2004 - ISSUE 1 by EFSUMB

EFSUMB Newsletter

February 2004

European Federation of Societies for Ultrasound in Medicine and Biology

Contents EFSUMB Officers and Committees .... 4 Report from the President................ 4 Report from the Honorary Secretary —“Clinical Ultrasonographywhere to go from here“ ................... 5 Report from the Honorary Treasurer ......................................... 7 Report from the Education and Professional Standards Committee ...7

EUROSON 2004 5th—8th June 2004 Zagreb, Croatia. See preliminary programm page 12.

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

Ultraschall 2004; 25

EFSUMB European Fedaration of Societies for Ultrasound in Medicine and Biology Report from the President

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)

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

ECMUS — EUROPEAN COMMITTEE FOR MEDICAL

scientific publications. We have reestablished

ULTRASOUND SAFETY

our scientific platform and from now on we shall

Chairman: K Salvesen (Norway) Secretary: T Whittingham (UK) Members: P Arbeille (France) M Delius (Germany) L Klinghammer (Germany) R Laurini (Sweden) K Marsál (Sweden)

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 official scientific journal of EFSUMB. In addition, the well established EFSUMB-Newsletter will be published in the Journal as well. We are grateful that David Pilling will continue his estee-

EDUCATION AND PROFESSIONAL STANDARDS COMMITTEE

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

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)

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

PUBLICATION COMMITTEE

of the regular price. Individual EFSUMB members may subscribe

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

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

EFSUMB NEWSLETTER

rally the articles were predominantly published in German, but in

Editor: D W Pilling (UK)

recent years the number of English papers has been rapidly increasing. In the near future the flow of submitted papers will de-

SECRETARIAT

termine the language of our journal. You are all invited to respond to our appeal and to submit your scientific work to our own journal. Young Investigator Award The future of any society lies in the quality of its young investigators. Therefore, EFSUMB gives high priority to the encouragement 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-

Ultraschall 2004; 25

EFSUMB Newsletter

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: efsumb@efsumb.org Website: http://www.efsumb.org

didate. The submitted abstract will be presented at the next

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

EUROSON Congress during the special young investigators ses-

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

sion. The presented papers will be assessed by the evaluation

safety and reliability of our performance. ECMUS is chaired by

committee in terms of scientific content and quality of presen-

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

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

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

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

next EUROSON Congress in Zagreb. On behalf of the Executive

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

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

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

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

nance.htm.

for us. The national societies are invited to nominate candidates for the Committee. We are looking for candidates whose areas

Working Groups and Committees

of interest special knowledge and expertise cover as wide a range as possible in the fields related to the bio-effects of ultra-

The development of ultrasound contrast agents has remarkably

sound, whilst the maintenance of parity (national representati-

improved the diagnostic information of ultrasound examina-

on) shall be of secondary importance.

tions. Under the auspices of EFSUMB a group of experts is going to meet in Rotterdam in January in order to elaborate recom-

Meetings and Congresses

mendations on the application of ultrasound contrast agents for the detection and characterization of focal liver lesions and their

EFSUMB was involved in the Congress of Vascular Medicine

use in the monitoring of treatment effects following local abla-

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

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

symposia on quality control in vascular duplex scanning; the

liver ultrasound are planned to be made accessible to all our

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

members as early as possible.

meantime we are looking forward to the next EUROSON Congress, to be held in Zagreb 5–8 June, 2004. Professor Ivan Drin-

The Education and Professional Standards Committee is in the

kovic and his team as well as the national organizing committee

process of preparing various syllabi for minimal training stand-

of the Croatian society are developing a promising programme.

ards in different areas of ultrasound practice. Further informa-

We hope to see you all in Zagreb next June.

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

in Zagreb.

President EFSUMB

Report from the Honorary Secretary Clinical Ultrasonography — where to go from here

The unique features of this beautiful tool are – the immediate access – the simplicity and repeatability of use

Once there was a dream: In a patient with abdominal, cardiothoracic, or vascular problems, you simply take a small instrument connected to a video screen, and with this device, you can easily look at the region of interest – be it one of the numerous abdominal organs, the heart, the pleural cavi-

– 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 colour-doppler techniques. – the additional possibility of immediate diagnostic or therapeutic ultrasound guided interventions.

