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 Launches National Clinical Imaging Research Registry™
The ACR has launched the ACR National Clinical Imaging Research Registry™ (ANCIRR), a set of data registries, to collect and curate case images and anonymized patient data from multiple practice settings to produce large data sets that support scientific research, AI development, and regulatory submissions. The ANCIRR will use the ACR Informatics platform, including TRIAD™ and ACR Connect™, for seamless data and image collection.
The ANCIRR differs from the National Radiology Data Registry (NRDR®), which receives data from facilities to enable practice quality improvement through site feedback and benchmarking against peers. Six active registries make up the ANCIRR suite, and eight more are in development. The data from these registries will enable researchers to address complex scientific questions and produce results applicable across various diseases, care settings, geographic locations, and populations.
The ANCIRR is a primary data collection pathway for the National Institute of Biomedical Imaging and Bioengineering-funded Medical Imaging and Data Resource Center (MIDRC), a joint project with RSNA and AAPM, which may become the largest COVID-19 medical imaging archive in the world. Sites can sign up to contribute data and access aggregated information via the registries.
COVID Resources Across the Pandemic
The ACR has continued its work to guide radiology through the various stages of the pandemic. The ACR provides up-to-date resources to help the radiology community battle the coronavirus and strengthen radiology practices. Resources cover areas like well-being, economic and regulatory updates, leadership, and clinical research (including the ACR National Clinical Imaging Research Registry™, which collects images and clinical data from multiple practice settings). In addition, open-access JACR articles spanning the pandemic have guided individuals and practices in decision-making in a quickly changing environment. The College will continue to add to these resources and support the specialty as healthcare, physicians, and patients recover from the pandemic.
Radiology Health Equity Coalition
The Radiology Health Equity Coalition will bring together the radiology community to address health disparities and measurably change outcomes. The “Mobilization Team” includes representatives from the American College of Radiology, American Roentgen Ray Society, Association of University Radiologists, Radiological Society of North America, Society of Chairs of Academic Radiology Departments, Society of Interventional Radiology, and American Board of Radiology as well as from the Radiology Section Councils of both the American Medical Association and National Medical Association. The intent is to involve as many radiology societies, organizations, and individuals as possible. This mobilized network of patient-focused radiologists will collect and disseminate resources and best practices, advocate for and connect with patients and community members, and collaborate on programs and services to empower others to act.
As the coalition comes together, individuals can sign on to “Commit to Act” to advance health equity in their practices and to reduce health disparities in radiology. Specialty-wide efforts will focus on systemic change that will be only be possible with all of radiology coming together to make a difference.
Imaging for Dementia
Upon the successful collaboration and involvement in the Imaging Dementia-Evidence for Amyloid Scanning (IDEAS) study published in JAMA, the ACR Center for Research and Innovation is continuing collaboration with the Alzheimer’s Association and study leadership on a new study. In April 2020, the Centers for Medicare and Medicaid Services (CMS) approved the study protocol for the project titled New IDEAS: Imaging Dementia—Evidence for Amyloid Scanning. New IDEAS builds off the historic momentum of the IDEAS Study, which provided the strongest Phase IV data to date supporting the clinical utility of amyloid PET scanning.
Expanding on the aims of the original IDEAS Study, New IDEAS will focus on a more diverse population, including over 50% recruitment of Black/African American and Hispanic/Latino study participants, individuals with typical vs. atypical clinical presentations of MCI and Alzheimer’s dementia, and individuals with early-onset cognitive impairment (<65 years of age). Tailored recruitment strategies will be implemented at the national and local level to ensure inclusion of these underrepresented populations. It is anticipated that this will allow for better understanding of the impact of amyloid PET scans on care management and health outcomes in a more diverse population of dementia patients with diagnostic uncertainty. New IDEAS will also collect biological samples to be stored in the New IDEAS Biorepository to test and validate emerging genetic and plasma biomarkers for Alzheimer’s and other dementia.
