Introduction by Croakey: How can we better use the expertise of radiologists in patient care? As artificial intelligence brings change to radiological practice, how can we harness it for good while guarding against harms?
What will enable the future radiology workforce to be diverse, resilient equitably distributed and capable of delivering culturally safe care? How can new applications for medical imaging improve diagnosis and revolutionise the management of some conditions?
These and many other questions will be under consideration at the upcoming 75th Annual Scientific Meeting of the Royal Australian and New Zealand College of Radiology, to be held in Naarm/Melbourne on 23-25 October.
The #RANZCR2025 convenors are working hard to ensure the meeting lives up to its theme of “celebrating 90 years of pushing boundaries and defining tomorrow”.
Below, Marie McInerney previews the event for the Croakey Conference News Service.
Marie McInerney writes:
An upcoming international conference in Naarm/Melbourne will aim to bring the hi-tech expertise of modern radiology “out of the darkness and into the light”, and to boost the visibility of issues in radiology that are also often in the shadows — from pelvic floor and prostate conditions to better identification of family violence and child abuse.
The 75th Annual Scientific Meeting (ASM) of the Royal Australian and New Zealand College of Radiologists (RANZCR) will be held from 23-25 October at the Melbourne Convention and Exhibition Centre on the lands of the Wurundjeri Woi Wurrung people of the Kulin nation.
Marking RANZCR’s 90th anniversary, the packed three-day event will offer a record number of sessions and streams, across three main fields: clinical radiology, radiation oncology, and interventional radiology (IR) and interventional neuroradiology (INR).
Out of the shadows
Celebrating the milestone, the RANZCR notes that it has been “at the forefront of innovation, shaping the future of radiology and radiation oncology through excellence in education, research, and clinical practice” through almost a century.
But, despite huge advances in technology and skill, the profession still struggles at times and in places with “being left in the dark”, clinical radiology specialist Dr Rose Thomas told Croakey. Thomas is one of four convenors of the event, and currently the RANZCR’s branch education officer for Victoria.
Being tucked away in the shadows was literally the case in the not so distant past, when radiologists often worked from the basements of hospitals, in rooms without windows, “bathed in darkness” so they could view their images, she said.
“You just didn’t really hear much about them or have much interaction with them until you were forced to go down there into the lion’s den,” Thomas told Croakey with a laugh.
That lack of visibility has continued metaphorically, exacerbated by the COVID-19 pandemic and now facing new challenges from artificial intelligence (AI) and other features of contemporary medical practice, as Dr Adrian Brady, a clinical professor of radiology at University College Cork in Ireland wrote in 2021 in European Radiology.
In an article titled: ‘The vanishing radiologist – an unseen danger, and a danger of being unseen’, Brady observed that diagnostic radiologists have at times been considered “peripheral” to clinical care and/or viewed as “the doctor’s doctor”, providing information for those who make the clinical decisions as “just another test result”.
“A friend of mine describes this as seeing radiologists as “FBC (full blood count) machines with a pulse”, he wrote.
Thomas and her fellow #RANZCR2025 convenors agree heartily that radiology deserves much higher visibility as a specialty that is critical to the day to day running of hospitals and patients’ journeys.
“We’re really integral,” she told Croakey. “I think you’d be hard pressed to find one patient in the hospital these days who hasn’t come to the radiology department for some reason or another.
“I think generally radiologists are trying to improve their visibility: make people more aware of what we do and how we do it, to encourage people to come to [the profession] because it really is an exciting specialty.”
Into the future
More than 1,500 delegates are expected to attend the RANZCR ASM, including a record number of international speakers and participants from countries as diverse as Morocco, Finland, Poland, Pakistan, Japan, Egypt, the United Kingdom, Taiwan and Singapore.
In the clinical radiology streams alone, the previous highest number of international speakers – in Brisbane in 2023 – was seven. This year it is 27, with 41 presentations in total across all streams.
And the representation is senior: a ‘future of radiology’ panel session will feature the presidents of the Radiology Society of North America (RSNA), of the European Society of Radiology, and the Asian Oceanic Congress of Radiology.