Ultraschall 2004; 25

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

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

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

ultrasonography are unbeatably low. So reality has maybe even

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

outstripped the dream.

This dream has become true, in realtime ultrasonography – with

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

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

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

EFSUMB Newsletter

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

fective abdominal, thoracic, or cardiovascular ultrasonography,

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

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

access to all training, learning and teaching modalities in scientific and in clinical ultrasonography.

Answering these questions can lead to conflicting replies and solutions, depending on a number of variables given. For ex-

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

ample the local and national conditions as well as the different

ropean Journal of Ultrasound” with the scientifically highrank-

financial backgrounds for sectional imaging procedures will af-

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

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

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

ming physician and the accessibility of ultrasound machines for

involved.

those colleagues who would like to perform it plays an important role, which again is connected to the economic conditions

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

pertaining.

cially our EUROSON congress at Zagreb in June 2004 hosted by the national society of Croatia – are an extraordinarily good ba-

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

sis for exchanging, learning and teaching practical and scientific

with for example abdominal conditions, will and must demand

progress and knowledge in ultrasound. It is worthwhile for any

access to ultrasound on his own for immediate integration of

doctor in Europe working within any of the sub specialties of

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

ultrasonography

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

interdisciplinary societies of ultrasound as well as in our

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

European Federation of Societies for Ultrasound in Medicine

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

and Biology (EFSUMB).

to cooperate actively in the national

in terms of economical considerations, but for our patients as well. Lucas Greiner, EFSUMB Honorary Secretary 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

Ultraschall 2004; 25

EFSUMB Newsletter 6

Report from the Honorary Treasurer As I have stated in my previous reports -EFSUMB is an economically healthy organiza-

Country

tion. The accounts from previous years

Number Of Members In Database on 31 December 2003

have shown considerable surpluses. The

AUSTRIA

813

budgets have been in balance and any acti-

BELGIUM

211

vity that EFSUMB has been involved in du-

BULGARIA

ring the recent years has led to a surplus to

CROATIA

our Federation. The status from the year

CZECH REP

DENMARK

409

FINLAND

264

FRANCE

361

2003 is obviously not available yet, however, 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-

GERMANY

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

GREECE

ceived from the various organizers of the EUROSON Schools.

HUNGARY

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-

5856 100 45

ISRAEL

101

ITALY

1884

NETHERLANDS

NORWAY

254

POLAND

1200

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

PORTUGAL

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

ROMANIA

247

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.

RUSSIA

SLOVAK REP

SLOVENIA

108

SPAIN

177

SWEDEN

Niels Juul EFSUMB Honorary Treasurer

SWITZERLAND

2593

2082

TOTAL

17162

Report of the EFSUMB Educational and Professional Standards Committee Meeting for the EFSUMB Newsletter All members of the Committee met in Lon-

The syllabi on Obstetrics and Angiology/Neurology are less far

don over the weekend of 6/7th December

advanced and further work on these would be undertaken prior

2003. The main purpose of this meeting

to the next meeting of the Committee. It was decided that the syllabus for Radiology was probably not required as the tea-

training standards in different areas of

ching and training of ultrasound within radiology training sche-

ultrasound practice, which had been

mes in Europe was already well addressed. However contact

drawn up by members of the Committee.

was being made with the European Association of Radiologists

The syllabi considered were Obstetrics &

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

Gynaecology,

Gastroenterology,

Radio-

Ultraschall 2004; 25

logy, Urology and Angiology/Neurology.