Adapting to a Changed World
As the COVID-19 pandemic continues, the ACR is adapting its resources to meet member and patient needs. At the start of the COVID-19 outbreak, most non-emergent healthcare was halted — including cancer screening. Unfortunately, cancer incidence does not stop with the pandemic. For some patients, skipping or postponing screening now could mean a delayed diagnosis, an increased cancer burden, and/or worse outcomes in the future. The #ReturntoCare coalition encourages patients to resume necessary care, including screening, and outlines for practices how to ramp back up safely.
In addition, the ACR released guidance for imaging practices preparing to reopen safely, including patient-focused resources and a mammography-focused toolkit to help referring clinicians reconnect with women ages 40 and older and encourage them to schedule yearly mammograms postponed by the pandemic. This information is part of the ACR’s library of resources to help the radiology community battle the coronavirus and strengthen radiology practices during the pandemic.
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
Online education as a new paradigm in learning
The effects of the global Covid-19 pandemic have had an unprecedented impact on the very core of our societies, causing profound changes to our personal and professional lives. We have witnessed a substantial paradigm shift affecting all aspects of the medical profession, including, perhaps more than any other area, the way we teach and the way we learn. In a very short time, online education has transformed from a somewhat useful addition into an essential tool for millions of healthcare professionals.
The European Society of Radiology (ESR) was quick to recognize the occurring changes as well as the numerous advantages of online education including flexibility, information accessibility, global reach, equity, innovation, and efficiency. Keeping true to its mission of promoting diagnostic and interventional radiology and associated disciplines through pre and postgraduate education, the ESR has introduced its new Premium Education Package which grants highly affordable access to all of the ESR’s core educational platforms. This unique product includes numerous ESR educational services such as Education on Demand Premium, with more than 450 courses from all areas of the training curriculum and the possibility to earn over 550 CME credits, Eurorad, offering more than 7,000 peer-reviewed case reports, and ESR Connect, with over 950 hours of education including ECR 2021, live ESOR courses and much more.
By introducing this easily accessible treasure trove of knowledge, the ESR re-iterated its commitment to facilitating access to state-of-the-art knowledge and consequently enhancing the quality of care for patients.
Looking forward, the flexibility and learning possibilities that have emerged from necessity should be seen as an opportunity to reimagine how education could be delivered. Online education will certainly co-exist with traditional education to provide more education options, promote education equity, and enhance education innovation, and the global radiological community is indubitably going to embrace the ESR’s dynamic approach to learning that offers highest quality education to the radiologists of the future. ESR provides special offers to radiological leaders who wish to grant their team access to the ESR Premium Education Package and make them profit from the ESR educational portfolio.
EU’s cancer policy and the ESR’s engagement
At European Union level, things are moving forward in terms of healthcare and cancer care policy. After the new leadership took over in 2019, with a new Commissioner for Health dedicated to the fight against cancer responsible for the EU’s healthcare agenda, a Europe’s Beating Cancer Action Plan is now to be adopted at the end of 2020 with the aim to reduce the cancer burden, based on the pillars of prevention, early diagnosis, treatment and follow-up care. The new EU funding programme for Research and Innovation, Horizon Europe, also includes a specific focus on the disease with the establishment of a “Cancer mission” to make funds available for research on health challenges, pool expertise and identify priority areas.
In the European Union (EU), screening is only recommended for breast, cervical and colorectal cancers when offered as part of a national or regional organised programme. Therefore, the European Society of Radiology built on the Europe’s Beating Action Plan’s ambition to investigate other types of screening. Indeed, it put forward the benefits of lung cancer screening by exchanging with relevant stakeholders, organising policy events, and publishing scientific and position papers. The ESR regularly contributes to EU-wide public consultations that are launched by the European Commission on initiatives in the area of cancer, emphasising the role of diagnosis, education and training, and research in the fight against the disease.
