Current Issue

This editorial will be published in full on 17 November 2018, as part of the conference issue of the BSR Annual Meeting.

Fabrice C. Deprez
French representative (Chair) of the IR section of the BSR)

Tom De Beule
Flemish representative (Secretary) of the IR section of the BSR

Interventional Radiology (IR) started to develop around the mid-1960s, when Charles Dotter, a pioneering U.S. vascular radiologist, performed the first angioplasty on a patient with gangrene and an ulcer on her foot. Since then, IR has expanded into almost all fields of medicine, “from head to toe”, concerning women, men and children’s health at once. Today, IR is indisputably a medical sub-specialty with still a strong growth potential, providing minimally invasive image-guided diagnosis and treatment by a wide range of techniques, constantly evolving.

IR is an essential part of Radiology and constitutes a fantastic showcase of our specialty. Despite that, we still don’t have IR title recognition in Belgium, and consequently we don’t have a specific IR nomenclature, specific IR suites and equipment’s recognition, and a coherent identified nationwide IR offer. Moreover, with this situation, Belgian IR suffers from a fierce competition with other medical specialties, in a very competitive and underfunded healthcare environment.

The IR section of the BSR is a very active and growing section of the BSR. One of our major goals is to improve IR networking, IR visibility and recognition regarding public and politics, and increase professional defense. For this reason, we endorsed and actively support the European Board of IR (EBIR) of the CIRSE (European Society of Cardiovascular and IR), and we encourage all our members, and especially the youngest, to obtain the EBIR certification.

By the way, we try to develop close relationships with the other European IR societies (especially with the French and the Dutch societies), which is why we are very proud to welcome very prestigious speakers at our BSR annual meeting.

As well as all Radiologists, Interventional Radiologists must be prepared to demonstrate their value to patients, providers and the public. Our guests are all key-opinions-leaders in IR and will show us the best we can expect from IR!

Our first speaker, Professor Hicham Kobeiter, is the past president of the SFICV (Société Française d’Imagerie Cardiovasculaire et interventionnelle) and a world-wide known expert in Imaging Guidance in IR. He is the Head of the department of Radiology in the University Hospital Henri Mondor, in Créteil (France). His IR room is equipped with the latest technical developments of C-arm CBCT.

Our second speaker, Professor Otto van Delden, is probably one of the most suited people in the world to talk about the role and the abilities of the Interventional Radiologist in 2018, as he is the Chairman of the European Board of IR (EBIR - CIRSE) and the chairman of the “Training & Education Committee” of the Dutch society of Radiology. 

Interventional radiology offers minimally-invasive therapies that have clear advantages over surgical procedures. Radiological interventions are safer, better tolerated and cheaper. One would assume that radiological interventions would be rapidly adopted once they have been shown to be equally effective as the surgical alternative. Not infrequently though, implementation of a radiological intervention into clinical practice is hampered, despite availability of scientific evidence demonstrating non-inferiority or even superiority over current standard of care.

Our last speaker, Professor Mark Burgmans, is a very famous IR and the president of the Dutch Society of Radiology. He will discuss promising radiological interventions that could or should have been a treatment of first choice, but have thus far failed to have a significant impact on clinical management in the Benelux. The technique, indications and available scientific literature will be discussed of 'misknown' radiological interventions, such as percutaneous hepatic perfusion, renal tumor ablation, uterine artery embolization, thyroid ablation and percutaneous placement of peritoneal dialysis catheters.

This editorial will be published in full on 17 November 2018, as part of the conference issue of the BSR Annual Meeting.

Robert Hermans
UZ Leuven

Jacques Widelec
HIS-IZZ Bruxelles

One of the themes during this Annual Meeting is the field of Head & Neck Radiology. During two sessions, one organized by the Young Radiologists Section, lectures will be presented on different topics of interest both to the general and more specialized radiologists.

This editorial presents the lectures and topics during the session moderated by Dr. Yannick De Brucker (UZ Brussel, VUB) and Dr. Jacques Widelec (HIS-IZZ Bruxelles).