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

The paper on Urology was accepted with the additional require-

ment and that to achieve level 1 training trainees would require

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

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

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

would be required to undertake a minimum of 300 ultrasound

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

examinations themselves. During the course of this time they

culated to members of the Committee for further consideration.

should also receive a theoretical course of lectures or seminars

EFSUMB Newsletter

was to refine various syllabi for minimum

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

nearing completion for publication in the EFSUMB newsletter.

thological Abnormalities. Following each period of training

Also near completion are ‘Guidelines for Ultrasound-Guided

each training department should undertake an assessment of

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

competence of the candidate before they can undertake ultra-

sound-guided thoracic interventions would be the next area to

sound scanning independently at that level. In order to progress

be developed. The Committee is very anxious that all guidelines

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

issued by EFSUMB should be evidence-based and that where

further minimum training period of a year, with a minimum

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

number of extra ultrasound examinations to be performed by

mendations are on the basis of expert opinion and practice.

the candidate of 600. One member of the Educational and Professional Standards As these syllabi are agreed by the Committee they will be circu-

Committee will attend a meeting organized by EFSUMB on

lated to the specialist societies in Europe for their consideration

ultrasound contrast agents to be held in Rotterdam in January

and hopefully for their support before being published. The

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

committee will review progress on all the syllabi at its next

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

meeting in Zagreb in June 2004.

vide practical guidelines for the use of ultrasound contrast agents. This meeting will comprise a group of experts from both

At the meeting in London the Committee also considered the

industry and EFSUMB with the focus of the meeting being on

possibility of having a syllabus in cardiac ultrasound, but agreed

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

that this was not appropriate as this was being well addressed

ultrasound contrast agents.

by the European Working Group on Echocardiography under the auspices of the Society of Cardiology. A review of the ‘Com-

David RM Lindsell Education and Professional Standards Committee Secretary

plications of Interventional Ultrasound in the Abdomen’ was

A Review of Complications of Interventional Ultrasound Procedures in the Abdomen The Professional and Educational Standards Committee of

thoroughly thanks Dr Buscarini for her

EFSUMB committee plans to publish a series of guidelines for

contribution.

ultrasound guided interventional procedures. We have already

Any comments on the review are wel-

published evidence based guidelines on amniocenteses and

comed and can be sent to EFSUMB’s Ge-

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

neral Secretary Mrs Gianna Stanford

lines the committee publishes below a review of complications

(e-mail: efsumb@efsumb.org).

of interventional ultrasound guided procedures in the abdomen written by Dr Elisabetta Buscarini. At the end of this document

Lil Valentin

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

Educational and

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

Professional Standards Committee

publication useful in their clinical work and the committee

Chairperson

Review of Interventional Ultrasound in the Abdomen

The small calibre of biopsy needles and the safety offered by US guidance has made interventional US a minimally invasive procedure; nevertheless fatal and major complications are reported, generally caused by abdominal interventional procedures.

Interventional ultrasound (US) includes invasive procedures

Therefore, physicians performing interventional US should have

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

a thorough knowledge of the relevant literature and of reported

nostic procedures are undertaken for cytology or tissue samp-

complications to improve their technical choices, to reduce the

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

risk of complications, and to minimise the consequences of

calibre less than 1 mm. Therapeutic procedures performed un-

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

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

prevent and how to correct complications.

tructed collecting systems (typically US guided nephrostomy), or of hollow organs for nutritional purpose. Tumour ablation

Definition

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

One problem when discussing complications is to ensure that

tion of thermal energy with radiofrequency electrode needles or

everyone is speaking about the same thing. Complications range

laser fibers is another therapeutic area.

from trivial incidents to major life-threatening crises, and

Ultraschall 2004; 25

EFSUMB Newsletter 8

“safety first”

without any generally agreed definitions it is difficult to make sense of overall figures. A complication can be defined as an unfavourable event, unexpected even if predictable, occurring because of the invasive procedure, in spite of technical accuracy of the proce-

Table 1 — Deaths, major complications, and tumor seeding observed after diagnostic or diagnostic and therapeutic interventional procedures (series 3, 6 and 7) guided by ultrasound. NR = not reported

dure. Authors

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)

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

0.008

0.05

0.017

Smith (2)

63,108

0.006

0.005

Weiss et al (3)

66,379

0.007

0.05

0.003

Smith (4)

16,38

0.031

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

Livraghi et al (8)

2,708

0.037

0.23

0.036

ed hospital discharge or renewed hospitalization – Fatal According to the timing of appearance complications are divid-

Major com- Tumor seeplications % ding %

Livraghi et al (1) 11,700

– Major, when they induce a significant worsening of the clinical condition of the patient and require substantial care

Number of Death % procedures or patients

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

ed into early and late.

spleen biopsy is a commonly feared procedure the related series Complications of Diagnostic US-guided Procedures

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

Mortality rate due to abdominal biopsies ranges from 0.001% to

1.3% (10).

