IS3R Global Scan
The IS3R Global Scan features articles on initiatives addressing strategic issues in the field of radiology and carried out by the major radiological societies among the IS3R’s member organizations.
ACR Responds to COVID-19
As the pandemic unfolds, the ACR is empowering members with a growing number of COVID-related resources. Projects include (but are not limited to):
- Providing early guidance to postpone non-urgent care, the role of imaging in COVID-19 diagnosis, provider safety, how to safely resume non-urgent care [LINK TO COME TUESDAY], and apply for Small Business Administration (SBA) and US Department of Health and Human Services (HHS) financial relief. Collaborating with other medical societies to develop and share information throughout the healthcare community.
- Creating educational materials to support members in updating their knowledge on chest imaging and familiarizing themselves with the imaging related to COVID diagnoses. Preserving resident and fellow training with an array of assessments, programs, and benefits.
- Furthering the scholarly literature behind imaging and COVID, with peer-reviewed JACR articles. Telling member stories and sharing firsthand knowledge via the ACR Bulletin and Imaging 3.0. All coverage is freely available, including Spanish translations of select JACR articles.
- Dedicating Data Science Institute resources to launching a real-time COVID-19 case repository for immediate submission and distribution of COVID-19 cases between facilities, collecting use cases for COVID-related AI algorithms, and developing additional tools.
- Constructing a COVID registry to inform optimal care and provide research opportunities across multiple specialties.
- Advocating for the specialty in fast-moving COVID-related legislation and initiatives already in progress.
The ACR is helping radiology professionals make informed decisions in the battle against coronavirus. The College is monitoring the specialty’s needs and adapting quickly to enable ACR members to provide the best care for their patients and support their colleagues through the pandemic. We suspect that many of the IS3R members are making similar efforts in their countries, and sharing of these and other ideas can inform a more rapid return to optimizing care globally.
The American College of Radiology Data Science Institute™ is collaborating with a variety of stakeholders throughout healthcare on the development and implementation of artificial intelligence applications that will help radiology professionals improve patient care.
With our panels of specialty experts, we have developed and published 140 freely available use cases for AI development in our Define-AI Directory. Our use cases provide guidance on clinical context as well as some of the key technical specifications that algorithm developers need in order to help the radiological community address the problems most amenable to AI solutions. Anyone can submit an AI use case idea through the portal. From there, the ideas are considered by panels of subspecialty experts who determine which will be developed into viable use cases. As part of its efforts, the DSI works to partner with other societies to democratize data science development. In addition, The Journal of the American College of Radiology recently added data science as an area of focus and released a special issue on quality and data science.
To accelerate the education and understanding of AI, the ACR launched ACR AI-LAB™. AI-LAB offers radiologists tools designed to help them learn the basics of AI and create, evaluate, and optimize models for their own investigational use. This platform is not limited to ACR members.
We are also working closely with the FDA on tools to validate algorithm readiness (Certify-AI) and monitor performance while in production (Assess-AI) in order to ensure safe and effective use in the United States as well as streamline the FDA review process. Learn more here or contact us about becoming involved.
Well-Being and Burnout
Stress, depression, anxiety and fatigue. As radiologists, we face these all-too-familiar symptoms at a distressingly high frequency. What does it amount to? A growing and dangerous challenge faced by physicians everywhere—burnout. According to the 2019 Medscape Radiology Lifestyle Report, almost half of radiologists surveyed admitted to symptoms of burnout. It has become abundantly clear we must work together to combat this issue.
To meet this need, we’ve created the American College of Radiology (ACR) Radiologist Well-Being Program for all ACR members:
- The proven and trusted Well-Being Index (WBI) survey tool, created by the Mayo Clinic to help physicians anonymously self-evaluate their level of well-being
- A toolkit of radiologist-specific articles and resources on critical well-being topics such as work-life balance, health behavior, emotional concerns, relationships and more, all accessible within the WBI
- A well-being curriculum with educational wellness resources appropriate for residents, medical students and career physicians
- A well-being curriculum for program directors and coordinators to use in their radiology residency programs, aligned with ACMGE well-being requirements
ESR’s activities in the fight against COVID-19
In this global fight against the Coronavirus pandemic, when radiologists around the world are being faced with unprecedented challenges, the ESR sees it as its duty to foster scientific exchange and connect colleagues currently fighting at the forefront.
In light of this, the ESR has developed a strategic approach with several tools to support the fight against the pandemic, such as the dedicated COVID-19 Resource Hub for radiologists that contains vital information on guidelines, publications, research, and support measures, including papers, case collection of COVID-19 images, research funding etc. The contents are being continuously updated thus keeping up with the latest developments.
