Dear friends and colleagues!

Dear Imaging Informatics passionates!

It’s s my pleasure and a privilege to serve as the President of European Society of Medical Imaging Informatics, in a great team of like-minded professionals. The board includes representatives of radiology departments, hospitals, universities, startup companies  and professional societies. This allows us having a balanced view on the development of Imaging informatics.

The society is growing. Now we almost have 100 members and every week there are more enthusiasts joining the society . 

In 2017 we have had a very successful meeting in Rotterdam at the Erasmus Medical Center, hosted by Gabriel Kristin and Wiro Niessen. It brought together more than 150 participants. 

We presented regular webinars on the emerging topics in imaging informatics. On April 21, 2018 we are organising a hands-on workshop on Computer Vision at the Radboud UMC in Nijmegen, NL. 

On our website you can find the links to our activities, presentations and publications. Quite soon, probably at the RSNA 2018, you will be able to find our Springer book on Artificial Intelligence in Medical Imaging, authored and edited by EuSoMII members and other renowned authors.

On October 27, 2018 we will have an Annual Meeting at the Erasmus MC in Rotterdam, NL. Please register on our website with the reduced price.

Our society is partnering with Society for Imaging Informatics in Medicine (SIIM). We are planning our first joint meeting in Reykjavik, Iceland in September 2019.

You are very welcome to join EuSoMII, and to grow with the team of like-minded professionals and next generation of experts in imaging informatics !

Sergey Morozov

Game Changers in Radiology

Peter van Ooijen, Hans Mekenkamp

Jointly organised with SIIM, ErasmusMC, MedicalPHIT and ISfTeH, the EuSoMII Academy 2017 took place in Rotterdam, Netherlands, on the 18th of November 2017, in the stunning Education Centre of the Erasmus Medical Center. More than 150 attendees from both Europe and US. A unique occasion to present, learn and discuss the practical applications of medical imaging informatics, being inspired by visionary speakers like Eliot Siegel.

The day started with a session on the strategic view on radiology evolution. Presentations by Elliot Siegel and Paul Suetens learned that in future healthcare there will be a large role for advanced artificial intelligence tools. However, the role of the radiologist is not over, there will still be a need for the radiology professional provided that the new developments and possibilities are embraced and implemented such that they increase the added value of the radiologist in the healthcare process. To achieve this, radiologists should utilize the tools and become more involved in the treatment of the patient.

In the second session, Bram van Ginneken, Ben Glocker and Raym Geis provided background information on how Machine Learning works. They showed that although many interesting applications of machine learning arise, it is still far from perfect. However, both in the image analysis and the procedural management of radiology a large role is seen for Machine Learning.

Third, a more broad insight into the radiological environment in which AI plays its role was sketched by presentations from Bernard Gibaud, Daniel Pinto Dos Santos, Jacob Visser and Peter van Ooijen. This environment is also dynamic and constantly changing with the increased need of big data and thus image sharing in large (imaging) biobanks, the increased demand of a more structured approach to reporting and the shift to more value based healthcare in radiology. In parallel with all these developments, rules and regulations are having a major effect on the actual application and implementation. The implementation of innovative technology like AI plays an important role in value based radiology. When computer assistance has been adopted in the right way the radiologist can increasingly focus on the patient.

In the open panel discussion that ended the day, some of the presenters debated with industry representatives about the future of AI in radiology. Conclusion: AI will effect mainstream radiology. Embrace the new technology is the advice for all radiology professionals and patients!

All in all, the EuSoMII Academy of 2017 was a big success and we are planning on making this into a yearly event in Rotterdam where hot topics in Medical Imaging Informatics will be covered in a one or two day Academy setting. Hope to see you there!

Medical Imaging Informatics training in Europe

Erik R. Ranschaert, Peter van Ooijen

Abstract

In the context of the ongoing fast digitisation of healthcare organisations, many radiology departments are confronted with a growing need for expertise in imaging informatics. The number of possibilities to use medical images in a healthcare system is increasing, as is the complexity of managing the sharing of this digital information.

The EuSoMII wants to promote  the idea of recognising imaging informatics as a subspecialty in radiology, and supports the concept of making it part of the European Training Curriculum.

Imaging Informatics: definition and evolution

The growing convergence of patient data and computer science applications is creating new opportunities for delivering higher quality patient care through better management and availability of information. Therefore the importance of Health informatics is increasing In every hospital and health-related organization. Almost simultaneously with the advent of electronic health records came the use of digital technology to analyse medical images. Imaging informatics, also sometimes referred to as radiology informatics or medical imaging informatics, concerns how medical images are used and exchanged throughout complex healthcare systems. Nowadays virtually every healthcare clinical discipline depends on imaging informatics (1).