0.038% as described in major studies, including questionnaire An intriguing complication is tumor seeding, which implies the

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

dragging of a critical number of tumour cells along the needle

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

track, their deposition in a favorable microenvironment and

have been described after biopsy of every abdominal organ. Two

subsequent tumour growth. The time elapsing between the pro-

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

cedure and tumour seeding generally corresponds to a few

hepatic

massive

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

haemorrhage. They occurred in one patient with hepatocellular

more. The incidence generally varies between 0.003% and

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

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

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

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

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

mour seeding correlates with needle calibre, number of biopsy

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

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

after puncture of liver haemangioma have been observed in a

probably easier after a puncture of superficial tumours while it

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

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

significant risk of bleeding after biopsy of liver haemangioma.

high incidence of tumour seeding after pancreas tumour biopsy

Therefore diagnostic work-up of liver haemangioma should be

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

completed whenever possible by using imaging techniques. The

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

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

reported series of pancreatic biopsies, including 2533 patients

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

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

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

to some authors biopsy should be avoided in patients who are

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

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

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

high diagnostic accuracy of imaging techniques strongly sup-

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

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

12).

the trend is to reduce invasive procedures. Irregularities of the

biopsy.

Both

fatalities

were

due

Ultraschall 2004; 25

The rate of major complications after ultrasound guided biopsy

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

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

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

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

study has shown these irregularities to induce greater cell drag-

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

ging after biopsy. Therefore echo-marker should be avoided

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

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

liver haemangioma puncture was confirmed, because in two ca-

it generally does not affect the patient outcome.

EFSUMB Newsletter

surveys obtained by multicentre and single institution series

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

Table 2 — Complications after percutaneous ethanol injection (16), the radiofrequencies cooled system port (21) and the radiofrequencies expandable system (22).

patients) of abdominal drainages no death related to the procedure was reported, but major complications were observed in 77 patients (8.6%) (18).

RF expandable system (22)

Complications of percutaneous ethanol injection (PEI) in the

Number of patients

1066

2320

166

treatment of HCC have been studied in a multicentre series of

Death

1 (0.09%)

6 (0.3%)

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

Major complications

haemoperitoneum). Major complication rate was 3.2%. The

Severe pain (session stop)

Abdominal wall necrosis

—

Cutaneous burn

—

Peritoneal haemorrhage

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

Haemobilia

—

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

Subcapsular haematoma

—

complications comprised haemorrhage (9 cases), pleural effusion, hepatic or portal vein thrombosis, hepatic infarct, and liver abscess. 40 cases of severe pain with interruption of the procedure were described but not included in the major complications. Tumour seeding along the needle track was observed in

Capsular necrosis

taneous therapeutic option used either for small HCC or for liver

Parietal haematoma

—

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

Haemothorax

—

two different technologies: The expandable needle electrode

Pneumothorax

—

Hepatic abscesses

—

Intestinal perforation

—

Acute cholecystitis

—

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

Acute cholangitis

—

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

Portal vein thrombosis

—

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

Caval vein thrombosis

—

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

Hepatic infarct

—

RF expandable system series (22).

Rapid hepatic decompensation

—

Large biloma

—

Right pleural effusion

—

Tumour seeding

The reported data confirm that RF thermal ablation can be considered at least as safe as PEI for the treatment of liver tumors. Needles and Guidance

Pulmonary embolism

—

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

Diaphragmatic paresis

—

Severe bradycardia

—

Sepsis

—

Common bile duct stenosis

—

Major compl.

