The European Congress of Radiology (ECR) is taking place March 1-5 in Vienna, and in many ways it’s a meeting that hopes to mark a return to normalcy. DOTmed spoke to Adrian Brady, president of the European Society of Radiology (ESR) to learn more about his background in medicine, and what people can expect at the meeting.

HCB News: Who or what inspired you to pursue a career in healthcare?
Adrian Brady: I didn’t have a family history in medicine. My parents did other things, but I was a nerdy kid, and from the moment I started studying science, and particularly biology, in secondary school, it clicked in my head that I loved this. Within biology, it was human biology that interested me most. So, in a way, I made life easy for my parents, because by age 12 I decided I wanted to be a doctor and I never deviated from that, and some substantial number of decades after that I have not regretted it.

HCB News: What are the main goals you are championing as ESR president?
AB:What I want to see, first and foremost, is a successful congress. The last couple of years have been strange for everybody. The COVID pandemic changed a lot of what we did, and the society leadership and office staff pivoted wonderfully to manage how we function. I want to see us return to doing what we’ve been very good at for decades now, which is providing comprehensive education to radiologists, and comprehensive updates for those who are subspecialists in their practice.

So, it’s like that old phrase, “if it ain’t broke don’t fix it”. I don’t want to change what is a wonderful structure, I want to see us return to the success of the congress, get people back in Vienna in March, and make it worth their while to be there. If we are successful in March, we will be successful this year as a society.

At the same time, there’s much more to our society than just the congress. Our European School of Radiology (ESOR), for example, traditionally provided education on a face-to-face basis with many fellowships and many courses throughout the academic year. All of that had to shift online and then, more recently, into a hybrid format. I suspect we may never go back to doing things precisely as we used to, but I’m glad to see the ESOR is very active again this year and is increasing our outreach. That’s another measure of success, a fully functioning school curriculum and agenda.

HCB News: Are there any developments within the field of radiology over the last 12 months that you’re particularly excited about?
AB:Ways of working have changed. Two years ago, we were talking about how COVID looked on imaging. Last year we talked about the long-term implications of COVID, imaging findings that would indicate long COVID, and sought out information on the pathophysiology. I think this year we may be talking about how adapting to COVID has influenced the way radiologists work.

For instance, the increase in remote provision of service, the increase in teleradiology: how has that changed the way radiologists think about their work-life balance and how they do their jobs?

Also, how do we manage the continually increasing demand for our services without getting burnt out? There is a mismatch between workload and workforce in many European countries; how will that be handled? The ESR has tried to consider how value can be measured and created in radiology, and I think the experience of recent years has made people think about this more.

In terms of modalities and tools, probably one of the hottest topics is photon-counting CT. We are having some sessions on that and I know there will be more research on that in the coming years.

HCB News: What can attendees expect at this year's ECR?
AB: I’m hoping they can expect crowded halls and lots of exciting things happening simultaneously. In terms of weather, it will unfortunately be very different than our meeting last July.

In terms of experiencing the congress, attendees will see a little more integration of technical exhibits and scientific exhibits than we’ve had in years past. Previously, we’ve had more of a division between those sides of the congress, but we’re making it easier for delegates to interact with technical exhibitors if they choose to do so. There will be more integration of the public spaces, so you won’t have to go as far to get from one area to another.

HCB News: Are there any presentations you are particularly interested in?
AB: In terms of presentations, the theme of this year is The Cycle of Life. I wanted to look at radiology in the round and consider the ubiquity of radiologic involvement in healthcare from the beginning of life to the end, and even going a little beyond those two extremes.

If someone is interested in antenatal imaging, there will be sessions on that. If someone is interested in post-mortem imaging, there will be sessions on that. Likewise, if someone is interested in radiology in the adolescent or the elderly patient, there will be themed sessions for all of this that will be clearly marked in the programme, so people can easily follow particular aspects of radiologic value creation and use at particular times of life.

We will also have some presentations concerning radiology’s role in archeology and paleontology, forensic imaging, sessions on contributions of radiology to art, assessments of artistic works and historic musical instruments, things that show aspects of the technology someone might not otherwise think about.

HCB News: What are some of the issues being faced in European radiology?
AB: There’s the workforce issue. We’re currently running a project called EU-REST that’s looking at all the education and training necessary in all of the specialties and professions using ionizing radiation. We want to better understand workload, and the impact of workforce availability. The underpinning of how work is done differs hugely across Europe, so we’re trying to gather data to find out exactly how things are done in all EU 27 member states. In the end, we will hopefully be writing recommendations for the European Commission on improving the state of play in those countries where the staffing numbers are too low, and perhaps work on implementing some standards. So, that’s a project that excites me. We’re still in the early phase of data gathering, but I think it will be very helpful to countries that are less well staffed than others.

Appropriate use of imaging is another major issue. The EU-JUST-CT project, winding up in 12 months, is identifying how much CT requesting across Europe is appropriate according to guidelines. We will be able to improve the use of guidelines once the project has reported. Along those lines, we’re also distributing the ESR iGuide, our clinical decision support software, that helps clinicians and radiologists make the right decisions.

A multidisciplinary approach to medicine is another big one, because most of us work in multidisciplinary environments and if we don’t understand what our referring colleagues want from us, we won’t be able to give them what they need. Likewise, if they don’t understand how we do our jobs and what we’re capable of delivering, they may not make the best use of us when they request studies. So, multidisciplinary teams are key to a better future, and we will be rolling out initiatives to try and enhance that over the coming year.

HCB News: What is one of the best pieces of advice you have received as a professional?
AB:Two pieces of advice. One concerns how we don’t always get it right, and how we can’t always be expected to get it right. I’ve been quite interested in what people sometimes call “errors” in radiology. I like to think of them more as “discrepancies.”

Often in medicine, if things don’t turn out the way we expect them to turn out, we look back in hindsight and think we could have done something differently. We tend to be very self-critical. However, there is a huge amount of research that shows you cannot be right all the time. Medicine, and radiology in particular, is not a binary process. It is much more complex than that. We must allow ourselves to understand imperfection and not beat ourselves up over things that are reflections of humanity and the world in which we live.

Another one, that was given to me when I was a trainee: don’t expect that the radiology you practice in 10 years will be anything like the radiology we’re teaching you today.

I think that’s been true in every decade of my professional life. New modalities come along, with new capabilities, and you need to be open to new things. Keep up to date, because much of what you learned previously will be superseded by different ways of doing things, so embrace that.