To cope with the growing demand for knowledge in this specific domain, the accreditation of “Certified Imaging Informatics Professional” (CIIP) was launched by the American Board of Imaging Informatics (ABII). The ABII was founded as a result of a collaborative effort between the Society of Imaging Informatics in Medicine (SIIM) and the American Registry of Radiologic Technologists (ARRT). The main purpose of this certificate is to provide recognition to qualified professionals in the successful implementation and management of Picture Archiving and Communication Systems (PACS). ABII is the organisation administering the IIP exam, since 2007. The ABII does not have a direct role in the training and education of the CIIP candidates however. An analogous situation can be seen in the relationship between the American Board of Radiology which is the main accreditation body for radiologists, and the American College of Radiology, the American Roentgen Ray Society, and the RSNA, which together share responsibility for the educational, advocacy, and political missions. Therefore educational and networking initiatives are currently undertaken by the SIIM (2, 3).

The EuSoMII thinks that this kind of training is necessary, also for European radiologists. As Prof. Morozov stated: If radiologists have to learn about the physics of MRI then I think learning about the basic principles of imaging informatics (PACS, RIS, networking, standards, IHE, Artificial Intelligence) is at least as important.”

However, despite the growing importance of Imaging Informatics as a discipline or subspecialty in radiology, no specific curriculum or training is available yet for radiology residents on a European level. Since 2017 the RSNA and SIIM are jointly organising a week-long online course called the National Imaging Informatics Curriculum and Course (NIIC), which unfortunately is not accessible for European residents (4). The EuSoMII has actively participated in the revision of the European Training Curriculum (ETC) for subspecialisation in radiology, in which Imaging Informatics is recognised as a subspecialty. Therefore the EuSoMII board wanted to explore the value of the SIIM-training and ABII-examination for European senior residents and radiologists, and to see if its content could possibly help in defining the ETC requirements. Both Dr. Sergey Morozov and Dr. Erik Ranschaert successfully obtained their CIIP degree in 2017. A few questions about the value of this test were asked to them and to Dr. Mansoor Fatehi and Dr. Laurens Topff, two other EuSoMII members that earlier obtained the certificate as IIP.  

According to Dr. Morozov “…giving radiologists the opportunity to obtain a certificate such as the CIIP would certainly facilitate collaboration and communication between all parties and would undoubtedly positively contribute to the further management of radiology departments and be in favor of providing better services to patients”. Also Dr Topff thinks that radiologists have to play a role in the rapidly evolving field of imaging informatics and that radiologists who understand the fundamentals of imaging informatics can improve the efficiency and accuracy of their daily work. He thinks that studying to obtain the CIIP certification is a good way to become familiar with these basic concepts. The SIIM provides an interesting webinar bootcamp to help master the required technical and business skills for the exam. For Dr. Morozov the bootcamp material was very valuable for preparing the examination, since it helps to structure the student’s knowledge.

 

When asked if residents should obtain the CIIP, both Dr. Morozov and Dr. Ranschaert think that only senior residents should participate. Dr. Topff confirms that it’s possible to take this test as a senior resident, which he also did. It provided him with a good introduction and foundation in imaging informatics to build upon. Thus obtaining the certificate should really be regarded as a subspecialty training that can only be completed after a few years of experience in the field. 

Moreover quite some information is irrelevant for EU-based residents or radiologists, because it’s referring to existing US legislation and regulations, which means that the training material should be adapted for European residents. Following Dr Ranschaert and Dr. Morozov it could be interesting for European radiologists to obtain this kind of certificate since it would facilitate the communication with the IT department and improve radiologists’ skills to manage a radiology department, which nowadays is highly dependent on Informatics. 

The IIP certification is targeting a broad audience of PACS administrators, technologists, IT professionals and physicians. The EuSoMII participants agree that it would be interesting to have a similar European type of certification, for which the training should provide a more profound and practical IT-knowledge to radiology residents. Ideally this training should be easily accessible for residents, which could be obtained by providing it through a digital platform similar to the NIIC.

Further developments

The EuSoMII has applied to the European Society of Radiology board in 2016 to introduce a new sub-specialty ‘Imaging Informatics’. As a result, a new ESR subcommittee has been established with the purposes of fostering the clinical adoption of IT and computer science techniques. The content of the ETC for radiology has also been updated with the requirements for an imaging informatics subspecialty.

Currently, the ESR leadership is discussing the establishment of the dedicated certification for the Clinical Imaging Informatics subspecialty. ECR 2018 and ECR 2019 will introduce a wide spectrum of IT, AI and computer science both in teaching courses and scientific sessions. The EuSoMII is also fostering its collaboration with the SIIM, which might result in a further collaboration for organizing an online teaching platform in imaging informatics.

References

Integrating Data in the Structured Report

Daniel Pinto dos Santos
Structured reporting has been around for decades now; however, it is still not well integrated in radiologists’ daily practice. Aside from the well-known benefits structured reporting has for the communication with referring clinicians, it also offers possibilities to easily integrate data from other sources – which is difficult in today’s narrative reports.

The discussion on how radiology reports should be written has been around for over a decade now. However, since the first documented written radiology reports at the end of the 19th century, little has changed. Reports are still mainly written as narrative texts, that follow only little form and do not share a standardized language.

Nowadays, with medical care becoming ever more data-driven this unstructured form of composing radiological reports has some relevant shortcomings. Not only is the information contained in the reports hard to access for further computer-based evaluation, but also the automated transfer of data, e.g. numerical measurements, is difficult to implement.