Increased connectivity and information exchange have proven to be vital when dealing with a threat on which so far little is known. For this reason the ESR strives to foster further discussion among imaging professionals through various online channels such as the dedicated ESR Twitter discussion thread.
In order to provide further support to radiologists around the world fighting this emergency, the ESR made its online educational platforms ESR Connect and Education on Demand freely available for a duration of 4 weeks, which allow access to a wealth of video content, recorded lectures, literature, and educational courses.
Finally, the ESR provides a platform for leading scientists to present their latest findings related to the ongoing pandemic, such as the lecture by Dr Josef Penninger, one of the world’s leading geneticists and molecular immunologists, as well as for experts from the most affected regions in Europe to give their valuable insights on imaging workflows, staff protection, prevention measures, and department management in our immensely popular ESR Connect episodes of radiology fighting COVID-19.
Children in Focus
At ECR 2020, the European Society of Radiology (ESR), in cooperation with the European Society of Paediatric Radiology (ESPR), will be organising ‘Children in Focus’. This unique programme follows last year’s highly popular ‘Women in Focus’ programme and will explore a variety of healthcare and social issues affecting children and adolescents. The programme was envisaged by ESR President Prof. Boris Brkljačić (HR) and has been developed by Dr. Lil-Sofie Ording Müller (NO) and Dr. Catherine Owens (UK).
The vision behind ‘Children in Focus’, and the ‘In Focus’ project more generally, is to expand the engaging and relevant non-scientific offerings for attendees of ECR. With an emphasis on interactivity with the audience, the ‘In Focus’ programme also aims to stimulate discussion on those areas of healthcare that often go undiscussed during a medical professional’s daily practice, but are nonetheless of great importance in the wider context of healthcare delivery.
In developing the programme, the organisers selected topics that are relevant to a wide range of medical professionals and not just paediatric radiologists. For this reason, ‘Children in Focus’ centres less on scientific developments in paediatric medicine and more on issues that relate to children’s health issues on a broader, global scale. Such issues include examining universal policy and development goals for children’s health, exploring the challenges of using imaging in cases of child abuse, and discussing strongly debated contemporary issues such as consent, data use, and the moral and medicolegal dilemmas we face when treating children. For a detailed overview of the programme and speakers, click here.
Alongside the ‘Children in Focus’ sessions, ECR 2020 will also see an array of additional initiatives centred around children. These include collaboration with local children’s hospitals, the publication of a children’s book about radiology, and the organisation of an ECR Grand Finale with child speakers.
RSNA Responds to COVID-19 Crisis with Research, Education, and Community
As COVID-19 began to spread across the globe, RSNA responded in the way it does best – by disseminating the latest research, providing education, and connecting radiologists. Radiology led the way with the first images of the novel coronavirus published on January 31, 2020. Since then, Radiology has received over 600 papers, and is publishing COVID-19 articles within three to seven days of submission.
RSNA is responding to the critical needs of radiologists, who need to prepare their departments and practices, assist with diagnoses, and support other imaging professionals. As in-person meetings are canceled, RSNA is developing digital education, webinars and micro-learning opportunities to disseminate the best current knowledge about COVID-19. New peer-reviewed cases of COVID-19 from around the world are being published in the RSNA Case Collection each week. This unique diagnostic resource is helping radiologists understand disease progression over time and study cases with varying degrees of severity.
RSNA is building an open COVID-19 Imaging Data Repository through collaborative partnerships. The image hosting, annotation and analysis framework will enable researchers to understand epidemiological trends and to generate new AI algorithms. To date, RSNA has interest from over 150 institutions in 46 countries. All interested parties are invited to join the initiative through this survey.
Finally, RSNA launched a new online forum to connect the radiology community with peer-to-peer support and useful resources for managing the COVID-19 crisis. The COVID-19 Community will enable exchange of ideas and solutions, connect people with experts and resources, and foster the feeling of community that is needed now, more than ever.
All RSNA resources on COVID-19 are available free of charge at RSNA.org/Covid-19.
Because artificial intelligence (AI) is destined to improve the value radiologists bring to patients, the Radiological Society of North America (RSNA) is committed to the rational development and deployment of AI algorithms into radiology practice. The Society offers a wide array of initiatives that provide the knowledge, training, community, and tools necessary to enable medical imaging professionals to integrate AI into their practice safely and ethically.