74 (6.9%)

50 (2.2%)

8 (4.8%)

theters, needle-electrodes b. Ultrasound guidance is sometimes difficult and may be replaced by computed tomography (CT). Comments

number (rate)

a. Experimental and multicentre studies on fine needles show no effect of needle calibre (23) nor between aspiration and

guidance. Literature survey does not indicate any connec-

cutting needles on procedure related bleeding , whereas the

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

use of large needles has been shown to be associated with an increased complication rate when compared to fine

Precautions to be taken

needles (1-9).

a. Careful patient history, check coagulation tests

b. In most of the series reporting percutaneous biopsies or

b. Choose a safe needle track

therapeutic procedures the guidance of choice has been US,

c. Use fine needles whenever possible

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

d. Reduce the number of needle passes

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

e. Experienced operator

Ultraschall 2004; 25

EFSUMB Newsletter 10

Percutaneous RF cooled Ethanol system Injection (19) (21)

Comments a. A detailed clinical history can sometimes reveal a haemostatic defect even in the presence of normal routine coagulation tests. Coagulation tests which should routinely be evaluated before a percutaneous procedure on deeply located organs include: Prothrombin time, partial prothrombin time, platelet count. The following values are generally considered safe: prothrombin time > 40 per cent, partial prothrombin time < 5 sec above the upper limit, platelet count > 50,000/mm続 (9). Discontinuation of aspirin and anticoagulants (possibly replace by heparin) is advisable before a biopsy, 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 parenchyma has to be carefully evaluated so as to avoid passage through main blood vessels, gallbladder, or colon (16). Systematic check of the needle track with Doppler US can easily identify interposed vessels or vascular lesions misinterpreted 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 procedures are certainly important factors affecting the complication rate of percutaneous biopsies (26). Personal opinion 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 considered a minimally invasive one, should only be performed if it is judged to be of benefit to the patient. It should not be performed 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 intervention). References

Elisabetta Buscarini Gastroenterology Department Ospedale Maggiore Crema, Italy

EFSUMB Newsletter

Ultraschall 2004; 25

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. Ultrasound 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 Gastroenterol 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 complications and deaths due to interventional ultrasonography: a review 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 fine-needle liver biopsy : a multicentre survey of preprocedure evaluation 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 Intervent Radiol 11: 43-46 14 Buscarini L. (1998) Complications of abdominal interventional ultrasound: 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 pancreatic 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: increasing cell dragging during biopsy. Acta Cytol 41: 1246-1249 18 Civardi G, Di Candio G, Giorgio A, Goletti O, Ceraioli T, Filice C, Caremani M, Buscarini L (1998) Ultrasound guided percutaneous drainage of abdominal abscesses in the hands of the clinician: a multicentre Italian Study. Europ J Ultrasound 9: 91-99 19 Di Stasi M, Buscarini L, Livraghi T, Giorgio A, Salmi A, De Sio I, Brunello 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 complication 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 implantation of hepatocellular carcinoma after percutaneous ethanol injection 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 radio-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 publication) 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 technique 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 complications of liver biopsy. Results of nationwide survey in Switzerland. Dig Dis Sci 38:1480-1484

EUROSON 2005 ULTRASCHALL XVII European Congress of Ultrasound in Medicine and Biology 29. Dreil채ndertreffen

Palexpo Congress & Exhibition Centre

Geneva Switzerland

25-28 September 2005 Euroson

2005

Ultraschall

Remember the Date 05 25-28 September 20

4 sites EUROSON 2004, PDF document

EUROSON 2005, PDF document

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 maintenance 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 organizing committee also wishes to highlight the Plenary Lectures and the Opening Ceremony on Sunday 25th and the Young Investigators Award. Ultrasound contrast media will be one of the hot topics. As a special focus, we would like to mention IT (Information Technology), which is developing rapidly in today’s medicine. In close collaboration with the Department of Medical Informatics of the University Hospital of Geneva, which has been a pioneer 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 ultrasonography 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 Airport 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 throughout the city during the Meeting are included in the registration fee. The choice of accommodation includes hotels of all categories. 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 international scientific, humanitarian, cultural and economic institutions 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 enjoyable 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.

