was a multi-

society statement in 2021 by five international radiological societies, including RANZCR. Our College initiated this process and was among the first organisations to take significant steps towards the development of policy and guidance on AI in medicine, and we remain at the forefront of the debate on the topic.

In coming months, I intend to explore other factors that may influence the future of our two medical specialties. I strongly encourage you to stay tuned to this discussion. IN

1. “Geoff Hinton: On Radiology”, https://www. youtube.com/watch?v=2HMPRXstSvQ

2. https://healthimaging.com/topics/artificialintelligence/fda-has-now-cleared-700-aihealthcare-algorithms-more-76-radiology

3. Van Leeuwen, KG, et al. Artificial intelligence in radiology: 100 commercially available products and their scientific evidence. Eur Radiol. 2021; 31(6):3797–3804, doi:10.1007/ s00330-021-07892-z

4. Brady, AP, et al. Developing, purchasing, implementing and monitoring AI tools in radiology: Practical considerations. A multi-society statement from the ACR, CAR, ESR, RANZCR & RSNA. J Med Imaging Radiat Oncol. 2024;68(1):7–26, doi:10.1111/1754-9485.13612

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Redefining Strategy

Members will soon receive the 2025–2040 RANZCR draft Strategic Plan for review and comment.

It has long been my view that the word ‘strategy’ is one of the most misused and abused words in the English language. Nowhere is this more evident than in the three-year ‘Strategic Plan’ of most companies. The majority of these plans are very good business plans that offer operational refinements of existing operations, but they do not set out the longer-term strategic direction of the company.

The current RANZCR three-year Strategic Plan is due to conclude at the end of 2024. The conclusion of this plan encouraged the College to conduct a local and international environmental scan of the health

sector, to uncover and analyse current and emerging trends, to draw insights into challenges and opportunities facing the sector and colleges, and to consider how to best position RANZCR for the future —not just to survive, but to thrive, grow and take a dominant future position in the sector.

With this in mind, at the May 2023 Board meeting, the RANZCR Board was presented with several potential scenarios of what the College might look like in 2040. After a vigorous discussion, the Board approved the CEO and executive team to build on a combination of these scenarios and develop a new RANZCR Strategic Plan to 2040.

A draft of this plan was presented to the Board at its March 2024 strategy meeting. With some refinements, the plan was reconsidered at the May 2024 Board meeting and approved for distribution for member comment. Members will soon be receiving an email containing the high-level draft Strategic Plan to review.

Members will notice that this plan presents seven strategic priorities and operates over three planning horizons from 2025 through to 2040. As when looking at a

“We live in uncertain and challenging times, but times that also offer excitement and opportunity. The College, due to the prudent decisions made by Boards current and past, is in a strong position to take advantage of these opportunities.”

mountain range, the closest horizon (2025–2027) contains the most detail, while the second (2028–2030) and third (2031–2040) horizons are less detailed. As RANZCR moves through the first horizon, the details of the second and third horizons will come into focus and may change depending on changes to the environment as time progresses. Although each strategic priority is allocated to one horizon, in practice most will spill over into two or even all three horizons.

There are a series of key initiatives under each of the strategic priorities. Some of these are operational in nature and others detail commercially sensitive business opportunities. In the Strategic Plan version sent to members, these specific initiatives have been replaced with a general description of what the strategic priority contains.

We live in uncertain and challenging times, but times that also offer excitement and opportunity. The College, due to the prudent decisions made by Boards current and past, is in a strong position to take advantage of these opportunities at this pivotal time.

I encourage each of you to read and consider this plan; and to offer your insights. This is your RANZCR and your contribution now will help shape the College for many years to come. IN

Duane Findley, CEO

How to Plan for Retirement

Research shows retirement can trigger positive lifestyle changes—but making the leap isn’t easy.

Making the decision to retire is a significant milestone. Surveys indicate a growing number of doctors choosing to work beyond the age of 651, due to a range of professional and psychosocial factors. Yet we know that retirement can have many positive influences on our health and wellbeing—with studies showing that people become more active, sleep better and reduce their sitting time when they retire2. If retirement is on your radar, here are some things to consider when planning your next chapter.

Your age

In Australia, the Age Pension is available for eligible people aged 67 years or over, but what suits you best will depend on a variety of factors including your ‘preservation age’. This is when you can access the money in your superannuation fund and it varies between age 55 and 60 depending on when you were born. Everyone can withdraw their super once they reach 65, even if they haven’t retired. In New Zealand, you can usually start withdrawing from KiwiSaver at age 65. This is also the age you can apply for NZ Super

(the equivalent of Australia’s Age Pension) if you meet the residence requirements.

Your finances

Consider the performance and fees of your current superannuation fund (or KiwiSaver in NZ). “[In Australia] we see a large percentage of clients with older superannuation fund products paying costly fees which impact on the overall performance of their funds,” says financial planner and director of Hills Financial, Rebecca Howarth, who adds that reviewing your insurances within superannuation is also a good idea.

“So many people accept that the default cover they have may be sufficient or have the belief that insurance offered by their superannuation fund is cheaper. This is often not the case and more appropriate, lowercost insurance can be obtained separately to the superannuation fund.

“You should also take advantage of contribution opportunities such as making voluntary contributions to further boost your super balance, being mindful of contribution caps to avoid penalties.”

Howarth says it’s worth knowing about something called the downsizer contribution. “This allows eligible Australians aged 55 or older to sell their home and contribute up to $300,000 (or $600,000 for couples) of the proceeds into their super. This contribution doesn’t count towards your non-concessional superannuation cap.”

But, with everything from taxation to financial risks having the potential to impact your retirement income and assets, seeking advice from a financial planner to develop a personalised retirement strategy tailored to your situation can be wise.

“Retirement can be a complex and overwhelming transition for many people, especially those who have had a specialised long-term career,” says Howarth.

“Retirement can be a complex and overwhelming transition for many people, especially those who have had a specialised long-term career.”

“Obtaining financial advice can provide you with peace of mind knowing you have a comprehensive plan in place to support your financial goals and aspirations in retirement.”

Your career

For clinicians, retiring may involve considering multiple parts of a business built up over many years of practice. Rather than closing the door on your career or business overnight, you could consider reducing your hours or working part-time for one or two years before you retire completely. This transition could be greatly beneficial for your colleagues, patients and staff—and give you time to work through all the details involved in transferring care and records, and notifying the relevant authorities. If you’ve reached your preservation age, seek financial advice about a ‘transition to retirement’ strategy, which can allow you to access some of your super while you keep working.

Your interests

We know that keeping your mind active during retirement is important for your health and wellbeing as you age. Make a conscious effort in the months or years before you retire to try some new activities, whether it’s taking up a sport, joining a club or even volunteering— these things can all help to avoid a ‘loss of purpose’ in

your post-work life. This can also help you forge new social circles to replace contact and interaction with colleagues and patients.

Your health

For many medical professionals, long working hours and competing commitments leave little time for sleep and exercise—and so retirement offers the opportunity to prioritise your personal health. In the lead-up to retirement, it’s a good idea to review your health insurance, have a thorough health check and discuss your long-term health plans with your doctor. While research shows positive correlations between retirement and physical health, it’s also important to consider how your retirement will affect your mental health. Consider the things that are likely to make you happy—be it time with the grandkids, time on the golf course or time to travel, and make the most of your retirement years. IN

RANZCR members can access financial planning consultations as part of their subscription fee. Visit www.ranzcr.com/college/member-rewards to see the offers. Retired Fellows are entitled to access complimentary member benefits—email members@ranzcr.edu.au to find out more.

1. www.mja.com.au/journal/2017/206/5/professional-and-psychosocial-factorsaffecting-intention-retire-australian

2. www.mja.com.au/journal/2017/206/5/professional-and-psychosocial-factors affecting-intention-retire-australian

More information: https://moneysmart.gov.au/retirement-income/prepare-to-retire https://my.gov.au/en/services/ageing/retirement/planning-your-retirement www.ato.gov.au/individuals-and-families/super-for-individuals-and-families/ super/withdrawing-and-using-your-super www.choice.com.au/money/financial-planning-and-investing/superannuation/ articles/planning-for-retirement www.qld.gov.au/seniors/retirement/retirement-planning-checklist www.fma.govt.nz/library/reports-and-papers/kiwisaver-report/ www.workandincome.govt.nz/eligibility/seniors/superannuation/index.html

Bragg Centre Updates

College members continue working towards delivering Proton Beam Therapy to Australian cancer patients.

One of the popular sessions of the 2023 RANZCR ASM in Brisbane was the Particle Therapy Session. There, members presented exciting updates about the national progress towards treating the first patients with proton beam therapy at the Australian Bragg Centre for Proton Therapy and Research (ABCPTR) in Adelaide in 2025/26.

A ground-breaking clinical and research facility, the ABCPTR, due for completion soon, is a purpose-built biomedical facility set to become home to leading cancer research institutes as well as house the first clinically dedicated proton beam precision therapy centre in the Southern Hemisphere.

Proton beam therapy (PBT) is a radiation therapy approach using charged particles to target cancer instead of conventional high energy beams (photon based radiotherapy, PRT). Due to its underlying favourable physical characteristics it has a significant potential for reducing both high-dose and specifically low-dose radiation exposure to adjacent normal tissues. Consequently, it safely delivers—in a very limited number

of indications—higher doses of radiation and improves their probability of cure. However, the primary benefit for the majority of suitable patients—particularly paediatric and young adult cancer patients—is that it meaningfully reduces the risk of radiation associated long-term side effects with an expected improved quality of survivorship.

This first PBT service will serve as the pioneer facility for PBT within Australia and the Southern Hemisphere and shall abolish the need for patients to travel for proton radiotherapy overseas. Once it becomes fully operational, the centre can treat up to 600–650 patients per year. Based on the currently agreed funded indications for PBT it is expected that 40–60% of patients being treated at the ABCPTR will be children, adolescents or young adults. The ABCPTR team is closely engaging with all relevant College working groups and special interest groups, as well as the national and international oncology community, to ensure equitable access to world-leading cancer care.

Dr Jeremy Khong is an author of a recent article in JMIRO on PBT and the Bragg Centre1. [On the advances in research in PBT], he said, “With an increasing number of operational proton radiotherapy sites worldwide proton therapy research activity is exponentially rising. These data will aid the evidence-based decisionmaking process to define future Australian indications for patients that will benefit from the conformality and tissue-sparing benefits of proton therapy treatment.