The first lecture is presented by Dr. Anja Bernaerts (St. Augustinus Hospital GZA, Antwerpen). Dr. Bernaerts graduated as MD from the University of Antwerp in 2000. She completed her radiology residency at the Sint-Maarten hospital in Duffel, the Gasthuiszusters Antwerp (GZA) hospital Sint-Augustinus in Antwerp, and the University hospital Antwerp in 2005. She currently works as a staff member of the department of radiology of the GZA hospitals, Antwerp, Belgium, with Breast radiology and Head and Neck radiology sub-specializations. In 2013 she obtained the European Diploma in Breast Imaging and in 2015 she also obtained the European Diploma in Head and Neck Radiology. She is team member of the Breast Unit of the GZA Hospitals, which has been certified with a European Cancer Care Certification. In performing Head and Neck radiology exams, she works closely together with Dr. Bert De Foer and Prof. Dr. Jan W. Casselman. In the field of Head and Neck radiology, she also has a particular expertise in Dental and Maxillo-Facial imaging, disposing also of the ‘Certificate of Competence in the Use of Cone Beam CT in the Dental Practice’, obtained at the Catholic University of Leuven in 2013. She authored and/or co-authored 30 peer reviewed articles and 5 chapters in books. She is also the principal investigator of the in-progress study of the department of Radiology and the European institute for ORL-HNS at the GZA hospitals on the value of ‘MRI in Menière’s Disease’.

During her lecture ‘MRI in Ménière’s disease’, she will show the possibilities of this relatively new MR-technique in the management of patients with otological symptoms possibly caused by endolymphatic hydrops. 

The second lecture is presented by Dr. Kunwar Bhatia. Dr. Bhatia is consultant radiologist, with a special focus on head and neck radiology, working in the Imperial college Healthcare NHS Trust, Division of Imaging and Interventional Radiology, London, UK. He previously had an academic tenure as Clinical Associate Professor (Radiology) in The Chinese University of Hong Kong (2007-2016).

In this session he will address ‘Imaging of salivary masses’. There are numerous causes of salivary enlargement, which can be broadly divided into focal masses, which may be neoplastic or non-neoplastic, and diffuse salivary diseases, which may be secondary to obstruction of salivary ducts (obstructive sialadenitis) or a wide range of other infective, inflammatory, autoimmune and other pathologies. Imaging fulfills several roles in the initial work-up including localization, diagnosis or characterization, staging of malignancies, image guided biopsy and therapeutic interventions (aspirations and stone extractions).

The third lecture is presented by Prof. dr. Robert Hermans (UZ Leuven, KUL). Prof. Hermans is staff member in the department of radiology in the UZ Leuven since 1992. His primary interest is head and neck radiology. He served as president of the International Cancer Imaging Society (ICIS).  He is also past-president of the Royal Belgian Society of Radiology (RBSR). From 2010 till 2017, he served as editor-in-chief of Insights into Imaging, journal of the European Society of Radiology (ESR). Dr. Robert Hermans authored about 180 articles and 40 book chapters, mainly on head and neck imaging, with a special focus on cancer imaging. He was editor of 4 books on this topic.

His lecture deals with ‘Imaging of perineural tumor spread’. As there are many nerves present in the head and neck region, these structures may provide tumours the opportunity to spread over a considerable distance from their point of origin. Perineural tumour spread may occur in all head and neck malignancies; adenoid cystic carcinoma, a tumour of salivary gland origin, is notorious for its tendency to spread along nerves. Perineural tumour spread is associated with a decreased survival rate. Imaging diagnosis is important to map the full tumour extent, and to avoid tumour progression from unrecognized perineural spread.   

This editorial will be published in full on 17 November 2018, as part of the conference issue of the BSR Annual Meeting.

Barbara Geeroms
UZ Leuven

It has become a good tradition: the parallel programme organised by the Young Radiologists during the Annual Meeting of the BSR. For the fourth year in a row, the young and eager have invited a nice selection of renowned experts in in the fields of Head and Neck Radiology, Interventional Radiology and Artificial Intelligence.

The first part of the morning will cover several radiological challenges in head and neck imaging and will be moderated by Anne-Sophie Vanhoenacker and Barbara Geeroms, both radiology residents at UZ Leuven. 

Prof. Marc Lemmerling will start off with a comprehensive presentation on temporal bone CT. Professor Lemmerling has been a head and neck imaging expert for over twenty years and made a doctoral thesis on ‘HRCT and MR imaging of the middle and inner ear’ at the University of Ghent. He has been working as a radiologist in AZ Sint-Lucas in Ghent since 2000. No ossicle abnormality escapes the eye of this temporal bone specialist. 

