EFSUMB UMB 2020, Issue 5 by EFSUMB

EFSUMB Newsletter

European Federation of Societies for Ultrasound in Medicine and Biology

EFSUMB during the pandemic EFSUMB Newsletter Editor Alexandros Sotiriadis and EFSUMB General Secretary Lynne Rudd

Like all Scientific Societies, EFSUMB is having to adapt and modify the way we deliver education and information. Fortunately, remote working for the general secretary was adopted a few years ago so there has been no need for administrative changes, nor for the web administrator but is “business as usual”. Our immediate response was to provide and share detailed and updated information on COVID-19 and its impact on ultrasound service delivery and EFSUMB activities. A dedicated section of the website brought all the news into one place, whether it was advising about cancelled or postponed meetings, online conferences, the use of lung ultrasound in COVID-19 management or ultrasound safety statements. EFSUMB hosted two webinars, one in April and one in May on the role of US in COVID-19 patient management and Lung US for the COVID era. The interest was extremely high in these topics and the webinar archive continues to bring in new visitors.

years the National Societies have felt that this was a resource being used worldwide rather than just by EFSUMB members, the Board of Delegates decided to create sections of the website exclusively for EFSUMB members as a benefit of their membership fee. Due to the impact of the pandemic, the COVID-19 area in the website was kept open to the general public. With the constitutional changes individual members are now welcomed and can log in to the full website. We have faced some issues with log in but the web administrator responds promptly to iron out any difficulties. Please contact Suzanne via the website if your National Society has not provided your information for website access. Offering more content has meant EFSUMB needs a new and faster platform to increase the website speed. We are taking advantage of the fewer changes that are usually necessitated by the Euroson Schools, Endorsed Courses and other meetings which have been postponed or cancelled, to make this upgrade along with an updated style and easier to navigate site. The Case of the Month edited by Prof. Adrian Lim continues to be the most visited area of the website and we will continue to try to meet the challenge of a new case each month. Contributions are always warmly welcomed. The recent installation of the Student Image Challenge has also

brought a new set of visitors to the EFSUMB site with weekly cases hitting at least 16 000 hits in the first week after publishing.

Euroson Schools The Euroson Schools have been severely disrupted, but the Munich School CEUS Hepatic and Extrahepatic Indications is planning to go ahead with appropriate personal safety measures in place. As some of the international speakers from China and Canada may not be able to attend, a hybrid course is planned with live talks relayed to the audience but still with the possibility of Q&A’s with the experts. Should the school have to be cancelled registrants will be reimbursed or the registration transferred to 2021. The PoCUS School in Vienna is postponed until 4–5 December and has received EACCME accreditation. It is not certain how the future Schools will be able to operate, but EFSUMB will consider more topic based online courses leading to certification. Endorsed courses are held in the national language and may be more viable in countries that are less affected by the pandemic and where registrants are not travelling from abroad to attend these.

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Ultrasound Learning Centres will be affected by the pandemic with the travel restrictions but remain an important option for those wishing to improve their specialist US skills without any costs to study at one of the 7 centres in Romania (Cluj Napoca and Timisoara), Switzerland, Spain, Norway, Italy or Germany.

year. To accompany this long-awaited update, EFSUMB has hosted three CEUS webinars so far this year. Two more webinars have been planned; one in September on CEUS for the management of focal liver disease and one in November on CEUS in non-abdominal organs. If you missed any of the previous webinars, they are available for free in the EFSUMB webinar archive.

EUROSON 2021

Guidelines in progress

EFSUMB Board of Delegates voted to adopt a biennial congress (alternating with the WFUMB Congress) from 2023. The Congress organisers of EUROSON 2021 Timisoara, Romania have planned an extensive programme including postgraduate courses in PoCUS, MSK, Breast, Emergency US, Vascular, Gynae and Echocardiology. In addition, they are planning a separate Student Congress to run during the 26–29 May congress. Whilst the plans are being made the organisers have to keep a close eye on the COVID-19 situation. As the hopes of an early vaccine are fading, a decision will be taken before the end of the year whether to proceed, offer a virtual congress or postpone to May 2022.

