2004 - issue 1

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Ultraschall 2004; 25

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EUROSON 20045th—8th June 2004Zagreb, Croatia.See preliminary programm page 12.

European Federation of Societies for Ultrasound in Medicine and Biology

EFSUMB

Newsletter

February 2004

Contents

EFSUMB Officers and Committees .... 4

Report from the President................ 4

Report from the Honorary Secretary —“Clinical Ultrasonography- where to go from here“ ................... 5

Report from the Honorary Treasurer ......................................... 7

Report from the Education and Professional Standards Committee ...7

A Review of Complications of Interventional Ultrasound................ 8

16th Euroson Congress 2004, Zagreb, Croatia .............................. 13

17th Euroson Congress 2005, Geneve, Switzerland ...................... 17

EFSUMB Contrast Agents Meeting, 23—24 January 2004 ....................... 17

EUROSON SCHOOL:· London, UK, 22-24 April 2004 .......18· Thurnau, Germany 17—19 June 2004 18· Riga, Latvia, 17—18 September 2004 19· Craiova, Romania, 19—20 September 2004 .................. 19

Report on the BMUS Congress, Harrogate 10—12 December 2003 .. 20

Diary Dates .................................... 21

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EFSUMBEuropean Fedaration of Societies for Ultrasound

in Medicine and Biology

Executive Bureau

President: K Jäger (Switzerland)

President Elect: D H Evans (UK)

Past-President: M Claudon (France)

Hon Secretary: L Greiner (Germany)

Hon Treasurer: N Juul (Denmark)

ECMUS — EUROPEAN COMMITTEE FOR MEDICAL

ULTRASOUND SAFETY

Chairman: K Salvesen (Norway)

Secretary: T Whittingham (UK)

Members: P Arbeille (France)

M Delius (Germany)

L Klinghammer (Germany)

R Laurini (Sweden)

K Marsál (Sweden)

EDUCATION AND PROFESSIONAL STANDARDS COMMITTEE

Chairperson: L Valentin (Sweden)

Secretary: D Lindsell ( UK)

Members: B Cacciatore (Finland)

B J Hackelöer (Germany)

I Sporea (Romania)

Ex-officio: D H Evans (UK)

PUBLICATION COMMITTEE

Chairman: D W Pilling (UK)

Members: M Bachmann Nielsen (Denmark)

J-M de Bray (France)

W Mann (Germany)

Ex-officio: M Claudon (France)

L Greiner (Germany

EFSUMB NEWSLETTER

Editor: D W Pilling (UK)

SECRETARIAT

General Secretary: Gianna Stanford,

Carpenters Court, 4a Lewes Road,

Bromley, Kent BR1 2RN, UK

Tel: +44 (0)20 8402 8973

Fax: +44 (0)20 8402 9344

E-mail: [email protected]

Website: http://www.efsumb.org

Report from the President

Journal

We have made a big step forward! EFSUMB, the

European Federation of Societies for Ultrasound

in Medicine and Biology is back on the stage of

scientific publications. We have reestablished

our scientific platform and from now on we shall

again have our own publication. Negotiations

with Thieme Publishers have successfully been

concluded and an agreement has been signed

between Thieme Publishers and EFSUMB. The

journal Ultraschall in der Medizin is now the of-

ficial scientific journal of EFSUMB. In addition, the well estab-

lished EFSUMB-Newsletter will be published in the Journal as

well. We are grateful that David Pilling will continue his estee-

med work as editor of the Newsletter and we especially appre-

ciate the readiness of Hylton Meire to join the Editorial Board of

Ultraschall in der Medizin as an EFSUMB representative.

The signed agreement entitles all EFSUMB members to subscribe

to Ultraschall in der Medizin at an extremely low rate. The annual

rate for six issues is € 29,- if the subscriptions are collected and

handled by the national societies (bulk order); this is about 1/10

of the regular price. Individual EFSUMB members may subscribe

directly via the EFSUMB secretary office at a rate of € 35,-. With

this subscription you share in one of the top ranked scientific

ultrasound journals (Impact Factor 1.14).

Ultraschall in der Medizin is already the official journal of the

three German speaking societies (Austria, Germany, Switzer-

land). Thus, 51 % of our members are already subscribers. Natu-

rally the articles were predominantly published in German, but in

recent years the number of English papers has been rapidly in-

creasing. In the near future the flow of submitted papers will de-

termine the language of our journal. You are all invited to respond

to our appeal and to submit your scientific work to our own jour-

nal.

Young Investigator Award

The future of any society lies in the quality of its young investi-

gators. Therefore, EFSUMB gives high priority to the encourage-

ment and career advancement of our young investigators. An

award is considered for original work in the field of clinical and/or

basic research. National societies are invited to nominate a can-

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Ultraschall 2004; 25 5

didate. The submitted abstract will be presented at the next

EUROSON Congress during the special young investigators ses-

sion. The presented papers will be assessed by the evaluation

committee in terms of scientific content and quality of presen-

tation. The incentive to participate in this contest cannot only be

the financial (€ 1000,-) but the scientific benefit of a European

award as best young scientist of the year. For further informa-

tion please visit our website at www.efsumb.org/gover-

nance.htm.

Working Groups and Committees

The development of ultrasound contrast agents has remarkably

improved the diagnostic information of ultrasound examina-

tions. Under the auspices of EFSUMB a group of experts is going

to meet in Rotterdam in January in order to elaborate recom-

mendations on the application of ultrasound contrast agents for

the detection and characterization of focal liver lesions and their

use in the monitoring of treatment effects following local abla-

tive treatment. These guidelines for the use of contrast agents in

liver ultrasound are planned to be made accessible to all our

members as early as possible.

The Education and Professional Standards Committee is in the

process of preparing various syllabi for minimal training stand-

ards in different areas of ultrasound practice. Further informa-

tion may be available by the time of the next EUROSON congress

in Zagreb.

Our “watch dogs”, the European Committee for Medical Ultra-

sound Safety (ECMUS), is watching our activities and cares for

safety and reliability of our performance. ECMUS is chaired by

Kjell Salvesen from Norway, who has been serving the Commit-

tee for more than ten years and who will stand down after the

next EUROSON Congress in Zagreb. On behalf of the Executive

Bureau and the whole Federation I would like to express our gra-

titude to Kjell for the fruitful and tremendous work he has done

for us. The national societies are invited to nominate candidates

for the Committee. We are looking for candidates whose areas

of interest special knowledge and expertise cover as wide a

range as possible in the fields related to the bio-effects of ultra-

sound, whilst the maintenance of parity (national representati-

on) shall be of secondary importance.

Meetings and Congresses

EFSUMB was involved in the Congress of Vascular Medicine

which was held in Toulouse in October 2003. We organized five

symposia on quality control in vascular duplex scanning; the

feedback we have received so far was extremely positive. In the

meantime we are looking forward to the next EUROSON Con-

gress, to be held in Zagreb 5–8 June, 2004. Professor Ivan Drin-

kovic and his team as well as the national organizing committee

of the Croatian society are developing a promising programme.

We hope to see you all in Zagreb next June.

Kurt Jäger

President EFSUMB

Report from the Honorary Secretary

Clinical Ultrasonography — where to

go from here

Once there was a dream:

In a patient with abdominal, cardiothora-

cic, or vascular problems, you simply take

a small instrument connected to a video

screen, and with this device, you can easi-

ly look at the region of interest – be it one

of the numerous abdominal organs, the heart, the pleural cavi-

ties, or any vascular structure containing a fluid (blood, bile,

urine, or pancreatic juice). This procedure should be available

both in an emergency or an elective situation, at a low price ,

harmless, repeatable, not too difficult to learn and easy to apply.

