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On the eve of RÖKO2024, the 105th German Radiology Congress in Wiesbaden, Mélisande Rouger spoke with the meeting’s presidents, Prof. Johannes Wessling from Germany and Prof. Thomas Helbich from Austria, about the congress highlights and double holding at different dates.

Radiology in transformation is RÖKO 2024’s main theme. What do you mean with that? 

Johannes Wessling (JW): We live in turbulent times. Digitalization, artificial intelligence (AI), chat GPT, to name a few, fascinate and challenge us at the same time. AI can rightly be seen as the driving and disruptive force of this new era, and this is particularly true for radiology.

Thomas Helbich (TH): With the motto “Radiology in Transformation”, we are expressing the fact that we are in a kind of turning point and that radiology is not facing but is in the middle of a process of change, and has already begun to shape this process. For the congress, we have defined three milestones – information, communication and precision – which mark the path towards a new, not purely image-focused radiology. 

What will be the highlights of the congress?

JW: Participants can look forward to a whole series of exciting and high-caliber events. One example is the opening event, where one of the most influential figures in German healthcare, will be speaking. As the chairman of the Federal Joint Committee, Prof. Josef Hecken is the public face of perhaps the most powerful body in the German healthcare system. It will be interesting to hear what he has to say about the transformation of the system.

TH: The X-ray lecture is one of the absolute highlights. Reinhard Heckel, a professor of machine learning at the Technical University of Munich, will present and discuss the fascinating new generation of AI-based imaging and the many opportunities and challenges it opens up for modern medicine. Not to be forgotten are the numerous highlight lectures from the various fields of radiology such as Carcinoma Screening Rethought, Molecular Imaging: From Lab to Bedside, Breast Imaging in 2040, and Developments in Contrast Agents and Tracers.

What’s new this year?

JW: RÖKO is increasingly focusing on edutainment formats. We have translated the well-known quiz show ‘Reverse Jeopardy’ into the world of radiology, to combine radiology training with entertainment elements. The teams play for money that will benefit the Röntgen School in Berlin.

TH: Our industry tours are also new. Participants will have the opportunity to actively engage with current company offerings in guided group tours with scientific expertise. For the first time, we are offering themed tours in the areas of AI, oncology and intervention. 

(from left to right) RÖKO2024 Presidents Prof. Thomas Helbich from Vienna, Austria, and Prof. Johannes Wessling from Münster, Germany.

The congress is both online and onsite, but not at the same time. Why do you spread the content on two different dates?

JW: The digital edition of the Röntgenkongress was actually only intended as a temporary solution so that we could continue to offer radiology training during the coronavirus pandemic. However, the enthusiasm was so great, and the demand so overwhelming, that the DRG (German Society of Radiology) decided to bring together the best of both worlds: digital training courses and the very real exchange in the context of a face-to-face event.

From March 1 to June 22, 2024, RÖKO DIGITAL offers radiological training in all its diversity. RÖKO WIESBADEN will focus on “hot topics” along the congress motto, which will be explored in greater depth here. We also have the opportunity to offer more interactive events and dialog formats on highly topical issues. Ultimately, a congress always thrives on personal exchange, which we facilitate with the face-to-face meeting.

Why are there two presidents from two different countries for a Germany-based meeting?

TH: The Austrian and German radiology societies have a friendship that goes back many years. The idea of organizing a joint congress came up back in 1973. And since this worked wonderfully, they have stuck with it and tried to continue this tradition every three years.

Austrian radiologists have great opportunities to update their knowledge: the ECR in Vienna, their own national meeting in Austria, and RÖKO. What is your advice to your European colleagues? Should they also look for educational opportunities outside their own countries? 

TH: The ECR is an incredible success story and we, the Austrian radiologists, are honored to be able to contribute to this story. However, this does not mean that we, and by that I also mean my European colleagues, should only focus on the ECR. Global knowledge is so far-reaching that I can only support active participation in international congresses and training courses. This also includes RÖKO in Germany.

