Conference Scene-1 2:5

Prenatal & Pediatric Imaging, La Timone Children Hospital, 264 Rue Saint-Pierre, 13385 Marseille, France

Corresponding Author:

Guillaume Gorincour
Prenatal & Pediatric Imaging
La Timone Children Hospital
264 Rue Saint-Pierre, 13385 Marseille, France
Tel: +33 491 386 797
Fax: +33 491 387 866
E-mail: guillaume.gorincour@ap-hm.fr

Abstract

Pediatric radiology is changing. Over the years this subspecialty has faced and passed many challenges, including a great vocation crisis. The 33rd Postgraduate Course and 47th Annual Scientific Meeting of the European Society of Paediatric Radiology (ESPR) gave us the opportunity to see that this crisis is being held off thanks to the presence of many young and enthusiastic pediatric radiologists. As it was almost 10 years since the last ESPR meeting in France (Paris, 2001), the French attendance was particularly numerous.

Postgraduate course

The topics presented during the first 2 days of the postgraduate course were very wide: neuropediatric radiology, chest imaging, and heart and vessels, gastrointestinal and genitourinary radiology, and also musculoskeletal and fetal imaging. As far as neuroradiology is concerned, the lectures given by Rutherford (London, UK) on pre- and post-natal injuries of the brain in full-term babies, and by Girard (Marseille, France) regarding cerebral malformations without antenatal diagnosis, which was very original and didactic, were particularly noteworthy. Puderbach (Heidelberg, Germany) presented an illuminating conference on the significance of MRI in the follow-up of cystic fibrosis. Pariente (Paris, France) gave a lecture on how to explore and follow-up chronic liver diseases, with a very promising insight into the future with the elasticity imaging techniques, especially supersonic imaging. New concepts around cystic diseases of the kidney were developed by Avni (Brussels, Belgium), who highlighted the changes that have occurred in the general approach of cystic renal diseases in children and on genetic mutations at the level of the primary cilia, which are considered to be the origin of many renal cystic diseases. Contrast media and sonography in children was discussed by Darge (Philadelphia, USA), who gave a thorough update on voiding urosonography. Wholebody MRI and bone diffusion imaging, very ‘trendy’ topics, were dealt with by Jaramillo (Philadelphia, USA); the only regret could be that whole-body diffusion magnetic resonance was probably not developed enough. As far as prenatal imaging is concerned, the main points and limits for the prenatal diagnosis of posterior fossa malformations were reviewed by Garel (Paris, France), through a didactic and very practical approach (two sonographic slices and six questions). Cassart (Brussels, Belgium) explained how to explore suspected fetal skeletal malformations or bone diseases, with a special emphasis on 3D multidetector CT, with very demonstrative iconography. A state-of-the-art lecture on how to explore and report in children with suspected nonaccidental trauma was brilliantly made by Adamsbaum (Paris, France). Last but not least, a very interesting presentation on the advantages and disadvantages of teleradiology – ‘is teleradiology a solution for the practice of pediatric radiology in the future?’ – was given by Johnson (Cincinnati, OH, USA).