EFSUMB is working on developing guidelines online using electronic meetings and voting. We aim to improve harmonisation of guidelines and avoid duplication of topics, as the latter can be very confusing for users. It is the role of the delegate to the National Society to communicate our programme. By inviting European experts (selected on their publication record) to share their experience we can ensure high quality English language guidelines. All EFSUMB guidelines follow our published guidelines protocol, which can be found on the EFSUMB website. Currently under preparation are the PoCUS Guidelines, led by Prof. Bob Jarman, which will be divided into three documents, thoracic/cardiac, abdominal and pelvic, and head/neck/procedures. Musculoskeletal Guidelines are underway steered by Prof. Daniela Fodor with EULAR representatives and looking at the clinical applications of US in MSK practice.

Some of our National Societies have held very successful virtual congresses, for example in Russia with 6000 participants. EFSUMB will be continuing its participation in other virtual congresses such as UEG, ECR, EASL and we are eager to learn how to adopt this for our future meetings. Our feedback from the US sessions at external congresses is always about the importance of hands-on training with demonstrations from the tutors and supervised scanning by the course participants. We need to find a way of being able to continue to provide this.

Guidelines The CEUS Liver Guidelines are published in this issue but were ePublished earlier this

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Future Guidelines An Update of the Dynamic CEUS guidelines published 2012 is under discussion and we invite ideas for other potential guidelines topics.

Position Papers Bosniak Cysts would have been the focus of the EFSUMB/ESR session at ECR. A paper is almost ready for publication and amongst the objectives is to review the classification of complex renal cysts and the relationship to malignancy, to appreciate the need for a CEUS classification of these complex cysts and to review and understand the nature of the enhancement of complex cysts with CEUS.

A Paediatric CEUS paper is almost ready and is the result of the database registry which collected adverse paediatric reactions to CEUS. This is eagerly awaited. A paper looking at Professional Standards for ultrasound users is being developed by the Education Committee (EPSC). This publication considers the basic principles of what quality standards make medical ultrasonography a professional service in the context of medical imaging, regardless of “who’s doing your scan”. There have been controversial discussions about whether ultrasound can be effectively carried out by clinicians without medical degrees. In many countries US is carried out by radiologists (except in special areas like cardiology and prenatal medicine). In other countries imaging specialists play a role and medical ultrasonography is performed by non-medical examiners, in accordance with local regulations. Head & Neck Training Standards led by Tobias Todsen and Julian Kuenzel will focus on the following: 1. minimum education standards 2. minimum technical standards 3. content of complete head and neck ultrasound examination B-Scan with contributions from endocrinologists and radiologists 4. minimum documentation standards 5. comments on the role of CEUS and Elastography

EFSUMB Course Book (ECB) EFSUMB is working to add the remaining chapters to the website. These are offered for purchase after an opportunity to view part of the chapter. A few chapters are offered free of charge. Prof. Christoph F Dietrich is the Editor of the second edition and without his tireless energy and the generous authors’ contributions we would not be able to offer this vast learning resource.

Virtual committee meetings All the EFSUMB Committees, Safety, Education, Publications and Student Committee and the Executive Bureau have been meeting virtually for some years now. This has proved to be cost saving but as colleagues

are more time pressed this has become a practical way forward. The EUROSON Congress is the time the Committees get to meet in person when presenting as lectur-

ers and moderators. We sincerely hope that the pandemic will not disrupt this important calendar event – EUROSON 2021 is conjoint with WFUMB 2021 and the con-

gress organisers have devoted themselves to producing a scientific programme of quality and excellence from which we can all benefit.