The ABCPTR provides Australia with a world-class facility that not only significantly enhances available national treatment options but also facilitates the participation in world-class research and clinical trials.”

1. Khong J, Tee H, Gorayski P, Le H, Penniment M, Jessop S, Hansford J, Penfold M, Green J, Skelton K, Saran F. Proton beam therapy in paediatric cancer: Anticipating the opening of the Australian Bragg Centre for Proton Therapy and Research. J Med Imaging Radiat Oncol. 2023; doi:10.1111/1754-9485.13614.

A/Prof Hien Le

A/Prof Hien Le is a member of the Particle Therapy Working Group and a co-author of a recent paper on the national registry for PBT patients2. He has been a key collaborator in the dissemination of information and international key stakeholder involvement for the Bragg Centre. He said, “The RANZCR Particle Therapy Working Group have met regularly and worked hard on achieving a number of milestones in order to successfully deliver proton therapy to this region.”

Prof Frank Saran is a senior radiation oncologist and a member of the RANZCR Radiation Oncology Research Committee. His work at the Bragg Centre focuses on exploring the clinical benefits of proton radiotherapy and the integration of proton radiotherapy into the rare cancer management. Prof Saran, said, “The ability for all Australians to have unhindered, fully funded access to PBT at the ABCPTR, particularly for children with cancer and their families, will be a game changer for their longterm outcome and future potential to lead a normal life.

The ABCPTR offers an opportunity for all of Australia’s oncology community to be at the forefront of medical cancer care due to the unrivalled potential of translation from bench to bedside.

“RANZCR has been a champion of PBT for many years now. In 2015, RANZCR issued a position paper on PBT. It included two central statements: firstly, that patients in Australia and New Zealand must be granted access to PBT and secondly, it promoted the College’s endorsement of establishing one or more PBT facilities in the region.

“Consensus reached through this paper and successive ones emphasises the need for a collaborative approach involving federal and state jurisdictions and the tripartite professional groups, which includes RANZCR, the Australian Society of Medical Imaging and Radiation Therapy (ASMIRT), and the Australasian College of Physical Scientists and Engineers in Medicine (ACPSEM).

“Staff training at the ABCPTR is aligned with recommendations set forth by the particle therapy working groups of RANZCR, ASMIRT and ACPSEM; the team is committed to the education of regional oncologists and physicians-in-training. The Australian particle therapy community annually holds symposia aimed at providing transparent communication, where the latest advancements and updates in the field are disseminated, inclusive of an educational component.

2 Hwang E, Gorayski P, Thwaites D, Le H, Skelton K, Loong JTK, Langendijk H, Smith E, Yock TI, Ahern V. Minimum data elements for the Australian Particle Therapy Clinical Quality Registry. J Med Imaging Radiat Oncol. 023;67(6):668–675.

The RANZCR Particle Therapy Working Group continues to work on the development of a nationally coordinated strategic plan for particle therapy facilities as well as developing a plan for the governance of a national referral network care path. This is in light of the near completion of the Australian Bragg Centre’s operation, and will provide some great models for finessing such therapies across the area.” IN

Dr Jeremy Khong

Prof Frank Saran

Stillbirth Investigations

Introducing the new Perinatal Post-mortem Investigation Training Package, available now.

RANZCR is delighted to announce the launch of the Perinatal Post-mortem Investigation Training Package, as part of the National Stillbirth Action and Implementation Plan (NSAIP) launched by the Australian Government.

The Australian Government, via the Department of Health and Aged Care, awarded funding to RANZCR to develop the Stillborn Investigation Project (SIP), as part of the NSAIP. The aim of the NSAIP is to reduce the rate of stillbirth in Australia by 20% by 2025 and ensure a greater quality of service for bereaved parents. RANZCR has worked in collaboration with other organisations involved in the NSAIP since 2022 to achieve the targets set out in the plan. Data gathered from a Program Logic workshop, stakeholder collaboration and pre-survey of target groups identified that clinical resources and comprehensive training would best support radiologists investigating stillbirths. The Training Package scope was derived from this data.

The Training Package seeks to equip users with the essential skills and resources to conduct a noninvasive stillbirth investigation, using a range of imaging modalities. The Package also advises how to set up and manage a perinatal post-mortem imaging service. The package is intended for radiologists who work in or have an interest in post-mortem imaging for stillbirth investigation.

The Training Package is free of charge and has been developed by local clinical lead Prof Stacy Goergen and leading international experts across the field of stillbirth investigation including:

Prof Owen Arthurs, Professor of Radiology at the University College London, Great Ormond Street Institute of Child Health and consultant at Great Ormond Street Children’s Hospital in London.

Dr Michael Aertsen, member of the European Society of Paediatric Radiology task force on post-mortem imaging.

“The aim of the NSAIP is to reduce the rate of stillbirth in Australia by 20% by 2025 and ensure a greater quality of service for bereaved parents.”

Dr Susan C Shelmerdine, academic Paediatric Radiologist and honorary Associate Professor at the UCL Great Ormond Street Institute of Child Health in London.

Prof Teresa Victoria, Chief of Paediatric Radiology at the Massachusetts General Hospital.

Prof Willemijn Klein, Paediatric Radiologist working in the Amalia Children’s Hospital & Radboudumc in Nijmegen, the Netherlands.

The Training Package consists of:

Background information and further reading Six webinars

Three radiology practice support resources

The background information and further reading was included by the subject matter experts to further expand upon the information and training they provide through the webinars. The need for the three radiology practice support resources was identified through the presurveying of target groups including bereaved parents, midwives and obstetricians, and heads of radiology and pathology departments. These resources can be used to support the implementation of educational activities in clinical practice and supplement learning, and include:

The Clinical Information Form (perinatal post-mortem MRI referral resource to be used at the time of referral for a perinatal post-mortem MRI examination to ensure the required information has been obtained to interpret imaging findings)

Perinatal Post-mortem MRI Report Template (to be used by the reporting radiologist to assist in the reporting of perinatal post-mortem MRI studies and can be amended by reporting radiologist where relevant)

The Perinatal Post-mortem MRI Policy and Procedure Template (to be utilised by medical imaging departments and radiologists to assist in determining the appropriate procedures regarding referrals,

consent, transportation and return of a stillborn infant during a post-mortem investigation).

As part of the NSAIP, RANZCR collaborated with several other organisations to develop resources specifically for parents, family and practitioners. Red Nose Australia has developed a range of resources for bereaved parents to assist in decision-making regarding a stillbirth. Stillbirth CRE developed the Care After Stillbirth and Neonatal Death (CASaND) guideline, to ensure best practice across Australia and New Zealand around the time of a perinatal death.

RANZCR would like to acknowledge the Australian Government and the Department of Health and Aged Care for their ongoing support across the provision of the Training Package as part of the RANZCR Stillbirth Investigation Project. IN

Scan the QR code to view the entire RANZCR Training Package.

Note: It is recommended that the webinars within the Training Package are viewed in sequential order and in their entirety.

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

Volunteer in the Spotlight

RANZCR relies heavily on volunteers, with more than 1,200 members currently offering their time to support the College. This issue, A/Prof Christen Barras talks about his experiences and highlights.

I’ m a neuroradiologist in Adelaide, though my journey started in surgery, then a PhD. This formative time was at Royal Melbourne Hospital, where I also completed my radiology training, followed by a Neuroradiology Fellowship in London for two years. I became a Consultant Neuroradiologist at Queen’s Square, returning to Australia in 2018. Presently, I work at various locations including Royal Adelaide Hospital, the South Australian Health and Medical Research Institute, the University of Adelaide and in private practice. I am honoured to have research students of my own, with broad interests including stroke, vision, AI, neuroanatomy, functional MRI and hypnosis-related research projects. I am increasingly aware that how we choose to spend our time and where we direct our attention is fundamental to our health and happiness. It improves the wellbeing of those who are close to us, and the health of our profession. Like you, volunteering forms a large part of my non-clinical time in various landscapes. Have you noticed that the things we are not paid for add most of the colour to the picture? Small or large contributions from individuals under sound leadership summate into improvements that benefit us all. There is enduring satisfaction to being a volunteer. For me, my volunteering contributions to RANZCR began

when I returned from overseas.

I emailed Dr Gabriel Lau and was welcomed as an Associate Editor for the Journal of Medical Imaging and Radiation Oncology (JMIRO). This was a chance to apply my research training to the neuroimaging submissions to the journal, and I had the joy of reading new scientific information for the first time, honing editing skills which I now use every day, and seeing the journal flourish under the wise leadership of Prof Michael Barton.

It was a natural progression to join other research-focused radiologists on the Clinical Radiology Research Committee, chaired by Prof Paul Parizel. Paul is such an inspiring and original leader, bridge-builder and clear thinker. The breadth of expertise on the panel is wonderful to reflect upon as we seek to support and expand the amazing research work that you do.

By far the most challenging and singularly rewarding volunteer role for me came in 2022 when, alongside radiation oncologist colleagues Dr Ram Govindaraj and Dr Laurence Kim, I convened the clinical radiology component of the RANZCR 2022 ASM in Adelaide with a very strong local organising

committee. I was always impressed by the outstanding work of RANZCR staff, who work right around the year to plan and implement the formidable logistics of this showcase event, this year to be held in Perth, 17–19 October (registrations are now open)

Following on from the fine leadership of my predecessor, the late A/Prof Brigid Hickey, I now Chair the ASM Committee, and share my experience with the next team of volunteer Fellows and trainees whose new, creative signatures are woven through the scientific and social event programs.

The value of sharing experiences motivates many volunteers serving our College. We see individual passions and talents thrive, learning from subspecialty expertise, meeting new people, finding new ways to look at things, sharing a vision and moving forward together.

The many former and current volunteers for RANZCR deserve gratitude but don’t seek it. In particular, our College leaders make a choice to share their time, energy and ideas. And to you, now considering how you can join a thriving team of RANZCR volunteers, be encouraged to do so today. IN

Prof Christen Barras

Q&A with a New Associate

We sit down with new RANZCR Associate Dr Christina Hannah and quiz her about her College experiences.

The RANZCR Associates program was created by the College as an opportunity for medical and health practitioners affiliated with our profession to build their knowledge, skills and relationships.