This dream has become true, in realtime ultrasonography – with

its unique features and add ons – as we all know.

The unique features of this beautiful tool are

– the immediate access

– the simplicity and repeatability of use

– the local resolution not achieved by any other imaging

technique

– the realtime nature rendering not only images but also

much dynamic information, especially in doppler and co-

lour-doppler techniques.

– the additional possibility of immediate diagnostic or thera-

peutic ultrasound guided interventions.

Moreover, the capital costs as well as the running expenses of

ultrasonography are unbeatably low. So reality has maybe even

outstripped the dream.

But do we all really recognize, activate and realize the true po-

tential of ultrasonography ? Isn’t there an under-use of cost ef-

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6

fective abdominal, thoracic, or cardiovascular ultrasonography,

with a simultaneous over-use of CT and/or MRI scanning?

Answering these questions can lead to conflicting replies and

solutions, depending on a number of variables given. For ex-

ample the local and national conditions as well as the different

financial backgrounds for sectional imaging procedures will af-

fect the decision. Moreover, the training status of the perfor-

ming physician and the accessibility of ultrasound machines for

those colleagues who would like to perform it plays an impor-

tant role, which again is connected to the economic conditions

pertaining.

It might be expected, however, that any active clinician working

with for example abdominal conditions, will and must demand

access to ultrasound on his own for immediate integration of

the ultrasound findings with the other clinical data in an indi-

vidual patient – without a waiting list, saving not only expen-

sive procedures such as CT or MR scanning, but saving time. This

is considered a much more precious factor in general, not only

in terms of economical considerations, but for our patients as

well.

So the future of our beautiful tool – clinical ultrasonography -

will be a bright one considering the quality of and the demand

for all ultrasound procedures. It will be a bright future especially

when we want it and once we work for it. This includes a good

access to all training, learning and teaching modalities in scien-

tific and in clinical ultrasonography.

In this sense, our step forward in integrating our EFSUMB “Eu-

ropean Journal of Ultrasound” with the scientifically highrank-

ing journal “Ultrasound in Medicine/Ultraschall in der Medizin”

is real progress and a typical win-win situation for all partners

involved.

In addition, the national and the european congresses – espe-

cially our EUROSON congress at Zagreb in June 2004 hosted by

the national society of Croatia – are an extraordinarily good ba-

sis for exchanging, learning and teaching practical and scientific

progress and knowledge in ultrasound. It is worthwhile for any

doctor in Europe working within any of the sub specialties of

ultrasonography to cooperate actively in the national

interdisciplinary societies of ultrasound as well as in our

European Federation of Societies for Ultrasound in Medicine

and Biology (EFSUMB).

Lucas Greiner, EFSUMB Honorary Secretary

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Report from the Honorary Treasurer

As I have stated in my previous reports -EF-

SUMB is an economically healthy organiza-

tion. The accounts from previous years

have shown considerable surpluses. The

budgets have been in balance and any acti-

vity that EFSUMB has been involved in du-

ring the recent years has led to a surplus to

our Federation. The status from the year

2003 is obviously not available yet, howe-

ver, I expect, that it will end up with a small

surplus. We have not yet received the final accounts from the

EUROSON Congresses in Warsaw in 2002 and Copenhagen in

2003. The amounts to EFSUMB arising from these two congres-

ses will probably first appear in 2004. Also money has been re-

ceived from the various organizers of the EUROSON Schools.

The accounts from the year 2002 together with the budget for

the year 2004 were shown in the newsletter September 2003.

Until recently our single highest expenditure, the newsletter

has been partly sponsored. However, as you can se the newslet-

ter is now incorporated in the journal: Ultraschall in der Medi-

zin. I hope for a fruitful cooperation also from an economical

point of view.

On this page you will find the membership numbers for each of

our member societies. The treasurer is grateful for the fees being

paid promptly.

Niels Juul

EFSUMB Honorary Treasurer

Report of the EFSUMB Educational and Professional Standards Committee Meeting for the EFSUMB Newsletter

All members of the Committee met in Lon-

don over the weekend of 6/7th December

2003. The main purpose of this meeting

was to refine various syllabi for minimum

training standards in different areas of

ultrasound practice, which had been

drawn up by members of the Committee.

The syllabi considered were Obstetrics &

Gynaecology, Gastroenterology, Radio-

logy, Urology and Angiology/Neurology.

The paper on Urology was accepted with the additional require-

ment for precise detail on what should be included in a logbook.

Detailed work was carried out to revise the syllabi on Gynaeco-

logy and Gastroenterology. These will now be rewritten and cir-

culated to members of the Committee for further consideration.

The syllabi on Obstetrics and Angiology/Neurology are less far

advanced and further work on these would be undertaken prior

to the next meeting of the Committee. It was decided that the

syllabus for Radiology was probably not required as the tea-

ching and training of ultrasound within radiology training sche-

mes in Europe was already well addressed. However contact

was being made with the European Association of Radiologists

to see whether it was felt that this was required or not.

It was agreed that each syllabus would have a similar require-

ment and that to achieve level 1 training trainees would require

a period of three to six months training, during which time they

would be required to undertake a minimum of 300 ultrasound

examinations themselves. During the course of this time they

should also receive a theoretical course of lectures or seminars

Country Number Of Members In Database on

31 December 2003

AUSTRIA 813

BELGIUM 211

BULGARIA 75

CROATIA 67

CZECH REP 45

DENMARK 409

FINLAND 264

FRANCE 361

GERMANY 5856

GREECE 100

HUNGARY 45

ISRAEL 101

ITALY 1884

NETHERLANDS 47

NORWAY 254

POLAND 1200

PORTUGAL 63

ROMANIA 247

RUSSIA 68

SLOVAK REP 40

SLOVENIA 108

SPAIN 177

SWEDEN 96

SWITZERLAND 2593

UK 2082

TOTAL 17162

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on the Physics of Ultrasound, Normal Anatomy and Common Pa-

thological Abnormalities. Following each period of training

each training department should undertake an assessment of

competence of the candidate before they can undertake ultra-

sound scanning independently at that level. In order to progress

from level 1 to level 2 it was proposed that there should be a

further minimum training period of a year, with a minimum

number of extra ultrasound examinations to be performed by

the candidate of 600.

As these syllabi are agreed by the Committee they will be circu-

lated to the specialist societies in Europe for their consideration

and hopefully for their support before being published. The

committee will review progress on all the syllabi at its next

meeting in Zagreb in June 2004.

At the meeting in London the Committee also considered the

possibility of having a syllabus in cardiac ultrasound, but agreed

that this was not appropriate as this was being well addressed

by the European Working Group on Echocardiography under

the auspices of the Society of Cardiology. A review of the ‘Com-

plications of Interventional Ultrasound in the Abdomen’ was

nearing completion for publication in the EFSUMB newsletter.

Also near completion are ‘Guidelines for Ultrasound-Guided

Breast Biopsy’ and it was agreed that guidelines for ultra-

sound-guided thoracic interventions would be the next area to

be developed. The Committee is very anxious that all guidelines

issued by EFSUMB should be evidence-based and that where

evidence did not exist, it should be made clear that the recom-

mendations are on the basis of expert opinion and practice.

One member of the Educational and Professional Standards

Committee will attend a meeting organized by EFSUMB on

ultrasound contrast agents to be held in Rotterdam in January

2004. This will follow on from the 9th European Symposium on

Ultrasound Contrast Imaging. The aim of this meeting is to pro-

vide practical guidelines for the use of ultrasound contrast

agents. This meeting will comprise a group of experts from both

industry and EFSUMB with the focus of the meeting being on

liver imaging, but also dealing with other areas of application for

ultrasound contrast agents.