Ultrasound education in the COVID-19 frame The COVID-19 pandemic changed the way we work, the way we interact with our patients and the way we provide the best medical care. Ultrasound practice and education was not an exception, and suddenly we find ourselves chained in restrictions that cannot be ignored. In this the new pandemic era, the ultrasound transducer remains a powerful and needed medical tool that can be safely used. Despite our initial fears, we now realize that we can perform ultrasound examinations without jeopardizing the safety of our patients and our own safety. Personal protective equipment and additional hygiene measures in health care facilities can make it possible for us to keep up with our training skills. In addition, the pandemic also opened the door to online learning and to make more use of the digital educa-

tional resources that many professional organization/societies provide for students, including EFSUMB. The online platform includes examination techniques video, a course book, a basic ultrasound image atlas and a weekly US image challenge. The COVID-19 forced us to stop, but now it is time to get our students back on track, to get them back to the ultrasound rooms and hands-on sessions, as long as safety measures are strictly met (ultrasound equipment disinfection, hand hygiene, personal protective equipment – facemask, gloves, limiting the number of participants, everyone has to keep a 1.5 m distance). For more guidance on how to keep a safe environment for teaching ultrasound, tutors can apply some of the measures issued in the WFUMB position paper: How to perform a safe ultrasound examination and clean equipment in

the context of COVID-19. Moreover, to make the procedure even safer, the possibility of using training models and phantoms for ultrasound training seems a very good option in this context. However, students need to get used to this “new way of life”, as long as they need to learn ultrasound. That is the way we are planning to slowly get back to a “new normal” for student ultrasound education in Portugal. Our patients and our students need our skills, so let’s continue with our mission. “Adaptability is not limitation. It means power of resistance and assimilations.” Mahatma Gandhi Richard Azevedo, Codruta Constantinescu EFSUMB Student Committee

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Association for the Application of Ultrasound in Medicine and Biology of the Republic of Serbia – SECHO

Population: 8963 753; Area: 88 361 km; Capital: Belgrade. Belgrade is the center of academical, cultural and political life in Serbia.

Dr. Danijela Miletić is the current Vice President of the SECHO Association for the Application of Ultrasound in Medicine and Biology of the Republic of Serbia. She is a gastroenterologist at the University Clinical Center of Serbia in Belgrade. Dr. Miletić’s main professional work is in the field of Application Ultrasound in digestive diseaseIBD. Besides being the Vice President at SECHO, she is a regular member of EFSUMB, ECCO, ESGENA, and UGS.

Manual written by Atanasije Tasa Marković, the headmaster of the Yugolsavian School of Ultrasound – 1997.

Dr. Danijela Miletić

SECHO dates its routes back to the Yugoslavian School for the Application of Ultrasound. The International School of Ultrasound was first founded by Prof. Dr. Asim

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Kurjak in Dubrovnik. Since the majority of the students and doctors were from Yugoslavia, Dr. Zoran Sretenović, decided to open another, this time a Yugoslavian School of Ultrasound in 1985. The Yugoslavian School for the Application of Ultrasound was offering various pro-

grams for all specialties and levels. It was established in Kragujevac and as the head doc. Dr Atanasije Tasa Marković was appointed. Due to the political situation and events, the Yugoslavian School for the Application of Ultrasound was closed in early 2000.

Nevertheless, the Yugoslavian School for the Application of Ultrasound fostered numerous professionals, who carried their work in all parts of the world and was the first of its kind. The main communication channel currently is our Newsletter, but in the future, we are going to publish a magazine. The main focus of the magazine will be promoting the guidelines of EFSUMB, besides our practical experiences and new accomplishments in the field of Ultrasound.

Training in ultrasound in Serbia During their medical studies, students have the opportunity to learn basic practical knowledge regarding ultrasound. Further on the if they wish to continue their education in the Application of ultrasound, there are various courses and internships at University Clinics, that are all approved fro SECHO.

Membership SECHO currently gathers 50 official members and 30 associates. All of our official members are part of EFSUMB as well. SECHO and EFSUMB Since 2020, SECHO is part of EFSUMB. We are looking forward to future cooperation.

National Meetings in Serbia The national meeting is held once every two years, at the moment.

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