The Medical Associate category of the program is for medical students or junior doctors who are interested in a career in clinical radiology or radiation oncology and have yet to become a Fellow at a recognised specialist medical college operating in Australia and New Zealand.

New RANZCR Associate Dr Christina Hannah completed her Bachelor of Medicine/Bachelor of Surgery at James Cook University in Far North Queensland and now works in Bundaberg as the radiation oncology principal house officer.

“Growing up in Broome and Cairns, I always had been interested in going into a healthcare-related career,” said Christina. “I think you become aware and experience firsthand some of the barriers

that rural and regional areas and its populations face, particularly with access to certain aspects of healthcare, and I had always hoped that I could contribute.

“I’ve thoroughly enjoyed my time as a junior doctor and the variety experienced during training. I have been lucky to work across a number of departments and specialties in the last few years and have certainly learnt a lot—I especially enjoyed working in oncology, paediatrics and women’s health.

“I hope to specialise in radiation oncology in the future because I think it is a wonderful career— I really enjoy the patient interaction and longitudinal relationships formed throughout the patient’s disease journey,” she said. “I enjoy working with people and the multidisciplinary team approach to cancer care and I find the scope for research and innovation interesting.”

To help on her journey to becoming a radiation oncologist, Christina recently joined RANZCR as a Medical Associate and has now made the College her CPD home.

“I decided to join RANZCR as a Medical Associate after looking at several options for CPD learning and finding the College’s tailored online education program the best for my career ambitions,” she explains. “I find the online CPD tool very easy to use. The videos are excellent and the dashboard accessible.”

“I really enjoy the patient interaction and longitudinal relationships formed throughout the patient’s disease journey.”

In addition to CPD learning, Associates enjoy many of the benefits received by Fellows, including access to research grants and discounted rates for conferences and events.

Associates can also access opportunities for involvement in RANZCR committees or special interest groups—something Christina is hoping to do.

“Currently I have been concentrating on using my Associate membership for its in-depth CPD offer,” she said. “But in the future I’m looking forward to getting more involved in the College. I know I will find the networking particularly useful and hope to attend an ASM.

“Any student or junior doctor considering clinical radiology or radiation oncology should take a serious look at becoming a RANZCR medical associate—I’ve found it incredibly useful.”

There are two other categories of RANZCR’s Associates program. The Nursing and Allied Health Associate is for healthcare professionals whose scope of practice identities with clinical radiology or radiation oncology.

The Specialist Associate is for a doctor who has trained and gained a Fellowship from a recognised specialist medical college in Australia, or New Zealand or another internationally recognised specialist medical society. IN

Scan the QR code for more information on becoming a RANZCR Associate.

Dr Christina Hannah

SABR Power

Targeting Cancer shines a light on stereotactic ablative body radiotherapy.

Targeting Cancer has recently launched a media campaign to raise awareness of stereotactic ablative body radiotherapy (SABR)—a revolutionary new treatment that can cure many early-stage cancers and control advanced disease.

As part of the campaign, Targeting Cancer committee coChair Dr Lucinda Morris sat down with Prof Shankar Siva from the Peter MacCallum Cancer Centre for a video interview outlining the benefits of SABR.

Prof Siva is a global expert in novel applications of SABR and has led numerous national and international clinical trials in its use. Most recently, Prof Siva’s “FASTRACK II” trial demonstrated SABR has unprecedented effectiveness in curing primary kidney cancer.

“SABR or SBRT is a very advanced, even revolutionary, type of radiation therapy,” explained Prof Siva during the interview. “It has so far shown exceptional outcomes and can be used in conjunction with or instead of systemic therapies.

“It offers the patient a highly precise dose of radiotherapy that can be delivered in as little as one to five sessions rather than multiple sessions over weeks,” he said. “It is appropriate for patients with early-stage cancer or low-volume secondary spread, and has shown to cure cancers such as lung, prostate and kidney.”

Prof Siva also discussed SABR from the patient perspective, explaining that “SABR is delivered in an outpatient clinic. No surgery is required meaning patients can

“It is a myth that radiation therapy is always second best to surgery, some patients will do better with radiation rather than surgery and vice versa.”

drive-in and drive-out for treatment.

This is particularly helpful for those living outside of the city or for people who might still be working while undergoing care. The side-effects in the short-term are minimal with the treatment both safe and effective.”

During the interview Prof Siva also advised patients to consider radiation therapy techniques if they are at the start of their cancer recovery journey. “Radiation therapy treatments such as SABR can cure cancer by itself and should be considered for patients who are in the high-risk category for surgery due to comorbidities,” he said.

“The clinical outcomes we have advanced to are exceptional.

“It is a myth that radiation therapy is always second best to surgery, some patients will do better with radiation rather than surgery and

vice versa,” he emphasised. “I would recommend any patient who has sadly been diagnosed with cancer to talk to a radiation oncologist about what might be appropriate for their treatment.”

For further information about Targeting Cancer, visit www.targetingcancer.com.au IN

Scan the QR code to

RANZCR Targeting Cancer’s Dr Lucinda Morris interview Prof Shankar Siva on the benefits of SABR.

Prof Shankar Siva

Earn CPD and Subscribe to Research Review

We provide regular overviews of new critical research across a wide range of Oncology areas, with guidance by Australian and New Zealand experts.

Sign up at no cost to receive digital publications and videos

– researchreview.co.nz or researchreview.com.au or email Dr Janette Tenne: janette@researchreview.com.au

RANZCR members can claim reading related to their practice as a CPD activity under the category ‘journal reading and web based no certificate *reflection required’. https://www.ranzcr.com/fellows/general/cpd-overview

Trainee’s Project Success

Dr Sijing Feng’s research into using AI to triage chest X-rays has led to the creation of the region’s first machine learning-ready medical imaging dataset.

RANZCR member Dr Sijing Feng was a second-year trainee in New Zealand when he applied for a Clinical Radiology Research Grant in 2020. The success of this has led to presentations in Australia and abroad, as well as a significant development in the understanding of AI in transforming radiology workflows.

It’s well known that artificial intelligence (AI) is an emerging technology that potentially can transform the workflow in radiology, improving patient care. Dr Feng’s project, “Automated Pneumothorax Detection on Adult Erect Chest X-Rays (CXR) with Convolutional Neural Network (CNN) Algorithms”, has been very successful in helping to automatically triage chest X-rays. Machine learning techniques could be used to create an automated CXR triaging system with high sensitivity to enhance pneumothorax detection. Before Dr Feng’s project, no such deep learning models for pneumothorax classification and segmentation had been trialled in New Zealand.

Dr Feng’s study aimed to create and test locally built AI algorithms on automated detection of pneumothorax on adult erect chest

X-rays in Dunedin Hospital. An interpretability study was performed to assess for the visual features the AI model uses to arrive at its prediction, allowing Dr Feng’s research team to examine for potential bias within the AI model, as well as attempting to understand the logic the AI model uses to arrive at its prediction of pneumothorax on adult chest X-rays.

The project was based on a multidisciplinary collaboration with data science and computer science, and machine learning experts, coordination between the medical annotation team and the

computer science modelling team: seven radiology consultants and 40 other medical house officers and registrars from New Zealand and Australia contributed to the medical annotation with their knowledge.

It also built a basic understanding of the deep-learning techniques including the convolutional neural network that enabled the deployment of a machine learning algorithm.

The creation and establishment of such a large local New Zealand machine-learning-ready medical imaging dataset is a first in the Australasian region. This is invaluable to attract AI specialists to build powerful AI systems to promote the development of the AI technology for the benefit of Australasian radiologists and patients.

This project will contribute towards the future identification of opportunities and areas where AI application could be helpful. IN

Dr Feng’s project dataset

The results of the project demonstrated that in a simulated environment, with the aid of AI triaging for pneumothorax on adult chest X-ray, there is a significant reduction in reporting delay and in turn, this translates to significant potential improvement to patients’ health outcomes. Presentations of the project were made at the RANZCR Annual Scientific Meeting, as well as at the Radiological Society of North America. The dataset produced as a result of the project has been made public and the research results were published in JMIRO in 2022.

Dr Sijing Feng

FIGURE 1: Curation Process and Final Characteristics of the CANDID-PTX Dataset

Save the Date

What’s in store for the 2025 ANZSNR ASM?

On behalf of the ANZSNR Council, we wish to thank and congratulate the Organising Committee, Dr Shane Lee, Dr Tim Elliott, Dr James Caldwell and Dr Ben McGuiness, on delivering a highly successful and well attended 2024 ANZSNR Annual Scientific Meeting in New Zealand last month.

This year we were pleased to be joined by three international leaders in the field of neuroradiology:

Prof Larry Ginsberg (US) Head and Neck/ENT Radiologist

Dr Mayank Goyal (Canada)

Interventional Neuroradiologist

A/Prof Timothy Shepherd (US)

Diagnostic Neuroradiologist

All recorded talks will be made available to delegates who registered. To access the recordings,

please contact secretariat@ anzsnr.org.au. We wish to thank all delegates for attending and we look forward to seeing you again in 2025.

2025 Annual Scientific Meeting

Plans are underway for the 2025 ANZSNR Annual Scientific Meeting. Next year, the ASM will be heading west to Perth from 27–29 March 2025. The ASM will be convened by a strong scientific committee team of neuroradiologists from Western Australia:

Neuroradiology: Prof Paul Parizel (Brain)/Dr Scott Davies (Spine) Head and Neck/ENT: Dr Daren Gibson/Dr Andrew Thompson

INR: Dr Tim Phillips/Dr Ruchi Kabra

We are once again planning an innovative three-full-day program

that will include a mix of head and neck, diagnostic neuroradiology, and interventional neuroradiology sessions. We look forward to welcoming international speakers in these fields to provide delegates with the latest educational opportunities and research from overseas.

Interested attendees are asked to save the date and prepare within their departments to attend. There will be tailored content for general radiologists with an interest in neuroradiology, and RANZCR accredited trainees are invited to submit abstracts with a generous prize (return economy airfare and registration costs to attend the subsequent ANZSNR ASM) available for the best presentation. ANZSNR members receive discounted registration (for more information contact secretariat@anzsnr.org.au)

To register your interest or for any questions, please contact the event manager at nc@ncevents.com.au.

Join us for the 2024 IRSA ASM, a meeting for Interventional Radiologists, general Radiologists with an interest in IR, Radiology trainees, nurses/Radiographers and Medical Students.

