The 2024 IR Leadership Meeting

July 11, 2024

On the eve of ET 2024, leaders of interventional radiology societies from across Europe met in Vienna for CIRSE’s first IR Leadership Meeting.

CIRSE President Prof. Christoph Binkert presented CIRSE’s vision for the future of interventional radiology in Europe at the opening ceremony of CIRSE 2023 in Copenhagen. In recognition of the fact that the journey towards realizing this vision can only be accomplished with the help of the IR community throughout the continent, CIRSE’s Executive Committee invited two representatives from each European CIRSE group member society to join the IR Leadership Meeting and workshop on the topic of the future of IR which took place the day before ET 2024 began.

The meeting included interactive discussions and breakout sessions on the current status and set-up of interventional radiology in Europe, and was supported by the present members of the CIRSE Executive Committee as well as senior staff from the CIRSE office.

Prof. Binkert warmly welcomed the delegates and opened the meeting by visiting every table individually to learn about the status of IR and clinical practice at each of the individual hospitals and countries represented. Already this introductory tour gave interesting insights from 20 different countries, showing that often small countries lead the way in terms of IR practices.

Throughout the meeting, it became clear that in spite of overarching goals that unite most IR practitioners, the reality of working in the field remains vastly different throughout Europe. Of the delegates gathered at the meeting, some have outpatient clinics, full responsibility of their patients, their own beds, 24/7 service, and work as a recognized subspecialty; others still struggle with funding, representation, educational pathways, and recognition amongst colleagues.

CIRSE’s vision for the future of IR

Prof. Binkert moved on to the presentations portion of the meeting, explaining the three pillars of CIRSE’s vision for the future of IR:

• Phase 1: Focus on clinical services and patient care: IRs should be clinically involved in patient management and care, and included in MDTs. They should also have access to resources and infrastructure.
• Phase 2: Focus on therapies and treatment: A practitioner’s daily work should focus on IR treatments, and the involvement in diagnostic radiology should be centred around IR patients and consultations during MDTS. Purely diagnostic services to other disciplines should be minimized.
• Phase 3: Focus on training and excellence in IR: IRs should be well-trained physicians who have had sufficient time for clinical training built into their education. The European Board of Interventional Radiology (EBIR) should become a standard requirement, and IRs should strive to achieve subspecialty status.

CIRSE is currently implementing phase 1 and will continue to focus on clinical services and patient care as a priority throughout the remainder of Prof. Binkert’s term as president. But as Prof. Binkert also emphasised throughout the meeting, these three phases can overlap and might be implemented at different speeds or in parallel in different countries, depending on local realities.

While visions sometimes run the risk of remaining without real follow-up, CIRSE has been very busy implementing the focus on clinical services and patient care over the past year. The first step was the establishment of the Clinical Services in IR Task Force. Prof. Andreas Mahnken, chairperson of this task force and CIRSE’s coordinator of clinical services in IR, joined Prof. Binkert to share what progress has been made so far on this topic.

CIRSE understands clinical services in IR to include patient-centred delivery of care, covering the entire patient pathway from the IR procedure and the care beyond. Direct patient access is a prerequisite for delivering a high level of clinical service, and this is where the visibility of IR is still a great challenge.

CIRSE’s first clinical practice document, “Clinical Practice in Interventional Radiology”, was published in 2007; since then, the society has produced multiple standards of practice documents on the topic, supported the creation of a UEMS IR division, and offered clinical education and training via the CIRSE Library. In 2021, CIRSE’s Clinical Practice Manual offered a long-term vision for clinical practice in IR. Following the publication of the manual, the Clinical Services in IR Task Force conducted a member survey to assess the current issues and needs of the community.

The task force is now at work using the results of the survey to develop projects that would best serve the community. A major focus of the task force’s work is to provide educational materials that should support IRs in getting their clinical practice up and running, as many IRs still feel uneasy about activities such as ward rounds. The educational toolbox put together by the task force is available on the CIRSE website and covers a webinar, dedicated congress sessions, relevant literature and micro-education videos. A CIRSE Academy course will be published later this year. At CIRSE 2024, a hot topic symposium and several sessions will be dedicated to this topic.

Food for thought

After the presentations, each of the eight working groups at the meeting broke off into individual discussion groups. Three tables answered questions on clinical services and patient care, three were assigned to focus on therapies and treatment, and the last two tables conversed on training and excellence in IR.

While a full hour was given over for these discussions, moderated by Executive Committee members, it quickly became clear that this exercise will need to be repeated often at future events. Many of these topics currently weigh heavily on the minds of IRs, particularly those in countries or hospitals with less official support.

After the discussion, each group was given time to present the main points of their findings and answer questions from other participants. The situations represented at the different tables proved to be as unique as the doctors themselves; however, challenges such as personnel, cooperation with other disciplines, training pathways and the visibility of IR were a recurring theme. Across all tables, there was a broad consensus that the EBIR can be an important asset in national training pathways, and that clinical services in IR are a must. The great collaborative spirit in the meeting left the participants optimistic that together we will be able overcome these challenges.

Although Prof. Binkert officially closed the meeting with words of thanks and appreciation for all participants, these important discussions ultimately continued well into the evening and throughout the subsequent days at ET 2024.