To support AI education, RSNA’s annual meeting offers more than 200 AI-related courses, education exhibits, scientific sessions, and hands-on workshops. The meeting offers a breadth of learning opportunities that range from scientific sessions highlighting foundational and complex research, to refresher courses featuring introductory and practical applications of AI. RSNA’s AI Showcase provides a forum for AI industry, laboratories, implementers, users, and future users, to deepen their knowledge and experience the future of AI in radiology firsthand.
RSNA drives innovation in AI through its popular annual AI Challenges, designed to engage the data science community and to spur the creation of AI tools for radiology. These data challenges also empower the radiology community to develop datasets useful for training AI systems that perform clinically relevant tasks. The 2019 AI Challenge focused on detection and classification of intracranial hemorrhage on head CT. More than 1200 teams competed to accurately detect and classify hemorrhage on over 25,000 head CTs labeled by 60 expert neuroradiologists from the American Society of Neuroradiology. The winners were recognized in the AI Showcase Theater during the Annual Meeting.
The RSNA R&E Foundation’s competitive grant program also is instrumental to developing new AI insights, providing nearly $500,000 for AI research and education in 2019 alone, with plans to award $500,000 to support AI Education projects in 2020.
Most recently, RSNA launched an online AI Community that provides a central forum for idea exchange, networking, Q&A, and collaboration throughout the year. The new AI Community is open to all who are interested in learning about and discussing exciting AI innovations in medical imaging. Beyond education, research, innovation, and networking, the Society leads and supports the development of the standards and tools necessary to integrate AI into clinical practice.
RSNA is proud to continue its strong support for AI research and education, while building the workforce, technology, and standards that accelerate AI innovation in radiology.
For more information about RSNA’s AI initiatives, visit www.rsna.org.
Initiatives to Keep Ultrasound Safe During the COVID-19 Pandemic
In December 2019, the first case of “a new virus” was described in China. It quickly spread to the entire planet and became identified as severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and was declared a Public Health Emergency of International Concern on 30 January 2020. The virus is mainly spread between people in close contact, by coughing, sneezing, or even talking. Infection is also possible when touching contaminated surfaces and then one’s face, hence the importance of frequent handwashing and need to adjust medical practice, in general and radiology departments in particular as well as other hospital departments utilizing ultrasound (such as obstetrics and gynecology, emergency medicine, cardiology and more). Medical personnel were faced with unexpected large number of very sick patients. Ultrasound quickly became the main diagnostic procedure for lung disease secondary to the infection. Medical practices were confronted with new challenges: how to continue performing studies, while keeping the patients and the practitioners safe and how to clean the machines and rooms to maintain a clean environment. Generally, while performing ultrasound, even in a busy practice, the risk of cross infection between patients is low (for scans performed on intact skin) and the practitioners are not at risk (except for respiratory infections, such as the flu). However, given the high infectivity of the corona virus, new protocols must be instituted.
Several national and international scientific societies quickly prepared statements on how to safely practice during the pandemic. A very early one was the Correct COVID-19 safety equipment video made by the chief of ultrasound department of Leishenshan hospital, Wuhan, China (available on YouTube1). One of the first to be published online (WFUMB.org) was the World Federation for Ultrasound in Medicine and Biology’s Position Statement: How to perform a safe ultrasound examination and clean equipment in the context of COVID-192, quickly translated into Russian, French and Japanese. Simultaneously, the International Society of Ultrasound in Obstetrics and Gynecology (ISUOG) published several statements on its website, specific for Ob/Gyn: ISUOG Safety Committee Position Statement: safe performance of obstetric and gynecological scans and equipment cleaning in the context of COVID‐193, Statement on use of personal protective equipment and hazard mitigation in relation to SARS-CoV-2 for practitioners undertaking obstetric and gynecological ultrasound4, on rationalization of gynecological ultrasound services in context of SARS-CoV-25, on rationalization of early-pregnancy care and provision of ultrasonography in context of SARS-CoV-26, on organization of routine and specialist obstetric ultrasound services in the context of COVID-197, many of them immediately translated in various languages, for instance, Spanish8. The American Institute of Ultrasound in Medicine (AIUM) also published guidelines for general ultrasound: Guidelines for Cleaning and Preparing External- and Internal-Use Ultrasound Transducers and Equipment Between Patients as well as Safe Handling and Use of Ultrasound Coupling Gel9; Quick Guide on COVID-19 Protections — Ultrasound Transducers, Equipment, and Gel10; Quick Guide on COVID-19 Protections — Patient and Ultrasound Provider Protection11.The World Health Organization (WHO) also prepared a safety document: Rational use of personal protective equipment for coronavirus disease 201912.