David RM LindsellEducation and Professional Standards Committee Secretary

A Review of Complications of Interventional UltrasoundProcedures in the Abdomen

The Professional and Educational Standards Committee of

EFSUMB committee plans to publish a series of guidelines for

ultrasound guided interventional procedures. We have already

published evidence based guidelines on amniocenteses and

chorionic villus sampling. As part of our work on such guide-

lines the committee publishes below a review of complications

of interventional ultrasound guided procedures in the abdomen

written by Dr Elisabetta Buscarini. At the end of this document

you will find a few guidelines (needles and guidance, and pre-

cautions to be taken). We hope that our readers will find this

publication useful in their clinical work and the committee

thoroughly thanks Dr Buscarini for her

contribution.

Any comments on the review are wel-

comed and can be sent to EFSUMB’s Ge-

neral Secretary Mrs Gianna Stanford

(e-mail: [email protected]).

Lil Valentin

Educational and

Professional Standards Committee

Chairperson

Review of InterventionalUltrasound in the Abdomen

“safety first”

Interventional ultrasound (US) includes invasive procedures

carried out under US guidance for diagnosis and therapy. Diag-

nostic procedures are undertaken for cytology or tissue samp-

ling, generally performed with a fine needle (FN), which has a

calibre less than 1 mm. Therapeutic procedures performed un-

der US guidance are for drainage of fluid collections, or of obs-

tructed collecting systems (typically US guided nephrostomy),

or of hollow organs for nutritional purpose. Tumour ablation

either by injection of chemicals (mainly ethanol) or by deposi-

tion of thermal energy with radiofrequency electrode needles or

laser fibers is another therapeutic area.

The small calibre of biopsy needles and the safety offered by US

guidance has made interventional US a minimally invasive pro-

cedure; nevertheless fatal and major complications are report-

ed, generally caused by abdominal interventional procedures.

Therefore, physicians performing interventional US should have

a thorough knowledge of the relevant literature and of reported

complications to improve their technical choices, to reduce the

risk of complications, and to minimise the consequences of

complications when they occur. It is important to learn how to

prevent and how to correct complications.

Definition

One problem when discussing complications is to ensure that

everyone is speaking about the same thing. Complications range

from trivial incidents to major life-threatening crises, and

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without any generally agreed definitions it is difficult to make

sense of overall figures.

A complication can be defined as an unfavourable event, un-expected even if predictable, occurring because of the inva-sive procedure, in spite of technical accuracy of the proce-dure.

Depending on their clinical and biological impact complications

are classified as:

– Minimal, when they cause transient inconvenience, they do

not imply a significant worsening of the patient’s condition,

they resolve spontaneously or with minimal care, even if

they may require a short period of intensive check-up of

some parameters (e. g., blood pressure)

– Major, when they induce a significant worsening of the

clinical condition of the patient and require substantial care

(e. g., blood transfusion, resuscitation, surgery) with delay-

ed hospital discharge or renewed hospitalization

– Fatal

According to the timing of appearance complications are divid-

ed into early and late.

Complications of Diagnostic US-guided Procedures

Mortality rate due to abdominal biopsies ranges from 0.001% to

0.038% as described in major studies, including questionnaire

surveys obtained by multicentre and single institution series

(1-8, Table I). Mortality and major complication rates are grea-

test for hepatic and pancreatic biopsies. However, cases of death

have been described after biopsy of every abdominal organ. Two

deaths out of 6,261 biopsied patients (0.03%) occurred after

hepatic biopsy. Both fatalities were due to massive

haemorrhage. They occurred in one patient with hepatocellular

carcinoma (HCC) out of 2,293 patients who underwent biopsy

for the diagnosis of HCC, and in one patient with liver haeman-

gioma out of 157 patients who underwent biopsy for the diag-

nosis of liver haemangioma (9). Another three cases of death

after puncture of liver haemangioma have been observed in a

series from a single institution (8). These data suggest a

significant risk of bleeding after biopsy of liver haemangioma.

Therefore diagnostic work-up of liver haemangioma should be

completed whenever possible by using imaging techniques. The

risk of bleeding is very important in case of biopsy of angio-

sarcoma. In spite of the rarity of this tumor, fatalities have been

reported after biopsy of angiosarcoma either in the liver (4, 10)

or in the adrenal gland (2). Fatal complications after pancreatic

biopsy are mainly due to severe pancreatitis, after puncture of a

normal gland in the wrong assumption of a pancreatic mass (11,

12).

The rate of major complications after ultrasound guided biopsy

is shown in table I. In a multicentre survey of haemorrhagic

complications after liver fine needle biopsy (FNB) the rate was

0.13%. It did not seem related either to the needle type (aspira-

tion or cutting needle) or to blood clotting function. The risk of

liver haemangioma puncture was confirmed, because in two ca-

ses out of 157 hemorrhagic complications occurred (9). Even if

spleen biopsy is a commonly feared procedure the related series

showed no fatalities, but major complication rate was as high as

1.3% (10).

An intriguing complication is tumor seeding, which implies the

dragging of a critical number of tumour cells along the needle

track, their deposition in a favorable microenvironment and

subsequent tumour growth. The time elapsing between the pro-

cedure and tumour seeding generally corresponds to a few

months, even if in some instances it is as long as two years or

more. The incidence generally varies between 0.003% and

0.036% but the exact incidence is difficult to determine, because

only in a proportion of the patients is follow up complete. Tu-

mour seeding correlates with needle calibre, number of biopsy

passes into the tumor, and location of the tumor. Seeding is

probably easier after a puncture of superficial tumours while it

seems to be independent of tumour histology (14). However a

high incidence of tumour seeding after pancreas tumour biopsy

is frequently reported, even if in one large series of pancreas bi-

opsies no case of seeding occurred (15). Another analysis of 33

reported series of pancreatic biopsies, including 2533 patients

altogether, revealed 1 (0.039%) case of seeding (16). According

to some authors biopsy should be avoided in patients who are

candidates for surgery to avoid the risk of tumour seeding. The

high diagnostic accuracy of imaging techniques strongly sup-

ports this point of view. The matter is still debated, even though

the trend is to reduce invasive procedures. Irregularities of the

needle surface to improve needle US visualization (the so-called

echo-marker) may potentially increase the seeding. An in-vitro

study has shown these irregularities to induce greater cell drag-

ging after biopsy. Therefore echo-marker should be avoided

(17). Tumour seeding seems to rarely have a clinical impact, and

it generally does not affect the patient outcome.

Table 1 — Deaths, major complications, and tumor seeding obser-

ved after diagnostic or diagnostic and therapeutic interven-

tional procedures (series 3, 6 and 7) guided by ultrasound.

NR = not reported

Authors Number of

procedures or

patients

Death % Major com-

plications %

Tumor see-

ding %

Livraghi et al (1) 11,700 0.008 0.05 0.017

Smith (2) 63,108 0.006 NR 0.005

Weiss et al (3) 66,379 0.007 0.05 0.003

Smith (4) 16,38 0.031 NR 0.006

Fornari et al (5) 10,766 0.018 0.18 0.009

Weiss et al (6) 95,070 0.001 0.09 0.006

Nolsoe et al (7) 8,000 0.038 0.18 0

Livraghi et al (8) 2,708 0.037 0.23 0.036

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Complications of Therapeutic US-guided Procedures

Drainage of abdominal collections is followed by a variable

number of major complications and deaths. In a large series (886

patients) of abdominal drainages no death related to the pro-

cedure was reported, but major complications were observed in

77 patients (8.6%) (18).

