My User Area
MyUserArea

Education

CONCERNS ABOUT SAFETY OF GADOLINIUM-BASED CONTRAST AGENTS (GBCAs)

A controversial debate about the safety of GBCAs recently prompted the European Medicines Agency and the U.S. Food and Drug Administration (see documents: FDA, EMA, ISMRM), to consider the clinical use of GBCAs in MRI. EUSOBI consider that indications for contrast-enhanced breast MRI as defined in our recommendations (Breast MRI: guidelines from the European Society of Breast Imaging and Breast MRI: EUSOBI Recommendations for women’s information) are still valid, and we believe that no breast MRI examination should be cancelled because the advantages (diagnosing breast cancer) clearly outweigh the possible problems contrast material could cause. We will modify our approach in the light of new evidence if appropriate.

Publications

Published book

We are happy to announce the book, ‘Screening & Beyond’, created especially for the International Day of Radiology.

It is packed with information provided by many of the world’s top experts on breast imaging, including member of EUSOBI – European Society of Breast Imaging, the Society of Breast Imaging, ESTRO, European Institute for Biomedical Imaging Research and EUROPA DONNA – The European Breast Cancer Coalition

Published papers

A survey by the European Society of Breast Imaging on the utilisation of breast MRI in clinical practice.
Clauser P, Mann R, Athanasiou A, Prosch H, Pinker K, Dietzel M, Helbich TH, Fuchsjäger M, Camps-Herrero J, Sardanelli F, Forrai G, Baltzer PAT.
Eur Radiol. 2017 Nov 22. doi: 10.1007/s00330-017-5121-4
PMID:29168005

Mammography: an update of the EUSOBI recommendations on information for women.
Sardanelli F, Fallenberg EM, Clauser P, Trimboli RM, Camps-Herrero J, Helbich TH, Forrai G; European Society of Breast Imaging (EUSOBI), with language review by Europa Donna–The European Breast Cancer Coalition.
Insights Imaging. 2017 Feb;8(1):11-18. doi: 10.1007/s13244-016-0531-4. Epub 2016 Nov 16.
PMID:27854006

Position paper on screening for breast cancer by the European Society of Breast Imaging (EUSOBI) and 30 national breast radiology bodies from Austria, Belgium, Bosnia and Herzegovina, Bulgaria, Croatia, Czech Republic, Denmark, Estonia, Finland, France, Germany, Greece, Hungary, Iceland, Ireland, Italy, Israel, Lithuania, Moldova, The Netherlands, Norway, Poland, Portugal, Romania, Serbia, Slovakia, Spain, Sweden, Switzerland and Turkey.
Sardanelli F, Aase HS, Álvarez M, Azavedo E, Baarslag HJ, Balleyguier C, Baltzer PA, Beslagic V, Bick U, Bogdanovic-Stojanovic D, Briediene R, Brkljacic B, Camps Herrero J, Colin C, Cornford E, Danes J, de Geer G, Esen G, Evans A, Fuchsjaeger MH, Gilbert FJ, Graf O, Hargaden G, Helbich TH, Heywang-Köbrunner SH, Ivanov V, Jónsson Á, Kuhl CK, Lisencu EC, Luczynska E, Mann RM, Marques JC, Martincich L, Mortier M, Müller-Schimpfle M, Ormandi K, Panizza P, Pediconi F, Pijnappel RM, Pinker K, Rissanen T, Rotaru N, Saguatti G, Sella T, Slobodníková J, Talk M, Taourel P, Trimboli RM, Vejborg I, Vourtsis A, Forrai G.
Eur Radiol. 2017 Jul;27(7):2737-2743. doi: 10.1007/s00330-016-4612-z. Epub 2016 Nov 2.
PMID:27807699

Breast MRI: EUSOBI recommendations for women’s information.
Mann RM, Balleyguier C, Baltzer PA, Bick U, Colin C, Cornford E, Evans A, Fallenberg E, Forrai G, Fuchsjäger MH, Gilbert FJ, Helbich TH, Heywang-Köbrunner SH, Camps-Herrero J, Kuhl CK, Martincich L, Pediconi F, Panizza P, Pina LJ, Pijnappel RM, Pinker-Domenig K, Skaane P, Sardanelli F; European Society of Breast Imaging (EUSOBI), with language review by Europa Donna–The European Breast Cancer Coalition.
Eur Radiol. 2015 Dec;25(12):3669-78. doi: 10.1007/s00330-015-3807-z. Epub 2015 May 23. Review.
PMID:26002130