The convenors have also shaken up the traditional program, choosing to boost the ratio of concurrent to plenary sessions in order to feature more topics across the 130 sessions. To encourage greater trainee involvement and skills development, there will be “deep dive” workshops on clinical practice on offer for the first time, led by international experts.
Hot topics for other sessions will unsurprisingly include the advent of AI, with one to be led by the RANZCR’s AI Committee. It will look at how AI is transforming the profession’s work, with a focus on patient consent, workforce preparedness, and findings from the Swinburne University of Technology’s AI and Healthcare project exploring AI’s impact on career optimism and burnout.
The ASC’s annual Nisbet Oration will be delivered by futurist Anders Sörman-Nilsson, in part to balance the “doomsday” concerns held by some in radiology about the future of the profession under AI, Thomas said.
Climate change will also be under discussion, particularly given that medical imaging is one of the biggest contributors to a hospital’s environmental impact, through energy consumption, medical waste, and equipment production, and that AI, which will be pervasive in radiology, has such a big environmental cost.
RANZCR’s Māori, Aboriginal and Torres Strait Islander Empowerment Committee (MATEC) will host a dedicated session on culturally safe care, which will include a presentation on the role of truth telling in health equity.
Other topics across the program will include women in leadership, equity of access to radiology, clinical advances in liver and kidney treatment, and perspectives on Australia’s new national lung screening program, along with discussions on social media, leadership skills, and workforce burnout.
The event will also feature an art competition (entries to date range from painted canvas and photography to a knitted tea cozy), an annual Targeting Cancer Fun Run, and RANZCR’s Annual Ceremony to welcome and recognise the achievements of 132 new fellows and 9 awardees.
Illuminating hidden problems
One highlight in the clinical program, Thomas said, will be a workshop on pelvic floor magnetic resonance (MR) imaging for women, an approach that remains under-explored in Australia.
It will be led by global expert Dr Anugayathri Jawahar, Assistant Professor at the Northwestern University’s Feinberg School of Medicine in Chicago, who will also present a session on ‘Imaging of the pelvic floor – the commonly ignored female pelvic disorder’.
Thomas doesn’t mince her words talking about the indignity of pelvic floor fluoroscopy, a contrast x-ray of the bowel to assess pelvic floor function, which she described as “quite invasive”.
“The patient basically has to poop in front of an audience, and you take a film as it happens,” she said.
But while pelvic floor MRIs, which offer a more dignified exploration, are common now in the United States and Europe, “even the fluoroscopic examinations are not done in very many centres” in Australia, she said.
“Like most things in women’s health, people just don’t speak about it so we are hoping to open people’s eyes to it…and then perhaps [they will] start developing a service in their own hospitals.”
Dr Clair Shadbolt, Clinical Radiology Director of The Royal Women’s Hospital in Melbourne, will present on MR imaging of endometriosis at the ASM. With her service being one of only a few in Australia where pelvic floor MRI is available, she told Croakey she was looking forward to Jawahar’s session.
“As a major training centre, it will be good to compare our techniques to ensure we remain up to date with the advances occurring overseas,” she said.
The conference will also hear from Dr Bharti Khurana, a pioneer in combining radiology and data analytics to detect intimate partner violence, whose research on an automated clinical decision support tool is titled ‘making the invisible visible’.
Khurana is Associate Professor of Radiology at Harvard Medical School, an emergency radiologist at the Brigham and Women’s Hospital, and the Founding Director of the Trauma Imaging Research and Innovation Center (TIRIC).
She has talked about how she shifted her clinical and research focus after learning that patients subject to family violence often present repeatedly to hospitals, where trauma clinicians may treat the injuries but fail to identify address their root cause.
“As soon as someone says we’re missing something, I feel personally responsible as an emergency radiologist to figure out why it’s getting missed,” Khurana said.
Thomas says many Australian hospital-based radiologists will have seen injuries from family violence or child abuse, but may not have connected the dots.
“Radiology is about pattern recognition, and once you see the pattern and recognise it for what it is, then you can report on it,” Thomas said. “But if you don’t, if it’s not something you’ve been exposed to…you’ll never think about it.”
She expects many participants to leave the session thinking ‘how many (cases of family violence) have I missed, how many fractures did I just think of as a fall?’.