Complications of percutaneous ethanol injection (PEI) in the

treatment of HCC have been studied in a multicentre series of

1066 patients (19). Mortality rate was 0.09% (one death due to

haemoperitoneum). Major complication rate was 3.2%. The

complications comprised haemorrhage (9 cases), pleural effu-

sion, hepatic or portal vein thrombosis, hepatic infarct, and liver

abscess. 40 cases of severe pain with interruption of the pro-

cedure were described but not included in the major complica-

tions. Tumour seeding along the needle track was observed in

7 patients (0.6%). In another paper (20) tumour dissemination

was found in 4 out of 348 patients (1.1%). An emerging percu-

taneous therapeutic option used either for small HCC or for liver

metastases is radio-frequency (RF) thermal ablation. There are

two different technologies: The expandable needle electrode

and the cooled tip needle electrode. Complications of the cooled

system have been described in a multicentre report (21), while

those of the expandable system are being reported in a series

from a single institution (22). It is certainly interesting to com-

pare adverse effects of PEI and RF thermal ablation (Table II).

However an “a priori” definition of complication is missing in

the paper on PEI (19), and the definition of major complications

in the RF cooled system series (21) differs from that used in the

RF expandable system series (22).

The reported data confirm that RF thermal ablation can be con-

sidered at least as safe as PEI for the treatment of liver tumors.

Needles and Guidance

a. Fine and large (> 1 mm) needles (aspiration and cutting), ca-

theters, needle-electrodes

b. Ultrasound guidance is sometimes difficult and may be re-

placed by computed tomography (CT).

Comments

a. Experimental and multicentre studies on fine needles show

no effect of needle calibre (23) nor between aspiration and

cutting needles on procedure related bleeding , whereas the

use of large needles has been shown to be associated with

an increased complication rate when compared to fine

needles (1-9).

b. In most of the series reporting percutaneous biopsies or

therapeutic procedures the guidance of choice has been US,

even if some difficulties in targeting the lesion (i. e.because

of meteorism or obesity) may indicate the need to use CT

guidance. Literature survey does not indicate any connec-

tion between complication rate and type of guidance (16).

Precautions to be taken

a. Careful patient history, check coagulation tests

b. Choose a safe needle track

c. Use fine needles whenever possible

d. Reduce the number of needle passes

e. Experienced operator

Table 2 — Complications after percutaneous ethanol injection (16),

the radiofrequencies cooled system port (21) and the radio-

frequencies expandable system (22).

Percutaneous

Ethanol

Injection (19)

RF cooled

system

(21)

RF

expandable

system (22)

Number of patients 1066 2320 166

Death 1 (0.09%) 6 (0.3%) 0

Major complications

Severe pain (session stop) 40 NR 3

Capsular necrosis 1

Abdominal wall necrosis — — 1

Cutaneous burn — 5 1

Peritoneal haemorrhage 5 6 1

Haemobilia 2 — —

Subcapsular haematoma 1 — —

Parietal haematoma 1 — —

Haemothorax -- 3 —

Pneumothorax 2 1 —

Hepatic abscesses 2 6 —

Intestinal perforation 1 5 —

Acute cholecystitis — 1 —

Acute cholangitis 1 — —

Portal vein thrombosis 3 1 —

Caval vein thrombosis 1 — —

Hepatic infarct 3 1 —

Rapid hepatic decompensation — 2 —

Large biloma — 1 —

Right pleural effusion 5 — —

Tumour seeding 7 12 1

Pulmonary embolism — 1 —

Diaphragmatic paresis — 1 —

Severe bradycardia — 1 —

Sepsis — 1 —

Common bile duct stenosis — 1 —

Major compl.

number (rate)

74 (6.9%) 50 (2.2%) 8 (4.8%)

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Comments

a. A detailed clinical history can sometimes reveal a haemos-

tatic defect even in the presence of normal routine coagu-

lation tests. Coagulation tests which should routinely be

evaluated before a percutaneous procedure on deeply locat-

ed organs include: Prothrombin time, partial prothrombin

time, platelet count. The following values are generally con-

sidered safe: prothrombin time > 40 per cent, partial pro-

thrombin time < 5 sec above the upper limit, platelet count

> 50,000/mm³ (9). Discontinuation of aspirin and anticoagu-

lants (possibly replace by heparin) is advisable before a bio-

psy, but it has to be weighed against the thrombotic risk

(24).

b. When deciding the needle track any interposed structure

between the abdominal wall and the target lesion or paren-

chyma has to be carefully evaluated so as to avoid passage

through main blood vessels, gallbladder, or colon (16). Sys-

tematic check of the needle track with Doppler US can easi-

ly identify interposed vessels or vascular lesions misinter-

preted as cysts or tumors (7).

c. See above, Needles, section a.

d. It has been shown that the diagnostic accuracy of cytology

significantly increases if two passes are made instead of

one, but that it does not increase if three or more passes are

made. It is therefore recommended to check immediately

the adequacy of every specimen by a rapid staining. This can

reduce risks of complication by saving an average of one

pass per biopsy (25).

e. Experience of the operator and number of performed pro-

cedures are certainly important factors affecting the com-

plication rate of percutaneous biopsies (26). Personal opini-

on and experience suggests that a number of 50 annual liver

biopsies is needed for biopsy to be safe.

Concluding Remarks

An ultrasound guided diagnostic procedure, even if it is con-

sidered a minimally invasive one, should only be performed if it

is judged to be of benefit to the patient. It should not be perfor-

med if it can be replaced by a less invasive procedure.

An US guided therapeutic procedure should only be performed

if it can be expected to give a result equal to or better than that

obtainable by a more invasive procedure (e .g., a surgical inter-

vention).

References

1 Livraghi T, Damascelli B, Lombardi G, Spagnoli I (1983) Risk in fine

needle abdominal biopsy. JCU 11: 77-81

2 Smith EH (1984) The hazard of fine needle aspiration biopsy. Ultra-

sound Med Biol 10: 629-634

3 Weiss H, Duntsch U, Weiss A (1988) Risiken der Feinnadelpunktion.

Ergebnisse einer Umfrage in der BRD (DEGUM-Umfrage). Ultraschall

Med 9: 121-127

4 Smith EH (1991) Complications of percutaneous abdominal fine

needle biopsy. Radiology 178: 253-258

5 Fornari G, Civardi G, Capanna L, Di Stasi M, Rossi S, Sbolli G, Buscarini

L & The Cooperative Italian Study Group (1989) Scand J Gastroente-

rol 24: 949-955

6 Weiss H (1994) Komplikationen der Feinnadel Punktion. DEGUM

Umfrage 2. Bildgebung Imaging 61 suppl 2: 25-28

7 Nolsoe C, Nielsen L, Torp-Pedersen S, Holm HH (1990) Major com-

plications and deaths due to interventional ultrasonography: a re-

view of 8,000 cases. JCU 18: 179-184

8 Livraghi T, Lazzaroni S, Civelli L, Marks M, Meloni F, Vettori C. (1997)

Risk conditions and mortality rate of abdominal fine needle biopsy. J

Intervent Radiol 10: 57-64

9 Di Stasi M, Buscarini L, Bolondi L (1995) Ultrasound guided fi-

ne-needle liver biopsy : a multicentre survey of preprocedure eva-

luation and complication rates. J Intervent Radiol 10: 43-48

10 Hertzanu Y, Peiser J, Zirkin H. (1990) Massive bleeding after fine

needle aspiration of liver angiosarcoma. Gastrointest radiol

15:43-46

11 Evans WK, Ho CS, Mc Loughlin MJ, Tao LC (1981). Fatal necrotizing

pancreatitis following fine needle aspiration biopsy of the pancreas.

