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BRITISH SOCIETY OF NEURORADIOLOGISTS

ANNUAL CONFERENCE, BELFAST OCTOBER 10th & 11th 2014

 

The omens were good on Friday morning as the wet weather of the previous few days cleared and the sun came out on the delegates who had gathered in the Hilton Hotel, Belfast for this year’s conference.  Most of those attending had arrived the previous evening and many had already enjoyed the hospitality of the pubs and restaurants in Belfast’s city centre.

On behalf of the local organising committee, Dr Steven McKinstry welcomed the delegates, the invited speakers and the sponsors to Belfast and he noted that it had been nearly 30 years since the BSNR had last held its annual conference in the city. He and his colleagues were delighted by this vote of confidence by the BSNR and hoped that everyone would enjoy their stay.

The conference opened with Dr Shane McKee’s lecture entitled “Building a better brain: genetics in neurodevelopmental disorders”, which gave a fascinating insight into the work of a clinical geneticist, and the current areas of research which are providing further understanding of the role of genetics in disorders of the central nervous system. Dr Andrea Rossi’s lecture “DTI and brain malformations” perfectly complemented Dr McKee’s lecture, by exploring the place of advanced MRI techniques in demonstrating the anatomy of congenital brain malformations, particularly those affecting the corpus callosum.

After lunch in the Sonoma restaurant, looking out over the River Lagan and the giant cranes of the Harland and Wolff shipyard, Mr Roy McConnell started the first afternoon session with his lecture “Spine: to boldly go”. His review of the anatomy and radiology of the Chiari malformations, and their relationship to clinical symptoms, provided much food for thought for neuroradiologists reporting MRI scans in these patients. In the second invited lecture of the afternoon, Professor Majda Thurnher gave a masterful exposition of the MRI appearances of common and rare intracranial infections and their differential diagnoses.

As well as the invited lectures, delegates also enjoyed the proffered papers, which covered subjects as diverse as Michelangelo’s potential to be a radiologist, and the use of fibrin glue in CSF leaks. Dr Stuart Currie was subsequently awarded the “Burrows Prize for best presentation” for his paper entitled “New GMC language checks to be introduced in 2014. How will neuroradiology reports fare?”

On Friday evening, delegates were collected at the Hilton and taken by coach through Belfast city centre to Crumlin Road Gaol. It was clear from the expressions on some of their faces that many were not sure what to expect! The Gaol was in use as a prison from 1845 until 1996, and is an outstanding example of a Victorian penal institution. It has been sensitively restored and is now used for social functions and guided tours.

In small groups, the delegates were taken on a short guided tour, including the tunnel which formerly linked the prison to the court house across the road, and the condemned cell and execution chamber. This part of the tour caused many to pause for thought. At the conclusion of the tour, the delegates enjoyed a buffet meal with Irish musical accompaniment before returning to the hotel.

The first session on Saturday morning started with Professor Jonathan Gillard’s lecture “Imaging carotid disease with MRI: do the numbers add up”, in which he discussed in beautifully illustrated depth the pathophysiology of atheromatous disease, and the role of computer modelling in gaining a better understanding of its relation to stroke risk. Later in the morning, Dr Tommy Andersson’s lecture “Problems and complications from endovascular treatment of acute stroke”, provided a sobering reminder of the need for interventional neuroradiologists to be aware of potential complications, and the need for correct selection of patients and procedures.

A wide range of topics was again covered by the proffered papers on Saturday. Dr Hannah Khirwadkar was subsequently awarded the prize for “Best Registrar Presentation”, for her paper entitled “MRI findings and MOG-IgG in NMO and NMO-like disorders”.

During the conference, delegates were able to review the selection of high quality posters which had been submitted to the conference. Dr Juveria Siddiqui was awarded the prize for “Best Poster” for his presentation entitled “Putting it bluntly: the role of CT and invasive angiography in blunt craniocervical trauma”.

After lunch, Dr Peter Flynn introduced the Du Boulay lecturer, Professor Jack Crane. Formerly the State Pathologist for Northern Ireland and Professor of Forensic Medicine at the Queen’s University of Belfast, Professor Crane was awarded the CBE in 2012. He was adviser in Forensic Pathology to the United Nations criminal tribunal for the former Yugoslavia and is currently chair of the Fitness to Practice Panel at the GMC.

