MyPACS encourages networking among radiologists in far-flung places

In its first seven years of existence, MyPACS has seen the number of cases posted grow from a few hundred images contributed by a handful of radiologists to well over 16,000 cases containing nearly 70,000 images uploaded by radiologists from hundreds of hospitals around the world.

MyPACS was created in 1999 by Rex Jakobovits, Ph.D., to give clinicians a free way to share knowledge. It has become a model for radiologists as a Web 2.0 social networking application. Web 2.0 sites comprise useful user contributions assembled to exploit collective experience.

"MyPACS.net has become a resource for physicians around the world who don't have access to local radiology services, who are being forced to make their own guesses at reads," Jakobovits said. "They're using MyPACS as a decision support resource."

Not all those seeking advice are isolated clinicians. Some are radiologists.

Dr. Rolando Reyna, a radiologist at Hospital Santo Tomas in Panama City, Panama, for instance, posted this case on MyPACS:

Need help, 27-year-old female, probably renal lymphoma. US shows increased renal echogenicity. no chemo, at time of US. What do you think about the kidneys?

One response, from Dr. Phillip Silberberg, a pediatric radiologist at Omaha Children's Hospital, wondered whether the increased renal echogenicity could be a response to previous chemotherapy. Silberberg said another consideration could be Burkitt's lymphoma, which can have diffuse increased echogenicity.

The Society of Pediatric Radiology recently saw how it could take MyPACS one step further. SPR has adopted MyPACS as the core platform to support a formal international outreach endeavor.

Under a pilot project, physicians in developing nations are invited to upload pediatric cases to MyPACS that they may lack expertise to diagnose. An e-mail alert is then sent to an SPR mailing list of volunteer SPR radiologists, who can respond with educational opinions.

Those involved with MyPACS are careful to stress these collaborations are educational in nature, not second opinions in the medicolegal sense.

"These are educational collaborations," Silberberg said. "We're sharing interesting cases, not giving second opinions. No money is changing hands."

SPR expects this form of direct person-to-person case sharing to accelerate the spread of radiologic expertise to developing nations, resulting in improved healthcare worldwide.

If it is successful, SPR will extend participation to its entire membership.

"MyPACS appears to be a great platform for this, because it offers a user-friendly interface for uploading cases, a high-quality viewer for evaluating cases, and an alert system that automatically sends e-mails to volunteers whenever someone is soliciting opinions on a case that matches their expertise," said Dr. Sarah J. Chilton, chair of SPR's International Outreach Committee.

MyPACS is entirely web-based, so it can be used from any PC or Mac - even on a locked down hospital workstation - without requiring any downloads or software installation.

Last year, the American College of Radiology licensed the MyPACS Enterprise imaging application to offer the ACR Learning File case library online. The ACR Learning File is a collection of over 3400 peer-reviewed teaching files depicting thousands of diagnoses organized by anatomy and pathology. The collection contains over 10,000 images, annotated to show findings and accompanied by detailed discussions. Until last year, the cases have been available only as a library of 11 CD-ROM volumes.

The MyPACS case viewer provides a PACS-like experience in the browser. Images are automatically resized to fit the viewing window, and users may zoom in and pan around on images in real-time. The MyPACS intelligent search engine provides instant access to reference images for diagnostic decision support, and residents can use Case Training Mode to study for board exams, according to the ACR.

For more information from the Diagnostic Imaging archives:

Digital case file system collects interdisciplinary 'intellectual capital'

Teaching file engines line up at infoRAD

Radiologists need to keep aware of broader IT picture