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20:21 CET
EM 2 - From morphology to function
Management/Leadership Interventional Radiology Education Research
Friday, March 1, 10:30 - 12:00
Room: A
Type of session: ESR meets Italy
Topic: Management/Leadership, Interventional Radiology, Education, Research
Moderators: L. E. Derchi (Genoa/IT), R. Grassi (Naples/IT)

Introduction: Radiology in Italy
C. Bibbolino; Rome/IT
Learning Objectives

1. To describe the most important features of Italian radiology.
2. To reflect on new developments of imaging in Italy and Europe.
3. To discuss the role and function of a systemic vision of a radiological society.


The Italian Society of Medical Radiology (SIRM) counts about 11,000 members. It is Italy’s largest scientific society and one of the largest in Europe. Its members include nearly all the radiologists working in Italian hospitals and public or privately owned health facilities, self-employed, residents and retirees. It is organised in twenty regional groups and twenty subspecialty sections. According to the OECD data, Italian Radiology runs more than 2,000 CT scanners and 1,715 MRI scanners, of which only 30% are less than five years old. A recent SIRM census showed that approx. 120,000,000 X-ray, US, CT and MRI examinations are performed every year. Many of the examinations mentioned above are not included in the figures published by the OECD and the Italian Ministry of Health. However, they cause problems of appropriateness and overdiagnosis. Many regional health services have general radiological archiving systems creating important databases. In Italy US investigations are performed by physicians: CT examinations are thus fewer than in countries where US scannings are performed by ultrasound technicians. Mammographic screening covers >70% of the female population between 50 and 70 years whereas screening of the lung and colon is routinely carried out only in some regions. In negotiations with the government and the owners of health facilities, the National Union of Radiologists counting more than 3,500 members represents the Italian radiologists. In 2016, SIRM supported Choosing Wisely by hosting the 3rd World Meeting in its Training Center in via del Cardello 24, Rome, near the Colosseum.

Italian emergency network
V. Miele; Florence/IT
Learning Objectives

1. To review the organisation of the emergency system.
2. To highlight the strengths and weaknesses of the emergency network regarding epidemiological factors, topographic features and territorial distribution of resources.
3. To define the possible areas of clinical improvement and organisational effectiveness of the emergency health system.


Italy’s healthcare system is a regionally organised National Health Service that provides universal coverage largely free of charge for Italian citizens. The request for emergency diagnostic and therapeutic services is constantly growing, due to both clinical and epidemiological factors, such as the increasing amount of traumatic events and non-traumatic clinical emergencies. Moreover, there is an overcrowding of the Emergency system, due to the fact that patients with minor health problems are also taken into care, in case of lack of immediate response in the territorial health system. In the care of emergency patients, diagnostic imaging has a very important role, so the majority of patients accessing the Emergency Department performs at least one diagnostic examination, mandatory to decide the care path (immediate treatment, hospitalisation or discharge). The availability of Department of Radiology staffed on a 24-hours a day for emergencies greatly influences the diagnostic performance. Generally, the regional emergency service is organised in specialised centres (“hub”), which are equipped and staffed to provide care for patients suffering from major traumatic and non-traumatic emergencies. In traumatic emergencies, Major trauma Centers (MTCs) are directly connected with peripherals, radially diffused, trauma units (“spokes”) that don’t provide major trauma care but still play an essential role in less severely injured patients. Despite the longer transport times, this envolves, triage of major trauma patients to an MTC results in a 30% decrease in mortality in the first 48 h compared with transport to a non-MTC, which may be the closest medical facility.

Interlude: The sirens: myth or reality?
R. Grassi; Naples/IT
Emergency interventional radiology: brain and body
G. Carrafiello; Varese/IT
Learning Objectives

1. To learn about indications.
2. To learn about techniques.
3. To discuss literature and personal experiences.


The demand for all types of radiological imaging and intervention on a 24-hour, seven days a week basis has increased significantly in recent years. The term ’24-hour radiological imaging services’ applies equally to elective and acute services.
Interventional techniques are now at the forefront of management of many life-threatening emergencies. Stopping haemorrhage (eg, trauma, gastrointestinal (GI) bleeding, post-partum haemorrhage), thoracic-abdominal aortic aneurysm, traumatic dissection and the complications of Type B dissection, ruptured peripheral aneurysms, acute peripheral and visceral ischaemia,
managing sepsis secondary to upper urinary tract and biliary obstruction (often urgent though rarely an emergency), image-guided intervention in subarachnoid haemorrhage and stroke, are the situations where urgent or emergency interventional radiology is indicated. Formal arrangements to secure provision of elective and emergency interventional radiology services are guaranteed in less than 10% of hospitals. These hospitals must be the reference for traumatic patients and stroke. Remnant hospitals should have contacts with closer invertional radiology services.

Interlude: The cyclops: myth or reality?
R. Grassi; Naples/IT
La Radiologia Medica: the role of the journal in an international setting
A. Giovagnoni; Ancona/IT
Learning Objectives

1. To learn about the organisation of the journal as the official organ of the SIRM.
2. To discuss the strengths and weaknesses of an international, general radiology scientific journal.
3. To consolidate knowledge and to explore future prospects in the international editorial scenario.


La Radiologia Medica is the official Scientific Journal of SIRM founded in 1914 that has inaugurated a new publishing season with the scope of becoming a reference point in the panorama of the major international Journal and a tool for constant and timely updating for members. Starting from January 2014, one hundred years after its foundation, the Journal has renewed its editorial model, equating it with that of major international journals with a monthly frequency in a version online in the English language. The new publishing model, has entered into full acceptance of the SIRM Members and has allowed a series of positive practical repercussions: the reduction of production costs, increase of foreign authorship a greater visibility and penetration within the international scientific / radiological community; greater citability with a consequent positive effect on the value of the IF. The contribution of foreign authors which amounted to 62% of the total submitted manuscripts. The selection of manuscripts is accurate and the percentage of rejection rate, in progressive growth, has reached a value of 67% with a constant increase of the IF which has reached the value of about 1.9. La Radiologia Medica represents one of the most important assets of the SIRM.

Panel discussion: How will the radiologists' profession evolve?
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