Mammography: EUSOBI recommendations for women’s information.
Sardanelli F, Helbich TH; European Society of Breast Imaging (EUSOBI).
Insights Imaging. 2012 Feb;3(1):7-10. doi: 10.1007/s13244-011-0127-y. Epub 2011 Oct 28.
PMID:22695994

Breast MRI: guidelines from the European Society of Breast Imaging.
Mann RM, Kuhl CK, Kinkel K, Boetes C.
Eur Radiol. 2008 Jul;18(7):1307-18. doi: 10.1007/s00330-008-0863-7. Epub 2008 Apr 4. No abstract available.
PMID:18389253

Guidelines from the European Society of Breast Imaging for diagnostic interventional breast procedures.
Wallis M, Tardivon A, Helbich T, Schreer I; European Society of Breast Imaging.
Eur Radiol. 2007 Feb;17(2):581-8. Review. Erratum in: Eur Radiol. 2007 Feb;17(2):589. Tarvidon, Anne [corrected to Tardivon, Anne].
PMID:17013595

Press release
September 22, 2016: EUSOBI Annual Scientific Meeting to kick off in Paris tomorrow

Thursday, September 22, 2016 (EUSOBI) – The European Society of Breast Imaging (EUSOBI) will hold its Annual Scientific Meeting in Paris, La Villette, in collaboration with the Society of Female Imaging – Société d’Imagerie de la Femme (SIFEM) on September 23–24, 2016. A breast magnetic resonance imaging (MRI) course for radiologists is also being held in advance on September 21–22.

Some 660 registered participants are expected to attend this year’s Annual Meeting, confirming a continuously increasing number of attendees over the years.

EUSOBI offers a balanced programme with cutting-edge science and good everyday practice. The Paris meeting will be a perfect opportunity to meet and exchange knowledge with experts and breast radiologists, as well as related companies from all over Europe and beyond.

The EUSOBI National Societies Network is made up of 29 countries. The first position paper from this large group of breast radiology societies will be published in European Radiology in October 2016, addressing the fundamental role of screening mammography for reducing the breast cancer mortality. EUSOBI unequivocally recommends all women to attend screening, according to their countries’ protocols.

This year, the 30th anniversary of contrast-enhanced breast MRI (1986–2016) will be celebrated with the EUSOBI Gold Medal Lecture delivered by Prof. Sylvia Heywang-Köbrunner, who was the first to report on this excellent diagnostic method in 1986. The Keynote Lecture will be delivered by Prof. Hedvig Hricak (Chairman of the Department of Radiology, Memorial Sloan-Kettering Cancer Center, New York, USA) on oncologic imaging in clinical decision making. The President of the U.S. Society of Breast Imaging, Prof. Elizabeth Morris (Chief of Breast Imaging at the Memorial Sloan-Kettering Cancer Center, New York, USA), will present the latest research and achievements in metastatic breast cancer.

The ‘Best way to screen’ session will tackle a hot topic as the debate on breast screening continues while the ‘Cutting edge’ and ‘B3 management’ sessions will include the latest scientific achievements. EUSOBI is currently focusing on breast MRI as this method already plays a major role in daily care, therapy planning and determining disease prognosis.

The EUSOBI Young Club will welcome its new active members at the special young scientists’ session, where the Young Investigator Award will be handed over and the best submitted poster abstracts will be presented.

EUSOBI will announce its new ‘5 points against breast cancer’ in Paris:

  • In Europe, there are slightly different breast screening protocols in every country, but one statement is uniform: mammography saves lives and life quality – it can decrease breast cancer death by up to 40%.
  • One in five breast cancers occur in women below 50, so screening should start before this age, at least at 45.
  • 45% of breast cancers and related deaths occur in women at 65 and over. One in three breast cancers occur in women over 70, so screening should not stop at this age, but continue at least up to 75.
  • If a woman has breast symptoms, the breast radiologist is the doctor to meet – he/she integrates all diagnostic techniques in order to give the most accurate information on breast health status e. g. cancer disease.
  • The woman’s risk profile matters: personalised screening protocols may include ultrasound and/or MRI – but should always be interpreted together with mammography.
Recommended articles

Digital breast tomosynthesis (DBT): a review of the evidence for use as a screening tool
Gilbert FJ, Tucker L, Young KC
Clinical Radiology. 2016 Feb;71(2):141-50. doi: 10.1016/j.crad.2015.11.008

Guidelines

ESR European Training Curriculum for Subspecialisation in Radiology

Ask the expert

Do you have a question on breast cancer?

Ask an expert via the EUSOBI Homepage! Our panel of experts in all the fields of breast will answer all of your questions. Share your thoughts with us on either breast imaging techniques, imaging interpretation, diagnosis, treatment, follow up or on research issues.