Back to the bedside
For co-convenor Associate Professor Diederick De Boo, a consultant interventional radiologist at Monash Health in Melbourne, the conference is an important opportunity to promote the relatively newer Interventional Radiology and Interventional Neuroradiology (IR and INR) fields.
Seeking to have IR and INR recognised as formal clinical specialties, the RANZCR argues they currently “suffer from a lack of identity, leading to inconsistency of service provision with respect to patient access and safety, practitioner training and workforce mobility”.
De Boo is particularly concerned that too many women undergo “invasive or unnecessary procedures and operations”, including hysterectomies, because interventional radiology is not only not well known to the public, but also among GPs, “who don’t necessarily know how to refer to us”.
Another drawback is in hospital funding hierarchies, where radiologists are funded to report scans, not to visit patients in wards, even though surgeons, for example, may be excused from such lineation.
De Boo recently co-authored an article in the Journal of Medical Imaging and Radiation Oncology on the impact of converting the ad hoc informal IR outpatient services at Monash Health to a formalised service in a dedicated space. The benefits included increased rates of consent prior to the day of the procedure, and decreased costly day-of-procedure cancellations and rescheduling.
What’s needed, still, is for the interventional radiologist to be involved in patient care “as a true clinician, not just a skilled mechanic”, he and his colleagues wrote.
Sessions at #RANZCR2025 will highlight where interventional radiology can offer much less intrusive or invasive treatment than surgery for women with uterine fibroids, as well as benefits for patients suffering symptoms of benign prostate enlargement or presenting with pulmonary emboli where, historically, systemic anticoagulation can carry many risks.
The IR stream will also include sessions on Interventional Oncology, “to further increase the awareness that interventional radiologists are offering evidence based, minimally invasive, image guided, curative treatment to patients with primary and metastatic cancers”, he said.
Its place will be discussed in dedicated sessions on management of renal and liver cancers with a strong focus on ‘what the evidence shows’.
Focus on equity
Another major focus for De Boo and his fellow convenors is on inequity of access to radiology for people living in rural, regional and remote Australia, where only around 11 percent of the RANZCR’s clinical radiology members work — representing a severe workforce maldistribution, particularly when it comes to time-critical treatment for ischemic stroke.
As well as hosting a full “prime time” session on rural and regional radiology, ASC sessions will drill down into advances like robotics, mobile stroke units (there are currently only two in Australia, both in Melbourne) and the potential for deploying ‘flying doctor-like’ stroke teams into regions, he said.
The strong international agenda means that wider geographic disparities will also be explored.
On the one side, the meeting will showcase “extremely high functioning” radiology departments in south east Asia in particular, says Dr Jyothirmayi Velaga, a co-convenor in clinical radiology, who admits it was a personal shock, after working in Singapore, to move to Australia and revisit the reality of working in a health system with infrastructure funding constraints.
“If you would see something new that’s unveiled at the Chicago RSNA, which is the premier radiology conference in the world, then the next thing you’ll see it being inaugurated in Singapore,” she said.
That, of course, is in stark contrast with the Pacific, where countries like Fiji don’t have a single MRI machine — issues to be canvassed in a session on Radiology Across Borders, a global charity founded and based in Australia, and in a presentation on radiation therapy cost, workforce and investment across country income levels by Dr Dania Abu Awwada from the University of Sydney.
Awwada told Croakey that in many low- and middle-income countries in the Asia Pacific, only a fraction of cancer patients – between 10 and 55 percent – receive the radiation therapy they need, due mostly to the relatively high cost of equipment versus staff salaries which are the greater expense in high-income countries.
There are ways to make treatment more affordable, such as buying machines in bulk and using fewer treatment sessions when medically appropriate, but the task is huge, she said.
“Focusing on just seven countries in the Asia-Pacific, researchers found that 90 more radiotherapy departments are needed just to keep up with current demand,” she said. “To treat every patient who needs radiation, that number jumps to 567.”
Marie McInerney will attend the conference on 24 October to provide live coverage via social media, and further reports for Croakey.
Bookmark this link for further coverage of #RANZCR2025 for the Croakey Conference News Service.
