A Message from the President of the CAR

Strengthening our Pan-Canadian Voice

When I wrote my first message to you as President of the CAR in the spring of 2011, I shared that although the challenges we face as a profession were somewhat daunting, I believed the CAR is better positioned now than it ever has been as a national specialty organization to address them. A year and a half into my term, I have been privileged to see the CAR national position strengthen.

In the last year we have been active on the national and international stage in many ways. Some of the areas we have been involved in are: (check out our 2011 Annual Report for others) partnering with other national bodies like the Canadian Medical Association to hold a Canadian Clinical Practice Guidelines Summit; providing input through the Wait Time Alliance to the Senate Committee on Social Affairs, Science and Technology for its review of the 2004 Health Accord; participating with a dozen international organizations on imaging guidelines being considered by the World Health Organization; holding the first ever Canadian Medical Imaging Team Day with five of our colleague associations; participating in the national clinical practice guidelines project initiated by the Council of Federation of premiers; and supporting provincial associations with statements on issues they faced within their province.

In addition, we are also currently involved in, among others, the creation of lifecycle of medical imaging technology guidance and wait time benchmarks for CT and MRI. Watch for these in 2013!

Recently, we held an event for our CAR Industry Partners at which we had valuable discussions on the future of general radiology, quality issues for imaging and advocating for radiology. You will read more about these important discussions in future messages. We were also pleased to be joined at that event by Mr. Jean Pruneau, Executive Director of the Office of Pharmaceutical Management Strategies of Health Canada (which also includes technology). He highlighted the federal government’s pan-Canadian approach to healthcare, the need for federal, provincial, and territorial jurisdictions to work closely together, respecting each other’s roles. I mention this as this mirrors what we see as the CAR approach in working with our provincial radiology association colleagues on issues related to medical imaging. To this end, it has been a focus of my presidency to further enhance communications between the CAR and provincial radiology associations as well as with other national radiology leadership groups including the Canadian Heads of Academic Radiology (CHAR) and the Canadian Radiology Program Directors.

The issues we face are no less challenging today than they were when I started as your president; in fact, they are more challenging in some areas. However, if we are to have any influence on the issues, we must advocate on them in one unified voice. The reality is that issues that arise in one province almost always eventually arise in other provinces. The best current examples of areas in which we see this unfolding are the funding quagmire that radiology in Ontario has been navigating and the mandate for a province-wide peer review program that British Columbia is moving forward. The CAR continues to support provincial association efforts in these areas; their leadership in these areas provincially can have important implications nationally.

We listened when you, our members, emphasized in our 2011 membership survey that advocacy in these and other areas must be a key role of the CAR. Working with a national public relations firm, the CAR is currently unfolding a national advocacy strategy, of which a key component will be working with our fellow provincial associations.

When speaking on behalf of the CAR, I often use the analogy of the issues facing radiology as a “perfect storm.” The way I see it is that we are facing some very intimidating challenges, a perfect storm of them that we may feel at times will capsize us. I believe, however, that with threat comes opportunity. If we work together we can brighten our skies into a strong future for radiology. Easy? No. Possible? Yes, with a strong and engaged CAR membership.

We believe any achievements we make require both the more seasoned of us as radiologists working alongside new radiologists and residents. It is the future of radiology that we need to guide after all. It is with this in mind that the CAR continues to expand its outreach and programming for radiology residents. Read more on some of those efforts in this e-publication, and let’s encourage residents and new radiologists to become active in the CAR.

As we wind down a busy 2012, I encourage you to sign up now for your 2013 CAR membership. We are making a difference and I am excited about the direction we will take in 2013. You can sign up as a 2013 CAR member at www.car.ca/en/membership.

In order to fine-tune our regular messages to you, we are also pleased to introduce to you this new e-publication format. Our publication title Beyond the Image was chosen recognizing that much of what we do as radiologists and the issues we face go beyond the imaging studies before us each day. As a physician, I am, in the words of the Royal College of Physicians and Surgeons, not only a medical expert but also a communicator, collaborator, professional, scholar, manager and health advocate. With that in mind, the CAR continues to promote the need for radiologists to be a visible and integral member of the healthcare team, and our commitment remains helping us all to navigate radiology issues and opportunities. We hope this new e-publication format will allow you to easily read through our news. If you have any feedback on the new format please email Tania Da Costa at [email protected].

Finally, we hope to see you at our annual CAR RSNA Canadian Reception which will be held on Sunday, November 25, 6:30-8:00 p.m. in the Adams Ballroom of the Palmer House Hilton Hotel (yes, the Grey Cup game will again be aired). The Reception has become one of the best Canadian opportunities to network of the year!

Sincerely,

 

 

 

 

Dr. James Fraser
President, Canadian Association of Radiologists

New CAR Diagnostic Imaging Referral Guidelines

Over the course of 2012, the CAR has updated and released nine of the CAR Diagnostic Imaging Referral Guidelines; they include:

The CAR Diagnostic Imaging Referral Guidelines are:

The reference guide outlining the recommendations, the level of evidence and dose, will soon be available.