Our international Keynote speakers for 2024 are: Professor Hyo-Cheol Kim (Republic of Korea) Professor Jafar Golzarian (USA)

Next Steps

An update on the application for specialty recognition for IR and INR.

The RANZCR Board of Directors and Faculty of Clinical Radiology Council made a commitment in 2017 to seek specialty status for members practising in interventional radiology (IR) and interventional neuroradiology (INR) in both Australia and New Zealand. The College’s strong desire is that specialty IR and INR practice be recognised at the respective national levels, and that radiologists who wish to practice in these areas have the option to undertake accredited training provided by the College towards becoming dual-qualified in radiology and IR or INR.

The Interventional Radiology Committee is leading this work for the College. The specialty recognition process involves two stages: Stage 1 (initial) assessment and Stage 2 (detailed) assessment. In February 2023, two separate Stage 1 applications were submitted to the Medical Board of Australia (MBA) that included a combined total of over 300 pages of documentation. These documents were contributed to by many members who practise in these specialties, including IRSA and ANZSNR representatives.

Key criteria for these applications include, that specialty recognition will:

Enhance protection of public safety; facilitate workforce mobility; improve access to health services; enable the continuous development of a flexible, responsive and sustainable health workforce; and promote innovation in service delivery.

Provide an overall net benefit to the community, and that alternative non-regulatory options will be insufficient to achieve the same benefit.

In January 2024, the College received the outcome of the MBA’s assessment. This was communicated to all RANZCR members via email in a Presidential Communique in February.

Unfortunately, on this occasion, the MBA determined the case for recognition had not yet been established.

Below is an outline of the highlevel key themes outlined by the MBA in their feedback to RANZCR.

1. The MBA acknowledged RANZCR’s extensive consultations in seeking perspectives from a broad range of stakeholders, but recommends that RANZCR undertakes additional consultation with patient groups and underserviced populations, including those who live in rural and remote communities, in order to better understand how recognition will improve patient care and health outcomes in these populations.

2. The MBA has identified the need for further analysis of other nonregulatory options to provide evidence that specialty recognition is the best outcome for the public.

3. While recognition of one specialty does not impact any other specialties’ ranges of practice, the MBA has recommended that RANZCR better articulate the complementary and competitive overlap of IR and INR with other medical specialties, and further evaluate the benefits and potential impacts on patient access and healthcare outcomes.

4. RANZCR should provide additional information on the structure and content of the IR and INR training programs to demonstrate the important clinical focus that underpins these specialties, and to illustrate the advanced knowledge and skills required for high-quality and safe specialist IR and INR practice.

The feedback and additional information requested by the MBA provides the College with clear pathways to achieve success in future re-applications. The College remains committed to achieving formal specialty recognition of IR and INR, and new applications to the Medical Board will be submitted once all the additional work and required information is completed.

If you feel that you can contribute to any of the key areas outlined above, or can provide supporting evidence for these applications, please get in touch at interventional@ranzcr.edu.au. IN

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ARGANZ Highlights

A recap of successful events and news from the Abdominal Radiology Group of Australia and New Zealand (ARGANZ).

Established in 2006, ARGANZ is a special interest group with a focus on education and research, collaboration and advocacy. Each year, ARGANZ convenes an ASM and workshops in Australia or New Zealand.

A Successful Meeting

The 2024 ARGANZ meeting in Melbourne commenced with a two-day CT colonography workshop and an ARGANZ workshop. It was a successful event attracting a record registration of 423 delegates. International speakers Prof Perry Pickhardt, A/Prof Cher Heng Tan and Dr Damian Tolan delivered worldclass presentations, supported by a strong Australian and New Zealand faculty, highlighting the expertise in abdominal imaging locally. The lectures not only sparked insightful discussions but also presented transformative ideas to potentially reshape current practices.

Fostering the Next Generation

ARGANZ was delighted with the increasing participation of registrars and JMOs. The inaugural ARGANZ Trainee Hub provided a networking

space for registrars and JMOs and an informal session on abdominal imaging fellowships was held, with recent local and overseas Fellows sharing their experience and advice. The 2024 meeting received a record number of abstract submissions for oral and poster presentations. The Mendelson Research Prize was awarded to Dr Alexander Kirwan. The runner-up was Dr Thu Nguyen and the popular poster vote winner was Dr Kosuke Kato.

Collaboration

ARGANZ remains committed to fostering collaborations with international abdominal imaging societies such as the European Society of Gastrointestinal and Abdominal Radiology (ESGAR), the Asian Society of Abdominal Radiology (ASAR), and the Society of Abdominal Radiology (SAR), as well as strengthening ties with clinical specialty groups in Australia and New Zealand. ARGANZ congratulates Dr Kirsten Gormly, who was the invited speaker for the prestigious ‘ESGAR 2024 honorary lecture’. This is an exceptional honour particularly for a nonEuropean radiologist. Furthermore, a collaborative virtual event, the Global Abdominal Imaging Forum, is scheduled for 8 November and will present speakers from ESGAR,

ARGANZ, ASAR and SAR, with a focus on hepatocellular carcinoma. This event features several Australian speakers and ARGANZ is thrilled to be part of this landmark collaboration. For information, visit www.esgar.org/workshops.

Looking Ahead

The 2025 ARGANZ meeting will be held on the Gold Coast (8–9 March). We are excited to announce three renowned international speakers, Prof Christine (Cooky) Menias (US), Prof Clare Tempany (US) and Prof Yves Menu (France). Additionally, there will be a new ‘Young ARGANZ Trainee Day’, featuring lectures pitched at the registrar level, as well as the School of ARGANZ part 2 mock exam session. We plan to host more online workshops during 2024, so stay tuned for more information.

Stay Connected

Check out the ARGANZ website (www.arganz.org) for a wealth of resources, including reporting templates, scanning protocols and free access to prior years’ meeting content. Stay informed about policy news and changes, new imaging guidelines and upcoming events by joining ARGANZ for free (via the website) and following us on X (@arganz_online) and Facebook (@arganzradiology). IN

Executive Committee members and international speakers of ARGANZ 2024.

Rectal MRI workshop at ARGANZ 2024. From left to right:

A/Prof Damien Stella, Dr Kirsten Gormly and Dr Verity Wood.

Dr Jessica Yang, ARGANZ Chair

Meeting Up

An update on the Faculty of Radiation Oncology GenitoUrinary Group’s (FROGG) members and upcoming events.

The FROGG Executive Committee has had a very busy start to 2024, having kicked off two teleconference meetings since February.

FROGG has worked with the College in the past to support a number of Medical Services Advisory Committee (MSAC) applications, and is currently working on a proposal for MRI planning for prostate radiation therapy. We are seeking expressions of interest from clinicians who are keen to engage with this proposal (not limited to FROGG members), and extend the invitation to training registrars. If you would like to be involved or have enquiries, please email faculty@ranzcr.edu.au

We would like to take this opportunity to give a big thank you to outgoing FROGG member Dr Mark Sidhom. Dr Sidhom has been a longstanding committee member who has brought a wealth of knowledge and expertise to the group, which we will always be grateful for. We would also like to thank outgoing trainee representative Dr Anna Lawless, who has worked very hard during her time on the committee, and has been pivotal in arranging the FROGG trainee workshop. We welcome newest FROGG member Dr Wee Loon Ong, who joined the committee in February, and we look forward to his contributions to the group. We are also thrilled to

announce the successful FROGG trainee representative for 2024 is Dr Tracy Lim.

In May, the committee hosted the FROGG Trainee Weekend in Sydney. The program covered many of the seminal topics in genitourinary cancers, including multidisciplinary input from surgical and medical oncology experts, as well as allied health

specialists. The event was a huge success, providing an invaluable teaching opportunity for registrars, particularly for those preparing for Phase 2 training and exams.

The next FROGG workshop will be held early September 2025. While we are yet to finalise the dates, program and venue, we will promise for it to be as outstanding as the previous meetings. IN

Attendees arriving at the event, which was held at Sydney Masonic Centre.

FROGG members at May’s Trainee Weekend event.

Inside NMSIG

The Nuclear Medicine Special Interest Group (NMSIG)’s Executive Committee shares key insights on their specialty.

A/Prof Stephen Schlict

How has NM/PET evolved and what excites you most about the specialty’s future? “Looking back over some 25 years as a nuclear medicine specialist, the practise (referred to today as molecular imaging) is constantly evolving to meet current clinical practice and management of our patients. No longer the low-resolution images of standalone gamma cameras but now the realm of fully diagnostic SPECT/CT and PET/CT, offering both exquisite structural images fused with functional and metabolic information, providing unique diagnostic and management insights into different disease entities. Fair to say NM/PET now has both the brains and the best looks in town!”

Dr Dalveer Singh

How have you seen dementia imaging evolve? “FDG PET is now becoming the standard functional imaging assessment for dementia. Having relied on perfusion SPECT imaging, it is great to see the complementary use of FDG PET to understand patterns of dementia in our patients. I’ve seen the earlier diagnosis really help patients and their families get a formal diagnosis and hopefully access emerging treatments. Occasionally I get to image patients with amyloid or other

novel tracers, which are incredibly exciting for the future.”

Dr Peter Jackson

How do you find balancing NM/PET with other parts of your practice? “I make my days interesting by keeping an eye on what’s new, adapting my skills, engaging the broader health community and leading a happy collective workplace that can fit it all together. The days can be long and busy. Mixing things up with concurrent procedure lists, theranostic consultations, sorting urgent cases, training a Fellow, and attending a multitude of MDTs is worth the challenge. Helping train Fellows and registrars keeps me grounded and up to date with the latest knowledge and skills.”

Dr Sidney Levy

How has PSMA PET impacted patient outcomes, compared to the ‘pre-PSMA’ era? “Over the past 10 years, PSMA PET CT has transformed the staging and restaging of prostate cancer, due to its superior accuracy compared with CT and bone scan. Along with MRI prostate, uro-oncologists now possess two powerful tools to optimise decision-making in the management of de novo and recurrent prostate cancer. More recently, PSMA PET CT is forming

the basis of targeted radionuclide therapy of metastatic prostatic cancer, in the emerging field of theranostics.”

Prof Alex Pitman

What do you enjoy in your dayto-day practice of NM/PET?