How many participants do you expect this year and how many do you think will come from Austria?

JW: We are expecting a similar number of participants as in 2023, made up almost equally of the digital and face-to-face parts  (Ed. note: 5,100 digital and 4,500 onsite participants). We will know the composition of the participants in detail after the congress. In any case, many of the speakers will be from Austria. 

The RheinMain CongressCenter (RMCC) will host RÖKO2024, which will take place May 8-10 in Wiesbaden in the heart of Germany.

Why is the use of AI not so widespread in Germany? What are the current bottlenecks to the technology’s deployment? What about Austria? 

JW: Even if AI is a disruptive force, its implementation in everyday clinical practice is more of an evolutionary process. From a radiological perspective, this begins in the area of image generation – reduction of radiation dose, fast MRI sequences – and will increasingly complement the diagnostic area where it frees us from redundant, error-prone and time-consuming procedures.

These developments are in full swing. Problems arise when suitable products have to be selected from the multitude of applications on offer today, implemented in everyday clinical practice and, of course, financed. Many AI products only fulfill individual tasks, e.g. round heart detection in the lungs. When implementing them on site, the costs must therefore inevitably be weighed up against the individual benefits. These can quickly add up in an AI portfolio of several applications.

We therefore increasingly need new and flexible platform solutions and “marketplaces” that enable us to try out AI applications in direct comparison or to adapt “pay per use” to our actual needs. Alongside technical AI developments, the digital, legal and economic infrastructure must therefore be developed further in order to increase its dissemination and acceptance in the German healthcare system.  

TH: The situation in Austria is comparable to Germany. Many of us forget that AI has already arrived in our daily lives. Just think of your cell phone. The situation is similar in some areas of radiology. AI is coming and we expect the first FDA approval for an AI-based diagnostic portal in breast cancer screening in the next few months. We expect this to result in a 40 percent workload reduction.

Conservative views of IT managers in the hospital sector are the biggest bottleneck when it comes to implementation. The private sector is much more flexible.

Staff shortages are more and more acute all around the world. What is the situation in Germany and Austria in this respect? 

TH and JW: Ongoing staff shortages and rising costs, which are exacerbated by the retirement of the “baby boomers” and the new work attitude of the new generations, are also setting the framework in Germany and Austria. Fortunately, we do not currently have any serious problems in the medical field. Radiology is in high demand as a very innovative specialty, as shown by the annual increase in specialist recognition.

However, the situation is much more dramatic for radiographers. There is a lack of personnel in many areas, which is why the DRG, together with the DGMTR (the German Society for Medical Technologists for Radiology), has set itself the task of making this exciting profession more visible to the public, to interest more young people in it. There are similar campaigns in Austria.

Irrespective of this, aspects of “new work” and the opportunities of digitalization with remote and home offices must be consistently considered and utilized. 

An aerial view of the Market Church in Wiesbaden, Germany

30% of private radiology practices in Germany are held by investors. Is this something that radiologists should worry or be happy about? Is the situation in Austria the same? 

JW: We are experiencing a progressive consolidation of practices and an increase in the influence of investor-led medical practices, which today dominate one third of the market. After phases of acquisition and restructuring, and detached from the pure pursuit of profit, these will increasingly have to form themselves as strong service providers. I believe that, depending on their motivation – e.g. part-time, salaried, self-employed – and practice situation, radiologists in private practice will increasingly find themselves in different forms of operation. Regardless of the type of practice, the current competition and cost pressure, and the possibilities of AI will change the radiologist’s immediate field of work and enable fully digital workflows, from referrals using a QR code to AI-optimized examinations and AI-supported findings in the patient’s interest.

TH: I am not aware of any investor-managed medical care center in Austria such as those in Germany. Fortunately, many practices in Austria are owned by families or several participating radiologists.