Radiology 141:61-62

12 Brandt KR, Charboneau JW, Stephens DH, Welch TJ, Goellner JR

(1993) CT- and US-guided biopsy of the pancreas. Radiology

187:99-104

13 Di Stasi M, Buscarini L, Cavanna L, Rossi S, Buscarini E, Silva M (1996)

Complications of ultrasound guided fine-needle biopsy of the

spleen: report on 110 patients and review of the literature. J Inter-

vent Radiol 11: 43-46

14 Buscarini L. (1998) Complications of abdominal interventional ultra-

sound: the dissemination risk. JMU 19: 149-152

15 Di Stasi M, Lencioni R, Solmi L, Magnolfi F, Caturelli E, De Sio I, Salmi

A, Buscarini L (1998) Ultrasound guided fine needle biopsy of pan-

creatic masses; results of a multicenter study. Am J Gastroenterol

93 : 1329-1333

16 Buscarini E, Di Stasi M. Complications of abdominal interventional

ultrasound, pp 24. Poletto Ed., Milan, 1996

17 Buscarini E, Foroni R, Rossi S, Di Stasi M, Silva M, Marinone G, Degli

Antoni G, Buscarini L (1997) Fine needles with echo markers: incre-

asing cell dragging during biopsy. Acta Cytol 41: 1246-1249

18 Civardi G, Di Candio G, Giorgio A, Goletti O, Ceraioli T, Filice C, Care-

mani M, Buscarini L (1998) Ultrasound guided percutaneous draina-

ge of abdominal abscesses in the hands of the clinician: a multicent-

re Italian Study. Europ J Ultrasound 9: 91-99

19 Di Stasi M, Buscarini L, Livraghi T, Giorgio A, Salmi A, De Sio I, Brunel-

lo F, Solmi L, Caturelli E, Magnolfi F, Caremani M, Filice C (1997)

Percutaneous ethanol injection in the treatment of hepatocellular

carcinoma. A multicenter survey of evaluation practices and compli-

cation rates. Scand J Gastroenterol 32: 1168-1173

20 Ishii H, Okada S, Okusaka T, Yoshimori M, Nakasuka H, Shimada K,

Yamasaki S, Nakanishi Y, Sakamoto M (1998) Needle tract implanta-

tion of hepatocellular carcinoma after percutaneous ethanol injec-

tion Cancer 82: 1638-1642

21 Livraghi T. Solbiati L, Meloni F, Scott Gazelle G, Halpern EF, Goldberg

SN (2003) Treatment of focal liver tumors with percutaneous ra-

dio-frequency ablation: complications encountered in a multicenter

study. Radiology 226:441-451.

22 Buscarini E, Buscarini L. RF thermal ablation with expandable needle

of focal liver malignancies: complication report. (submitted for pu-

blication)

23 Scott Gazelle G, Haaga JR, Rowland DY (1992) Effect of needle gauge,

level of anticoagulation, and target organ on bleeding associated

with aspiration biopsy. Radiology 183:509-513

24 Moulton JS, Moore PT (1993) Coaxial percutaneous biopsy tech-

nique with automated biopsy devices: value in improving accuracy

and negative predictive value. Radiology 186:515-522

25 Civardi G, Fornari F, Cavanna L, Di Stasi M, Sbolli G, Buscarini L (1988)

Value of rapid staining and assessment of US-guided fine needle

aspiration biopsy. Acta Cytol 32:552-554

26 Froelich F, Lamy O, Fried M, Gonvers JJ (1993) Practice and compli-

cations of liver biopsy. Results of nationwide survey in Switzerland.

Dig Dis Sci 38:1480-1484

Elisabetta Buscarini

Gastroenterology Department

Ospedale Maggiore

Crema, Italy

XVII European Congress of Ultrasound in Medicine and Biology

29. Dreiländertreffen

Palexpo Congress& Exhibition Centre

GenevaSwitzerland

Remember the Date25-28 September 2005

Euroson 2005 Ultraschall

25-28 September 2005

25-28 September 2005

EUROSON2005

ULTRASCHALL

4 sites EUROSON 2004, PDF document

EUROSON 2005, PDF document

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17th Euroson Congress September 25—28, 2005 — Geneva, Switzerland

Welcome to Geneva !

Dear Colleagues and Friends,

Remember the date of September 25-28, 2005 ! Indeed, it will be

our pleasure to invite you to Geneva to Euroson 2005, the 17th

European Congress of Ultrasound. It will be a joint meeting with

Ultraschall 2005, which is the meeting of the German, Austrian

and Swiss Ultrasound Societies.

Euroson is the yearly occasion to reinforce the multi-disciplinary

contacts between clinicians, leading teachers and researchers in

the field of ultrasonography. It allows establishment and main-

tenance of fruitful relationships between people from numerous

medical specialties, who all use ultrasonography in their daily

practice as a major diagnostic tool and more and more frequently

as a guidance for therapeutic procedures.

The continuing educational program will cover all aspects of

clinical ultrasound with invited lectures, workshops, symposia,

free communications, poster exhibitions and sessions. The orga-

nizing committee also wishes to highlight the Plenary Lectures

and the Opening Ceremony on Sunday 25th and the Young Inves-

tigators Award. Ultrasound contrast media will be one of the hot

topics. As a special focus, we would like to mention IT (Informa-

tion Technology), which is developing rapidly in today’s medici-

ne. In close collaboration with the Department of Medical Infor-

matics of the University Hospital of Geneva, which has been a pi-

oneer in the electronic patient record (EPR) and in PACS (Picture

Archiving and Communication System), we will present an

up-to-date overview of the commercial solutions to electronical-

ly integrate ultrasound images into the patient record, for easy

transfer and archiving. Colleagues interested in the forefront of

science will have the opportunity to get the latest results on ul-

trasonography in molecular medicine, which opens exciting new

horizons on the role of ultrasonography in medicine.

As a crossroad of Western Europe, Geneva is easily accessible by

air from all major European cities, and there are interesting

low-budget connections from several of them. Access is also easy

by rail or car. The congress venue is Palexpo Conference Centre,

which is ideally situated next to the Cointrin International Air-

port with its underground railway station and its 10 minutes’ bus

connection to downtown. There are nearby parking facilities.

Free tickets for public transportation to the venue and through-

out the city during the Meeting are included in the registration

fee. The choice of accommodation includes hotels of all catego-

ries.

Besides Euroson 2005, the city of Geneva with its lake and nearby

mountains is well worth a visit. Important ideas and movements

have originated here, including those of Jean Calvin, Jean-Jacques

Rousseau and Henry Dunant. Today, Geneva is host to many in-

ternational scientific, humanitarian, cultural and economic insti-

tutions as well as the United Nations. Many of these facilities are

open to the public.

We are confident that Euroson 2005 will fulfil your expectations,

offering an exciting teaching and scientific event as well as an en-

joyable social and cultural experience.

EFSUMB Contrast Agents Meeting January 23—24, 2004 — Rotterdam

EFSUMB in agreement with Industry is organizing a 1-1/2 day

closed meeting with the scope of providing practical guidelines

for the use of contrast agents, to be widely circulated to users in

Europe. A group of international experts will meet with Industry

representatives to focus on liver imaging and briefly touch on

other fields of applications.

