MyPACS: YouTube for radiologists

In its first seven years of existence, the number of cases on MyPACS has grown 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 (http://www.mypacs.net) was created in 1999 by Rex Jakobovits, Ph.D., to give clinicians a free way to share knowledge. It has become a perfect example of 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 INCREASE 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. Further, Silberberg said another consideration is that it is related to the entity called American Burkitt 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 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.