MINUTES
Inflammation/Infection Committee Meeting
Date: March 20, 2014
Time: 9:00-16:30
Venue: EANM Executive Secretariat, Vienna
Participants: Committee members
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Attending: A. Signore (Chair), E. Lazzeri (vice-chair), F. Rouzet (secretary), R. Chakravartty, PA. Erba,
A. Glaudemans, O. Israel, F. Jamar, J. Martin-Comin.
B. Krause and K. Leissing participated in a telephone conference during the afternoon.
Excused: John Buscombe.
1. Welcome by the Chair and approval of agenda
Welcome by AS, chair of the committee.
All members approved the agenda.
2. Minutes of previous meeting in Lyon, October 19, 2013
All members approved the minutes of the Committee meeting and the minutes of the interest group
in Lyon.
3. Report of last Advisory Council meeting (AS)
AS reported on the main topics of the last Advisory Council meeting (6 December 2013). During a 15
minutes presentation, he reported on Inflammation & Infection Committee activities. A new
Translational Molecular Imaging Committee headed by Marion de Jong has been created. The
Advisory Council wishes the set up of collaborations between committees in courses, CME and joint
sessions.
One of the main topics of discussion related to the set up of courses in Vienna. B. Krause said that
the first edition of an infection course could be scheduled for 2015. A setup meeting is programmed
in April 2014. EANM supplies a template for the program of courses as well as external experts to
assist the committee in organising courses. The Committee will take advantage of the long history of
most of our Committee members in teaching to prepare the program of basic and practical courses.
The Committee also discussed about the pros and cons of practical courses in the Seibersdorf facility
near Vienna or in AKH or rotating in different European qualified centers. The pros of Vienna
locations are ease of use, cost, and procedure standardization. The cons are the absence of clinical
environment: no interaction with patients or clinicians, high cost of attendance for most European
technicians being this course addressed mainly to them. To be discussed next Saturday during the
advisory council meeting and Sunday during the ESNM meeting.
ESNM meeting Sunday (8 December 2013) suggestions:
1- agree to perform a basic theoretical course in Vienna with good interaction with participants and
possibly creation of small groups discussing a clinical case.
2- for each course, the committee will propose 3 speakers (rotation between committee’s members)
and some external teachers.
3- practical courses to be determined after AS and PE visit AKH and Seibersdorf facility.
4. Program of the next EANM congress (OI)
Three educational activities during the next EANM congress in Gothenburg:
- CME n°5 (joint session inflammation & Infection, Bone & joint and Paediatrics): Bone
infection in adults and children (Chaired by PE and C. de Labriolle Vaylet). FJ as a speaker.
- CME n°9 (joint session Bone & joint and I&I): Low back pain. EL invited as a speaker.
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Still awaiting a time slot (to be determined during
the next scientific committee meeting on June 3rd):
“Imaging in Inflammatory Disorders - Rheumatic
Diseases, Sarcoidosis, Vasculitis", (chaired by AS and
OI), speakers RC, FR and AG.
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5. Relations with other Societies
- ESC: participation of PE in the ESC taskforce guideline on infective endocarditis. ESC wishes the
guideline ready for the end of the year, in order to be presented next year at ESC congress.
Applicable in the whole of Europe. Endorsement of the text by EANM is anticipated.
- ESCMID: AS reports the participation of committee’s members as speakers to the symposium at
the ESCMID congress. Excellent contact with president of the ESCMID. Prof. Petrosillo is the
person indicated by ESCMID to interact with us.
- EASD: OI reported that B. Lipsky published a review paper where the role of PET/CT and WBC
scan in diabetic foot is clearly explained. Common paper on hybrid imaging SPECT/CT with
members of the committee will also be published instead of preparing a guideline on diagnostic
flow charts. RC and AG with assistance will collaborate with OI on this review. They will contact B
Lipsky, representative of EASD, to prepare a revised version of previously published guidelines,
published 2 years ago.