Experts

Albrecht Thomas, Germany

Blomley Martin, UK

Bolondi Luigi, Italy

Claudon Michel, France

Correas Jean-Michel, France

Cosgrove David, UK

de Jong Nico, Netherlands

Greiner Lucas, Germany

Jäger Kurt, Switzerland

Leen Eddie, UK

Lencioni Riccardo, Italy

Lindsell David, UK

Martegani Alberto, Italy

Solbiati Luigi, Italy

Thorelius Lars, Sweden

Tranquart Francois, France

Weskott Hans-Peter, Germany

Whittingham Tony, UK

Companies Representatives

Paul Gordon, Amersham

Stefano Nervetti, Bracco

Marc Engelhardt, Bracco

Marty Rosenberg, Brystol Meyers

Daniela Bokor, Esaote

Marco Macciò, Esaote

Kirstin LaConte, GE Ultrasound

Holger Frey, Hitachi-Medical-Systems

Ursula Weinbrecht, Hitachi-

Medical-Systems

Mike Averkiou, Philips

Diane Kaharick, Philips

Patrick Philips, Siemens

Ellison Bibby, Siemens

Thomas Scheper, Schering

The publication of the adopted guidelines will be circulated to the

EFSUMB members in the following issue of the EFSUMB News-

letter and on the on the EFSUMB website.

If this meeting will be successful a second meeting will be orga-

nised in 2005 to adapt these guidelines and provide detailed re-

commendation for other clinical fields.

Michel Claudon

Past President EFSUMB

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18

EUROSON School

EUROSON School on 3D Ultrasound Imaging and the 3D Ultrasound Users Group Meeting

April 22nd—24th, 2004The Wolfson Conference Centre, Hammersmith Hospital Campus, London, United

Kingdom. Organized jointly with the British Medical Ultrasound Society. For further

details of program and registration forms please contact HITEC, Department of

Imaging, Hammersmith Hospital, Du Cane Road, London W12 0HS. E-mail address:

[email protected]

Accreditation applied for from the Royal College of Radiologists

3D Ultrasound Imaging

Imperial College Faculty of Medicine, in association with the British Medical Ultra-

sound Society, is organizing a three day course on 3D Ultrasound Imaging incorpo-

rating a meeting of the 3D Ultrasound Users Group. The course will cover the basic

principles of 3D and 4D applications on the first day followed by a series of invited

presentations on the latest developments in the subject on the second day.

3D Ultrasound Users Group

The 3D Ultrasound Users Group has been established to provide an informal open

forum for presentation and discussion of the latest clinical developments of these

techniques and abstracts are now invited for presentation. For further information

on the Users Group contact:

Mr. K. Humphries, 3D Ultrasound Users Group, RSU, Dept of Imaging, Imperial Col-

lege (Hammersmith Campus), Du Cane Road, London W12 0HS. E-mail address:

[email protected]

Accommodation

Special rates have been negotiated at the Thistle Hotel and the University Park. For

further details contact the meeting Secretariat.

Administration Centre

For program and registration forms contact: HITEC, Dept. of Imaging, Hammers-

mith Hospital, Du Cane Road, London W12 0HS, United Kingdom.

Exhibition/Practical ‘Hands-on‘ Sessions

An exhibition of the latest 3D and 4D ultrasound equipment will be held throughout

the three days. Between two and three hours will be available each day for delega-

tes to gain supervised training and practical experience in the use of 3D and 4D

ultrasound systems in scheduled sessions within the program.

Social events

A Reception and Dinner will be held on 23rd April, 2004

Sponsorship

The Course Organizers gratefully acknowledge the support given to this meeting

by Diagnostic Sonar LTD.

EUROSON School on 3D Ultrasound Imaging

Thursday, April 22nd.

Basic Theory and Practice

08.45 Welcome and Introduction

08.50 Fundamentals of 3D imaging

09.30 Position sensing devices

— Electromagnetic sensors,

— Mechanically driven arrays

— Correlation techniques

10.30 Coffee/Exhibition

10.45 3D Surface and volume rendering techniques

11.15 The Stradx 3D imaging system

11.40 Volume measurements

12.00 Practical Session I: System Demonstrations: basic 3D facilities

13.00 Lunch/Exhibition

Cardiovascular Applications

14.00 3D and 4D cardiovascular imaging techniques

14.30 Transoesophageal imaging

15.00 Intravascular 3D imaging

15.30 Tea/Exhibition

15.45 3D vascular ultrasound imaging

16.10 Carotid Imaging

16.30 Practical Session II: Cardiovascular

Friday, April 23rd

General and small parts

08.45 Applications of 3D ultrasound in Image-Guided Surgery

09.15 3D surgical applications

09.45 3D oro-maxillary imaging

10.05 Coffee. Practical session III: General

10.45 3D Breast Imaging.

11.10 Endoanal imaging

11.35 Prostate

12.00 Practical Session IV: General

13.00 Lunch/exhibition/workshop

Obstetric and Gynaecological Applications

14.00 3D/4D ultrasound techniques in obstetrics

14.30 3D/4D ultrasound techniques in obstetrics: Case studies

15.15 Review of 3D ultrasound in Gynaecology..

15.45 Tea

16.00 Practical Session IV: Obstetrics & Gynaecology

19.45 Course Dinner:

Saturday, April 24th.


08.45 3D ultrasound in the Evaluation of fetal malformations.

09.15 3D face and neck anomalies

09.45 Volume sonography of fetoplacental vessels

10.05 Coffee/Exhibition. Practical session V: Obstetrics

11.00 4D Fetal Echocardiography

11.20 Volume sonography of the pelvic floor after childbirth.

11.40 3D Gynaecological Imaging: Quantitative measurements of vascularity and

volume.

12.00 Practical Session VI: Obstetrics and Gynaecology

12.30 Lunch/Exhibition


13.30 Latest developments in 3D obstetric applications

14.00 The Role of 3D Ultrasound in reproductive medicine.

14.30 Redefining uterine perfusion with 3D power Doppler angiography

15.00 Tea/Exhibition/Practical Session VII: Obstetrics

15.15 Multiple Choice Examination

16.00 Course closes

“Sonography in Gastroenterology”

June 17-19, 2004 in Thurnau near Bayreuth, Germany.Address for contact and registration:

Dr. Klaus Dirks

Medizinische Klinik, Klinikum Bayreuth

Preuschwitzer Str. 101

95445 Bayreuth

Germany

Tel.: 0921/ 400 6413, Fax.: 0921/ 400 6409

Mail: [email protected]

www.sonoweb.de

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EUROSON SchoolInternational Breast Ultrasound School in

conjunction with the Latvian Association of

Roantgenologists and Radiologists

Advanced Breast Imaging Seminar, Hotel Latvia, Riga, Latvia,

Friday and Saturday, September 17-18, 2004

Invitation

We wish to invite you to attend the Advanced Breast Ultrasound Seminar to be

held on September 17 and 18, 2004 at the Hotel Latvia in Riga, Latvia.

The seminar program consists of lectures, workshops, panel discussion and

case presentations, and has been organized by the International Breast Ultra-

sound School (LBUS)in conjunction with the Latvian Association of Roentge-

nologists and Radiologists (LRRA). This seminar is the first comprehensive bre-

ast teaching programme in the Baltic States, and has been structured to meet

the requirements of continuing medical education with contributions from an

expert local and international faculty. We look forward to seeing you in Riga.

Dr. Jack Jellins, Founding President — IBUS

Ardis Platkajis, President — LRRA

Faculty Members

Dr Edward Azavedo — Sweden, Dr Sabine Pankl-Huber — Austria, Professor

Dace Baltina — Latvia, Professor Rainer Otto — Switzerland, Dr Jack Jellins — Aus-

tralia, Dr Ingrida Slosberga — Latvia, Professor Alexander Mundinger — Germa-

ny, Dr William E. Svensson — United Kingdom, Dr Sulev Ulp — Estonia

Registration fee: € 220,- before July 30, 2004

Registration fee: € 260,-

Concessional fees apply to members of the Baltic States or Eastern European

medical societies

Registration fee: €50,- before July 30, 2004

Registration fee: € 75,-

Trainee registrants are eligible for a reduced fee of € 150,- and € 180,- respec-

tively, and € 40,- and € 55,- respectively for members of the Baltic States or Eas-

tern European medical societies

Seminar Secretariat: Con-Ex Latvia Tours Group, 8 Kalku Str.LV-1050 Riga, Lat-

via, Tel: +3717085014, Fax: +371 782 0020,


For general information visit the IBUS homepage at: http://www.ibus.org or

send an E-mail to: [email protected]

Session Topics

— Imaging strategies for cancer detection, — Advantages and limitations of

imaging modalities, — Differential diagnosis, Interventional procedures, Tu-

mour extension and multifocality,— Screening strategies, Postsurgical ima-

ging, Future directions.

