Radiology plays greatest role to date at the Olympics Games in Vancouver

Imaging studies at the 2010 Winter Olympic Games increased 65% from when they were last held, in Torino, Italy. At the Vancouver games, 950 imaging studies were performed, according to Dr. Bruce Forster, a professor at the University of British Columbia in Vancouver and the Vancouver Organizing Committee imaging supervisor.

Never in the history of the Olympics has diagnostic imaging played such a huge role. For the first time ever at the Winter Olympic Games, all four modalities– digital radiography, ultrasound, CT, and MRI–were represented in both the Alpine and city settings. Another first for the Olympic Games was the addition of portable ultrasound units at, or near, the field of play.

Ninety CT examinations were performed in Vancouver, which is double the number of scans at the Beijing Summer Olympics. In all, around 7500 medical encounters occurred over the course of the games. Of the total, 34% were athletes, Forster said. The rest were facility workers and others who were within the athletes' village boundaries, even temporarily, such as reporters covering the event.

Alpine skiing produced the most injuries, followed by snowboarding, cross country skiing, and bobsledding. The most commonly injured body parts were the knee, pelvis, and low back.

Digital radiography was the most common exam, followed closely by MR, then ultrasound and CT. The consultancy role of the radiologists was a major factor in athlete injury management.

“Often there would be three or four individuals, including the athlete, discussing the imaging findings with the radiologist,” he said.

The Olympic diagnostic imaging equipment was situated in the athletes' villages in Vancouver and Whistler at what are called poly clinics, according to Forster. Poly clinic is an Olympics term that refers to a clinic that provides all medical services to athletes and Olympic families, which means everything from physiotherapy to imaging to lab to consultation by sports medicine physicians, he said.

In a first, each poly clinic had a 1.5T MRI, a 16-slice CT, a digital radiography machine, and an ultrasound machine, all provided by GE, a platinum global sponsor.

Another first was the use of portable ultrasound machines the size of a laptop in five venues outside the villages. The venues were Cyprus Mountain, where snowboard, cross country, and freestyle skiing competitions were held, Canada Hockey Place, where men's hockey was played, UBC Thunderbird Arena, another hockey rink, Whistler Olympic Park, the Nordic sports venue, and Richmond Olympic Oval, the site for long track speed skating.

The idea was to bring imaging to the athlete instead of vice versa, and allow coaches and National Olympic Committee physicians to have the most data they can to determine whether an injured athlete could return to the field of play, Forster said.

"For example, if you're a women's hockey player, and you're playing at UBC rink and you strain a calf muscle in the first period, we can image you in between periods and help the coaches decide whether you can go back,” he said.

The units were staffed by musculoskeletal sonographers and the images were then sent via an extensive network to the poly clinics, where the radiologists interpreted them and gave immediate feedback to the physician, according to Forster.

Nineteen radiologists and 51 technologists, all Canadian, were at the games. The host country picks the physicians and historically they all come from the host country. In Vancouver the individuals were all volunteers who worked 13 shifts each, with a shift lasting about eight hours. While the poly clinics were open from 7 a.m. to 11 p.m., a patient could come in at any time and still get imaged. Radiologists were on call, Forster said.

Generally speaking, the radiologists were all MSK-fellowship trained. But as there was only one radiologist at each poly clinic, it was important to have diverse skills and be able to cover the unexpected imaging finding-head CTs, and acute trauma, or acute spine trauma CTs, Forster said.

“We had to make sure when selecting the team the radiologists could manage that diverse set of requirements,” he said. The application process to volunteer for the Olympic Games asks about experience in MSK radiology and what sort of modalities the radiologist covers. There also is a security and accreditation check.

But just because the radiologists were at the Olympics didn't mean they got to go to games for free, Forster said.

“Everyone sees themselves at the gold medal hockey game, but the volunteers are told very early on there will not be a chance to go to any of the events for free,” he said.

“I bought tickets just like everybody else.” On the other hand, the radiologists and technologists did get to eat in the same dining hall as the athletes and attend concerts in the athletes' village.

“We eat at the same hall, but there is still a divider between us and them,” Forster said. “It's important that we don't distract athletes. Usually any interaction is operational.”