The European Society of Radiology’s 1st Vice-President, Prof. Beets-Tan, has also been nominated as a board member of the Horizon Europe cancer mission. This enables the European Society of Radiology to further ensure that medical imaging is highlighted as a strong driver to improve cancer prevention, detection and care in each EU Member State. Furthermore, the ESR has been a member of the European Cancer Organisation since May 2016. Through its membership, the ESR seeks to influence cancer policy in Europe and relay the imaging perspective via the organisation’s policy activities and advocacy towards the EU. The ESR is also actively involved in the European Commission Initiative on Breast Cancer (ECIBC), and contributes to the development of recommendations and guidelines on breast cancer screening and diagnosis.
The European Parliament established a Special Committee on Beating Cancer (BECA) and a Special Committee on Artificial Intelligence in the Digital Age (AIDA) in September 2020. A EU4Health funding programme was also put forward in response to the COVID19 pandemic. These new EU initiatives are additional opportunities for the European Society of Radiology to strengthen its advocacy work at EU level to ensure that the voices of radiologists and patients are heard in all policies. Moreover, they offer territory to continue highlighting that research excellence relies on an efficient uptake of AI with common standards for data acquisition and analysis, and underlining the importance of harmonising professional qualifications in Europe.
As regards research, the ESR European Imaging Biomarkers Alliance (EIBALL) aims to facilitate imaging biomarker development, standardisation and promote their use in clinical trials and in clinical practice by collaborating with specialist societies, international standards agencies and trials organisations to develop a network of excellence. In a recent paper, the important role of quantitative imaging biomarkers derived from medical images has been described, informing on disease detection, characterisation and treatment response. In addition, their potential to provide objective decision-support tools in the management pathway of patients has been highlighted. Also, the group set up an open-access biomarkers inventory as a reference for researchers and trialists, listing what biomarkers exist and what evidence for their use exists, so that these biomarkers can be incorporated into clinical trials so as to start building an evidence base.
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.
Radiology Coalition Aims to Improve Healthcare Equity
Healthcare inequities in the United States have been well-documented for more than a decade. At the national level, the CDC and others have examined disparities in deaths and illness, healthcare utilization, behavioral risk factors for disease, environmental hazards, and social determinants of health.
Over the past year and a half, particularly with coronavirus disproportionately affecting some racial and ethnic minority groups, the issue of healthcare inequities has taken sharp focus, demanding both attention and action.
RSNA is proud to join the American College of Radiology, American Board of Radiology, American Roentgen Ray Society, Association of University Radiologists, Society of Chairs of Academic Radiology Departments and Society of Interventional Radiology to form the Radiology Health Equity Coalition (RHEC). Because medical imaging touches most patients at some point, radiologists are uniquely positioned to help eliminate inequities in healthcare. The RHEC brings together the radiology community to address health disparities and measurably change outcomes, ensuring that all patients have access to high value imaging care. The RSNA Board committed to the RHEC as one of many diversity, equity and inclusion initiatives supporting RSNA’s Strategic Plan and core values.
RSNA has appointed Jinel Scott, MD, as its representative to the RHEC. “In 1966, Martin Luther King Jr. said, ‘Of all the forms of inequity, injustice in health care is the most shocking and inhumane,’” Dr. Scott said. “Radiology has a role in addressing inequities in healthcare and I am proud to represent RSNA as a part of the Radiology Health Equity Coalition.” Dr. Scott is a clinical assistant professor in the Department of Radiology at SUNY Downstate Health Sciences University, and director of emergency imaging, quality and patient safety services at Kings County Hospital Center, both in New York City.
RSNA looks forward to serving on the coalition and beginning the important work of developing a roadmap for radiology’s role in eliminating inequities in healthcare. Stay tuned to RSNA.org for more information on RHEC activities and resources and opportunities to support these efforts.