“The most enjoyable part of nuclear medicine is our ability to accurately characterise physiological processes and provide an explanation of what’s happening. Often the explanation is logical and retrospectively selfevident, yet completely invisible to structural only imaging. Consider the diagnosis of osteomyelitis, or the determination of fracture healing age, or the characterisation of activity of inflammatory arthritis, or provision of split renal function, or characterisation of lung shunt versus pulmonary embolism. Such diagnoses are elegant and simple with nuclear medicine.

The most enjoyable part of PET is the sheer impact it makes on so many of our patients on a hereand-now basis of adding years to life and of saving lives. The ability to characterise and predict response, and to accurately stage disease, is life-saving. When I see successful cures and successful cancer control, that reaffirms the human benefit we bring to society as PET imagers. Curing cancer is a compelling reason to get out of bed and to come to work.” IN

Improving Access and Equity

How the College is promoting access, equity and inclusion for members, trainees and patients. Plus, a reminder about InsideRadiology.

As the College continues to prioritise efforts that promote access, equity and inclusion for members, trainees and patients, I am pleased to provide you with an update on just a few of these initiatives.

MRI Deregulation MMM2-7

The term ‘postcode lottery’ has been used to describe the wide variations in people’s access to healthcare, depending on where they live. People residing in regional, rural and remote communities experience significant barriers including the need to travel large distances, and often excessive out of pocket expenses. The College’s advocacy efforts have included deregulation of magnetic resonance imaging (MRI) licensing. The College was therefore delighted when the Australian government deregulated Medicarefunded MRI services in regional, rural and remote areas (MMM2-7) at the end of 2022.

Designed to improve access

to these vital diagnostic imaging services in underserved parts of the country, we are now beginning to see the results of this expansion.

It is encouraging that early indications from the Department of Health and Aged Care (DoHAC) suggest that more rural and regional patients are receiving MRI scans closer to home.

There has been significant and sustained growth of MRI services in MMM2-4 regions, where patients are benefitting from reduced travel time to access Medicare-rebatable MRIs, with the average patient contribution decreasing from $182 to $166.80.

Importantly, easier access to diagnostic imaging will lead to improved healthcare outcomes for these patients, enabling better detection and diagnosis of medical conditions.

The College continues to advocate for the deregulation of the MRI licensing system in MMM1 locations this year, as part of our ongoing efforts to promote equitable access to diagnostic imaging services throughout Australia.

Using InsideRadiology

InsideRadiology is the leading Australasian resource on clinical radiology tests, procedures and interventions, providing up-to-date information to health consumers (patients, their families and friends), and health professionals including referring clinicians and allied health professionals. It is gratifying to note that InsideRadiology is used globally as a ‘go-to resource’ in radiology

information. InsideRadiology receives approximately one million hits online each year from across the globe.

InsideRadiology is a treasure trove of valuable content for both clinician and patient, from referral through to diagnosis, enabling patients to make informed decisions about their treatment and providing comprehensive clinical information for referrers.

Developed by Australian and New Zealand radiologists and other health professionals, with input from consumers and GPs, content is categorised according to the audience.

Consumers can search for information about the varied roles of the clinical radiologist, discover what’s involved in a particular procedure and learn about the different types of imaging available.

Health professionals, including referrers, can access useful facts about the types of tests and treatments including nuclear medicine, their pre-requisites and contraindications, and relevance to specific medical conditions and patient groups (e.g. paediatric).

I encourage members to use this resource and recommend it to patients, colleagues and referrers.

Training initiatives

In our efforts to develop a diverse and sustainable workforce, the College is committed to boosting the numbers of Aboriginal and Torres Strait Islander and Māori trainees and addressing the maldistribution of clinicians in rural and remote locations.

Dr Rajiv Rattan, Dean (FCR)

“Easier access to diagnostic imaging will lead to improved healthcare outcomes for patients.”

Following the announcement of 15 additional training positions for clinical radiology by New Zealand’s Minister of Health in 2022, five for 2023, five for 2024 and five for 2025, it is pleasing to see two of the positions being advertised are for placements in regional centres for first-year trainees. I’d like to send a thank you to those sites involved.

Recruitment is underway for approximately 29 positions, with successful applicants commencing their training in January 2025.

New Zealand is one of the first branches to recruit under the new RANZCR-wide training selection policy that came into effect on 1 January this year. It aims to ensure a fair, transparent and inclusive process for all applicants across Australia and New Zealand as mandated by the AMC.

There has been a smooth transition to the new preregistration process where applicants are required to preregister with the College to determine their eligibility prior to submitting their application.

Under the new policy, applicants who identify as Māori or Aboriginal and Torres Strait Islander and meet the eligibility criteria now progress straight to interview and will have their application fee waived.

This acknowledges their under-representation within both specialties and reflects the commitment of the College to growing a more diverse and culturally responsive workforce. Currently, 11 clinical radiology trainees identify as Māori.

Meanwhile, four trainees have commenced training under the Regional and Rural Training Pathway (RRTP) Pilot Program, which seeks to address the maldistribution of clinical radiologists and radiation oncologists in regional and rural Australia.

RANZCR continues its efforts in advocacy across various aspects involving our profession. IN

The Works

A quick recap of key achievements and current initiatives from the Specialty Training Unit.

There is much work underway in multiple facets of our busy Specialty Training Unit. Our focus for the CRETC (Clinical Radiology Education and Training Committee) this year is engagement with our Directors of Training (DoTs) and Clinical Supervisors, and also meeting our Australian Medical Council (AMC) requirements.

Examinations

The Phase 2 written examinations recently returned to examination centres, and feedback from candidates indicates they wish this practice to continue.

For the first time, pictorial multichoice questions were used in the Radiodiagnosis (MCQ) examination. Pleasingly, the statistical performance of these questions was good regarding discrimination, and the feedback from candidates has been very positive, such that we will look to increase the number over time.

Feedback from candidates who sat the Pathology examination was also positive and several comments were made about consistency in style between the two examinations. Our thanks to A/Prof John Cockburn, Chair of the CRRERP (Clinical Radiology Phase 2 Radiology Examination Review Panel) who worked very closely with the mostly new Pathology panel and its new Chair, Dr Ines Nikolovski.

DoT Workshops

Dr Ruth Sutherland (our Medical Educationalist) is developing a number of strategies to assist our

DoTs in their very important roles, and is working with Dr Jash Agraval, DCC (Curriculum and training) to deliver DoT workshops. The focus for the next workshop is on making the most of WBAs. I look forward to seeing many of you at our DoT workshops this year, both in Australia and New Zealand.

Selection

Selection for trainees commencing in Clinical Radiology 2025 is well underway and the College’s new registration process has been running smoothly. The new process and relevant policy aims to assist candidates with transparency and equitable opportunities. Feedback on the new policy and process is welcome and encouraged.

Centralised Learning Program

I thank our outgoing Centralised Learning Program (CLP) coconvenors, Dr Jane McEniery and Dr Sally Ayesa, for their hard work to develop this lecture program. I am pleased to welcome Dr Vidisha Vaidya and Dr Maneesh Khanna, who will take over as the new CLP co-convenors. I am confident they will continue to follow the high standards that have been set.

Accreditation

Following member feedback, the revised Accreditation Standards are now ready to be circulated for a second round of consultation. We look forward to receiving your feedback before we finalise these. The Accreditation team is planning a series of roadshows and webinars to support the introduction of the

new standards following its launch at the ASM in Perth. The new standards are outcome-focused and therefore aligned to the training program learning outcomes. They are flexible, meaning that training can be offered on non-traditional training sites in the future.

STPS and IRTP

From the 2024 clinical year, the College has successfully secured two additional Specialist Training Placements and Support (STPS) funded posts and one additional Integrated Rural Training Pipeline (IRTP) funded post under the Specialist Training Program (STP).

RANZCR has recently secured funding from the Department of Health and Aged Care to grow the number of RANZCR Indigenous trainees. This two-year project is a multi-faceted capacity-building initiative that will provide individual trainee support, education and training to key clinical personnel to foster a culturally safe and inclusive training environment.

As part of RANZCR’s pre-budget submission, the College has asked for extra funding from the Federal Government to expand RANZCR’s Regional and Rural Training Pathway (RRTP) pilot program to help boost the regional and rural workforce, address current shortfalls and significantly improve patient access to diagnostic and cancer services. IN

Dr Barry Soans, Chief Censor (FCR)

Melbourne Musculoskeletal MR Weekend Workshop

July 20-21, 2024

Melbourne Monday Small-Parts MR Workshop

July 22, 2024

Sydney Musculoskeletal MR Weekend Workshop

July 27-28, 2024

Sydney Monday Small-Parts MR Workshop

July 29, 2024

Adelaide Musculoskeletal MR Weekend Workshop

Aug 10-11, 2024

Brisbane HRCT Aug 3-4, 2024

Sydney HRCT Aug 17-18, 2024

Melbourne HRCT Aug 24-25, 2024

Print copy of 140-page HRCT book Included

Cardiac CT Training 2024

We go beyond simply meeting training requirements:

l Participants eligible to claim 40.75 RANZCR CPD hours for the Masters and 23.75 RANZCR CPD hours for the Recertification course.

l Maximum allowable course based live and library cases for ANZ credentialing.

l Clinician led teaching by high volume operators.

l State of the art low dose, High Definition imaging.

l Unrivalled venue and catering.

Lee

2024 Goals

An overview of the main objectives for the Clinical Radiology Trainee Committee this calendar year.

The Clinical Radiology Trainee Committee (CRTC) has been hard at work contributing to the work of various committees across the College and sharing the voice of trainees at these meetings. I wanted to share the main goals of the Commitee in 2024. These are goals that we’re aiming to make significant progress on this year as well as continue to pursue longer term goals such as voting rights for trainees and a trainee Board member.

• Pilot mentorship program in conjunction with radiation oncology

• Examination masterclasses on

topics that have lower pass rates in the OSCERs

• New trainee survey

• Improve the pathology exam curriculum

• Improve communication channels to trainees

• Reduce minimum allowed parttime training to 0.2 FTE

• Release of accreditation site reports directly to trainees at that site

• Change recognition of prior learning policy to align with radiation oncology We are currently progressing these goals through the College committees and hope to make sure

we’ve got real achievement on all of them by the end of 2024.

As always, we look forward to hearing your feedback, questions and comments. You can reach us at clinicalradtc@gmail.com. Also feel free to reach out to me personally. You can reach me at 0405 472 499 or sanjay.hettige@gmail.com.

