Third World Congress on Medical Imaging, Cairns, Australia, August 25-29, 2005

Chris Barry

Images provided by Janelle Jawenko


Figure 1. Delegates to the 3rd World Conference of Medical Imaging, Cairns Queensland Australia 2005.

Figure 2. Professor David Malin in full flight during his talk on images made from radiation outside the visible range.

Figure 3. Exhibition, Natural Sciences – Joss Dimock, (UK).

Figure 4. Exhibition, Clinical/Medical Illustration – Levant Efe, Aus.

If you were going to choose a location for a conference, where would it be? Perhaps where the rainforest meets the sea or where the Great Barrier Reef comes closest to land? The Convenors of the Third International Congress on Medical Imaging chose Cairns, North Queensland in Australia where both of these phenomena occur.

Julie Murray and Vicki Adams were approached by Peter Lowie and Cees Hersbach (International Congress Committee members) about hosting the Third World Congress. Previous locations were Amsterdam and Florida. Julie (Meeting Chairperson and Vicki (Co-Chair) agreed immediately and recruited Janelle Jakowenko (Treasurer) and Chris Barry as Program Coordinator. After lengthy trans-Australian and trans-global debates, Cairns, Far North Queensland was chosen as the venue and it was decided that the best time of year to hold the meeting would be August. Four keynote speakers were recruited:

• Major General, Professor John Pearn, Surgeon General of the Australian Army, Paediatric Consultant and keen historical medical illustration speaker and supporter.
• Steve Parish, Australia’s most prolific photographer and publisher with a photography business turning over more than $7 (US) million a year.
• Professor David Malin, an astronomer with an energetic and enthusiastic interest in imaging outside the visible spectrum.
• Martin Johns FIMI, Director of Medical Illustration in the University of Cambridge at Addenbrooke’s Hospital Cambridge, U.K.

All the organizational details were in place as the conference date approached, venues were booked, catering organized and attendees registered. In late August, delegates and families began to arrive at the International Hotel in Cairns from throughout Australia and around the world. The exhibition and display had been sent off by road from Brisbane, two days away. Unfortunately the truck was involved in a road accident and the police confiscated all the trucks contents until the cause of the accident could be determined. After this initial setback, most people would be more than disconcerted, but not the organizers; to them it was a mere glitch and a hurdle to be overcome. From the first night’s meeting of colleagues and friends, new and old, the “feel” of camaraderie and fellowship was forged for the rest of the Conference.

The first afternoon was devoted to workshops, which included: Low-cost video editing (Greg Tuchin), Web design (Adam Leadoux) and Photoshop for the artist (Levent Efe). It was intriguing for workshop attendees to learn how Photoshop could be used for drawing. Levant, an award winning artist and medical doctor, first showed some of his commissioned works and then led the group through the steps he uses in Photoshop to produce his eye-catching work. Like all apparently complex tasks, when broken down into their components, Levent made the process look simple.

The evening consisted of a wine tasting sponsored by McWilliams fine wines and the official opening of the Conference Exhibition. Professor David Malin went to great lengths to describe what should have been on display but was in the hands of the Queensland police force. Needless to say, the dissertation was quite humorous fuelled by some delightful wine and witty interjections.

Day 1
The next day began with Keynote speaker Professor John Pearn’s “Images as Heritage.” Professor Pearn opened his address with the following: “The profession of Medical Illustration is one of the oldest and most enduring of all the creative sciences. A Medical Illustrator is a scientist and artist both. The skill and craft of yesterday creates the heritage of today.” This was an excellent way to open a congress whose audience was comprised for the most part of medical and scientific imagers. During the same session, John Boland offered an amazing look at the microscopic structures of the sea cucumber, an intriguing and artistically provoking view of this marine invertebrate. John was awarded “Best Conference Abstract” for his fascinating talk.

The afternoon featured a forum “Trends in Medical and Scientific Imaging.” The forum was a two-way discussion between a panel which included: Professor John Pearn (Chair), Martin Johns, Susanne Williams, Richard Wylie and Marshall Tyler giving viewpoints from Australia, the U.K. and the U.S.A., and included animated audience participation. The major topic of discussion was the increasing use of mobile phones, palm sized video cameras and digital cameras by various hospital personnel and the associated medico-legal implications. Of particular note was Martin Johns’ talk on the English Medical Illustrators who are about to become State Registered and consequently will be the only individuals that the National Health Service will employ as clinical photographers in the U.K. Government Hospital system. Martin was particularly strong on promoting patient’s rights in cases where documentary images were used for purposes other than patient care. All delegates agreed that patients’ rights were paramount and it was decided that a joint declaration should be formulated at the meeting regarding the use of patient images and patient consent. Martin Johns undertook to formulate a series of points to present to the group. After extensive consultation both during and after the Conference a document that has become known as the “Cairns Convention” has been agreed to (see Appendix at the end of this report).

Day 2
Steve Parish was the keynote speaker for day two with his talk entitled: “Inspired By Nature.” Steve began his career as an underwater photographer at the age of 16. This kindled a passion in him for natural history and a desire to share his discoveries with others. As his focus broadened, he turned his lens to recording the diversity of Australia – plants, animals, landscapes, people, architecture and the urban environment. Steve shared the full repertoire of his imaging and publishing skills and left the audience spellbound. Susanne Williams (Victoria, Australian Institute of Medical and Biological Illustration [AIMBI] sponsored speaker) talk “Bee Vision” featured a discussion of a fascinating camera that utilizes straws to demonstrate how bees see. Susanne won the prize for “Best Conference Presentation” and this included a donated original print by Australian Artist Ken Done. Marshall Tyler (Chief Ophthalmic Photographer Wake Forest University Eye Center in Winston-Salem, NC) next shared his stereo world of ophthalmology with his talk: “Creating Chromatic Anaglyphs in Photoshop.” The audience was asked to wear red/cyan anaglyph glasses as Marshall lead them through some eye-popping images which were accompanied by “oohs” and “aahs” from an appreciative audience.