2013 CAR Membership

It is increasingly critical that we lead Canadian radiology towards a bright future, by proactively taking charge of our profession and showing ourselves to be medical leaders. The CAR leads through its quality initiatives, which serve to sustain and protect the profession of radiology while advancing the best imaging care possible for patients. Just some of the many initiatives the CAR undertook in 2012 include:

With our 2012-2016 strategic plan well underway, the CAR has been working hard on moving closer to our main strategic goals in the areas of: advocacy; quality, safety and patient care; member engagement; and organizational resilience. Our primary focus has been on building the CAR's advocacy efforts on behalf of our profession. The CAR must be our united voice at this critical time. To learn more about the CAR strategic goals visit www.car.ca/uploads/about/overview.
The 2013 CAR membership fee for a full CAR member is $780.00, a modest increase over the previous year to reflect the year-on-year increase in the cost of doing business. For more information on the different member dues and categories, click here.
The earlier you pay your dues, the easier it is for the CAR to plan for our many endeavours slated for 2013. Paying by March ensures no interruption in the delivery of your CAR Journal and entitles full members to vote at our Annual General Meeting in April.
You may select one of the following options to pay your 2013 CAR dues:

We look forward to counting on your support in 2013!

Reminder! The CAR Canadian Reception at the RSNA

The CAR invites you to one of its most anticipated events of the year: the CAR Canadian Reception at the RSNA. The event gives Canadian radiologists the opportunity to come together with fellow Canadian radiologists during one of the world's leading radiological events.
The reception will be held on Sunday, November 25 from 6:30 to 8:00 p.m. in the Adams Ballroom of the Palmer House Hilton Hotel, 17 East Monroe Street, Chicago, Illinois. As the event coincides with one of the great Canadian sporting events of the year, the CAR is pleased to provide coverage of the Canadian Football League's 100th Grey Cup.
Those wishing to attend are asked to contact Louise St-Amand at [email protected] or at 613 860-3111, ext. 212. Please remember to specify whether you will be accompanied by guests or colleagues. We look forward to seeing you there!

First Annual International Day of Radiology

Thursday November 8 was International Day of Radiology (IDoR). This special day marked the 117th anniversary of the discovery of the X-ray by German physicist, Wilhelm Röntgen, and the tremendous advances in patient care made possible by radiation therapy and medical imaging exams.
The mission of this day is to build greater awareness of the value of radiology research, diagnosis and treatment in patient care and the vital role of radiologists in healthcare delivery. It is sponsored by the American College of Radiology, the European Society of Radiology and the Radiological Society of North America.
The CAR joined more than 66 medical societies in 38 countries around the world in taking part in the November 8 IDoR commemoration.
For additional information regarding IDoR, visit www.idor2012.com.

The IDoR initiative is similar in nature to the Canadian Medical Imaging Team Day (MITD), a day set aside to honour the work of the team of healthcare professionals who collaborate to improve the health of Canadians, ensuring that the appropriate diagnostic imaging tests are performed and interpreted expertly, with the highest standard of patient safety, comfort and care. MITD is a collaborative effort between the CAR, the Canadian Association of Medical Radiation Technologists, the Canadian Association of Nuclear Medicine, the Canadian Interventional Radiology Association, the Canadian Organization of Medical Physicists, and the Canadian Society of Diagnostic Medical Sonographers. Look out for updates on the 2013 MITD.

Residents' Corner

We would like to welcome all radiology residents to the CAR! Your university program directors have generously paid for your membership into your national professional association. Don't forget to take advantage of the benefits that come along with being a member, such as reduced rates to the CAR Annual Scientific Meeting (ASM) and accessing the CAR Journal online. Simply contact the CAR to obtain your CAR member ID, and then log in to the CARJ website using your CAR member ID and creating a password.

As part of the CAR 76th Annual Scientific Meeting, several outstanding opportunities have been developed specifically for residents, including:

 
2012 Radiologists-in-Training Reception
The ASM is also a great way to network and partake in lectures from some of radiology's leading national and international experts.

We hope to see you all there!

Call for Nominations – 2013 CAR Gold Medal and Young Investigator Awards

The CAR is now accepting all nominations for the 2013 CAR Gold Medal Award as well as the 2013 CAR Young Investigator Award.

The CAR Gold Medal Award represents the highest award that lies within the power of the CAR to bestow upon a CAR member for his or her distinguished and extraordinary service to the CAR and to the discipline of radiology. These achievements can be demonstrated through teaching, basic research, clinical investigation or radiologic statesmanship.

In 2012, the recipient of the CAR Gold Medal Award was Dr. Louise Samson for her illustrious career in radiology, her determination as an innovative and open-minded leader, and for her invaluable and tireless contributions to medical education and to the Canadian Association of Radiologists.

For more information on the CAR Gold Medal Award and the process of nomination, visit www.car.ca/en/education/awards/gold-medal.

The CAR Young Investigator Award represents the highest award that lies within the power of the CAR to bestow upon a young researcher, with no more than 10 years of practice since completing residency or fellowship, for medical imaging related research. This research is recognized by the CAR for quality and consistency in the early phases of a career.