Michel Claudon Past President EFSUMB

EFSUMB Newsletter

Ultraschall 2004; 25

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, HitachiMedical-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 Newsletter and on the on the EFSUMB website. If this meeting will be successful a second meeting will be organised in 2005 to adapt these guidelines and provide detailed recommendation for other clinical fields.

EUROSON School EUROSON School on 3D Ultrasound Imaging and the 3D Ultrasound Users Group Meeting April 22nd—24th, 2004 The 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: Hitec@hhnt.org Accreditation applied for from the Royal College of Radiologists 3D Ultrasound Imaging Imperial College Faculty of Medicine, in association with the British Medical Ultrasound Society, is organizing a three day course on 3D Ultrasound Imaging incorporating 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 College (Hammersmith Campus), Du Cane Road, London W12 0HS. E-mail address: k.humphries@ic.ac.uk 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, Hammersmith Hospital, Du Cane Road, London W12 0HS, United Kingdom.

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

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 delegates 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

19.45 Course Dinner:

Sponsorship The Course Organizers gratefully acknowledge the support given to this meeting by Diagnostic Sonar LTD.

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 Obstetric and Gynaecological Applications 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

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

Saturday, April 24th. Obstetric and Gynaecological Applications 08.45 3D ultrasound in the Evaluation of fetal malformations. 09.15 3D face and neck anomalies 09.45 Volume sonography of fetoplacental vessels

“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: Klaus.Dirks@t-online.de www.sonoweb.de

Ultraschall 2004; 25

EFSUMB Newsletter 18

11.15 The Stradx 3D imaging system 11.40 Volume measurements 12.00 Practical Session I: System Demonstrations: basic 3D facilities

EUROSON School International 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

EUROSON School Breast Ultrasound Romania, Craiova, 19—20 September 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 Ultrasound School (LBUS)in conjunction with the Latvian Association of Roentgenologists and Radiologists (LRRA). This seminar is the first comprehensive breast 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 — Australia, Dr Ingrida Slosberga — Latvia, Professor Alexander Mundinger — Germany, 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,- respectively, and € 40,- and € 55,- respectively for members of the Baltic States or Eastern European medical societies

University of Medicine and Pharmacy —Craiova National Society of Oncology Local 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 tumors 20.00—22.00 Reception

For general information visit the IBUS homepage at: http://www.ibus.org or send an E-mail to: Latvia@ibus.org

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 mammography, magnetic resonance imaging and other investigative techniques 17.00—18.00 Final test

Session Topics — Imaging strategies for cancer detection, — Advantages and limitations of imaging modalities, — Differential diagnosis, Interventional procedures, Tumour extension and multifocality,— Screening strategies, Postsurgical imaging, Future directions.

Registration Contact Viorela Enachescu MD. University of Medicine and Pharmacy of Craiova Mail:Stirbei Voda Street, no. 16, 200374 Craiova, Romania E-mail: vemd1@yahoo.com, vemd1@umfcv.ro, Fax: 004.251.562824, Phone: 004.251.533516,/004.251.418291

Seminar Secretariat: Con-Ex Latvia Tours Group, 8 Kalku Str.LV-1050 Riga, Latvia, Tel: +3717085014, Fax: +371 782 0020, E-mail: Vita.Jostina@latviatours.lv

Registration fees

Payment details

Presenting authors: free of charge

Bank Transfer to: FUNDATIA MEDI-

Participants: 100,- €

CINA

Resident doctors: 50,- €

BANCA COMERCIALA "ION TIRIAC"

Accompanying persons: 50 ,- €

Account no: 17.10.121.971.005-EUR 17.10.121.971.009-USD 17.10.121.971.002-ROL

EFSUMB Newsletter

Ultraschall 2004; 25

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, — Benign and malignant ultrasonic diagnostic criteria, Mammographic interpretation criteria, Use of colour Doppler to improve diagnostic accuracy of breast ultrasound, 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, Computer-assisted detection, Quality assurance, guidelines and accreditation, Advances 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

Report On the British Medical Ultrasound Society congress Harrogate — December, 10—12, 2003 For BMUS the highlight of the year is always the Annual Scien-

quality exhibits no doubt encouraged by the substantial prizes

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

on offer for the best.