- ESVS: FJ reported that the new president of ESVS is Prof Jean-Baptiste Ricco, (Poitiers, France).
He will be contacted for asking the name of a member to collaborate with us on guidelines.
- ECCO/ESGAR: JMC said guideline already published but continuous collaboration is required for
updates. JMC wishes to resign and accordingly, RC will be appointed as contact person with
ECCO. AS will establish a new contact with ECCO.
- ESR: AS reported that a direct contact between EANM and ESR is anticipated.
- Letters to societies should be sent by the end of the month (copy to AS and FJ).
6. Report on relations with ISORBE
It appears that some activities of ISORBE and EANM are overlapping and should be clarified
(regarding particularly WBC labelling courses). Some EANM members are/were members of ISORBE
and we propose to establish collaboration with ISORBE as follows:
1- preparation of common diploma
2- preparation of common program on basic and practical courses
3- EANM could deliver teaching and diploma in Europe, and ISORBE outside Europe.
A letter has to be sent by the President of EANM to ISORBE, in order to propose collaboration for
courses that will take place in 2015 (EANM). Advanced course might be jointly organized. AS will talk
to Wim Oyen and prepare such letter with EANM President.
The committee also discussed about the opportunity to undergo an accreditation by EARL of nuclear
medicine centres performing white blood cells labelling.
7.
-
-
Guidelines on Flow-Charts and Medline searches
Procedure guideline IV has been submitted to EANM Ex Board
Osteomyelitis and PJI (AS and AG propose a general framework for guidelines presentation, draft
and meta-analyses. The committee’s members agreed to use “Levels of evidence and grades of
recommendation based on the GRADE system (see their webpage).
EL proposed a guideline draft for spondylodiscitis and AS will help her and will contact the
President of European Neuroradiology Society.
Endocarditis: PE has been invited as member of the task force to develop ESC guidelines on
infective endocarditis. She will ask to involve also FR.
Vascular graft infection: FJ and FR will draft guidelines and meta-analysis on vascular graft
infection in collaboration with the ESVS.
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The guideline on diagnostic flow chart in Diabetic foot
and in IBD have been cancelled or postponed.
Advanced guideline drafts are expected by the end of
May.
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8. Interest group meeting
At the last Interest Group Meeting in Lyon, we suggested 3
different activities:
1- a multicentre study comparing WBC scan with FDG scan in vascular prosthesis (the actual aim was
to look at practice and then if appropriate to propose a multicentric study, provided each participant
would have local funding – this is what was discussed in Lyon)
2- a multicentre study in vasculites (again this is aimed to look at diagnostic criteria, not to undergo a
prospective study)
3- a multicentre study comparing WBC scan and FDG scan in diabetic foot
AS and FR will prepare the protocol for project 1; FJ with Annibale Versari (from Reggio Emilia, Italy)
will prepare protocol for project 2; AG will prepare the protocol for project 3. These 3 projects to be
prepared by the end of April 2014 and then sent to all members of the Interest Group.
4- a European survey on legislation for WBC labelling was proposed by Annalisa Davit (Cuneo, Italy)
and AS will contact her for an update on the project since she did not send us anything yet.
JB is Committee member in charge of the organization of the Interest Group. We have also asked
Agnes and Katharina to update the list of members of Interest Group including all those who
participated to the two previous meetings.
9. Update on Facebook and other press activities.
RC reported on an ever increasing number of members and comments posted on the Inflammation &
Infection Committee Facebook page, which is the largest of all EANM committees. A Webpage will
soon be implemented in collaboration with EANM office.
10. Updates on new technologies
AG reports on the advent of PET/MR systems. The committee agrees on the need to keep updated
on preclinical research and new technologies. FR will be involved in small animal dedicated cameras
and animal models of infection, RC will be involved in new software, and PE in radiopharmaceuticals
targeting infection and inflammation.
New members of the Committee should be more particularly involved in legislation and regulation
issues.