In 2012, Dr. Jonathan Leipsic was the recipient of the Young Investigator Award. He is recognized for his superb medical background, excellence in innovation and outstanding rapport with his colleagues, patients, other physicians, and staff.

For more information on the CAR Young Investigator Award and the process of nomination, visit www.car.ca/en/education/awards/young-investigator.

Health Canada – National CT Survey

Radiation awareness is a topic of importance to the CAR. Where appropriate, the CAR supports national efforts that promote radiation safety in patient care. One such effort is Health Canada's National Survey of Computed Tomography (CT) Imaging, coming soon.

Health Canada, in collaboration with provincial and territorial governments, will be conducting a National Survey of Computed Tomography (CT) Imaging, the purpose of which is to collect CT imaging data from Canadian hospitals and clinics in order to recommend up-to-date national Diagnostic Reference Levels (DRLs) and to promote optimization of CT imaging. National DRLs is an area that the CAR believes is an important aspect of radiation safety for patients. DRLs are dose guidance levels, established from surveys of imaging practice and act as a tool to manage dose so that the dose is commensurate with the clinical purpose. The establishment and on-going revisions of DRLs is recommended by the International Commission on Radiological Protection. DRLs have been shown to improve patient dose awareness and lead to overall dose reductions.

The number of CT scanners and CT examinations performed in Canada has been increasing. In 2011, the Canadian Institute for Health Information reported that there are over 500 CT scanners in hospitals and clinics and over 4.3 million CT exams performed yearly. Including as many of these scanners as possible in the National CT Survey will ensure that national DRLs are reflective of the range of CT technology and its use across Canada.

In preparation for the survey, Health Canada has consulted with provincial/territorial governments and medical professionals. The survey will collect information on the CT equipment used, the routine protocols (adult, pediatric) for commonly performed examinations and image acquisition data of patient examinations. The standard examinations included in the survey and the associated clinical indications are shown in the table below.

Anatomical Region Clinical Indication

Routine Head [Adult]

Headache, Cerebrovascular Accident (CVA), or Transient Ischemic Attack (TIA)

Chest [Adult]

Primary cancer or known/suspected metastasis

Abdomen, Pelvis [Adult]

Primary/metastatic work-up or abscess

Chest, Abdomen, Pelvis [Adult]

Lymphoma staging or follow-up

Pediatric Head

Trauma, including non-accidental injury

Pediatric Chest

Detection of malignancy

Pediatric Abdomen

Detection of malignancy

For establishment of DRLs, imaging data will only be collected from examination of patients considered to be of standard size. Explicitly, data will only be collected from adult patients weighing between 50kg and 90kg and pediatric patients of all ages less than or equal to 13 years old. No patient identifying information will be collected.

Health Canada is making efforts to communicate plans for the National CT Survey with medical professionals involved in CT imaging. The support and participation of radiologists, technologists and medical physicists is essential for the success of the survey. The benefits to facilities from participation in the survey include the opportunity to compare local practice with national DRL benchmarks, identification of potential areas of CT optimization and ability to highlight commitments to patient radiation safety.

Facilities with CT equipment will soon receive a letter inviting their participation in the survey. Survey material will be distributed in December of this year to participating facilities. Completed survey forms will be due by the end of April 2013. The CAR encourages participation in the study.

For additional information on the National CT Survey contact the Consumer and Clinical Radiation Protection Bureau:

Consumer and Clinical Radiation Protection Bureau
Health Canada
Email: [email protected]
Tel: 613 954-6699

Threshold for Eye Lens Lowered by the ICRP

The work of the International Commission on Radiological Protection (ICRP) helps to prevent cancer and other diseases and the effects associated with exposure to ionising radiation, and to protect the environment. Although issued just under two years ago, its recommendations regarding the threshold in absorbed dose for the lens of the eye may not yet be known to all Canadian radiologists.

According to a statement released in April 2011, the recommendations state that the threshold in absorbed dose for the lens of the eye is now considered to be 0.5 Gy. Additionally, for occupational exposure in planned exposure situations, the Commission now recommends an equivalent dose limit for the lens of the eye of 20 mSv in a year, averaged over defined periods of five years, with no single year exceeding 50 mSv.

For further details, please refer to the ICRP Statement on Tissue Reactions, available here. To access all ICRP publications, visit www.icrp.org/publications.asp.

The CAR and CRF Are Relocating!

As of January 7, 2013, the Canadian Association of Radiologists and the Canadian Radiological Foundation offices will be relocated from the existing offices at 310-377 Dalhousie Street, Ottawa, ON  K1N 9N8 to:

294 Albert Street, Suite 600
Ottawa, ON
K1P 6E6

With changes in the Ottawa landscape, the CAR was able to obtain a better and even more cost-effective home for your CAR, thus strengthening one of our 2012-2016 goals of being a resilient organization.

Find the new location here:

View Larger Map

Our telephone and fax numbers will remain the same:
Tel: 613 860-3111
Fax: 613 860-3112

During the first two weeks of January, we expect intermittent interruptions of our telephone and email communications while we undergo the relocation; however we will endeavour to make the transition as seamless as possible. We thank you in advance for your patience and understanding.