Radiology fighting COVID-19

Learning objectives 1. To review imaging findings in COVID-19
2. To evaluate pathophysiology of COVID-19
3. To assess the role of D-dimer testing on prognosis and as an indicator for thrombosis
4.To issue guidance on use of D-dimer, additional testing and anticoagulant prophylaxis and treatment

In the first of three episodes dedicated to cardiovascular and workflow issues that radiologists have to face when treating patients with the novel coronavirus disease, Prof. Edwin van Beek will speak about vascular complications in the lung, especially thromboembolism, and how it can be efficiently diagnosed, avoided and treated.

Van Beek is the Chair of Clinical Radiology of the the Scottish Imaging Network - a Platform of Scientific Excellence (SINAPSE) and co-director of "Edinburg Imaging", a Clinical Research Imaging Centre and joint venture between the University of Edinburgh and NHS Lothian.

Description
In the second of three episodes dedicated to cardiovascular and workflow issues that radiologists have to face when treating patients with the novel coronavirus disease, Dr. Thomas C. Kwee will give practical and scientific insights on managing an MRI suite efficiently with the help of abbreviated protocols, as this is essential in settings of constrained resources.

Kwee is a consultant radiologist at the Department of Radiology, Nuclear Medicine, and Molecular Imaging of the University Medical Center Groningen in The Netherlands

Professor Penninger’s lecture “ACE2 – a rational frontline therapy for COVID-19” aims to shed light on the discovery and function of ACE2 – angiotensin converting enzyme 2. The lecture will also cover the relationship between ACE2 and renin–angiotensin system (RAS) – a hormone system responsible for systemic vascular resistance and for regulating blood pressure and fluid-electrolyte balance – in instances of lung injury. Furthermore, the lecture will highlight the predisposition of ACE2 as a SARS-CoV and SARS-CoV-2 receptor.

Prof. Josef Penninger Austrian Professor Dr Josef Penninger is one of the world’s leading geneticists and molecular immunologists. Recipient of numerous prizes, he established the Viennese Institute of Molecular Biotechnology, and is the current Director of the Life Sciences Institute at the University of British Columbia in Canada. The main focus of his work has been autoimmune, bone, and heart and lung diseases, and cancers. APEIRON Biologics AG a company Penninger founded, is currently tackling the ongoing outbreak of COVID-19 in China and is scheduled to start a pilot clinical trial for their newly developed drug that is supposed to decrease mortality in those affected by the virus.

Prof. Nicola Sverzellati from Parma, Italy, made himself available again to answer more of the numerous questions raised by the audience. Joining him in this episode is Prof. Francesco Sardanelli, Professor of Radiology at the University of Milan and Head of Radiology at the Research Hospital (IRCCS) Policlinico San Donato. In an expert interview led by ESR 2nd Vice President, Dr. Adrian Brady from Cork, Ireland, both Italian radiologists will share valuable insights on imaging workflows, as well as staff protection, prevention measures and department management based on their own experiences during the ongoing outbreak, with their own regions being among the most affected areas in Europe to date.

This episode of the ESR Connect Special Reports is dedicated to supporting the imaging community and addressing questions and challenges during the current COVID-19 pandemic. This special session features two renowned chest radiologists from France and Spain, who will share their unique country perspectives as well as practical and institutional experiences during these challenging times.

Building on previous sessions related to imaging findings and appropriate use of modalities, this episode will focus on practical imaging equipment issues and recommendations on how to maintain radiology services in terms of equipment and operation for non-COVID patients during the pandemic.

This episode is brought to you in collaboration with the International Atomic Energy Agency (IAEA) and the International Society of Radiology (ISR). It is a great pleasure to welcome Dr. May Abdel-Wahab, Director of the IAEA’s Division of Human Health, who will provide the introductory statement and set the scene for this important discussion.

Prof. Marie-Pierre Revel, Professor of Radiology from Paris, France, will present the recently published advice from the ESR and the European Society of Thoracic Imaging (ESTI) entitled “COVID-19 patients and the Radiology Department”. Prof. Revel will highlight France’s experience in relation to practical imaging equipment issues and address considerations for the upkeep of imaging services for non-COVID-19 patients during this pandemic. Providing Spain’s views and experiences for these significant considerations, we will be joined by Prof. Marcelo Sanchez Gonzalez, Professor of Radiology from Barcelona, Spain, for his unique country perspective.

The moderator for this episode will again be ESR 2nd Vice President, Dr. Adrian Brady from Cork, Ireland, who will facilitate an exciting Q&A segment, providing our virtual audience with the opportunity to ask questions that may not have been addressed in previous sessions.

