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EFSUMB Newsletter
Fig. 1 Original unenhanced view of the lesion in the pancreatic tail using endoscopic Doppler ultrasound. The rich vascularisation of the tumour is not as impressive as in the 3D reconstruction due to longer scanning time in 3 D mode.
Fig. 2 Clearly hyperenhanced tumour after injection of contrast enhancer in low MI mode. The machine is already set up in 3D data acquiring mode.
Fig. 3 3D Color Doppler reconstruction of the rich vascularisation of a renal cancer metastasis in the pancreatic tail. The normal surrounding tissue is shown in gray colors.
Fig. 4 3D reconstruction of the metastatic lesion after demarcation with help of contrast enhanced low mechanical index endosonography. The normal surrounding pancreatic tissue does not take up the contrast enhancer and therefore remained not visible in the picture.
working diagnosis of a late onset of renal cancer metastasis in the pancreatic tail was made. No further lesions could be shown in further CT and MRI scans and the woman
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could be successfully operated on a second time with confirmation of the diagnosis.
Conclusions ▼▼
The combination of 3D reconstruction with enhanced and unenhancend endoscopic ultrasound seems to be a feasible method to give the investigator and the referring doctor new insights into the anatomy and outer borders of a neoplastic lesion. The advantage of the new method is the small learning curve and the possible combination with any endoscopic ultrasound technique. The disadvantage seems to be the interrupted investigation due to the data aquiring period (in total between 15 and 20 sec.). This means that the advantage of real time contrast enhanced ultrasound has to be compromised. So far using this tool we have to inject two contrast vials, the first time for the dynamic analysis of the lesion and the second time for requiring data for the 3D reconstruction. Developing the low mechanical index endosonography into better scanning quality might outcast the disadvantages and lower the costs. Real time 3D scanner, as already in use in gynecological ultrasound, could improve the method even further. References 1 Dietrich CF. [3D real time contrast enhanced ultrasonography,a new technique]. Rofo 2002; 174(2):160-163. 2 Dietrich CF, Ignee A, Frey H. Contrast-enhanced endoscopic ultrasound with low mechanical index: a new technique. Z Gastroenterol 2005; 43(11):1219-1223. 3 Dietrich CF. Contrast-enhanced low mechanical index endoscopic ultrasound (CELMIEUS). Endoscopy 2009; 41 Suppl 2:E43-E44. 4 Hocke M, Schulze E, Gottschalk P, Topalidis T, Dietrich CF. Contrast-enhanced endoscopic ultrasound in discrimination between focal pancreatitis and pancreatic cancer. World J Gastroenterol 2006; 12(2):246-250. 5 Hocke M, Ignee A, Topalidis T, Stallmach A, Dietrich CF. Contrast-enhanced endosonographic Doppler spectrum analysis is helpful in discrimination between focal chronic pancreatitis and pancreatic cancer. Pancreas 2007; 35(3):286-288. 6 Hocke M, Schmidt C, Zimmer B, Topalidis T, Dietrich CF, Stallmach A. [Contrast enhanced endosonography for improving differential diagnosis between chronic pancreatitis and pancreatic cancer]. Dtsch Med Wochenschr 2008; 133(38):1888-1892.
Michael Hocke, Christoph F Dietrich christoph.dietrich@ckbm.de
EFSUMB Newsletter
Message from Dr Caroline Hong to all EFSUMB Members and Friends of ASUM Caroline Hong
session at the Opera House, and I was given the privilege to give the speech at the Mayor’s reception on behalf of all the international guests at the Copenhagen City Hall. ASUM was represented by 8 speakers, Prof Rob Gibson, Prof Ron Benzie, A/ Prof Amar Trevedi, Dr Talat Uppal, Penny Koh, Vanessa Pincham and Dr Sue Westerway at this congress.
By the time you read this message, I would have said goodbye to many friends of ASUM, including those of EFSUMB, who have supported and worked with me on various common goals for promoting excellence in ultrasound. My first introduction to EFSUMB was through Prof Soren Hanke when I was involved in the bidding for the WFUMB 2009 world ultrasound congress in 2001. Later in 2004, I met a tall handsome charismatic Dane, Dr Christian Nolsøe, who together with another tall handsome charismatic Dane, Prof Michael Bachmann Neilsen, introduced me to the Danish Society for Diagnostic Ultrasound (DSDU). My President at that time was Dr Glenn McNally and we initiated discussions for collaboration between the two societies, (inspired by Princess Mary and Prince Federik). Then in 2005, the ASUM President, Dr David Rogers and I signed a Memorandum of Understanding called CADUCEUS, which is an acronym coined by the well known Prof Ron Benzie, also my former President. CADUCEUS stands for Collaborative Australasian Danish Undertaking of Continuing Education in UltraSound. This program has been running successfully since 2005, with exchange speakers at each other’s annual meetings in Australia, New Zealand and Denmark. Furthermore, we have had several placements of doctors from Denmark in Australia to learn and experience ultrasound practice in our region. The profile of Denmark and EFSUMB is very high in Australia and New Zealand.
My last day at ASUM as Chief Executive Officer is 11 May 2011. I have had 10 wonderful years as ASUM’s inaugural CEO, a career that I will remember fondly with pride and joy. To all EFSUMB members, friends of ASUM, I want to say a big thank you for your friendship and support. The world is small and technology allows us to remain in contact no matter what paths we choose to move on to. There is LinkedIn, Facebook and email. Some are already connected to me in that way. I will continue to advocate for excellence in ultrasound globally in my professional life. My mantra in life is “Passionate to be the difference to make a difference”. I hope I have in some way, being Asian born, Australian educated, being different, have contributed to being a strong ambassador for the goals of ASUM working with DSDU and EFSUMB in the ultrasound world. My successor is Mrs Annie Gibbins, who comes from a strong background in education and nursing. She was National Education Manager for the Orthopaedic Society for nearly 3 years in her most recent role. I wish her every success and I have done my best to ensure that ASUM continues to remain friends of EFSUMB and that the CADUCEUS continues into the future generations. That, I feel, would be a legacy that I would feel proud to have played a part in advocating, nurturing and fostering for DSDU, EFSUMB and ASUM. With warm regards, Dr Caroline Hong ASUM CEO (2001 to 11 May 2011)
It was my proudest moment to be an invited guest speaker at the EFSUMB 2010 congress in Denmark, and where there was a dedicated EUROSON Meet ASUM
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