We look forward to working with you all this year to make radiology training the best it can be. IN

Dr Sanjay Hettige, CRTC Chair

Good Relationships, Good Outcomes

Why the relationships we build—our ‘trust capital’— are critical in achieving the outcomes we seek.

The Federal Government’s recent announcement of the new MBS funding schedule for radiation oncology, due to be implemented on 1 July, is but one of many positive outcomes that have been achieved as a result of the relationships RANZCR has nurtured over many years.

This ‘trust capital’ is critical to our ongoing advocacy work, where the College has established itself with government and other stakeholders in both Australia and New Zealand as a trustworthy source of advice and input into policy matters that directly impact members.

The government frequently seeks and values the College’s advice on multiple issues across both faculties, which encompass the breadth of clinical practice and the regulatory space we operate within.

The extent of the efforts involved in our advocacy work may be largely invisible to members considering that much of it occurs behind the scenes and, in some cases, takes years before there is an outcome.

A/Prof Dion Forstner (former Dean of the Faculty of Radiation Oncology) can certainly attest to this, given that he was involved in the MBS review taskforce from the very beginning.

“The review of the Radiation Oncology MBS was first announced in 2012, but it wasn’t until 2015 that we began work in earnest to ensure that the new schedule supported the long-term sustainability of our profession,” said A/Prof Forstner.

“The work mostly fell on the shoulders of a few dedicated people, and often required forensic attention to the minutiae, while remaining focused on the big picture,” he said. “It was a very slow and, at times, frustrating process. I sometimes remark that when we started this work, my youngest child hadn’t commenced primary school. They are now in middle high school.

“Nonetheless, the countless hours have definitely been worth it. I have personally benefitted from extending my collegial relationships and it is particularly pleasing the extent to which departmental staff value close collaboration with the College.

“However, while the changes to the MBS are very welcome, it is likely that some are already out of date given that this review has taken so long. We therefore need to continue our advocacy so that the MBS reflects our fast-changing profession,” he explained.

“So, why get involved in the activities of the College? The bottom line is, none of us can afford to just sit back and wait. We get the outcomes we work for.”

Further to A/Prof Forstner’s comments, I would like to acknowledge the immense contributions of all who were involved and sincerely thank them for their perseverance and commitment. A well-funded sector that values quality activity is the best outcome for patients and helps us plan for the future.

While the outcomes of the MBS review are specific to radiation oncology, it is also important to recognise that the whole College benefits from the relationships strengthened throughout this lengthy process.

Particle Therapy and the Bragg Centre

The College also plays a critical role in government decisions that directly impact individual patients’ access to treatment.

As we know, particle therapy treatment facilities are increasing in number worldwide. The roles of particle therapy in the modern era are generally accepted, particularly for paediatric, adolescent, and adult patients with rare forms of cancer.

The Australian Bragg Centre for Proton Therapy and Research in Adelaide is aiming to become the first healthcare facility offering particle therapy in Australia within the next few years.

Once fully operational, the Bragg Centre will provide proton beam therapy (PBT) to patients, however until then, Australian patients wishing to access this treatment overseas can apply for Federal Government financial assistance through the Medical Treatment

Dr Gerry Adams, Dean (FRO)

Radiation Oncology MBS Review Timeline

More than 20 members and 10 staff contributing 1,000s of hours over 10 years...

MBS Review Taskforce announced by government

Oncology Clinical Committee Report endorsed

Review of Radiation Oncology first identified

MBS Review Taskforce Oncology Clinical Committee commenced Implementation Liaison Group commenced

New RO Schedule Agreement achieved

New MBS funding schedule for radiation oncology implemented 1 July

“This ‘trust-capital’ is critical to our ongoing advocacy work, where the College has established itself as a trustworthy source of advice and input into policy matters that impact members.”

For more information about the Australian Bragg Centre, visit www.protontherapy.sahmri.org. au/about/the-centre

Overseas Program (MTOP).

RANZCR is working closely with government and playing a pivotal role in assessing patients who may be eligible for financial assistance under the MTOP.

Applicants complete a detailed written application which is submitted to the Department of Health and Aged Care, which then forwards this to RANZCR for assessment. Each application is subjected to a comprehensive review by appropriate clinicians from the assessor pool, with a further assessment and authorisation by senior faculty members.

Given that time is often a factor for patients seeking MTOP support, RANZCR aims to provide this service in a timely and efficient manner. With the rising number

of applicants, this is becoming increasingly challenging and time consuming both for volunteer assessors and College staff.

The fact that the department relies upon the College to manage this comprehensive process, and trusts the integrity of the clinical judgements made, is a testament to the value of the relationships that have been fostered between both parties.

It also reinforces the fact that, as well as being the bedrock of the clinician-patient relationship, trust is a valuable strategic resource for our profession. It is vital for knowledge sharing, problem solving and innovation, and strengthens our ability to successfully advocate on behalf of members and ultimately achieve the outcomes we seek. IN

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Continuous Improvement

An update on changes to examinations and accreditation.

The year is truly underway and I am so grateful for the dedication and work that so many of you undertake both on behalf of the College and for all our trainees. I know that as representatives of the College many of you are on the frontline trying to explain and work through practicalities of decisions made. Please reach out to myself, our Dean, Dr Gerry Adams, office bearers and the College staff, as we are all here to support you. For those who are not in volunteer roles, please support those who are putting their hand up to help better our training program. Without their selflessness and commitment we would not have the excellent training program we do.

Examinations

In the vein of improving the training program, we have been working on changing the examination format and marking rubric to improve relevancy and incorporate more real-life scenarios into the

examination setting.

I would like to thank all the examiners and particularly Dr Tanya Holt and Dr Benjamin Chua for their work on the changes of the Phase 2 Examination, and Dr Apsara Windsor for her wonderful contribution as the Phase 1 Examination Lead. We are lucky as a College to have Dr Alex Tan as Chief of Examinations and I thank him for his excellent leadership. The examiners work extremely hard to ensure that examinations are fair and accurate assessments, and we will continue to support trainees as best we can through these stressful periods.

Accreditation

I am excited about the new Accreditation Standards which are currently working their way through the final stages of the governance process. Our previous Chief Accreditation Officer, Dr Vanessa Estall, and deputy Dr Anne Capp laid the groundwork for these positive changes and I am very grateful for their vision.

I would like to take this opportunity to thank all the people involved in the Accreditation Standards Working Group, the Chief Accreditation Officer, Dr Matthew Seel, and the College secretariat.

The revised Accreditation Standards and processes are intended to be:

Encouraging and supportive to help training sites deliver high-quality training

Simpler and clearer, so it is easier for training sites to know exactly what is expected to meet the requirements

More comprehensive, to include elements frequently identified as key determinants of whether good training is occurring

Flexible enough to acknowledge that training sites have different ways of achieving the same endpoint

More streamlined for all parties, so everyone can be more efficient and timely with decision-making and completing the necessary documents.

DoT Workshops 2024

I am looking forward to the DoT workshops, where I get to hear from so many of you. Dr Ruth Sutherland, our Medical Educationalist, is working with Dr David Kok and the Learning Experiences and Outcomes Committee (LEOC) to develop workshops and other support mechanisms for our DoTs and clinical supervisors. The focus for the June DoT workshop is identifying and supporting underperforming trainees, the new Accreditation Standards and understanding the new Phase 2 Examinations. IN

As always, I am very happy to be contacted at any time by anyone who wishes to connect, ask questions, give feedback, volunteer, or needs support. Lisa. sullivan@act.gov.au

Dr Lisa Sullivan, Chief Censor (FRO)

Embracing Collaboration

Exchanging ideas and sharing knowledge is key to our success—both

individually and professionally.

Our specialty is inherently one that depends on collaboration. Within our departments, our work is impossible without our nursing, radiation therapy and medical physics colleagues. In the clinics and MDTs, we work side by side with medical oncology, surgical oncology, pathology, palliative care and radiology to ensure our patients receive the best possible care. However, as I progress through my training, I am learning that our strongest form of collaboration, and also the one with the most potential

for further growth, is when we collaborate with each other.

For a group that forms a minority portion of the College, we certainly punch above our weight. The research output through the many special interest groups is worldclass, volunteer ROs are constantly ensuring our voice is heard and influencing decisions at important tables, and local experts continue to grow influence on the global stage. Collaboration is also becoming easier as barriers to accessing people and information are being removed. For many of us, we are more likely to hear about the latest practice-changing trial from a morning Twitter/X scroll than a local journal club. Social media has become the new forum for a battle of controversial clinical ideas or critique by leading experts, which was otherwise reserved for rare and infrequent scientific meetings or editorials.

As the rate of change increases, and information becomes more accessible, trainees need to prepare for a future working environment that needs to be agile and adapt quickly. Trainees are already learning how to do this well.

“We need to keep pushing and learning how change is safely implemented and the levers that need to be pulled to make effective change happen. Learning these skills will likely be as valuable as any other in our training.”

Our education is heavily digital, allowing us to collaborate with each other nationally. Whether it’s digital notes that get passed down from trainee to trainee, study groups that blossom and persist despite hundreds of kilometres separating its members, or the development of a centralised learning platform that will allow knowledge to spread quickly and more equitably. Even the way our exams are written and delivered has been adjusted to acknowledge that practice-changing information can be released between candidates registering and sitting for exams. To start, trainees are also uniquely placed to enhance collaboration in our workplaces. Our training, with its mandatory rotations, allows us to be a fomite for ideas. This exchange allows us to learn new things in new environments but also offer tried solutions to problems on a local/regional level. We need to keep pushing and learning how change is safely implemented and the levers that need to be pulled to make effective change happen. Learning these skills will likely be as valuable as any other in our training. Opportunities such as SMART workshops, the RANZCR ASM and other training courses may allow trainees to extend our networks nationally.

It’s hard to predict where our specialty is going and what our work as radiation oncologists in 2040 will look like, but one thing is for sure—our ability to collaborate and innovate together will be key to our success, both individually and as a profession. IN

Dr Riche Mohan, ROTC Chair

What’s Next for CPD?

Our Clinical Radiology and Radiation Oncology Chiefs of Professional Practice update us on the latest requirements from regulatory bodies.