- Narrowing the Gap: Imaging Disparities in Radiology
Stephen Waite, Jinel Scott, and Daria Colombo
Radiology 2021 299:1, 27-35
- RSNA News series on healthcare equity
RSNA Aims to Improve Patient Care Globally Through Education Outreach
In 2019, the Radiological Society of North America (RSNA) launched the Global Learning Center (GLC) program with a goal to improve radiology education and patient care in underserved regions throughout the world. Through the GLC program, RSNA partners with established radiology departments based in low- or middle-income countries with a demonstrated need for radiology education and resources. Over a three-year period, an RSNA team of volunteers works with the GLC host site to develop a customized educational plan including a curriculum with hands-on training, didactic lectures, conferences, online courses, and other educational offerings. Equipment and technical assistance are also provided based on the needs of the institution.
The first RSNA GLC program was launched in July 2020 at Stellenbosch University in Cape Town, South Africa. Due to the pandemic, the program was adapted to launch and run virtually until in-person participation and travel become safe again.
Earlier this year, RSNA was honored to be awarded a grant by the U.S. Department of Energy’s National Nuclear Security Administration (NNSA) to develop a Global Learning Center (GLC) in Sub-Saharan Africa. The grant is designed to facilitate access to the peaceful uses of nuclear energy, including for medical purposes. In fulfillment of the grant, the Muhimbili University of Health and Allied Sciences (MUHAS) in Daar Es Salaam, Tanzania, was selected as the second GLC site.
“The Global Learning Centers program offers a unique opportunity to develop education based on the specific needs of the host community,” said Umar Mahmood, MD, PhD, RSNA Board Liaison for International Affairs. “We are able to tap into RSNA resources and provide a team of dedicated volunteers to create a comprehensive, dynamic curriculum for the GLC.”
To learn more about the RSNA Global Learning Centers program, visit RSNA.org/GLC.
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.
Ultrasound, the Best
Promoting the best use of ultrasound is another important role of WFUMB in addition to encouraging the widespread availability of ultrasound throughout the world. WFUMB adopted a new slogan ‘Ultrasound, the best’ to emphasize the unique problem-solving capability of ultrasound, which is better than any other imaging modalities. We are having a campaign to share cases that well explain this slogan ‘Ultrasound, the best’. WFUMB member societies are participating in this campaign by encouraging their members to submit and share their ‘Ultrasound, the best’ cases through the WFUMB website. Some member societies hold ‘Ultrasound, the best’ cases competition session during their congresses.
WFUMB considers safety an important aspect of the practice of ultrasound. This encompasses two elements: bioeffects of ultrasound and safety; and safe practice of cleaning transducers between patients. The first issue is monitored by WFUMB’s Safety Committee who follows the scientific and lay literature and responds to the published reports. In addition, the Committee recommends statements to be reviewed and approved by the Administrative Council for publication on the WFUMB website and in Ultrasound in Medicine and Biology (UMB). The second aspect is transducers’ cleaning. WFUMB published a document on transducer cleaning, but this became particularly important in this time of the SARS-CoV-2, also known as the COVID-19 pandemic. WFUMB was one of the first organizations to publish a statement on its website, translated in several languages, thanks to individuals in affiliated Federations and subsequently printed in UMB, on how to perform a safe ultrasound examination and clean equipment in the context of COVID-19.
COE handheld devices
WFUMB has recently decided to donate an ultrasound handheld device to participating Centers of Education (COEs). There are currently 19 COEs distributed around the world (please visit www.wfumb.org to see more). As the main purpose of WFUMB is to bring sustainable ultrasound to all regions of the world and only 1/3 of the World’s population has access to medical imaging, we hope these handheld devices will offer the possibility of medical imaging on a larger scale in the future.
Handheld devices have been described in many papers, and position papers have been published by many societies including the European Federation for Ultrasound in Medicine and Biology (ref. Nielsen MB et al. Ultraschall Med. 2019;40). In most publications results are encouraging especially for point of care ultrasound.
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 Webpage
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