Nearly every radiologist has a collection of interesting cases in their personal repertoire, and new updates to RSNA's free Teaching File System have made it easier than ever to compile them.

Flanders

"It's really surprising how few people know that this tool is available for their use," said Adam E. Flanders, M.D., a professor of radiology and rehabilitation medicine at Thomas Jefferson University Hospital in Philadelphia and chair of RSNA's Radiology Informatics Committee. "It's free and even more accessible and there's no good reason every radiologist shouldn't be using it."

A project of RSNA's Medical Imaging Resource Center (MIRC), RSNA's Teaching File System is a free tool allowing radiologists to author and share their own teaching files, complete with multiple images, histories, findings, diagnoses, discussion and references. Users can then save the files as personal cases accessible via a secure login—or they can submit them to the RSNA collection of shared cases so their colleagues can benefit from them. The MIRC Subcommittee of the Radiology Informatics Committee oversaw development and realization of the project.

"Instant" Collections are Among Improvements

The Teaching File System recently added improvements that make it even easier to use, including a new interface conceptualized by MIRC Subcommittee members Krishna Juluru, M.D., and Marc D. Kohli, M.D.

Each time they access the system, RSNA members use the intuitive new interface to search for and view cases. Along with a standard installer that works on all platforms, the system features a Windows-specific installer developed by MIRC Subcommittee member William J. Weadock, M.D. MIRC software can be installed on a personal or departmental computer. In addition, some facilities have made their MIRC sites available on the Internet.

Another useful feature is a zip service that allows users to convert old images into MIRC files and build an instant collection without starting from scratch.

Using RSNA's Teaching File System, radiologists can author and share their own teaching files, complete with multiple images, histories, findings, diagnoses, discussion and references. Examples from the file: (from left) Bilaterial quadriceps tendon rupture secondary to hyperparathyroidism, by Ben Tarigan, M.D., renal artery aneurysms in neurofibromatosis, by Cynthia Tan, M.D., and "osteopetrorickets," by Jimmy Wang, M.D., and Andrew Poznanski, M.D.

"If you already have an existing teaching file, say, on a USB drive, with a bunch of cases that you've been collecting for years, a tool built inside the teaching files software will read all that data from your collection of cases and convert them to web cases," Dr. Flanders said, noting that he uploaded several thousand cases in a single submission.

Along with images, the system allows users to save PowerPoint presentation and convert them to MIRC documents.

The new system is clearly in demand. According to a 2011 RSNA membership survey, nearly 85 percent of respondents collect teaching files and would prefer an easier method to host them, Dr. Flanders said.

"We want users to understand that the Teaching File System is something every radiologist can use, it's free of charge and it has a lot of cool features that make teaching files fast and easy," he added.

Anonymization Capability is "Powerful"

A primary strength of the Teaching File System is its ability to remove Protected Health Information from DICOM images, making it possible to incorporate the images into teaching cases while meeting Health Insurance Portability and Accountability Act (HIPAA) privacy regulations.

The Teaching File System incorporates the same anonymization feature as RSNA's Clinical Trials Processor (CTP) software, another MIRC tool that enables clinical trials administrators to securely move data among multiple institutions. "It's the most powerful anonymizer in the world," Dr. Flanders said.

To get the maximum educational value, the file should contain text information about the patient. "An old directory-based file usually only contains images, but sometimes there's a text file with information. The zip service is smart enough to recognize the text file and pull it out of the document," Dr. Flanders said.

Although both the CTP and Teaching File System are packaged under the same MIRC banner, Dr. Flanders stresses that they are two separate tools.

The Teaching File System is useful for individuals and institutions alike. In fact, radiologists may have viewed a RSNA Teaching File System interface without even realizing it—for example, the Society of Pediatric Radiology uses it to host its Unknown Cases feature on its website.

A free Teaching File System app for iPhone is now available in the App Store, Dr. Flanders added. While it wasn't developed by RSNA, the app carries the MIRC tagline. It was developed by Houman Ebrahimi, M.B.B.S., radiology registrar at Hunter England Imaging, Newcastle, Austalia. A version for iPad is also in development.

"Because this is all open-source, we encourage experimentation—if people want to use bits and pieces of this software to create something, by all means, knock yourself out," Dr. Flanders said.

Users can see the Teaching File System in action—complete with a large collection of sample cases—and download the software in one click with the query http://mirc.rsna.org/query.

"We wanted to show people what a teaching file site could look like, with real cases," said Dr. Flanders. "There are tons of cases in there to peruse."

Web Extras

• To download RSNA's free Teaching File System app from the App Store, click here 
• To view RSNA's Teaching File System—complete with a large collection of sample cases—and download the software, go to mirc.rsna.org/query.
• For more information on RSNA's Medical Imaging Resource Center (MIRC), a set of free software tools to support radiology teaching files and imaging clinical trials, go to RSNA.org/Informatics/mirc.cfm.
• Collections offered by several institutions running MIRC sites are searchable at mirc.rsna.org/query.
• To access a Wiki article on MIRC, go to mircwiki.rsna.org/index.php?title=MIRC