In order to streamline workflows in radiology and to improve radiological report throughput and quality structured reporting could prove a key technology. In structured reporting as outlined by the RSNA’s Radiology Reporting Initiative radiology reports are generated using dedicated report templates. These templates are provided according to a standard (IHE MRRT) as HTML-files, that users can potentially integrate into their reporting software to create standardized and structured reports. From a technological point of view, this offers the possibility to not only extract the information from the respective template fields, but also to merge data from different sources into the corresponding parts of the template.

Studies have shown, that the automated transfer of information into radiological reports has the potential to reduce the time needed to complete a report and significantly reduces errors due to faulty transfer of measurements to the mostly dictated report. In a pilot implementation at the University Medical Center of Mainz we were able to show that the automated transfer of measurements provided as DICOM-SR from the ultrasound machine to the corresponding report template is easily feasible (Fig. 1). Moreover, as the template also provided some conditional logic to classify the degree of stenosis of the internal carotid artery according to its peak systolic velocity, radiologists needed only minimal interaction with the reporting system in order to finalize the report.

Similarly, other data from different sources could be integrated into structured reports, e.g. data from the electronic health record or laboratory subsystems. Such structured reports could potentially provide referring physicians with more accurate and complete information and radiologists with the opportunity to more easily mine the information contained.

Especially in the context of new emerging technologies such as machine learning, having the data contained in a radiological report stored in databases as discrete pieces of information could prove vital. In this scenario, the data easily could be used as valid annotations for specific cases, maybe even linked to specific images. But also in less complex situations, such as auditing for quality control or retrospective analyses, an easily minable database of radiological reports would greatly help the process (Fig. 2).

While the benefits of structured reporting are well known and accepted, its widespread implementation in clinical routine still lags behind. Apart from some radiologists being reluctant to change their accustomed ways of reporting, a major challenge is to convince vendors that there is a need for practical solutions that allow for structured reporting to be easily and interoperably integrated into their systems.

EuSoMII, as a society heavily involved in health informatics, supports other society’s statements that structured reporting should finally be implemented in radiologists’ daily practice. With the advent of more advanced technologies especially in the field of computer vision, radiologists need to understand the value of the data contained in their images as well as their reports and transition from a role as mere image interpreters to a more complex role as image and data scientists.

Visit us at ECR 2018. Take a picture in our booth: a nice surprise is waiting for you!

Become a Member now, benefit from the ECR 2018 promotional fee of 10 Euro (from February 26th – March 5th).

We are about to reach one hundred members: Member #100 will receive a 50% discount for EuSoMII Workshop and Annual Meeting. Hurry up!

If you are interested in Imaging Informatics, don’t miss our Board Members lectures during ECR 2018!

Sergey Morozov, Erik Ranschaert, Emanuele Neri, Daniel Pinto do Santos, Elmar Kotter , Peter van Ooijen, Nadya Pyatigorskaya,Wiro Niessen, Mansoor Fatehi, Angel Alberich-Bayarri, Francesca Coppola, Annalisa Trianni.

What are the benefits of joining
EuSoMII?

Daniel Pinto dos Santos

Why join yet another scientific society? EuSoMII like only few other
societies has its special focus on recently emerging technologies like social
media, telemedicine, and imaging informatics in medicine and radiology in
particular. Especially younger members are encouraged to engage in the
community and actively take part in the societies projects.

The answer to the question what the benefits of joining EuSoMII are may very well vary according to your personal starting point. But whether you are only vaguely interested in the field of medical imaging informatics but willing to learn more about it or already an expert in DICOM or deep learning wanting to engage with others, EuSoMII strives to connect clinical radiologists, data scientists and informatics experts across Europe.

Since its beginnings as EuroPACS the society has undergone quite some transformations and has managed to keep up the pace with technical developments. From using social media to promote exchange and engagement in the community, to telemedicine applications, structured reporting, imaging biomarkers and machine learning, EuSoMII tries to cover all modern technologies that will surely shape radiology’s future.

But to make things short, here are some key benefits you receive as member of EuSoMII

Scientific meetings

EuSoMII will be organizing Annual Meetings with a special focus on educational lectures as well as scientific presentations each year and a number of hands-on-workshops and academies. As a member, you receive special discounted rates and timely notifications.

Webinars

Monthly webinars are held where experts in the field will be presenting on a variety of relevant topics. You will be able to participate in those webinars, get in touch with the experts and have your questions answered. In addition, as a member you will have unlimited and free access to all recordings of the webinars.

News

Follow us on social media and additionally receive a regular newsletter. As a member, you will have access to the complete newsletter and be able to take part in discussions with the authors.

Contacts

Get involved! Shape the future of radiology! As a society, we strongly encourage members to engage in the community. Whether it be during a meeting or online, scientific exchange and collaboration is becoming more and more important, especially within the field of imaging informatics.

EuSoMII also provides a special possibility for younger members, to become involved in a scientific society or to have their works promoted. We are always happy to discuss new ideas, share expertise and provide a platform for new members to contribute to the field.

Contact us!

Feel free to ask questions.

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