How do we best handle these cysts and nodules in the thyroid gland that we are often so uncertain about? Dr. Kunwar Bhatia will teach us her tips and tricks and more. Just read the Head and Neck editorial of this issue to learn more about Dr. Bhatia.

And finally, when you find yourself facing a difficult head and neck imaging case at the most exotic hours in the emergency department, just think back at the presentation of Dr. Yannick De Brucker at this Annual Meeting. Dr. Yannick De Brucker has been a head and neck imaging specialist for several years now, after completing two fellowships in the field: a first at the University of Florida in 2015 and a second at UZ Leuven in 2016. Currently he is working as a staff member in UZ Brussel.

During the second part of the morning sessions, several experts on wires and tubes will tell you all about how to really get interventional. Dr. Astrid Van Hoyweghen, radiologist at UZA, and Dr. Pierre-Antoine Poncelet, radiology resident at UCL University Hospital in Brussels, will moderate the lectures.  

The first speaker is Prof. Romanic Loffroy from the University of Dijon School of Medicine. He was a postdoctoral research fellow at Johns Hopkins Medical Hospital in Baltimore and is currently doing research, among other things, in new interventional radiology therapies for liver cancer, deep vein thrombosis and arterial diseases and in new embolic materials.  He will share all his secrets on biopsies and drainage techniques.

A dilemma probably every radiologist has faced in the emergency department when he or she has just diagnosed an active hemorrhage: is this a case for our interventional radiology colleague or do we send this to the surgeons to handle? Dr. Otto van Delden will address this and other questions in his talk on the management of hemorrhages. You can read more about Dr. van Delden in the Interventional Radiology editorial.

Finally, Prof. Marco Midulla will take us on a short journey through his views on the future of interventional radiology and the emerging techniques in the field. Professor Midulla is currently working at Dijon University Hospital. He made a doctoral thesis on ‘Hemodynamic Aortic Imaging’ and got specific training in Vascular and Interventional Radiology in major aortic centers in Stanford (US), Toulouse and Lille.

Traditionally the afternoon starts off with a message from Prof. Geert Villeirs, president of the Belgian Society of Radiology, in which he will discuss actual problems and challenges in radiology , as well as his view on the future of radiology.

Following this message, Dr. Matthias Lavens and Dr. Barbara Geeroms, both radiology residents at UZ Leuven, will share the results of a survey performed by the YRS on actual and future job opportunities in radiology in Belgium. 

The last sessions of the 2018 Annual Meeting will cover the probably hottest topic in radiology these days: Artificial Intelligence (A.I.). Moderators Dr. Cedric Bohyn and Dr. Matthieu Deltomme, both radiology residents at UZ Leuven, will guide us from speaker to speaker. 

The first speaker is Prof. Erik Ranschaert, vice-president of EuSoMi. He made a doctoral thesis at the University of Antwerp titled “The impact of information technology on radiology services”. He is an expert on Artificial Intelligence. Currently he is working at the ETZ Teaching Hospital in Tillburg, the Netherlands. Professor Ranschaert will share his views on the emergence of artificial intelligence. 

During the next lecture, two lawyers from law firm ‘Dewallens & partners’ will elaborate on the legal aspects and possible concerns that A.I. will bring us.

Dr. iur. Christophe Lemmens and Dr. iur. Nils Broeckx both studied law and obtained a doctoral degree at the University of Antwerp. They are both specialists in digital data management.

Dr. iur. Christophe Lemmens has a broad orientation in health law and is specialized in the patients' rights and obligations and in medical liability.

Dr. iur. Nils Broeckx has special expertise in medical liability and data protection law (including GDPR) with a specific focus on the health care sector.

The final talk of the day will be given by Prof. Bram van Ginneken from Radboud University Medical Center, the Netherlands. In 2001 he obtained his Ph.D. at the Image Sciences Institute on Computer-Aided Diagnosis in Chest Radiography. He pioneered the concept of challenges in medical image analysis and is thus the designated person to tell us more about real life artificial intelligence applications.  

We hope you will enjoy the programme we have put together for this Annual Meeting. We also have a little ‘surprise act’ in store for you and the lucky hundred who registered in time will be able to enjoy the very first Ultrasound party afterwards!