11. T-Con with Bernd Krause
Practical courses: AS exposed the pros and cons of courses in Vienna (see above). Program of the
theoretical course should be ready by mid-2014 to be implemented in 2015. He recommends that in
vitro practical courses to be settled in Seibersdorf (IAEA) and AKH. AS and PE are to visit the site on
Friday 21st. The program of theoretical courses should be presented at the ESNM meeting to be held
on March 23rd.
AS presents the state of collaborations with other societies, and the next validation of the practice
guideline on WBCs interpretation criteria.
Gothenburg: CME session on inflammation pending W Oyen answer.
Communication: the Committee’s Facebook page is successful.
B Krause agrees on the need of official contact between EANM and ISORBE, regarding particularly
courses in Vienna.
12. Closing remarks and date of next meeting
Meeting ended at 16:30 and next meeting of the Committee is planned on Saturday October 18,
2014 in Gothenburg (4-6 pm presumably). On Sunday 19th we will have a dinner to thank our senior
members Ora and Josè, leaving the Committee at the end of their mandate.
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Note:
Attached a short summary of the Advisory Council Meeting
of 22nd of April (AS attended) and of the ESNM meeting of
23rd of April (PE and AS attended) as integration to the above
minutes.
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Tel: +43-(0)1-212 80 30, Fax: +43-(0)1-212 80 30-9
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Advisory Council Meeting
The Advisory Council meeting of Saturday 22nd of April 2014 was very productive.
EANM President started with a general introduction and survey of nuclear medicine centers in
Europe.
Then Bernd Krause introduced the discussion of Committees and reminded the Priorities of the
Executive Board:
- Young members
. Focus on science
- Relation with relevant clinical societies
- Guideline development
- Website/communication
- Education/ESNM
It was also mentioned that EANM can pay the membership fee of 1 member of each Committee for 1
clinical society in order to keep a closer contact with their activities.
I would therefore propose that
- AS gets membership of ESCMID and ECCO
- EL gets membership of Neuroradiology Society
- AG gets membership of BJIS
- RC gets membership of EASD and DFSG (Diabetic Foot Study Group)
- PE gets membership of ESC and ESCVI (European Society of Cardio-Vascular Imaging)
. FJ gets membership of ESVS
- FR gets membership of ESC and EACVI
- JB gets membership of ESR and ESGAR
Bone & Joint Committee
Presented an update of their activity and mentioned a collaboration with EULAR (Dr. Uwe Kompen)
to prepare common guidelines on chronic inflammatory rheumatisms.
Cardiovascular Committee
Presented several activities and guidelines and the idea to start a guideline or a meta-analysis on
Atherosclerosis imaging. They also established good connection with ESC and EACVI.
Translational Molecular Imaging Committee
Marion de Jong showed mainly the organization of the M2M track at next EANM congress. There will
be indeed the possibility to submit an abstract to this special track session of the congress and we
have to help spreading this news amongst members of our Committee and our Interest group.
It's not easy to find the small box to tick for sending the abstract to this track, while submitting the
abstract you should click on "awards" and at the bottom of the page you'll find the instructions and
the box to tick for this track.
Inflammation/Infection Committee
AS presented the new subgroup composition, the future guidelines and collaborations, the courses
and the problems with ISORBE, the website and Facebook. An open call will soon be opened to
replace Ora and Josè.
AS then had further meetings with Bernd Krause, Wim Oyen and Valerie Lewington to discuss these
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issues in details.
EANM Executive Office
AS also announced officially that in our long term plan, after
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finishing the guidelines on infections, we would like to start
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guidelines
on
inflammatory
diseases
including,
atherosclerosis, vasculitis, rheumatoid arthritis and
sarcoidosis. AS therefore offered our collaboration to CV
committee and B&J committee for the atherosclerosis and
rheumatoid arthritis but we will take the lead for vasculitis and sarcoidosis.