Many regard this as the start of Christmas and are in appropriate festive mood when they arrive for the conference but this does

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

not prevent very active scientific participation by most.

program. The highlight of the Wednesday evening was an informal evening with an eight piece soul band the Blooze Doctors

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

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

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

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

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

was available.

casions, each meeting being very successful both scientifically

provided by the Annual Dinner at the Majestic Hotel. The

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

Annual Dinner was followed by a very lively Disco which went

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

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

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

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

of Harrogate in the convivial atmosphere of the unique

a different light from the more usual sedate persona they

conference centre with its spiral walkway. Everyone attending

normally show.

The Thursday evening entertainment was

the meeting in Harrogate gets plenty of exercise as there is no feasible alternative means of reaching the lecture theatre apart

No report of the meeting would be complete without comment

from walking up this gentle incline.

on the most extraordinary event of Tuesday evening.

The

President Elect of BMUS locked himself in the bathroom and The meeting itself commenced the following morning with

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

three parallel sessions running throughout the day. Abdominal

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

ultrasound dominated in the main auditorium with a mixture of

escaping from his room. Unfortunately he was foolish enough

other topics including physics, paediatrics, and sonographic is-

to reveal this information to several other members so this will

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

now be recorded for posterity.

were repeated enabling delegates to explore a number of areas of practical ultrasound with advice from experts drawn from far

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

and wide.

mous amount of work from an organizing committee ably led by the aforementioned President Elect but with the Scientific Pro-

The second day of the conference covered a number of obstetric

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

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

nables.

rinary and breast sessions elsewhere. The highlight of the day was the Donald McVicar Brown lecture which this year was

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

given by Professor Francis Duck on the fascinating subject of the

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

heritage and horizons of ultrasound. His lecture covered a wide

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

range of topics including some most unusual devices to en-

cial program and probably more interesting but unpredictable

courage weight loss but culminating in fascinating insights into

events to be recorded.

the future. David Pilling, Past President BMUS The final day of the conference covered more obstetric, physics, vascular, and small parts sessions.

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 Ultraschall 2004; 25

EFSUMB Newsletter 20

Whilst the majority of the meeting consists of guest lectures

DIARY DATES March 20, 2004

June 14—16, 2004

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

XIX European Congress of Perinatal Medicine, Athens, Greece,

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

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

tional Breast Ultrasound School (IBUS) in partnership with the

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

4th European Breast Cancer Conference. CCH Congress Centrum

E-mail: perinatal2004@cnc.gr, Website:www.cnc.gr

Hamburg. Contact: IBUS at info@ibus.org June 17—19, 2004 April 7—9, 2004

EUROSON school on - “Sonography in Gastroenterology”

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

Thurnau near Bayreuth, Germany.

further details and registration forms please contact: Secreta-

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

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

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

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

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

1610 E-mail: hitec@hhnt.org

EE-mailmail: Klaus.Dirks@t-online.de, www.sonoweb.de

April 27—28, 2004

June 20, 2004

NPL International Conference on Advanced Metrology for Ultra-

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

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

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

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

E-mail: bkinney@aium.org; Website: www.aium.org

tion National Physical Laboratory, Queen's Road, Teddington, Middlesex TW11 0LW. +44 (0)20 8943 6581 Fa: +44 (0)20 8614

June 20, 2004

0421 E-mail: adam.shaw@npl.co.uk Web:

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

www.amum2004.npl.co.uk

tact: www.fetalmedicine.com

May 7, 2004

June 20—22, 2004

VIII World Congress of Echocardiography and Vascular Ultra-

Third World Congress in Fetal MedicineVenue: Nicosia, Cyprus

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

Contact: www.fetalmedicine.com

President ISCU, PO Box 323, Gardendale, AL 35071, USA. Tel: + 1 205 934 8256; Fax:+ 1 205 934 6747; E-mail: isuc@iscu.org