In collaboration with the International Atomic Energy Agency (IAEA) and International Society of Radiology (ISR)

This episode of ESR Connect Special Reports will focus on how collaboration across professions and specialties is the key factor in managing the challenges posed at healthcare systems during the coronavirus pandemic. Two main topics will be covered: structured reporting, in times of crisis an even more important tool to enhance collaboration with other departments, as well as how to ensure safe workflows for patients and staff alike, based on the experience in a metropolis’ radiology department.

Anagha Parkar, chest radiologist from Bergen, Norway, will explain the structured report proposal as presented in the ESR-ESTI advice paper, and how recognising and identifying the COVID-19 pattern will enable swifter recognition and aid clinicians to triage these patients. Radiologists must not only be aware of these findings, but also report findings and level of confidence of the presence or absence of typical COVID-19 findings in their structured reports.

Felix Döllinger, chest radiologist and in charge for hygiene measures in the radiology department of Charité Berlin, together with David Günther, leading radiographer at the same institution, will share their experience in how to prepare for a crisis like this, and how to ensure safe workflows. They will give valuable insights into multi-professional approaches and collaboration from one of the biggest hospitals in Europe, and on the German COVID-19 measures and strategies.

In this episode of "ESR Connect - Radiology fighting COVID-19", European experts will discuss how artificial intelligence can be used to support radiologists in coping with the challenges of this pandemic. Moderated by Helmut Prosch, Professor of Radiology specialised in chest imaging from the Medical University Vienna, Angel Alberich-Bayarri (Valencia, Spain) and Georg Langs (Vienna, Austria) will give an up-to-date educational overview of the challenges, benefits and pitfalls in the development of AI algorithms in general, and will present their personal experience in this field.

Angel Alberich-Bayarri is a biomedical engineer by training and founder of QUIBIM, a spin-off company of the La Fe Research Institute in Valencia, dedicated to quantitative imaging biomarkers in medicine. He will explain how AI and radiomics can be tools for the detection and follow-up of COVID-19.

Head of the Computational Image Analysis and Radiology Lab (CIR) at the Medical University of Vienna, Georg Langs is a trained mathematician and computer scientist. His research focusses on machine learning and medical image analysis, and he will present a European multicenter trial currently being set up together with his university’s spin-off company contextflow that will help predict the course of COVID in patients.

This episode of "ESR Connect - Radiology fighting COVID-19", will focus on the benefits and challenges in the development and implementation of new protocols and guidelines in times of the COVID-19 crisis. Standardisation, evidence and quality assurance are fundamental to modern, high-class health care, but the current pandemic shows that time can be our biggest enemy, putting immense pressure on health care providers. How can we make sure to adapt to a new problem not only as quickly as possible but also as accurately as possible?

Moderator Helmut Prosch, Professor of Radiology at the Medical University Vienna, will welcome two chest imaging experts from world-renowned institutions to share their first-hand experience in developing and implementing new protocols and guidelines in their departments.

Professor Michelle Ginsberg, chief of thoracic imaging at the Memorial Sloan Kettering Cancer Center in New York will speak on the developments in the US’ most affected area of the past weeks, and how MSKCC was challenged to adapt its routines as cancer center to the new circumstances.

Dr. Arlette E. Odink is chair of chest radiology at the Erasmus Medical Center in Rotterdam, and will share her experience in coordinating guidelines and protocol development and implementation in her department, as well as on Dutch national level.

The 7th episode of ESR Connect dedicated to radiology’s fight against COVID-19 will focus on the complications the new disease can bring to patients, as they potentially cause massive challenges in diagnosis and treatment to health care providers.

In an expert discussion with 3 radiologists from hospitals treating many COVID-19 patients over the last weeks, moderated by Helmut Prosch, Professor of Radiology at the Medical University Vienna, they will speak about imaging aspects of acute respiratory distress syndrome (ARDS), pulmonary embolism, and neurological complications in COVID-19 patients.

Mickaël Ohana is a radiologist at the Strasbourg University Hospital, and professor of radiology at the University of Strasbourg, specialized in non-invasive cardiovascular and chest imaging. He will speak about ARDS, and how imaging can play a role in the long-term follow-up.

Professor of practice in thoracic imaging Anand Devaraj from Imperial College London’s National Heart and Lung Institute, is a consultant radiologist at the Royal Brompton Hospital in London. He will share his insights on imaging pulmonary embolism in the context of COVID-19.

Myriam Edjlali-Goujon is a neuroradiologist at Hôpital Raymond-Poincaré, Paris-Saclay University, France and will report on her experience with neurological complications in COVID-19 patients, and how imaging can play a central role in their management.

Together with moderator Helmut Prosch, Professor of Radiology at the Medical University Vienna, three speakers from highly affected areas across Europe will not only summarise what was learned from the coronavirus outbreak, but also how it will in the future impact the daily routine in radiology departments worldwide.

