DOI: 10.1148/radiol.2472080187
(Radiology 2008;247:307-310.)
© RSNA, 2008
Net Assets: Personal Technology for Productivity in Radiology1
Stuart R. Pomerantz, MD
1 From the Department of Neuroradiology, Massachusetts General Hospital, Harvard Medical School, 55 Fruit St, Gray 2-B285, Boston, MA 02114. Received and accepted January 29, 2008.
Address correspondence to the author (e-mail: netassets{at}rsna.org).
In Net Assets, you will find a regular, easy-to-peruse roundup of the latest dynamic Web sites that can supercharge a busy day in radiology. The embarrassment of radiologic riches on the World Wide Web has made the online experience an indispensable ally for the modern radiologist. Yet, the thrill of uncovering the exact "pearl" for a confident diagnosis is often tempered by the frustration of unsuccessfully sifting among myriad distracting sites. Whether one's goal is improved radiology searching, efficient ways of staying current with the literature, sharing great cases with colleagues, or enhancing presentations, I will focus on the most useful features of the best radiology Web sites and how to make the most of the time you spend on them.
Recent advances in Web technology, sometimes referred to as "Web 2.0," are not only making radiology content much more accessible but also turning the Web into an amazing personalized productivity tool. Net Assets will explore how the ingenious general-interest (and often free) online services that seem to pop up regularly on sites like Google can be tailored to enhance the practice of radiology. We will also look at how various consumer gadgets can help radiologists multitask ergonomically, whether it be navigating a three-dimensional image volume or juggling multiple input devices to communicate our findings.
The remainder of this issue's column will focus on several Web sites that are already incorporating cutting-edge technologies to enhance the Internet as the ultimate clinical and anatomic reference in radiology.
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RADIOLOGY-CENTRIC SEARCH
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The massive collections of radiology links on portal sites such as AuntMinnie.com (http://www.auntminnie.com) and RadiologyEducation.com (http://radiologyeducation.com) are a testament to the enthusiasm with which radiologists have embraced the Internet as an "e-learning" platform (1). The ideal is clear: fast relevant answers from reliable sources on beautifully illustrated Web sites that are easy to navigate. However, when one is hunting for a quick answer during a hectic day or a lonely overnight shift, the deficiencies of the Web for point-of-care decision support become glaring. Although general search engines have improved, one still often encounters too much irrelevant information for the radiologist, including advertisements, patient-oriented information, and outdated or unreliable material. Luckily, we have now entered the age of the "radiology-centric" search.
Yottalook: "Y'oughta Look"
Fusing proprietary technologies with a highly customized Google search engine, the developers of Yottalook (http://www.yottalook.com) at iVirtuoso (Washington, DC) have optimized the radiology search experience by incorporating a semantic, or concept-based, approach (2). A user's query is analyzed with reference to various medical ontologic taxonomies, including an enhanced version of Radlex, the radiology lexicon developed with sponsorship from the Radiological Society of North America (RSNA). The search engine can consequently expand the query to all possible relevant terms and index the results in a way that enables intelligent filtering. For example, if one were to enter "PE" into the Yottalook search box, the site understands that this could refer to pulmonary embolism, preeclampsia, or pericardial effusion and allows one to choose appropriately. The semantic search engine cleverly recognizes synonyms such as gallstones and cholelithiasis and utilizes hierarchic relationships between medical concepts to return the most comprehensive and relevant search results. For example, when one enters the disease category "phakomatosis" in Yottalook, the related terms tuberous sclerosis, neurofibromatosis, and ataxia-telangiectasia are offered as additional search options.
Radiology-specific filters are another key strategy by which Yottalook enhances the search experience. By restricting the scope to such relevant categories as teaching files, journal articles, continuing medical education materials or to specific modalities such as computed tomography (CT) or magnetic resonance (MR) imaging, one can much more quickly get to the right answer (Fig 1). The "Anatomy" filter will preferentially return search queries from dedicated online atlases such as Gray's Anatomy and journal articles likely to have high-yield anatomic content, such as one example titled "The Cystic Duct: Normal Anatomy and Disease Processes" (3) from an online education exhibit in RadioGraphics. Combining the various filters is possible in order to make even more specific searches practical. For example, if one were trying to update one's practice's MR imaging protocol for carotid dissection, a Yottalook search could be performed with the "MRI" and "Protocol" filters chosen. Top results would include the links to various institutions' Web sites that have made their protocols freely available online (eg, Massachusetts General Hospital Neuroradiology—MRI Protocols, http://www.mghneuroradiology.org/NewFiles/mrip.html). If one were to choose the filter for a specific hardware manufacturer, only journal articles that listed the appropriate equipment in their methods section would be listed.
Image searching is robustly implemented in Yottalook, with over 500 000 entries indexed. A detailed listings view displays thumbnail images with adjacent image captions and online journal links. A convenient thumbnails-only view squeezes up to 50 images on a single page (Fig 2). As the cursor passes over the various images, a pop-up text box displays the appropriate caption. By clicking on the "Bookmark" button, you can store the image collection in your browser's favorites list or store and share it online through a number of different social bookmarking sites.
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Figure 2: Screenshot from Yottalook images: thumbnails-only view. Pop-up window with corresponding caption and journal link appears as cursor passes over each image. Note the option to filter further by modality.