An important document regarding point of care ultrasound (POCUS) can be found on the American Society of Echography website13. There are also many guidelines on performance of diagnostic studies during the Covid-19 pandemic on the American College of Radiology website14 and the RSNA website, in particular, for instance: Radiology Department Preparedness for COVID-19: Radiology Scientific Expert Panel15. Another potential source of information can be found in the websites of various ultrasound companies.
There are in addition, many guidelines, either as documents or webinars, regarding approaches to the diagnosis of the disease and its complications, for instance from the European Society of Cardiology (Escardio.org): COVID-19: how to use and interpret lung ultrasound16, the European Society of Radiology (ESR.org): COVID-19 patients and the Radiology department –advice from the European Society of Radiology (ESR) and the European Society of Thoracic Imaging (ESTI)17, and from the Society and College of Radiographers (SoR.org): SoR Covid-19 information and resources18 . Further resources can also be found at the Australasian Society for Ultrasound in Medicine website (ASUM.org)19, the European Federation of Societies for Ultrasound in Medicine and Biology (EFSUMB.org)20.
There are 5 major aspects of practicing diagnostic imaging during the COVID-19 pandemic:
- Triage of patients: each practice/institution must prioritize exams in emergent, urgent and elective (i.e. can be deferred)
- Protecting the patient and ultrasound providers by stressing hand hygiene, personal protective equipment (respirator or facemask, eye protection, gloves, gowns)
- Preparing and cleaning the ultrasound room: thorough cleaning with low-level disinfectant (LLD), including all elements (such as closet knobs, computer, door handles etc)
- Ultrasound equipment disinfection: clean all elements (except transducers, see below) of the ultrasound machine with LLD between each patient
- Transducer cleaning: keep number of transducers attached to the machine to a minimum; ultrasound transducers that come into contact with intact skin can be cleaned and disinfected by LLD; ultrasound transducers that come into contact with non-intact skin, blood, body fluids and mucous membranes (transvaginal, transrectal) require high-level disinfection (HLD); ultrasound transducers that are used for invasive procedures (e.g. needle guidance during biopsies, aspirations, drainages) require sterilization. For details, see for instance references 2, 9, 10, 14.
Practices across the world have adopted or adapted various recommendations, corresponding to their local circumstances.
Ultrasound the Best
The mission of WFUMB is to improve global healthcare through collaboration, communication and education. The latest WFUMB initiative to encourage this is a new site on the webpage named “Ultrasound the best”. Here readers are encouraged to submit cases where ultrasound plays an important role in diagnosing or treating patients. The submitters of the five best “Ultrasound the best cases” selected by the WFUMB Executive Bureau will be awarded by an invitation to the WFUMB 2021 Congress. For further information please visit: www.wfumb.org.
This initiative adds to the already existing “Case of the Month”, where readers are encouraged to submit interesting ultrasound cases. The latter page has been restructured as a quiz to encourage readers to test their knowledge and to increase their learning curve. Please visit: https://wfumb.info/icotm/
Optical Surgical Navigation: An Interest Group to help drive Standardization, Collaboration, and Regulatory Approvals
Optical imaging methods have significant potential as effective intraoperative tools to visualize biochemical events in cells and tissues. Optical imaging can provide real-time assessment of tumor margins, guiding the surgeon to adequately resect the tumor while sparing critical tissues. To achieve acceptance and utilization, several barriers in the field will need to be addressed such as standardization, further development of instruments and dyes as well as regulatory approvals. To begin to address this, the World Molecular Imaging Society created the Optical Surgical Navigation (OSN) interest group bringing together Radiologists, Scientists, Engineers, and Surgeons. The OSN interest group is committed to holding annual workshops that promote collaboration, discussion and active dialog with regulatory agencies. It is the goal of WMIS through the OSN interest group to facilitate those involved in the development of optical imaging to come together on a global scale to identify priorities. Our forum has the unique opportunity to set these global standards and work with the relevant organizations and authorities to implement them. https://www.wmis.org/wmis-interest-groups-main/osnig-main/
ABOUT WORLD MOLECULAR IMAGING SOCIETY
The WMIS is dedicated to developing and promoting translational research through multimodality molecular imaging. The education and abstract-driven WMIC is the annual meeting of the WMIS and provides a unique setting for scientists and clinicians with very diverse backgrounds to interact, present, and follow cutting-edge advances in the rapidly expanding field of molecular imaging that impacts nearly every biomedical discipline. Industry exhibits at the congress included corporations who have created the latest advances in preclinical and clinical imaging approaches and equipment, providing a complete molecular imaging educational technology showcase. For more information: www.wmis.org