Annual meeting

The annual meeting was held over 2.5 days. A large series of scientific sessions were held. As expected, head and neck sessions were dominated by MRI and its help in tissue characterization, prognosis assessment and treatment follow-up of many conditions (congenital and acquired). Furthermore, as predicted, genitourinary sessions were more ultrasound focused. Nevertheless, two presentations were of note: Paltiel (Boston, MA, USA) presented the preliminary results of contrast-enhanced volumetric ultrasound imaging of tissue perfusion and Arthurs (Cambridge, MA, USA) introduced magnetic resonance voiding cystourethrography for vesicoureteric reflux in unsedated infants, which seems very promising. The interventional session was enlightened by the presentation by Lambot-Juhan (Paris, France) on percutaneous ethanol injection of primary aneurismal bone cysts in children, who proposed a vascular classification. The antenatal scientif ic session was very crowded, reflecting the rising interest in this field. Of note were the works from the French Research Group on Fetal Imaging (GRRIF): Garel demonstrated the improvement of image quality for fetal brain MRI thanks to maternal sedation, while Cassart presented the use of fetal MRI for the analysis of suspected fetal liver conditions. Unsurprisingly, five out of the seven communications concerned MRI in the cardiovascular session, especially 3D and volumetric techniques. CT played the biggest part in the chest session, so I will highlight two original topics: the quantification of collateral blood flow in cystic fibrosis assessed by phasecontrast MRI by Knowlton (Cincinnati, USA) and the use of Doppler sonography in pulmonary consolidations in order to predict the clinical outcome by Yilmaz (Istanbul, Turkey). The gastrointestinal session was discussed widely, particularly in the presentations by Lee (Montreal, Canda) on the long-term outcome of portal-vein discrepancy in pediatric liver transplants and in the talk by Franchi- Abella (Paris, France) on the complications and outcome after closure of congenital portosystemic shunts. The oncology session was almost exclusively dedicated to MRI; nevertheless, one of the most interesting communications was given by McHugh (London, UK), who highlighted worries on the applicability of the Response Evaluation Criteria In Solid Tumors (RECIST) in pediatric rhabdomyosarcoma. A radiation protection session was proposed, pointing out the growing interest of teams from the USA on this topic and challenging the pioneer European leadership. The last sessions regarded musculoskeletal imaging: in particular the tremendous work from the European workgroup on juvenile idiopathic arthritis must be highlighted, which was presented in three brilliant presentations on normal and pathological MRI features.

Symposiums

Needless to say, molecular imaging and functional imaging were at the very heart of these lectures. Claudon (Nancy, France) proposed online tools for European co-operation in magnetic resonance urography studies, molecular pediatric imaging was developed by Brader (Australia), and Hertz-Pannier (Paris, France) shared her great experience in high-field MRI with us.

The highly anticipated Jacques Lefebvre conference was given by Garel (Montreal, QC, Canada) who asked the question: ‘Antenatal imaging: does the postnatal impact justify the effort?’. He enlightened us with a few polemical thoughts raised by his long-lasting practice in fetal imaging.

A very interesting speech was given by Fotter (Austria), to help us structure and organize research in pediatric radiology in partnership with medical teams, adult radiologists and the industry. Low-dose imaging was a ‘hot’ topic where the sessions were co-organized with our partners from the industry (Philips, GE HealthCare, Biospace and Siemes). Dose optimization in pediatric CT, PET-CT, flat-panel technology and EOS whole-body 2D/3D ultra-low-dose devices were examined.

Awards

The ESPR gold medal is an exceptional award recently introduced to recognize a lifetime’s work and outstanding achievements in pediatric radiology in Europe. The 2010 gold medalist was Ulrich Willi, who has held the position of attending physician in major Swiss and American Hospitals, published 24 book chapters and 40 original papers, and has contributed to numerous international symposia.

Four other members of the ESPR were honored:

▪ Veronica Donoghue from Ireland, who was president of ESPR and organizer of the annual meeting in Dublin in 2005;

▪ Freddy Avni from Belgium, who was president of ESPR and organizer of the annual meeting in Brussels in 1994, and has been an honorary member of the French Radiological Society since 2009;

▪ François Diard from France, who is Chateil’s mentor and has very recently retired. He made a tremendous speech dedicated to Chateil’s commitment to both his department and the ESPR;

▪ Paolo Toma from Italy, who was president of ESPR and organizer of the annual meeting in Genoa in 1993.

Future meetings

With about 600 attendees, the 33rd Postgraduate Course and 47th Annual Scientif ic Meeting of the ESPR in Bordeaux, France, 7–11 June 2010, was a great success. The next appointment will be in London, 27–31 May 2011, where the meeting will be organized by Catherine Owens, who will certainly devote her endless energy to the benefit of the future attendees, and Dorothy Bulas, as it will be a conjoined meeting on behalf of both the ESPR and the Society for Pediatric Radiology.

Financial & competing interests disclosure

The author has no relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript. This includes employment, consultancies, honoraria, stock ownership or options, expert testimony, grants or patents received or pending, or royalties.

No writing assistance was utilized in the production of this manuscript.