AS hen asked the President to re-send official letters to other societies to confirm the links and the
people involved in view of our guidelines. AS will therefore prepare all these letters with Fred and
Katharina and in particular to:
- ESR (for PJI, VGI, OM) via EANM secretariat
- ESCMID (for SD, PJI, OM) Prof Gunnar Kahlmeter (Växjö, Sweden): gunnar.kahlmeter@escmid.org
- EBJIS (for OM) Prof Heinz Winkler (Vienna, Austria): info@ebjis.org
- EASD (for DF) Prof Andrew Boulton (Manchester, UK): aboulton@med.miami.edu
- ESVS (for VGI) Prof Jean-Baptiste Ricco (Poitiers, France): jeanbaptistericco@gmail.com
- ESNR (for SD) Prof Turgut Tali (Ankara, Turkey): turgut.tali@gazi.edu.tr
We will also explore the possibility to contact Patient's associations (John Buscombe).
Technologist and Radiopharmacy Committee will help us for the practical course as we requested
and the Translational Molecular Imaging Committee will name a member to interact with FR and PE
for the preparation of the database on animal models for infection imaging and
radiopharmaceuticals and also a nice review paper can come out from this work.
We briefly discussed about how to make clinical guidelines and to have internal standards for rating
papers for our meta-analysis. After some discussion we decided to follow the GRADE system
(http://www.gradeworkinggroup.org/index.htm and
http://cebgrade.mcmaster.ca/aboutgrade.html).
We find this system very complex and therefore we will propose the Oxford CEBM System again
(http://www.cebm.net/index.aspx?o=1025).
ESNM Courses
Paola Erba will also report about the ESNM but Val reported us that EANM is thinking of "re-shaping"
the format of courses. Many suggestions were made. If no much will change there will still be 3
courses every year in Eastern Europe with a budget of 15,000€ each for about 30-60 students each
(500-250€/student), paying registration food and 2 nights accommodation.
AS proposed to reduce the number of courses in Eastern Europe (maybe making them more
dedicated to involve clinicians) and pay instead travel grants to those students who wish to attend
Vienna courses and have economical problems.
Anyhow, committees are asked to provide suggestions for some 3h topics with possible speakers.
We suggest the followings:
Package 1 (basic), (Lazzeri, Signore, Jamar, Chakravartty):
- pathophysiology of infections
- labelling techniques and QC
- acquisition and interpretation of images
Package 2 (bone and soft tissue infections), (Lazzeri, Signore, Glaudemans, Buscombe):
- Osteomyelitis, PJI
- Spondylodiscitis
- Abscesses and soft tissue infections
Package 3 (cardiovascular infections), (Jamar, Rouzet, Erba, Buscombe):
- Endocarditis
- Vascular grafts infections
- Cardiac devices
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Package 4 (FDG in inflammation), (Erba, Chakravartty,
Rouzet, Glaudemans):
- Sarcoidosis and other lung infections
- Vasculitis and other vascular infections
- FUO and joint inflammation/infection
Package 5 (hybrid imaging), (Jamar, Rouzet, Lazzeri,
Chakravartty):
- SPECT/CT in infections
- PET/CT in Infections
- PET/CT in inflammations
Package 6 (WBC and beyond), (Buscombe, Signore, Glaudemans, Erba):
- radiolabelled WBC and antibiotics for imaging infections
- radiolabelled antibodies for imaging infection and inflammation
- FDG and other PET new radiopharmaceuticals
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Discussion then started on the way to run new courses in Vienna. We had a 59% loss of attendees in
Vienna in 2013 respect to 2010 and this is due to the high costs of these courses, the repetition of
topics and old fashion teaching system. Therefore the whole strategy should be reviewed. Our course
on Infection could be the start of a new strategy. Paola will tell us more on this topic including the
result of the visit we made to AKH and Seibersdorf.
Wim Oyen accepted our 2 extra symposia to be inside the official program. However the exact date
and time will be decided on June 3rd. These are:
- Hybrid imaging in infection/inflammation
- Imaging the rheumatic patient (vasculitis, sarcoidosis, RA)
Speakers and chairmen about being decided
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