The afternoon continued with more engaging presentations including Professor Pearn’s “Images of Bioterrorism.” This paper summarized some of the basic facts of the bioterrorist threat and discussed some of the potential images of bioterrorism that will form an inescapable part of our future.

Day 3
Everyone was up bright and early to catch a boat for a day on Green Island, the closest island of The Great Barrier Reef to the mainland. After a rather wet start, the sun came out just as everyone arrived at the Island. After spending three days in talks and workshops, this was a great opportunity to go sight seeing and look at some of the dazzling array of corals that can easily be viewed by snorkelling.

Day 4
Keynote speaker was Professor David Malin with his presentation: “Atomic to Cosmic, An Imager’s View of the Universe.” Professor Malin’s talk explored scientific imaging, covering an astonishing range of disciplines. It was pointed out that it is the job of the scientific imager to capture these often unseen phenomena and events and translate them into a form that the brain can understand, or at least visualise.

Several speakers followed discussing the business aspects of imaging either in government departments (Greg Tuchin, John Baird) or outside of medical or scientific establishments (Des Sloane, Levent Efe). Of particular note was Ross Clayton from New Zealand with his innovative “Mole Mapping,” which is now an ever expanding business in the Bay of Plenty, North Island.

For the final evening, the group went to the Casino private function rooms for a Banquet and presentation of awards. The group now, familiar with the Australian vernacular, roundly applauded each prize winner adding their own touches to compliment the recipient. Prizes were sponsored by: Fujifilm, Kayell Australia, Steve Parish Publishing, Novartis Ophthalmics, Prof D. Malin, Adobe, Apple Australia, Taylor & Francis Group, Foto Reisel and AIMBI.

The conference came to an end with many new friendships forged, lessons learned and upcoming challenges at least recognized, if not solved, by the wealth of information offered by each speaker. The broad range of topics covered can not be fully detailed here without repeating verbatim all that was said. However, we thank all those who gave their time and energies to pass on their thoughts and to all those that attended. I really think that many new friendships were made and many others renewed. Our common bond of wanting to learn with open minds from those with knowledge and experience and to come together as a group with a common passion has left us all enriched both professionally and personally. Lets hope that the next World Medical Imaging Conference, wherever it is held, can be as fulfilling and just plain good fun as Cairns 2005.

Chris Barry
Lions Eye Institute, Perth, Western Australia
cjbarry@cyllene.uwa.edu.au

Appendix: The Cairns Convention on Consent for the Use of Clinical Photography Other Than for the Direct Care of the Patient*

• Patients have a right to privacy that should not be infringed without informed consent.**
• The informed consent of the patient (or other appropriate representative of the patient) is essential before any use of clinical photographs, video and audio recordings other than for the direct care of the patient or for the audit of that care (e.g. for teaching, research or publication).
• Anonymity of images (e.g. by pixellation or other masking of the eye region) does not guarantee anonymity and does not replace the need for informed consent.
• This right to informed consent extends to all images including those that are not immediately identifiable, but which may become so in the context in which they are used.
• In the case of publication, the requirements of the International Committee of Journal Editors should be applied.
• Patients should be made aware (as a part of the informed consent process) that they may withdraw their consent to further use at any time.
• They should also be made aware (as a part of the informed consent process) that if they agree to publication of their images on the World Wide Web, it will be impossible to stop further dissemination of the images.
• Unwillingness of patients for their images to be used for purposes outside their direct care should in no way compromise their treatment.
• Patients (or other appropriate representative of the patient) have the right to access clinical photographs, video and audio recordings taken of them. Medical Institutions and Practices should ensure that appropriate storage and retrieval systems are in place to accommodate image retrieval.

*Published by the International Committee of Biomedical Photographers at the World Congress in medical Illustration, Cairns, Australia, August 2005
** Uniform Requirements for Manuscripts Submitted to Biomedical Journals: Writing and Editing for Biomedical Publication (International Committee of Journal Editors, http://www.icmje.org/#privacy, October 2004)

Excerpt from: Uniform Requirements for Manuscripts Submitted to Biomedical Journals: Writing and Editing for Biomedical Publication
International Committee of Journal Editors, http://www.icmje.org/#privacy, October 2004.

Patients have a right to privacy that should not be infringed without informed consent. Identifying information, including patients’ names, initials, or hospital numbers, should not be published in written descriptions, photographs, and pedigrees unless the information is essential for scientific purposes and the patient (or parent or guardian) gives written informed consent for publication. Informed consent for this purpose requires that a patient who is identifiable be shown the manuscript to be published.

Identifying details should be omitted if they are not essential. Complete anonymity is difficult to achieve, however, and informed consent should be obtained if there is any doubt. For example, masking the eye region in photographs of patients is inadequate protection of anonymity. If identifying characteristics are altered to protect anonymity, such as in genetic pedigrees, authors should provide assurance that alterations do not distort scientific meaning and editors should so note.

The requirement for informed consent should be included in the journal’s instructions for authors. When informed consent has been obtained it should be indicated in the published article.