Dewey European Radiology

https://doi.org/10.1007/s00330-024-10588-9

EDITORIAL

The ESR Essentials for the medical imaging

community
Marc Dewey1,2,3,4*   

Clinical research in imaging is at an inflection point.
We need to move beyond small single-center observa-
tional studies to multi-center medical imaging trials [1,
2]. This is illustrated by the upcoming 10th anniversary
of the Clinical Trials in Radiology (CTiR) sessions at the
European Congress of Radiology (ECR) in 2024 (https://​
www.​myesr.​org/​congr​ess/). Randomized medical imag-
ing trials have a substantial impact on clinical practice by
prompting changes in the use of medical imaging tech-
nologies for specific clinical scenarios.
Changing clinical medicine depends on three crucial
factors: first, new evidence primarily derived from robust
data generated from randomized trials or large registries;
second, reimbursement decisions by health technol-
ogy assessment agencies based on clinical evidence and
health economics studies; and third, a general consensus
on the application of diagnostic tests and therapy within
medical communities. Achieving consensus in the com-
munity often relies on acceptance of updated or revised
clinical practice guidelines.
Clinical guidelines often tend to be long and cater
to the needs of medical subspecialties. To drive change
in medical imaging, it is crucial to provide the general
*Correspondence:
Marc Dewey
marc.dewey@charite.de
1 and second, they will be composed by the foremost experts
Department of Radiology, Charité – Universitätsmedizin Berlin,
corporate member of Freie Universität Berlin and Humboldt-Universität
zu Berlin, Berlin, Germany
2
Berlin Institute of Health at Charité – Universitätsmedizin Berlin, Berlin,
Germany
3
Berlin University Alliance, Berlin, Germany
4
DZHK (German Centre for Cardiovascular Research), Partner Site Berlin,
Deutsches Herzzentrum der Charité (DHZC), and DKTK (German Cancer
Consortium), partner site Berlin, Berlin, Germany
medical imaging community with straightforward, evi-
dence-based recommendations for clinical practice.
We are therefore pleased to introduce a new series, the
ESR Essentials, that has been developed in close collabo-
ration with the European medical imaging subspecialty
societies, which have selected the authors of the respec-
tive writing groups and decided on the topics of the arti-
cles in agreement with the guest editor of the Essentials.
The Essentials is a series of both concise and evidence-
based practice recommendations that summarize the
core knowledge for pivotal questions in clinical care and
are aimed at a general radiologist audience. The vision is
to inform the community of best-practice imaging sup-
ported by the highest evidence in relevant topics by each
of the subspecialty societies.
We hope that the Essentials will provide a more acces-
sible knowledge base and more commonly used guide
to clinical recommendations owing to their concise but
evidence-based nature. Importantly, all 14 European sub-
specialty medical imaging societies have agreed to join
forces with the ESR, the European Radiology Editor and
Editorial Board, the Editorial Office, the Guest Editor,
and the ESR Publications Committee in bringing to our
readers this new format.
Almost all Essentials articles feature several key aspects
that aim to enhance comprehensibility and direct usability
within clinical practice. First, the articles will be succinct,
in their field. Third, the Essentials will specify the current
levels of evidence [3] and whether the underlying studies
were conducted at a single or multiple centers (presented in
tables) for every significant recommendation made. Fourth,
they will make use of flowcharts of the clinical pathways to
summarize recommendations and provide specific guid-
ance for clinical situations. Fifth, the Essentials will provide

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Dewey European Radiology Page 2 of 2

exquisite illustrations of the typical imaging results that can
be expected along common clinical pathways.
I am confident that the Essentials will aid readers in uti-
lizing medical imaging technologies effectively in specific
clinical scenarios. The articles will also account for varia-
tions in available equipment and expertise among readers,
enabling them to apply the Essentials to their own settings.
Subspecialty writing groups have the freedom to obtain
input from additional non-imaging specialty societies,
including surgical and medical subspecialties, to generate
genuine multidisciplinary recommendations. If necessary,
specific protocols outlining image acquisition, reconstruc-
tion, and analysis can be appended as electronic supple-
mentary material to the articles.
I strongly believe that this initiative will be pivotal in
the future of medical imaging. This is because we need to
gather more data on important questions that are verifi-
able and broadly generalizable using global collaboration
and data sharing [4]. This may lead to better ways of gen-
erating the essentials of radiology for our community and
lead the way forward in medical imaging.
In order to actually start to implement this vision, it is
crucial that the core clinical information about the use of
medical imaging is made available in both a digestible and
evidence-based fashion for the entire radiological community
to increase the uptake of trial results in clinical practice. The
final aim of the ESR Essentials initiative is to enable each sub-
specialty medical imaging society to publish ten articles, each
updated every four to five years, resulting in an overall num-
ber of 120–130 articles in this series being available in 2028.
The first two Essentials we are publishing in this issue
of European Radiology are from the European Society
of Gastrointestinal and Abdominal Radiology (ESGAR)
and the European Society of Cardiovascular Radiology
(ESCR), and are dedicated to diagnosing hepatocellular
carcinoma [5] and cardiac MRI [6].
I am immensely thankful for the support and input
from the ESR Board of Directors and the ESR Executive
Council, the editor of the ESR Journal Family, the edi-
tors and editorial board members of European Radiology,
Insights into Imaging, European Radiology Experimental,
Eurorad, and, last but not least, the ESR and editorial
office. I wish the writing groups that their Essentials are
met with appreciation by the medical imaging commu-
nity and will help change clinical medicine for the better.
Funding
Open Access funding enabled and organized by Projekt DEAL. The author
states that this work has not received any funding.
Conflict of interest
The author of this manuscript declares no relationships with any companies,
whose products or services may be related to the subject matter of the article.
Marc Dewey is Guest Editor of the ESR Essentials series, and chairperson of the
ESR Publications Committee.
Statistics and biometry
No complex statistical methods were necessary for this paper.
Informed consent
Not applicable.
Ethical approval
Not applicable.
Study subjects or cohorts overlap
Not applicable.
Methodology
• Not applicable.
Received: 13 December 2023 Revised: 13 December 2023 Accepted: 19
December 2023
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Declarations
Guarantor
The scientific guarantor of this publication is Marc Dewey.