Radiopaedia.org case playlists to increase trainee access to teaching file cases

Background: Teaching cases are a hallmark of radiology education. Teaching files are typically designed for PACS review, presenting inherent limitations: 1) cases are only readily available to trainees while in the hospital, 2) diagnoses are often not available, 3) key images and learning objectives may not be readily apparent to a trainee on independent review, and 4) adopting a new PACS or faculty changing institutions may lead to loss of teaching cases. Uploading cases to Radiopaedia.org addresses these limitations. Cases are permanently available and can be viewed by trainees on any device, from anywhere with an internet connection. Learning objectives, diagnoses, key images, and teaching points can be provided by the case creator. In addition, full DICOMs can be uploaded, allowing trainees to scroll through cases, simulating a PACS environment for image review. Radiopaedia cases can be grouped and shared with trainees as playlists, allowing the opportunity to create learning modules, or simply to show multiple companion cases in succession. When sharing cases or playlists, the user is given the option to keep the diagnosis hidden, a feature that can be utilized for cases conferences or examinations. Finally, playlist content is not limited to one’s own cases, allowing the user to incorporate good cases uploaded by other users.

Objectives: Increase trainees’ access to teaching file cases by making cases available on Radiopaedia.org, to teach normal biodistribution of both single photon radiopharmaceuticals and F18-FDG, basics of Tc-99m-MDP skeletal scintigraphy, and interpretation of common nuclear medicine call cases.

Methods: Cases were identified from our institution’s PACS, authors’ personal case files, or from cases already uploaded by other users to Radiopaedia.org. Case images were vetted to ensure they did not contain PHI. DICOM files downloaded from PACS were anonymized to ensure HIPAA compliance. Cases were uploaded to Radiopaedia.org and playlists were created to function as introductory primers on: 1) Normal biodistribution of single photon radiotracers used in general nuclear medicine studies, including Tc-99m-MDP, I-123-MIBG, I-123-pentetreotide, Ga-67 citrate, Tc-99m-pertechnetate, I-123-NaI and I-131-NaI, In-111-DTPA WBC, and Tc-99m sulfur colloid. 2) Introduction to Tc-99m-MDP whole body scintigraphy, including normal variants, common pathologies, and common pitfalls. 3) Normal biodistribution of 18F-FDG and common variants in FDG PET. 4) Protocoling and interpreting V/Q and HIDA scans Playlists were made available to radiology residents at our institution, for use during nuclear medicine rotations and as part of their call preparation. Summary: Cases uploaded to Radiopaedia.org and organized into playlists provided trainees with permanent access to teaching cases from any device and from any location with an internet connection. Playlists were made available to radiology residents during rotations on our general nuclear medicine and PET services to assist in learning basic principles needed for these rotations. Call preparation playlists were also provided to radiology residents at our institution to assist in learning to protocol and interpret V/Q and HIDA scans, which are the most common nuclear studies performed during resident call shifts at our institution.