L“We are working hard to ensure that the ongoing changes being placed on all the medical colleges by the MBA, the Medical Council of New Zealand (MCNZ) and the Australian Medical Council (AMC) are met in order to be compliant.”

ast month the Medical Board of Australia (MBA) sent all doctors on the AHPRA (Australian Health Practitioner Regulation Agency) medical register an email advising that it is a requirement that every doctor has a CPD home. For doctors practising in Australia, if you are a member, CPD participant or Associate with the College, we are your CPD home unless you have registered with another provider.

If you have a CPD home you need not do anything. If you are a Medical Associate with us we would strongly urge you to speak with your colleagues and ensure they too have registered with a CPD home in Australia.

As the Chiefs of Professional Practice for Clinical Radiology and Radiation Oncology, we are working hard to ensure that the ongoing changes being placed on all the medical colleges by the MBA, the Medical Council of New Zealand (MCNZ) and the Australian Medical Council (AMC) are met in order to

be compliant—but in ways that work for us as members, CPD participants and Associates, as we strive to meet those requirements.

Last month’s email from the MBA is just one of the activities the MBA is currently doing with regards to CPD. Recently, College staff met with AHPRA to clarify the requirement for all CPD homes to report to AHPRA the CPD compliance of all Australian doctors in 2025.

At this meeting, AHPRA confirmed that is a mandatory requirement for us to report to the agency and it will require the following information from us: Compliance

Non-Compliance

Break-in-Practice/Training. AHPRA advised that its process will be to cross-check this information with the declaration we make to the agency as a part of our annual registration process. From our declarations, AHPRA will cross check the information sent

Dr Carol Johnson, CHoPP (FRO)

Prof Dinesh Varma, CHoPP (FCR)

to it by all the CPD homes to confirm if the declarant:

Does have a CPD home

Declared they do not have a CPD home

Is compliant with the CPD requirements

Declared that they are not compliant with CPD.

Where information received from CPD homes and declarants does not match, AHPRA will investigate. If it finds that the declarations were wrongly made, AHPRA could consider it to be a false declaration and further action may be taken against the declarant.

The NZMA only requires us to notify it of all NZ practising doctors who are non-compliant. In New Zealand, the relevant college is the only recognised CPD home. Feedback from doctors generally about CPD requirements to the MBA has not been well received

(as you may have seen from the interview with the Chair of the MBA, Dr Anne Tonkin AO, in AusDoc), and the MBA is determined to push ahead with continued changes. This has also been the experience of the College in our efforts to push back on the MBA.

In February, we invited the AMC and MCNZ to a meeting with the combined Professional Practice Committee (PPC) members to discuss the conditions placed on the College as a CPD home following the accreditation visit in August 2023. Our AMC report can be found at: www.amc.org.au/wpcontent/uploads/2024/03/2023RANZCR-CPD-HomesAccreditation-Report.pdf

Again, as the Chiefs of Professional Practice along with the members of both PPC we discussed in detail those conditions and the implications for members,

CPD participants and Associates. It is clear that they will not be considering any pushback from any CPD home.

In February, the FCR Chief of Professional Practice brought together a small working group to review the feedback from members on the ePortfolio platform as well as the ability of members to be able to meet some of the requirements. Working with College staff we are considering all the feedback and will consult members on changes at the Perth ASM, so that we can implement them by 2026.

We are also inviting the regulatory bodies to the Perth ASM to be able to discuss the further changes they require directly with our members, CPD participants and Associates.

If you have any questions regarding CPD or ePortfolio, please contact the College CPD team at: CPD@ranzcr.edu.au IN

Awarding Excellence

The WA Branch celebrates the outstanding achievements of its members.

Turab Chakera Teaching Award

The RANZCR WA Branch would like to congratulate Dr Vidisha Vaidya for being awarded the 15th Turab Chakera teaching award by the WA Radiology Teaching program trainees at March’s annual WA Registrar Dinner.

Dr Vidisha Vaidya MBBS (Adelaide), FRANZCR, PG Cert Medical Ed (Radiology) (RCR/Dundee, UK) is a RANZCR Director of Training and Director of Medical Education at SKG Radiology and National Co-Convenor of the RANZCR Centralised Learning Program for Clinical Radiology.

Named in honour of the late Prof Turab Chakera, the award recognises excellence in radiology teaching and education. Dr Vaidya has been involved in radiology and pathology teaching for several years and has implemented biannual Phase 2 Trial Examinations in Western Australia. “I am humbled to be recognised with this award,” said Dr Vaidya. Here are the award’s past winners:

Turab Chakera Teaching Award

Year Winner

2010 Dr Geoff Robey

2011 Dr Geoff Robey

2012 Dr Sven Thonell

2013 Clin A/Prof Mike Bynevelt

2014 Clin Prof Richard Mendelson

2015 Dr Emmeline Lee

2016 Dr Kay-Vin Lam

2017 Dr Jolandi van Heerden

2018 Dr Yi-Jin Kuok

2019 Dr Fiona Bettenay

2020 Dr Gavin Chapeikin

2021 Dr Victor Wycoco

2022 Dr Mike Bynevelt

2023 Dr James Seow

2024 Dr Vidisha Vaidya

UWA Chancellor’s Medal

The University of Western Australia’s Chancellor’s Medal is awarded for outstanding contributions to the university. Late last year, the medal was awarded to Prof Lesley Cala. A pioneering neuroradiologist, educator and champion of women’s rights, Prof Cala notably procured the first CT machine in the Southern Hemisphere for Perth in 1975, providing access to CT brain scans in Perth’s five teaching hospitals.

Beyond her many years of teaching and research at UWA, she has also held positions in the National Council of Women Australia, the International Council of Women and the UWA Centenary Trust for Women.

Upon presenting Prof Cala with the medal, UWA Chancellor, the Honourable Robert French AC, said, “As a UWA graduate and a proud member of the Convocation of the University, Prof Cala is a highly deserving recipient of the Chancellor’s Medal, recognition of a lifetime of remarkable achievements and a deep commitment to her community.”

The RANZCR WA Branch would like to congratulate Prof Cala on her achievement, and on her continued commitment to improving the field of radiology. IN

Dr Vidisha Vaidya

Prof Lesley Cala (centre) at UWA.

Together, to Share

Looking forward to the upcoming ASM. Plus, an update on training vacancies.

Kia ora koutou. I am pleased to announce that Jenna Howell has been appointed as Manager, NZ. Many of you will know Jenna, she has been with the College for more than eight years in a variety of roles. Wiebke Ashby (Training Officer), Ella Steele (Program Officer) and Felicity Murray (Examinations) have recently joined the team.

Selection

In 2021, Minister Andrew Little announced 15 additional training positions for clinical radiology spread over three years. The first five were added to the 2023 intake, the next to the 2024 intake and the last tranche we are recruiting for now, to start training in 2025. It’s pleasing to see that many training centres have capacity to take the increased numbers, and there are many others keen to take trainees in the future. In 2023, the government allocated an additional five radiation oncology training positions and another five for the 2025 intake.

together and sharing more with you as they are implemented. The Radiology Clinical Networks are underway, with Dr Sharyn MacDonald as one of the National co-leads. There is an expression of interest open for another co-lead for radiology — this is part of Health New Zealand Te Whatu Ora’s journey to create a more cohesive, accessible and peoplecentred health system.

NZ Branch ASM Queenstown 2–4 August 2024

This year’s NZ Branch ASM is being held in Queenstown, with the theme ‘Together, to Share’. Thank you to our clinical radiology convenors Dr Sharon Ngu and Dr Luke Wheeler, and radiation oncology convenors Dr Jerusha Padayachee and Dr Giuseppe Sasso. Keynote speakers include: A/Prof Farshad Foroudi, Director of Radiation Oncology at Austin Health, Melbourne

“It’s pleasing to see that many training centres have capacity to take the increased numbers, and there are many others keen to take trainees in the future.”

Currently we have 33 clinical radiology vacancies to start training in 2025, and for radiation oncology we have 12 vacancies — which is the largest intake on record for New Zealand. Countless hours are spent by those involved in the shortlisting and the interview process, and the success of the training program is due to this. Words cannot express our gratitude for your dedication.

National Clinical Networks

As we go to print, the Clinical Cancer Networks are in development— we look forward to collaborating

Dr Richard Do, hepatopancreaticobiliary imaging expert from Memorial Sloan Kettering Cancer Center in New York

Dr Giles Maskell, past president of The Royal College of Radiologists (UK), based at Royal Cornwall Hospital, UK

Dr Wendy DeMartini from Stanford University School of Medicine, Editor-in-Chief of the Journal of Breast Imaging and past president of the Society of Breast Imaging, US

Early bird registration closes 23 June: visit www.ranzcr2024.co.nz.

I look forward to seeing you there. IN

Dr Gabes Lau, NZ Branch Chair

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

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

See all Member Rewards offers in:

New Zealand Australia

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.

KPMG BMW & MINI CORPORATE

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

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.

The Gift of Time

A note of thanks to our volunteer members, who drive the success of the College with their time, effort and talent.

Awise person once said, “Those who can, do. Those who can do more, volunteer.” RANZCR relies heavily on volunteers, with some 1,200 members currently contributing their time (and talent) to support College activities and committees. You may have noticed the ‘Volunteer in the Spotlight’ section we run in Inside News each issue (turn to page 17 to read a letter from our Chair of the ASM Committee, A/Prof Christen Barras) but in reality, there are far more hardworking volunteers than we can recognise in these pages alone.

In 2023, more than 1,600 of our College volunteers were awarded with specialty pins—a small but heartfelt token to thank them for their valuable service. Some of the official volunteer roles for College Fellows include Board, committee

or sub-committee members; branch office bearers; College examiners and ASM convenors. Other ways for members to be involved is to join a Special Interest Group, participate in your local branch, attend events, or become an author or reviewer for JMIRO (the Journal of Medical Imaging and Radiation Oncology) By volunteering with the College you can help to drive key projects, share your ideas and enhance the voice of clinical radiologists and radiation oncologists to make positive changes within the organisation, and for the lives of patients. As Prof Liz Kenny said, “When we really distil the College ethos, it is all about improving the lives of its members and the people we serve.” For more information on volunteering, email members@ ranzcr.edu.au to receive a welcome pack and volunteer pin. IN

Dr Munish Verma, GM—Members, Privacy and Partnerships

“You can help to drive key projects, share your ideas and make positive changes within the organisation, and for the lives of patients.”

Scan the QR code to view current opportunities within both faculties of the College.