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By automatically stripping out results unrelated to medical imaging, Yottalook vastly increases the utility of the various specialized search services that you may already be familiar with in Google. For example, Google Book Search allows you to search within the actual text of an enormous number of hard-copy books, both recent and out of print. The digitized copy of the book appears onscreen opened to the page of interest, with your search terms already marked in yellow highlighting. The preview mode allows you to jump between chapters or flip page by page through surprisingly extensive sections of each book. Yottalook optimizes this already impressive service by listing only radiology texts in the search results. A search for "glioblastoma" is thus reduced from an overwhelming 1306 books in the native Google Book Search, including numerous patient survival guides and basic science texts, to a more manageable 168 medical imaging texts in Yottalook Books (Fig 3). Similarly, when one searches in the Yottalook customization of Google Scholar, one's results are already prefiltered to include only the imaging literature.
"Yottalinks" are special sites that the Yottalook editors have designated as particularly high yield for particular radiology search topics. For example, if one queries "renal failure," a Yottalink to an online glomerular filtration rate (GFR) calculator appears in a separate section of the results page.
There are numerous additional features to be discovered on the Web site. After using it just a few times, I believe that many radiologists will opt to make Yottalook their first-line search rather than Google or other general search engines.
There are several ways of making access to Yottalook's search results even easier. One can make Yottalook the Web browser's default homepage, add a Yottalook button to the Google search toolbar, or incorporate it into one's own customized Google "mash-up" homepage (iGoogle). Yottalook will be showing up in other contexts as well, since it is available for developers to include in their own Web sites and has already been integrated as the search engine of the RSNA Web site (http://www.rsna.org).
ARRS GoldMiner: A Semantic Radiology Image Search Engine
ARRS GoldMiner (http://GoldMiner.arrs.org/) is another radiology-centric search engine whose niche is providing the radiologist with direct access to images selected only from peer-reviewed journals. GoldMiner was created by Charles E. Kahn, Jr, MD, of the Medical College of Wisconsin (Milwaukee, Wis) and is offered as a free service of the American Roentgen Ray Society (4). Its collection was recently markedly expanded to more than 170 000 images and over 225 journals by partnering with BioMed Central, a free database of peer-reviewed scientific articles. Like Yottalook, GoldMiner performs a concept-based search that expands the user's search query beyond simple word-matching. The GoldMiner service can be useful in assembling a presentation or in scanning for look-alike images when struggling with a problem case. The Web site features a clean design, with each row of the display containing a thumbnail image, as well as the source article's title and journal link (Fig 4), though it would be helpful to be able to view more images per page, as in the Yottalook thumbnails-only view. A click on the thumbnail image directs you to the full-resolution image on the journal's Web site and the full text of the article it came from. A PowerPoint (Microsoft, Redmond, Wash) slide containing both the image and appropriate reference notation can often be downloaded through these links. This online access is possible because the journals typically make their content fully available on the Web within 12–24 months after publication. One can filter the results by modality, patient age, and patient sex from a set of pull-down tabs that also indicate how many image results are available in each category.
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Figure 4: Screenshot from ARRS GoldMiner. Image results for the search term "adenomyosis" narrowed by "MRI," "Adult," and "Female" filters applied concurrently. (Image courtesy of the American Roentgen Ray Society.)
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A newer offering from the same site is GoldMiner Global. Alhough still in a developmental (beta) status, this multilingual interface enables users to submit search terms in any of 10 languages to the GoldMiner image database.
e-anatomy: Interactive Atlas of Anatomy
What if hunting for a structure in an anatomy atlas was as easy and dynamic as scrolling through a stack of images on a picture archiving and communication system workstation? On the e-anatomy Web site (http://www.e-anatomy.org), the development team at Campus Medica (Montpellier, France) have leveraged Web technologies, in particular Adobe Flash (Adobe, San Jose, Calif), to accomplish this amazing feat. The Web site, which was recognized with a Certificate of Merit and Excellence in Design awards at the 2007 RSNA Annual Meeting, currently contains 12 modules divided among head and neck, trunk, and limbs regions. Modules load in fewer than 15–30 seconds (with a broadband connection) and offer fluid scrolling in multiple image planes. Correlation of section position and orientation is visualized on accompanying three-dimensional models, and instantaneous switching between different CT window and level settings or MR image weightings is possible. As you navigate the stacks in the various e-anatomy modules, anatomic labels track with their structures in real-time. Labels can be turned on or off for "quiz" mode or selectively displayed in any combination of anatomic groupings, such as arteries, veins, nerves, and bones. Segmental anatomy is also displayed dynamically. As the cursor passes over the portions of the various hepatic or pulmonary segments on any given section, the segment is identified by name and highlighted in color (Fig 5). The inclusion of additional anatomy modules and more flexibility in choosing which image plane to scroll through could make this site even better.
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Figure 5: Screenshot from the e-anatomy abdomen-pelvis CT module. In addition to pinpoint anatomy labels and multiplanar and three-dimensional correlation in sidebar images, organ segments are dynamically highlighted and labeled as the cursor passes over them.
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ACKNOWLEDGMENTS
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The author thanks Tarik Alkasab, MD, Keith Dreyer, DO, PhD, and Manjil Chatterji, MD, for their comments.
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FOOTNOTES
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Author stated no financial relationship to disclose.
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References
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- Scarsbrook AF, Graham RN, Perriss RW. The scope of educational resources for radiologists on the Internet. Clin Radiol 2005;60:524–530.[CrossRef][Medline]
- Flanders AE. Next generation Web search: augmenting information access for radiologists. RadioGraphics 2007;27:1519–1521.[Free Full Text]
- Turner MA, Fulcher AS. The cystic duct: normal anatomy and disease processes. RadioGraphics 2001;21:3–22.[Abstract/Free Full Text]
- Kahn CE Jr, Thao C. GoldMiner: a radiology image search engine. AJR Am J Roentgenol 2007;188:1475–1478.[Abstract/Free Full Text]
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