We are collecting your questions and publish them right here:

Is MRI indicated in patients >80 with bilateral breast cancer?

YES:
If surgical candidate with either dense breast/ suspicion of multifocality/-centricity on conventional imaging (with equivocal findings on conventional imaging).
If neoadjuvant chemotherapy planned
If not surgical candidate and neoendocrine treatment planned if MRI is tolerated (otherwise US)

NO:
Bilateral mastectomy planned
Non-dense breast with unifocal cancer/ no suspicion of multifocality/-centricity on conventional imaging
Obviously, in case of contraindications to MRI or contrast agent administration

answered by R. Mann, K. Pinker-Domenig and P. Clauser

A focus or focal area of NME on MRI breast that is separate to the known primary cancer in the context of a patient with known breast cancer, how does one manage it?

In case of a focus (enhancing lesion < 5 mm), it is important to make sure that there is no correlate in the pre-contrast and in the T2-weighted images that might help with further characterization towards a small suspicious mass or benign lesion. In the absence of a correlate on T1 and T2 weighted sequence, the symmetry should be evaluated: diffuse, symmetric foci  are in general expression of diffuse benign changes in the breast.

In case of a single focus or focal non mass enhancement, there is only a little number of findings specific for a benign diagnosis. Small intralesional cysts, high ADC values and homogeneous and persistent enhancement curves suggest a benign finding. In the clinical context of cancer staging, it is very important whether the additional finding may be oncologically relevant (thus, discuss the impact on the therapy with the team). In many cases, such findings represent B3 lesions which e.g. in case of adjuvant radiation therapy and antihormonal therapy may be oncologically well treated without dedicated surgery. It is a difficult and case-by-case decision to biopsy such lesions or not (thus, all imaging and clinical information should be considered).

answered by P. Baltzer and P. Clauser

Does linear-ductal non mass stippled enhancement always have to enhance in the direction of the nipple to be considered worrisome...or is it possible that this type of worrisome non mass enhancement can configure in a direction away from the nipple?

Linear enhancement is most frequently intraductal in origin, and consequently follows the ductal structure of the breast.

The term stippled however does no longer exist, as stippled enhancement has been grouped with background parenchymal enhancement.

In the area of non-mass enhancement you might encounter a focal area of enhancement or regional enhancement that does not conform to a ductal tree structure. These may still be worrysome as they may be caused by diffusely growing infiltrative tumors (e.g. lobulars). In most of the cases you will find more features pointing in the direction of cancer (i.e. exceptionally rapid enhancement and wash-out, edema, low adc values, etc.)

answered by R.M. Mann

News

Submit breast related news and publications here.

Journals

EUSOBI has an affiliation with the following medical journals:

European Radiology

The flagship journal of the European Society of Radiology (ESR) continuously updates scientific knowledge in clinical radiology by publishing original research articles of general interest and importance as well as state-of-the-art reviews, and short communications written by leading radiologists.

Members of the ESR receive free electronic access to the journal, which is Europe’s No.1 journal for general radiology.

More information at www.european-radiology.org

European Radiology Experimental

The youngest member of the ESR journal family concentrates on basic scientific discoveries, novel approaches and techniques in experimental settings in the field of medical imaging. It is an online gold open access journal.

Article Processing Charges for publication in European Radiology Experimental are covered for all corresponding authors who are active members of the ESR.

More information at www.er-x.org

Insights into Imaging

This online gold open access journal specialises on critical reviews, guidelines and policy statements, and is dedicated to education and strategies in radiology.

Article Processing Charges for publication in Insights into Imaging are covered for all corresponding authors who are active members of the ESR.

More information at www.i3-journal.org

Fellowship

The rapid increase in the demand for imaging women with symptoms and for population screening means that there is a need to sufficiently train further young radiologists to render confident diagnosis in breast imaging and intervention using all modalities. This has led the European Society of Radiology (ESR) and the European Society of Breast Imaging (EUSOBI) to take the initiative in establishing an exchange programme for fellowships or subspecialisation training in breast imaging.

Application for 2018 is closed.

For further information please refer to the ESOR website.

Aim

Breast Imaging is at the heart of modern management of breast disease which aims to make a clear cut diagnosis as promptly as possible to discharge women with benign disease and make a non operative diagnosis of cancer. The programme offers an opportunity to complement subspecialisation training in breast imaging or an existing structured fellowship programme, through exchange. During three months of training the trainee will be provided with intense modular training in breast imaging and will be supervised by a specialised tutor in a pre-selected, highly esteemed, academic training centre in Europe.