Inside News Readership Survey

What do you think of Inside News? What would you like to read in future issues? Please take two minutes (really, only two minutes) to provide your feedback so we can better tailor Inside News to your needs and interests. Your feedback is anonymous and will be used by RANZCR’s In-House Editor to inform the editorial direction of the publication. For any queries about the survey, please email editor@ranzcr.edu.au. Thank you.

Scan the QR code to complete the survey.

Where to Next

Reflecting on our successes in 2024, and looking ahead to FY2025.

As another fiscal year comes to an end it’s worthwhile taking a moment to reflect on the progress and achievements of the past 12 months. The continued support of our members and the dedication of our volunteers have been instrumental in shaping the successes of FY2024. Here are just a few key initiatives and achievements that we’re particularly proud of:

Accreditation Achievement

The AMC granted accreditation to RANZCR’s specialist medical programs until 2027, confirming their quality. This maximum permissible period between reviews highlights the excellence of RANZCR’s programs.

Advancing Breast Health

RANZCR’s updated position statement advocates for mandatory reporting of mammographic breast density to improve breast cancer screening accuracy. This recommendation underlines the importance of informed decision-making in breast health, acknowledging the significant impact of breast cancer on Australian women.

Advocacy Impact

RANZCR’s decade-long advocacy efforts resulted in a new MBS

funding schedule for radiation therapy, effective July 2024. This change reflects a significant milestone in advancing equitable access to essential healthcare services.

Guidance on AI Implementation

RANZCR collaborated with international bodies to publish guidance on AI tools in radiology, offering valuable insights into their development, purchase, implementation and monitoring. This initiative supports members and the wider community in navigating the evolving landscape of radiological practice.

Improving Standards in Clinical Radiology

Changes to Recognition of Training in CT Coronary Angiography will be introduced in July 2024, following advocacy by members of the Professional Practice Committee. These updates aim to enhance standards in clinical radiology, ensuring the highest quality of care for patients.

Indexation of Nuclear Medicine

Significant achievement with the announcement of $92.8 million allocated in the budget. This funding aims to enhance the viability of nuclear medicine imaging by implementing a targeted schedule fee increase and reinstating annual

indexation, thereby aligning with indexation arrangements for other diagnostic imaging modalities.

Increased Training Positions in New Zealand

RANZCR’s ongoing advocacy in conjunction with our New Zealand members has resulted in increased training places for both radiation oncology and clinical radiology.

Regional and Rural Training Pathway (RRTP) Pilot Program

The RRTP Pilot Program, supported by the Federal Government’s FATES program, aims to address the unequal distribution of clinical radiologists and radiation oncologists across Australia. By aligning training with Indigenous community needs, the program offers opportunities for Aboriginal and Torres Strait Islander candidates, contributing to the sustainability of the healthcare workforce in regional and rural areas.

Removal of MRI Licences

RANZCR achieved a significant milestone in its long-standing advocacy efforts for equitable access to MRI services. Following persistent campaigning and collaborative discussions with the Department of Health and Aged Care, the government announced the complete removal of MRI licences by specific dates: from July

2025, practices with existing licences will receive a ‘practicebased’ licence, and by July 2027, all ineligible MRI machines in comprehensive diagnostic imaging practices will be upgraded for full Medicare-funded MRI services access.

Successful ASM

The 73rd RANZCR Annual Scientific Meeting brought together over 1,600 professionals and industry partners, facilitating learning and collaboration. Special thanks were extended to volunteers whose contributions were crucial to the event’s success.

Looking Ahead to FY2025

We’re excited to build upon the momentum of our past successes

and embark on new initiatives to support our members and advocate for our sector, including:

Continued advocacy efforts to shape healthcare policy and promote the interests of radiation oncologists, radiologists and their patients.

Innovation in digital health technologies to enhance the delivery of radiological services and improve patient outcomes.

Strengthening of partnerships and collaborations with College branches to build a supportive and inclusive radiology and radiation oncology community.

Following careful consideration of member feedback, we have transitioned from PayPal to Stripe, which offers expanded payment options and greater flexibility for you.

We are thrilled to announce an exclusive offer for all RANZCR members in collaboration with the European Society of Radiology (ESR). On behalf of our members, the College has negotiated an outstanding rate, providing a significant discount on the ESR Premium Education Package (PEP).

Offer Details:

How You Can Help

Members can choose to make a voluntary donation to the College to support student members and the broader professions of clinical radiology and radiation oncology. Based on member feedback, here are the areas where your donation can have the biggest impact:

Supporting equitable work and health outcomes for Māori, Aboriginal and Torres Strait Islander Peoples

Supporting students and members in distress

Supporting research and education

Supporting the Targeting Cancer campaign, including the consumer-facing website

Visit www.ranzcr.com/college/ membership/fees/make-a-donation IN

• Discounted Rate: €250 (regular price €390)

• Validity: The promotion code RANZCR_250 is now available and offers ongoing access without a fixed expiration date.

• Package Duration: 12 months from the date of purchase.

This is an excellent opportunity to enhance your professional development at a reduced cost. For more information on how to apply the discount, visit www.ranzcr.com/college/ document-library/esr-premium-education-package-2024

Looking back at a successful 2023 ASM in Brisbane.

45th Annual Scientific Meeting

The Cairns Convention Centre, Queensland, Australia

Wed 24 – Fri 26 July 2024

Don’t miss this chance to be amongst the very best breast cancer researchers for the premier event on the clinical trials calendar.

This is where eminent international researchers, Australian and New Zealand guest speakers and big thinkers come to showcase the best ideas and updates on trials. It’s also where the next generation of researchers can learn more about how to be involved in this rewarding, multi-disciplinary research.

The theme for the 2024 Annual Scientific Meeting is ‘International Collaboration in Breast Cancer Trials’, and we look forward to colleagues joining the meeting.

Register at bct2024.org

Ideal preparation for the Radiology Part 1 AIT Examination. Includes 12 hours of MRI specific CPD.

Presented by Associate Professor Marc Agzarian With MRI progressing rapidly, a sound understanding of the physics, technology and equipment is required to fully exploit MRI’s potential. MRI safety, image quality, artefacts and optimisation strategies are covered throughout the course.

With all original, vendor neutral content, this course will benefit radiologists, radiology registrars, radiographers, radiation therapists, neurologists, cardiologists, neurosurgeons, researchers and medical physicists wanting to gain a better understanding of MRI.

10-11 August 2024

Marion Hotel, 849 Marion Road, Mitchell Park, SA

COURSE

‘Excellent course. Marc is a fantastic teacher. Few people could make MRI physics interesting like Marc can.’

- Dr Mike Ratcliffe

For more information and to view the full program visit www.ncevents.com.au/events ncosta@ncevents.com.au

Meet a Staff Member

In this new regular column, we get to know some of the staff working behind the scenes at the College. This issue, we meet Freya St Julian—Project Officer for Professional Practice in the Standards Unit.

How long have you worked at the College and how would you best describe your role?

I celebrated my 15-year anniversary of working at the College in March 2024. Currently I am a Project Officer, Professional Practice in the Standards Unit of the College and I look after the Continuing Professional Development (CPD) program and the CPD system in the RANZCR ePortfolio, while assisting members with their CPD submissions each year.

Tell us a bit about your professional background. Prior to commencing at the College (more than 15 years ago!) I completed my Bachelor and Masters degrees and I had worked in tertiary education and customer service roles. Upon first joining the College I worked in CPD, and over the years have worked across many other areas including examinations, the training programs, committee support, survey design, implementation and reporting, data analysis and database management.

What are you currently working on? Work on CPD is not just limited to the December deadline — it continues all year round. We are currently in the process of auditing a random selection of members on their 2023 CPD activities before we commence preparation for the 2025 CPD program. The changes to the CTCA training requirements are also commencing on 1 July 2024.

What do you like about working at RANZCR? Working at the College is always an interesting experience and CPD is an area of significant growth at the moment from a regulatory perspective. I enjoy the regular contact with members, assisting them with their CPD submissions and getting feedback and suggestions for improvement to the CPD program.

What changes have you seen in recent years?

Last year was the first calendar year of the new CPD requirements introduced by the Medical Board of Australia and Medical Council of New Zealand, and this represents a significant change in CPD and medical registration requirements. There has been a significant amount of work from our Professional Practice Committees, the CPD team and the IT team to enable the College to continue to provide a CPD program that meets the new requirements. We appreciate the support and understanding from members as the CPD ePortfolio system continues to evolve to support our members in meeting their registration requirements.

What’s something that members might be surprised to know? In my spare time I enjoy baking, and my RANZCR colleagues have always been very enthusiastic testers of my latest creations. IN

For CPD enquiries, please email cpd@ranzcr.edu.au

“We appreciate the support and understanding from members as the CPD ePortfolio system continues to evolve.”

of the Ladder

Each year, the Journal of Medical Imaging and Radiation Oncology (JMIRO) celebrates its top downloaded articles, recognising the journal’s high-impact authors and reviewers. The 2024 list covers a broad range of research topics, from AI and machine learning to gender and diversity. Eight of the 13 articles appeared in Special Issues, and each one was published as open access. Authors of these influential papers are awarded a certificate and invited to add a ‘Top Downloaded’ certification to their LinkedIn profile.

#1

Diagnostic imaging for suspected pulmonary embolism during pregnancy and postpartum: A comparative radiation dose study

#2

Basic cancer immunology for radiation oncologists

#3

Non-radiologist perception of the use of artificial intelligence (AI) in diagnostic medical imaging reports

#5 #7

Quality indicators for radiation oncology

F-18-FDG PET/ CT features of immune-related adverse events and pitfalls following immunotherapy

#6 #8

Role of radiomics in predicting immunotherapy response

Fostering an inclusive workplace for LGBTQIA plus people in radiology and radiation oncology

#9 #11

Impact of DNA damage response defects in cancer cells on response to immunotherapy and radiotherapy

#13

#4 #10

Clinical evidence for synergy between immunotherapy and radiotherapy (SITAR)

Immunotherapy and Transarterial therapy of HCC: What the interventional radiologist needs to know about the changing landscape of HCC treatment?

Machine learning imaging applications in the differentiation of true tumour progression from treatment-related effects in brain tumours: A systematic review and meta-analysis

#12

Iodinated contrast media shortage: Insights and guidance from two major public hospitals

Improving the synergistic combination of programmed death-1/programmed death ligand-1 blockade and radiotherapy by targeting the hypoxic tumour microenvironment