Regina Beets-Tan

Radiologists converge in Vienna for the ECR meeting

July 15, 2022
by Sean Ruck, Contributing Editor
Professor in Oncologic Imaging, Regina Beets-Tan, chair of the Department of Radiology at the Netherlands Cancer Institute in Amsterdam and current president of the European Society of Radiology spoke with HealthCare Business News in advance of the European Congress of Radiology taking place July 13-17 in Vienna. Professor Beets-Tan shared insight on what drives her and what she believes needs to drive radiology in the near and long term.

HCB News: Who or what first inspired you to pursue a career in healthcare?
Regina Beets-Tan: My dad was a medical doctor. So I think that’s the short answer. He inspired me because he was a medical doctor and a very respected leader in church.

HCB News: Did your dad have the opportunity to see you rise through the field?
RBT: No. It’s unfortunate because he would have been so proud. But he died just one month after his retirement and I was just at the start of my residency at the time.

HCB News: He did get the chance to see you following in his footsteps though.
RBT: That’s true. And my mom is still very healthy, and that’s the reason I convinced her to come to ECR, so she can witness this on behalf of my dad. She’s very proud, she is coming.

HCB News: Can you tell us about your background with the European Society of Radiology? How you came to join, how you elevated yourself to the level you’re at now.
RBT: You start as a researcher presenting at ECR. I remember so well my very first scientific presentation at my very first ECR — that was quite an experience. Over the years you grow into the leadership because of a track record that has been built. As faculty or as ESR committee member you show commitment and are given opportunities to take challenging tasks and deliver. The more you show you can deliver the more you’re considered for even more challenging tasks.

I’ve never had the ambition to take seats. The influential positions I was and am now in needs to serve a bigger goal. I have a strategic mind, I’m not so much for details, but if I see something that needs to be changed and there’s the opportunity, I grab it. So for me, the most important thing is my vision, which has been formed since the start of my career in radiology. I was trained as a radiation oncologist, but the radiation oncologists were using conventional X-rays to see the tumor and guide their treatment but we all know the poor soft tissue contrast resolution of X-rays. I knew radiology had better tools — MR scans, CT scans — and I didn’t understand why those images were not used to better guide the radiation treatment. That was 30 years ago. I noticed the gap between the two worlds. I thought about how I was technically oriented and a researcher and I would do much more good if I go to the radiology world and help the radiologist make the bridge to the clinical world. So 30 years ago when I transferred as a radiation oncologist into another specialty in radiology that was my mission. It was to have the radiologist’s role be more than just experts who follow the orders from the clinics, experts who evaluate images using pattern recognition sitting in the dungeon the whole day without any interaction with the referring physicians simply because of the high workload. I did not want to accept that, because I knew that radiologists can add more value to patient care if they can combine the technical knowledge with their knowledge about treatment. But for that, a change needs to happen and radiologists need to become more visible.

Along the path, I started on a smaller scale and grew. First the research, and my research was multidisciplinary. And then, a larger scale, which was my department and collaboration with other departments. Then, a larger scale — two European societies — the European Society of Oncologic Imaging and the European Society of Abdominal Imaging, and I was president of both. And then I was given the opportunity to lead the ESR and I’m grateful that I can, from this position, make the difference.

I don’t see this as a once-in-a-lifetime opportunity. I see it as a way to help kick things off. I think it will take multiple generations, well beyond me. But someone needed to start the change.

HCB News: How long have you been a member of the society?
RBT: I’ve been a member for 25 years or so.

HCB News: So goals you are focused on — increasing the visibility of radiologists and their role in collaboration?
RBT: Yes. And in recent years, it has been more common and has been adopted that the radiologist is in a patient meeting — a multidisciplinary meeting — where the patient is discussed and the radiologists are finally there. Still, we have room for improvement because now, we are only there to show the images. I think what we have to evolve into is a clinical partner that also shares our opinions. For example, if a treatment is proposed, we are an equal partner. We can contribute to the discussion as a spar because our images can direct treatment stratification. This is where I would like radiologists to go — to that area where they feel comfortable being a true partner. I think the radiologist has the knowledge of technology, but if they improve their knowledge of the clinical world, they have the perfect combination. That is the opportunity I see for radiologists. That’s why I ask clinicians to come to our congress. This year, we have 100 clinicians in 100 multidisciplinary sessions — neurologists, cardiologists, thoracic surgeons, etc. — they will all be there. It’s a unique program and my wish is that ECR 2022 will truly kick off a new era in radiology because we need to make this crucial turning point.

HCB News: Are there any developments in the field of radiology that you’re particularly excited about?
RBT: What is very important in radiology is that there will be technical innovations and it will focus not only on machines and diagnostic equipment, but also digital infrastructure and artificial intelligence. Artificial intelligence, like scans, is a tool. But what’s important now is that with our data we finally have in this digital revolution the chance to be more accurate in predicting the response to treatment and predicting the outcome. That is where I believe our society should focus; not only on education on how to interpret the imaging and which technology we should focus on and investigate, but also how can we transform our radiology in such a way that we make use of the digital transformation to the benefit of our patients.

HCB News: I’d like to discuss data a little more. For decades, there’s been all this data gathered with very little done, but with machine learning, information has been getting plugged in more and more to make use of it.
RBT: That is one thing. The other thing is that now is the time to become more of a clinical spar. And that is, of course, feasible, because although the workload is increasing, we have the digital tools to help us. I believe in 10 years’ time the radiologist will perform in a different way. It will be a different radiology practice.

HCB News: With the pandemic still in flux, what does the attendance level look like for the upcoming congress?
RBT: Like all other congresses, the levels are 60 to 70% and the number of parallel tracks are adapted accordingly.

HCB News: Are there any presentations you have a high interest in attending?
RBT: The program highlights are the multidisciplinary sessions; for example: a surgeon, a radiologist, an oncologist each lecturing very briefly (15 minutes) followed by a long panel discussion, a multidisciplinary tumor board case-based discussion. So I have these kinds of sessions throughout.

Another highlight is the Patient in Focus program. So the patient will have the podium for four days to share with us their needs, to share with us how a radiologist should communicate with them.

A third highlight is the Open Forum program. See it as a sort of speaker’s corner at Hyde Park, where people can voice their opinions and interact with speakers.

And a highlight worth mentioning is the roundtable discussions with leaders from different disciplines who will discuss pressing issues in radiology. There will be politicians, clinicians, patients, they will all be in that program.

HCB News: What are some of the issues being faced in European radiology? Do you have issues with reimbursement? Funding for new equipment?
RBT: What is very important are the issues about the increasing costs of healthcare, also because of an increasing use of imaging. Increasing use of imaging means increasing workload for the radiologist, while there is a shortage of radiologists in many countries. So how are we going to deal with that? And the turf battles — between our specialty and others. Meaning, not only do we have diagnostic radiology — that’s OK, everyone accepts diagnosis making is ours — but we have interventional radiology, and with that we’re stepping in the field of the treatment and borders will fade. These are all discussions we have to have because radiology’s role is inevitably changing.

HCB News: What is one of the best pieces of advice you have received as a professional?
RBT: I don’t think I have received it, but it’s in my DNA. When one door closes, another opens and often we spend too much time looking at the closed door so that we miss the open door.