In his lecture “Forensic Radiology: the death of the autopsy?” , Professor Crane first discussed the role of the forensic pathologist in establishing cause of death and providing evidence for the courts, including cases resulting from the “Troubles” in Northern Ireland, and also investigations in which he had been involved when with the UN in the Balkans. Booby-traps attached to bodies in Kosovo meant that he often had to be accompanied to scenes of mass burials by bomb disposal experts, and X-rays had been used to detect devices hidden inside cadavers.

Professor Crane then moved on to review the proposed use of radiology, principally CT and MRI, to replace traditional autopsy in cases of sudden death referred to the coroner. He noted the objections of some religious groups to post mortem examinations but felt that this was not a valid argument in favour of their replacement.  The evidence in support of CT and MRI scanning was in many cases flawed and after illustrating the issue with many fascinating examples, his conclusion was that at present the traditional autopsy remained the best way to establish cause of death. However, the place of CT and MRI scanning did need to be established and it has been suggested that those training in forensic pathology should gain some experience in these techniques.

Professor Crane’s lecture had clearly awed and fascinated his audience, and Dr John Straiton, President of the BSNR, thanked him on behalf of the society before presenting him with a commemorative medal.

Dr Nigel Hoggard then gave a short presentation about next year’s conference in Sheffield, which generated a lot of interest amongst delegates, and for which plans are already well advanced.

Dr Seamus Looby from Dublin provided delegates with a brief introduction to the recently formed Irish Society of Neuroradiology, which had had its first meeting and two day seminar in Dublin in June 2014. This had been very successful, attracting over 100 attendees and being supported by the Faculty of Radiologists in Dublin. The plan is to hold annual seminars in Dublin and Belfast, and to cooperate with BSNR in hopefully having a joint meeting in Dublin.

The last invited lecture was given by Dr Paul Burns on the subject “Developing a Neurointerventional stroke service: future challenges”. Dr Burns reviewed the evidence from the various completed trials, and the current ESCAPE trial. Based on his experience whilst working in Calgary, and subsequently in Belfast, Dr Burns discussed the logistics of providing an acute neurointerventional service. In passing, he noted that the island of Ireland is just slightly smaller than the state of Alberta, for which the Foothills Hospital provides such a service.

Finally, in a lighter mood, Dr Seamus Looby invited delegates to participate in a Neuroradiology quiz based on cases seen in Dublin and during his time in the USA. Conducted at breakneck speed, it covered a dazzling spectrum of pathologies, culminating in a series of questions based on Irish history and famous personalities who had originated in Northern Ireland, including Sir Joseph Larmor. The prize for the top score was awarded only after a tie break question, which concerned a speeding offence committed by the chair of the local organising committee.

On Saturday evening, delegates travelled by coach to Titanic Belfast. Costing over £100 million, Titanic Belfast was opened in 2012, one hundred years after Titanic was launched from the adjacent slipway. It is the world’s largest Titanic visitor experience and will shortly become the most visited attraction in Ireland.

After passing by escalator through the magnificent building, delegates, sponsors and their partners and guests were welcomed to the Titanic Suite where they enjoyed a glass of sparkling wine and a traditional Irish harpist. The centrepiece of the Titanic Suite is a replica of the ship’s famous Grand Staircase, which prompted many photo opportunities.

Delegates then took their seats for dinner, only to be interrupted by an announcement regarding procedures in case of emergency. However, the promised test sounding of the alarm turned out to be the signature tune of first one, then two, then three members of the singing trio “Cameoflage”, who entertained guests with a mix of pop, swing and opera favourites, culminating in a memorable rendition of “Nessun Dorma”.

At the conclusion of the evening, the new President of the BSNR, Dr Chris Rowland-Hill, presented the prizes awarded during the conference and thanked the local committee for organising this year’s event. He also thanked the outgoing President, Dr John Straiton, and other members of the various BSNR committees, for all their hard work on behalf of the BSNR. Looking forward to Sheffield in 2015, Dr Rowland-Hill anticipated an excellent attendance and reminded everyone of the new training day due to take place before the start of the conference.

Finally, Dr John Straiton presented a suitably surprised but grateful Dr Steven McKinstry with the President’s Gold Medal on behalf of the BSNR, before the conference was officially brought to a close.