Lecture Topics -

— Historical perspectives of breast ultrasound — The “signal-to-noise“ concept

— The tomographic approach,— Pathological sprectrum of lumps, — Current

status of breast imaging, — Imaging patterns of premenopausal women, — Be-

nign and malignant ultrasonic diagnostic criteria, Mammographic interpreta-

tion criteria, Use of colour Doppler to improve diagnostic accuracy of breast ul-

trasound, Cell harvesting, Tissue harvesting, Imaging of intraductal cancer

spread, Preoperative staging of invasive cancer, Screening options for women

at increased risk, — The breast cancer screening program in Estonia:

2002-2006, Tissue reactions after breast conserving therapy, Imaging of the

augmented breast, — Colour Doppler and contrast enhancing agents, Compu-

ter-assisted detection, Quality assurance, guidelines and accreditation, Ad-

vances in breast ultrasound plus Interactive workshops, panel discussions and

case presentations.

The official language will be English

A book of reference materials will be distributed to each registrant

EUROSON School

Breast Ultrasound

Romania, Craiova, 19—20 September 2004

University of Medicine and Pharmacy —Craiova National Society of OncologyLocal Organizing Committee:

Presidents: Andrei Bondari, Florinel Badulescu

Secretary: Viorela Enachescu

Treasurer: Aristida Georgescu

Members: Dragos Camen, Daniela Dumitrescu, Mihai Popescu,

Luana Tarabic

Preliminary Program

Saturday, 18 September

18.00—20.00 Welcome reception

Sunday, 19 September

08.30—09.00 Opening ceremony

09.00—10.30 Scientific Programme: Standards of breast US, guidelines for US

examination, equipment requirements.

10.30—11.00 Coffee break

11.00—13.00 Scientific programme: Examination technique , echoanatomy,

other imaging breast sections.

13.00—15.30 Lunch

15.30—18.00 Scientific programme: Inflammatory diseases and benign tu-

mors

20.00—22.00 Reception

Monday, 20 September

09.00—11.00 Scientific programme: Malignant tumors

11.00—11.30 Coffee break

11.30—13.00 Scientific programme: Interventional procedures

13.00—15.00 Lunch

15.00—17.00 Interactive workshops covering ultrasound, X - ray mammogra-

phy, magnetic resonance imaging and other investigative techniques

17.00—18.00 Final test

Registration Contact

Viorela Enachescu MD. University of Medicine and Pharmacy of Craiova

Mail:Stirbei Voda Street, no. 16, 200374 Craiova, Romania

E-mail: [email protected], [email protected], Fax: 004.251.562824,

Phone: 004.251.533516,/004.251.418291

Registration fees Payment details

Presenting authors: free of charge

Participants: 100,- €

Resident doctors: 50,- €

Accompanying persons: 50 ,- €

Bank Transfer to: FUNDATIA MEDI-

CINA

BANCA COMERCIALA "ION TIRIAC"

Account no:

17.10.121.971.005-EUR

17.10.121.971.009-USD

17.10.121.971.002-ROL

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20

Report On the British Medical Ultrasound Society congressHarrogate — December, 10—12, 2003

For BMUS the highlight of the year is always the Annual Scien-

tific Meeting and for most this is the last meeting of the year.

Many regard this as the start of Christmas and are in appropriate

festive mood when they arrive for the conference but this does

not prevent very active scientific participation by most.

This year’s meeting was in Harrogate, within easy reach of se-

veral big cities including Manchester and Leeds, again a very po-

pular venue for the Society. We have met here now on four oc-

casions, each meeting being very successful both scientifically

and socially. Many people gathered for the Civic Reception be-

fore the opening of the Congress, an opportunity to meet old

friends, make new ones and to be welcomed by the Lord Mayor

of Harrogate in the convivial atmosphere of the unique

conference centre with its spiral walkway. Everyone attending

the meeting in Harrogate gets plenty of exercise as there is no

feasible alternative means of reaching the lecture theatre apart

from walking up this gentle incline.

The meeting itself commenced the following morning with

three parallel sessions running throughout the day. Abdominal

ultrasound dominated in the main auditorium with a mixture of

other topics including physics, paediatrics, and sonographic is-

sues in the other venues. The very popular hands on workshops

were repeated enabling delegates to explore a number of areas

of practical ultrasound with advice from experts drawn from far

and wide.

The second day of the conference covered a number of obstetric

topics in the main auditorium with vascular, abdominal, vete-

rinary and breast sessions elsewhere. The highlight of the day

was the Donald McVicar Brown lecture which this year was

given by Professor Francis Duck on the fascinating subject of the

heritage and horizons of ultrasound. His lecture covered a wide

range of topics including some most unusual devices to en-

courage weight loss but culminating in fascinating insights into

the future.

The final day of the conference covered more obstetric, physics,

vascular, and small parts sessions.

Whilst the majority of the meeting consists of guest lectures

from both national and international experts in their fields a

pleasing number of proffered papers were presented in most

areas and these continued to be of a high standard. The meeting

is accompanied by a scientific poster exhibition with high

quality exhibits no doubt encouraged by the substantial prizes

on offer for the best.

Some will remember (some more easily than others!) the social

program. The highlight of the Wednesday evening was an infor-

mal evening with an eight piece soul band the Blooze Doctors

led very ably by the husband of the current President of BMUS,

Jane Bates. For those of a more sedate disposition a Jazz Quartet

was available. The Thursday evening entertainment was

provided by the Annual Dinner at the Majestic Hotel. The

Annual Dinner was followed by a very lively Disco which went

on until the early hours of the morning and showed many senior

members of BMUS ( and even the President Elect of EFSUMB ) in

a different light from the more usual sedate persona they

normally show.

No report of the meeting would be complete without comment

on the most extraordinary event of Tuesday evening. The

President Elect of BMUS locked himself in the bathroom and

was seen walking along the balcony of the first floor of the hotel

clad only in a small hand towel, this being his only means of

escaping from his room. Unfortunately he was foolish enough

to reveal this information to several other members so this will

now be recorded for posterity.

As usual no conference like this takes place without an enor-

mous amount of work from an organizing committee ably led by

the aforementioned President Elect but with the Scientific Pro-

gramme led by Pat Smith and the Social Program by Heather Ve-

nables.

Manchester 2004 seems a long way away and yet those of us

who have being going to BMUS for many years realize it will be

around all too soon. There will be new science, an excellent so-

cial program and probably more interesting but unpredictable

events to be recorded.