The programme is aimed at board-certified radiologists within the first three years after certification who desire to become radiologists with a subspecialist interest in breast imaging.

Number of available places

During 2018, three such programmes will be offered and organised through ESOR and the successful applicant will receive a grant jointly provided from ESR/ESOR and EUSOBI.

Eligibility
  • This programme applies to radiologists within the first three years after certification, who desire to become subspecialist radiologists in breast imaging.
  • Core training in clinical radiology in line with national training scheme and in accordance with ESR syllabus. This should include core experience in breast imaging.
  • Applicants must be proficient in English.
  • ESR and EUSOBI membership fees for 2018 must be settled.

Applicants who were successful in the past cannot be considered for a second time.

 

Duration of fellowship and funding

The training will start in the second half of the year and last for 3 months. The fellow will receive a grant upon completion of the training and delivery of a final report. During the period of the training the fellow is responsible to cover their expenses and his/her own health insurance. The training itself is offered for free.

Programme structure

Based on a weekly training programme, the trainee will familiarise his/herself with all aspects of breast imaging and intervention by case-by-case hands-on teaching on routine clinical cases provided by an experienced staff. The trainee will design a personalised programme with his/her tutor to cover areas that will be most useful to his/her anticipated practice, ie referral-based imaging, screening, interventional or MRI. At the end of the training programme the trainee would be expected to have developed a sound knowledge in subspecialty breast disease on which further training and experience may be built-up.

In non-native English speaking training centres teaching would be in English, while major radiological conferences and reporting may be in the local language. Some knowledge of the local language may be an advantage.

The trainee will be able to observe clinical activities, but will not have direct patient care responsibilities.

It is the trainee’s responsibility to communicate with the centre regarding the details of the training and whether more responsibilities than observer status can be obtained. ESOR solely acts as facilitator and coordinator between the training centre and the trainee.

Certification

After successful completion of the three months training the trainee receives a certificate from ESR/ESOR and EUSOBI. In order to receive this, the fellow must present a written report about his/her work and activities during the programme.

Scholarship

Application for 2018 is closed.

For further information please refer to the ESOR website.

Aim

The ESOR Visiting Scholarship Programme (Europe) offers qualified trainees the opportunity to get to know another training environment and to kick off an interest for subspecialisation in radiology. During three months of training the scholars will be provided with a structured, modular introduction to different subspecialties and will be supervised by a specialised tutor in a pre-selected, highly esteemed academic training centre in Europe.

Number of available scholarships

During 2018, up to 36 scholarships are available on different topics and will be realised in partnership with Bracco and ESR. One additional scholarship for Spanish radiologists will be offered in partnership with the Spanish Foundation of Radiology. Furthermore, two of the available scholarships will be provided for residents from Ukraine within the ESR Support Initiative.

Eligibility
  • These scholarships apply to residents in their 3rd, 4th or 5th year of training in radiology who desire to get the benefit of a mentored modular training of a specific subspecialised topic in radiology.
  • Completion of the training curriculum from at least the first two years of residency is required, verified by the head of the department. Competence in producing a radiological report and communicating with clinicians and patients is appreciated, as well as knowledge of the principles of administration and management applied to a clinical department with multi-disciplinary staff and high-cost equipment.
  • Previous exposure in any field of special interest, including basic knowledge of imaging methods, indications for imaging and clinical expectations, is advantageous.
  • Applicants must be proficient in English.
  • ESR membership fees for 2018 must be settled.

Applicants who were selected for this programme or the Visiting Scholarship Programme USA in the past cannot be considered again.

 

Duration of scholarship and funding

The training will start in the second half of the year and last for three months. The scholar will receive a grant upon completion of the training and delivery of a final report. During the period of the training the scholar is responsible to cover their expenses and his/her own health insurance. The training itself is offered for free.

Programme structure

The programme offers a structured modular training in a highly esteemed training centre. The trainee will have the opportunity to follow and participate in the core knowledge training programme through tutorials and lectures, followed by hands-on teaching on routine clinical cases and/or modality techniques and protocols, led by an assigned tutor.

In non-native English speaking training centres teaching would be in English, while major radiological conferences and reporting may be in the local language. Some knowledge of the local language may be an advantage.

The trainee will be able to observe clinical activities, but will not have direct patient care responsibilities.

It is the trainee’s responsibility to communicate with the centre regarding the details of the training and whether more responsibilities than observer status can be obtained. ESOR solely acts as facilitator and coordinator between the training centre and the trainee.

Certification

After completion of the training programme, the resident receives a certificate from ESR/ESOR. In order to receive this, the scholar must present a written report about his/her work and activities during the programme.