August 31, 2004 14th World Congress on Ultrasound in Obstetrics and Gynecol-

May 17, 2004

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

7th Congress of the Asian Federation of Societies for Ultrasound

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

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

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

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

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

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

son@sghms.ac.uk

Medical School, Minamikawachi, Tochiqi-ken 329 0498, Japan. Tel:+ 81 285 587 385; Fax:+ 81 285 448 249; E-mail: itokoiti.@ji-

September 17—18, 2004

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

2004–EUROSON SCHOOL on ADVANCED BREAST IMAGING IBUS–Advanced Breast Imaging Seminar Riga, Latvia. Contact:

May 19, 2004

IBUS Secretariat at info@ibus.org, http://www.ibus.org.

IXth International MASU Congress and International course VeSeptember 19—20, 2004

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

EUROSON SCHOOL–Breast Course–Craiova, Romania. Contact: Prof Radu Badea, Secretary SRUMB, Departamentul de ultra-

June 5—8, 2004

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

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

Cluj-Napoca, Romania, E-mail:badea@mail.dntcj.ro

junction with CSUMB. Contact: hko Lašinska cesta 94, HR – Ultraschall 2004; 25

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

September 23, 2004

234 76 63, E-mail:congress@hko.hr, Web-

ASUM 2004. 34th Annual Scientific Meeting of the Australasian

site:http://www.euroson2004.com

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

EFSUMB Newsletter

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

tralia. Contact: ASUM, 2/181 High Street, Willoughby, NSW, 2068. Tel: +61 2 9958 7655; Fax: +61 2 9958 8002; E-mail: asum@asum.com.au

DIARY DATES October 6—10, 2004

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

Ultraschall 2004–Dreiländertreffen–Hannover Congress Cen-

E-mail: asum@asum.com.au

trum, 30175 Hannover, Germany. Contact: CPO HANSER SERVICE, Hanser & Co GmbH, Zum Ehrenhain 34, 22885 Barsbüttel, Germany, Tel.: +49 40 670 88 20, Fax: +49 40 670 32 83,

—2006—

E-mail:hamburg@cpo-hanser.de May 18, 2006 October 8—9, 2004

X World Congress of Echocardiography and Vascular Ultra-

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

sound. Venue: Marrakesh, Morocco

medicine.com

Contact: Navin C. Nanda, MD, President ISCU, PO Box 323, Gardendale, AL 35071, USA. Tel:+ 1 205 934 8256; Fax:+ 1 205 934

December 8—10, 2004

6747; E-mail: isuc@iscu.org

36th BMUS Annual Scientific Meeting and Exhibition, Manchester international Convention Centre. For further details

May 28 ,2006

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

11th Triennial Congress World Federation for Ultrasound in

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

Medicine and Biology. Venue: Seoul, Korea.

E-mail: secretariat@bmus.org

Contact: Byung Ihn CHOI, M.D., Congress Secretariat, Tel: +82 2 760 2515; Fax: + 82 2 743 6385; E-mail: choibi@radcom.snu.ac.kr; Web:http://www.wfumb2006.com

— 2005— September 22—26, 2006 June 19, 2005

EUROSON 2006, 18th Congress of the European Federation of

AIUM Annual Convention. Venue: Walt Disney World Swan and

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

Dolphin, Orlando, FL USA.

Contact: EFSUMB Secretariat. E-mail:efsumb@efsumb.org

Contact: Brenda Kinney, AIUM, Tel:+ 1-301-498-4100; E-mail: bkinney@aium.org; Website: www.aium.org September 25—28, 2005 EUROSON 2005, 17th EFSUMB Congress: Palexpo, Geneva, Switzerland, in conjunction with the Dreiländertreffen at the Palexpo Geneva. Contact: Scientific Secretariat: Prof François Terrier, Radiologie Hôpital Cantonal Universitaire Genève 1211, Genève 14, Switzerland, Tel : + 41 22 3727001, Fax:+ 41 223727047, E-mail: Francois.Terrier@hcuge.ch 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-

Ultraschall 2004; 25

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