Lukas Ebner is the leading thoracic radiologist at the Inselspital Berne, Switzerland. He will speak on current recommendations, give a brief overview on imaging findings on chest radiographs which show low sensitivity in early COVID-19; however, in more advanced cases, radiographs are usually abnormal at presentation. He will discuss the general role of radiography as well as benefits and pitfalls of CT versus radiography in consideration of local disease management, health care policies and resources.

Senior lecturer and radiographer at the Homerton University Hospital and the Canterbury Christ Church University in Canterbury, United Kingdom, Nick Woznitza was much affected in his work life by COVID-19 over the last weeks. He will explain the British Society of Thoracic Imaging’s Radiology Decision Support Tool, and share his experience on how imaging findings have an impact on daily workflows of radiographers. He will also summarize how radiographers can keep patients and colleagues safe.

Together with moderator Helmut Prosch, Professor of Radiology at the Medical University Vienna, three speakers from highly affected areas across Europe will not only summarise what was learned from the coronavirus outbreak, but also how it will in the future impact the daily routine in radiology departments worldwide.

Lukas Ebner is the leading thoracic radiologist at the Inselspital Berne, Switzerland. He will speak on current recommendations, give a brief overview on imaging findings on chest radiographs which show low sensitivity in early COVID-19; however, in more advanced cases, radiographs are usually abnormal at presentation. He will discuss the general role of radiography as well as benefits and pitfalls of CT versus radiography in consideration of local disease management, health care policies and resources.

Senior lecturer and radiographer at the Homerton University Hospital and the Canterbury Christ Church University in Canterbury, United Kingdom, Nick Woznitza was much affected in his work life by COVID-19 over the last weeks. He will explain the British Society of Thoracic Imaging’s Radiology Decision Support Tool, and share his experience on how imaging findings have an impact on daily workflows of radiographers. He will also summarize how radiographers can keep patients and colleagues safe.

In collaboration with the EFRS

In this episode of ESR Connect, a world-class multidisciplinary panel of experts will discuss the status quo of lung, breast and colorectal cancer screening programmes in Europe, how patients were affected by the COVID-19 pandemic, and how can programmes be restarted now.

The episode will be hosted by one of the leading oncologic imagers in Europe, Regina Beets-Tan from The Netherlands Cancer Institute, currently 1st Vice-President of ESR and a board member of ECCO (European Cancer Organisation) as well as member of the EU Cancer mission board.

Hans-Ulrich Kauczor, professor of radiology at the Heidelberg University Hospital and the German Centre for Lung Research, will give an overview of the current recommendations for lung cancer screening he has co-published in a European expert panel last year, and why it is important to do screening the right way and under the right circumstances. He will also report on how the pandemic influenced ongoing screening programmes in different countries and how they will cope with the new circumstances.

Professor of radiology at Lund University, Sweden, Sophia Zackrisson is one of the leading scientists in her field and will speak about the status quo of breast screening, the potential role of digital breast tomosynthesis and other imaging modalities, and if artificial intelligence can be of assistance. Zackrisson, who holds a PhD in epidemiology and has initiated several clinical and epidemiological studies in cancer imaging, will also describe Sweden’s experience with COVID-19 and discuss how breast screening programmes can be brought to full capacity again.

Evelien Dekker is a gastroenterologist at the Amsterdam University Medical Centers location AMC and a professor of gastrointestinal oncology at the University of Amsterdam. She is a world renown expert in her field and will provide insight on her research on screening methods for colorectal cancer. Dekker will also report on the effects of the COVID-crisis on the Dutch screening program for colorectal cancer, a programme for which she has been advisor for over a decade, and share the lessons taken from it for the future.

In collaboration with the European Cancer Organisation

In this episode of ESR Connect, experts from The Netherlands and Switzerland will report on how cancer care is normally organised, which changes occurred during the acute phase of the coronavirus pandemic, and what mental challenges patients and staff faced.

Hosted by Regina Beets-Tan from The Netherlands Cancer Institute, a leading oncologic imager in Europe, the experience of a clinician and a radiologist will be shared, as well as an update on the EU Cancer Mission board, of which Beets-Tan is a member.

Gabe Sonke is a medical oncologist specialised in female cancers at The Netherlands Cancer Institute. He will present data on COVID-19 in cancer patients, effects on their prognosis and complications that arose due to co-infection, as well as how cancer care is currently organised and what will have to be learned from the experience of the last months. Sonke will also report on his patients’ perspective and their experience of additional psychological burden caused by COVID-19.

Radiologist Andreas Gutzeit from Hirslanden Klinik St. Anna in Lucerne, Switzerland, will explain how imaging services can be maintained under challenging conditions based on his experience with cancer patients under diagnosis or therapy during the acute COVID-19 phase. He will underline the importance of hygiene measures to protect immunocompromised patients and put into perspective different measures taken in China and Europe. Gutzeit will also speak about the psychological stress the staff experienced during the times of crisis, and why it should not be neglected.