David Pilling, Past President BMUS

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DIARY DATES

March 20, 2004

Special Workshop - "Ultrasound and Breast Cancer: Current sta-

tus and future trends". A workshop presented by the Interna-

tional Breast Ultrasound School (IBUS) in partnership with the

4th European Breast Cancer Conference. CCH Congress Centrum

Hamburg. Contact: IBUS at [email protected]

April 7—9, 2004

London, UK EUROSON School on 3d Ultrasound Imaging – For

further details and registration forms please contact: Secreta-

riat: HITEC (Hammersmith Hospital), Du Cane Road, London

W12 OHS, UK. E-mail +44 (0)20 8383 1601 Fax: +44 (0)20 8383

1610 E-mail: [email protected]

April 27—28, 2004

NPL International Conference on Advanced Metrology for Ultra-

sound in Medicine, Teddington, UK. For further details please

contact: Adam Shaw, Centre for Acoustical and Ionising Radia-

tion National Physical Laboratory, Queen's Road, Teddington,

Middlesex TW11 0LW. +44 (0)20 8943 6581 Fa: +44 (0)20 8614

0421 E-mail: [email protected] Web:

www.amum2004.npl.co.uk

May 7, 2004

VIII World Congress of Echocardiography and Vascular Ultra-

sound. Venue: Antalya, Turkey. Contact: Navin C. Nanda, MD,

President ISCU, PO Box 323, Gardendale, AL 35071, USA. Tel:

+ 1 205 934 8256; Fax:+ 1 205 934 6747; E-mail: [email protected]

May 17, 2004

7th Congress of the Asian Federation of Societies for Ultrasound

in Medicine and Biology (AFSUMB)/77th Meeting Japan Society

of Ultrasonics in Medicine. Venue: Utsunomyia-City, Tochiqi, Ja-

pan. Contact: Prof. K Itoh, Dept of Clinical Lab. Medicine, Jichi

Medical School, Minamikawachi, Tochiqi-ken 329 0498, Japan.

Tel:+ 81 285 587 385; Fax:+ 81 285 448 249; E-mail: itokoiti.@ji-

chi.ac.jp Website: http://www.congre.co.jp/afsumb2004/

May 19, 2004

IXth International MASU Congress and International course Ve-

nue: Al Assad University Hospital, Damascus, Syria, MASU Web-

site: http://www.agonet.it/masu

June 5—8, 2004

EUROSON 2004, 16th EFSUMB Congress, Zagreb, Croatia in con-

junction with CSUMB. Contact: hko Lašinska cesta 94, HR –

10000 Zagreb + 385 1 236 0052/00385 1 2347661, Fax:+ 385 1

234 76 63, E-mail:[email protected], Web-

site:http://www.euroson2004.com

June 14—16, 2004

XIX European Congress of Perinatal Medicine, Athens, Greece,

Contact: C&C International S.A., 16 Paradissou Strr., 151 25

Athens, Greece. + 30 210 6889100, Fax: + 30 210 6844777,

E-mail: [email protected], Website:www.cnc.gr

June 17—19, 2004

EUROSON school on - “Sonography in Gastroenterology”

Thurnau near Bayreuth, Germany.

For contact and registration: Dr. Klaus Dirks, Medizinische Kli-

nik I, Klinikum Bayreuth, Preuschwitzer , Str. 101, 95445 Bay-

reuth, Germany, Tel.: +49 921 400 6413, Fax.:+49 921 400 6409,

EE-mailmail: [email protected], www.sonoweb.de

June 20, 2004

AIUM Annual Convention.Venue: Desert Ridge Resort, Phoenix,

AZ USA.Contact: Brenda Kinney, AIUM, Tel:+ 1-301-498-4100;

E-mail: [email protected]; Website: www.aium.org

June 20, 2004

Advanced Course in Fetal Medicine Venue: Paphos, Cyprus Con-

tact: www.fetalmedicine.com

June 20—22, 2004

Third World Congress in Fetal MedicineVenue: Nicosia, Cyprus

Contact: www.fetalmedicine.com

August 31, 2004

14th World Congress on Ultrasound in Obstetrics and Gynecol-

ogy. Venue: Stockholm, Sweden. Contact: Ms S Johnson, Ex. Dir.

ISUOG, 3rd Fl, Lanesborough Wing, St Georges Hospital Medical

School, Cranmer Terrace, London SW 17 ORE, UK. Tel:+ 44 20

8725 2505; Fax:+ 44 20 8725 0212; E-mail: john-

[email protected]

September 17—18, 2004

2004–EUROSON SCHOOL on ADVANCED BREAST IMAGING -

IBUS–Advanced Breast Imaging Seminar Riga, Latvia. Contact:

IBUS Secretariat at [email protected], http://www.ibus.org.


EUROSON SCHOOL–Breast Course–Craiova, Romania. Contact:

Prof Radu Badea, Secretary SRUMB, Departamentul de ultra-

sonografie, clinica Medicala III, str. Croitorilor 19-21, 3400

Cluj-Napoca, Romania, E-mail:[email protected]

September 23, 2004

ASUM 2004. 34th Annual Scientific Meeting of the Australasian

Society for Ultrasound in Medicine. Venue: Hilton, Sydney, Aus-

tralia. Contact: ASUM, 2/181 High Street, Willoughby, NSW,

2068. Tel: +61 2 9958 7655; Fax: +61 2 9958 8002;


EFSUM

B N

ewsletter


22

DIARY DATES

October 6—10, 2004

Ultraschall 2004–Dreiländertreffen–Hannover Congress Cen-

trum, 30175 Hannover, Germany. Contact: CPO HANSER SER-

VICE, Hanser & Co GmbH, Zum Ehrenhain 34, 22885 Barsbüttel,

Germany, Tel.: +49 40 670 88 20, Fax: +49 40 670 32 83,

E-mail:[email protected]

October 8—9, 2004

The Research and Developments Meeting. Contact: www.fetal-

medicine.com

December 8—10, 2004

36th BMUS Annual Scientific Meeting and Exhibition, Man-

chester international Convention Centre. For further details

please contact the BMUS office, 36 Portland Place, London W1B

1LS. +44 (0)20 7636 3714 Fax: +44 (0)20 7323 2175


— 2005—

June 19, 2005

AIUM Annual Convention. Venue: Walt Disney World Swan and

Dolphin, Orlando, FL USA.

Contact: Brenda Kinney, AIUM, Tel:+ 1-301-498-4100;

E-mail: [email protected]; Website: www.aium.org


EUROSON 2005, 17th EFSUMB Congress: Palexpo, Geneva, Swit-

zerland, in conjunction with the Dreiländertreffen at the Palex-

po Geneva. Contact: Scientific Secretariat: Prof François Terrier,

Radiologie Hôpital Cantonal Universitaire Genève 1211, Genève

14, Switzerland, Tel : + 41 22 3727001, Fax:+ 41 223727047,


September 29— October 2, 2005

ASUM 2005, 35th Annual Scientific Meeting of the Australasian

Society for Ultrasound in Medicine.Venue: Adelaide Convention

Centre, Adelaide.Contact: ASUM, 2/181 High Street, Willough-

by, NSW, 2068. Tel: +61 2 9958 7655; Fax: +61 2 9958 8002;


—2006—

May 18, 2006

X World Congress of Echocardiography and Vascular Ultra-

sound. Venue: Marrakesh, Morocco

Contact: Navin C. Nanda, MD, President ISCU, PO Box 323, Gar-

dendale, AL 35071, USA. Tel:+ 1 205 934 8256; Fax:+ 1 205 934

6747; E-mail: [email protected]

May 28 ,2006

11th Triennial Congress World Federation for Ultrasound in

Medicine and Biology. Venue: Seoul, Korea.

Contact: Byung Ihn CHOI, M.D., Congress Secretariat,

Tel: +82 2 760 2515; Fax: + 82 2 743 6385; E-mail: choibi@rad-

com.snu.ac.kr; Web:http://www.wfumb2006.com


EUROSON 2006, 18th Congress of the European Federation of

Societies for Ultrasound in Medicine and Biology, Bologna, Italy.

Contact: EFSUMB Secretariat. E-mail:[email protected]

2004 - issue 1

Documents

efsumb newsletterultraschall

efsumb members

efsumb representative

euroson congress

d w pilling ukmembers

established efsumbnewsletter

d lindsell ukmembers

efsumb contrast agents