A RADIOLOGIST AND HIS AMIGA
Now that my computer and I are back from Chicago, I want to tell
you about a recent exhibit I had at the annual meeting of the
Radiological Society of North America held this past December in
Chicago's McCormick Place.
This is one of largest professional meetings in the world,
attracting over 51,000 people, with many non-U.S. attendees. The
purpose is one of education, with a large number of lectures and
courses designed to keep radiologists up to date. Much equipment is
also on display--several football fields worth. In fact, is said that
McCormick Place is one of the few places in the United States that can
accommodate a meeting such as this.
INFORAD
One rather new section of the meeting is devoted to the
educational role of computers in Radiology. Radiologists, usually
from prestigious medical centers, compete for space by submitting
proposals about computer exhibits and projects they are working on.
It came as a surprise to me that my own proposal "A Nuclear
Medicine Teaching File -- Start to Finish" was among those selected
because it involved Amiga computers, which were not among those listed
as being supported at the meeting.
WHAT IS NUCLEAR MEDICINE? -- A QUICK DIGRESSION
Nuclear Medicine is a subspecialty of Radiology which itself is a
subspecialty of medicine.
In radiology, a patient is exposed to some form of energy and an
image is obtained. Generally speaking, the energy is external to the
patient and the images that are produced give information about
anatomy, e.g., about whether a bone is broken or how many kidneys a
person has.
In nuclear medicine, the radiation is internal to a patient,
usually given as an extremely small amount of radioactive material
intravenously. While this sounds dangerous, the fact is that the
radiopharmaceuticals and the amounts that are used are rigorously
controlled by the government and are only approved after careful
studies have demonstrated their safety and usefulness. Hospitals and
radiology departments must be licensed to use such materials and are
under continued monitoring. Physicians administering these materials
and interpreting the results of such tests must themselves undergo
special training and licensing.
Hospitals go to great length to be able to offer the services of
nuclear medicine because nuclear medicine, unlike most of radiology,
gives information about function. Thus, while there are many studies
in radiology that will tell you that you have a heart in addition to
two normally positioned kidneys, it is nuclear medicine that can give
a rather precise answer to the question as to how well your heart and
your kidneys are working.
A COMPUTER BASED TEACHING FILE SYSTEM
Given that it is desirable to have nuclear medicine procedures in
a modern radiology department, it becomes imperative to have people
trained to perform and interpret such studies. Traditionally
radiologists-in-training spend time with an experienced nuclear
radiologist learning how procedures are performed and then how to
interpret the resulting images. While there are many nuclear
radiology textbooks available, a computer based atlas of nuclear
images would be of particular value.
First, creating and maintaining such a teaching file teaches nuclear
medicine because each image would have to have an accompanying text
describing the important findings on the image along with some relevant
questions and answers for other people reading the computer atlas.
Second, in order to make such a file or even just to add cases to a
partially completed file one has to know something about computers
such as how to digitize, store and use an image. Third, a computerized
book need never go out of date because the next case that one adds makes
a new edition.
THE AMIGA AND THE TEACHING FILE
For me there is no question that the best and most affordable
computer for graphics of any kind is the Commodore Amiga.
Nuclear images were scanned into the computer using Progressive
Peripheral's FrameGrabber256. I used ASDG's Art Department
Professional to convert the 256 gray scale images into the Impulse
format for display with their 24 bit graphics display board, the
FireCracker24. For an authoring program, I used Gold Disk's
HyperBook. This is a very easy program to use.
In a computer based teaching file, the computer becomes a book
and every screen becomes a page. On each page, I had a miniature
nuclear medicine image with a series of questions related to that
image. Answers could be obtained by selecting questions with the left
mouse button. For more detail, images could be output to the
FireCracker24. Because cases are linked together according to disease
categories, the reader could study related cases rather than simply
"turning the pages" of the computer book. The program even provided
the option of listening to an audio CD in the background, accessed
from the Xetec CD ROM drive.
THE MEETING ITSELF
At the meeting itself, I had two Amiga 2000's and one Amiga 3000,
all supplied by Commodore. The various boards and peripherals came
from home, a major commitment on my part, I feel.
The first Amiga 2000 had a GVP combo 33 board inside and ran the
teaching file application. To it was connected my Panasonic WV1410
black and white video camera by way of my FrameGrabber256. I used
this to demonstrate how xrays and nuclear scans can be captured by the
computer and used for the teaching file.
The second Amiga 2000 had my old GVP 68030 accelerator, GVP hard
card, and impulse FireCracker24. The latter was connected to a Sony
PVM 1342Q monitor. I also connected my Xetec CD ROM and my external
Quantum drive/Teac tape drive (purchased from TTR Development) to the
SCSI output. A Supra 2400 modem was attached to the serial port. I
used this Amiga to play CD music in the background and show high
resolution images while demonstrating the teaching file. I also used
this system to demonstrate how professional bulletin boards can be
used to provide images for teaching. I also had AMAX attached so that
I could show the Amiga's ability to handle other computer formats.
The third Amiga was an Amiga 3000 which ran a Scala based slide
show, entitled "Computers in Radiology Education." I actually turned
these Scala images into real slides using the Polaroid CI-3000 and my
Amiga 3000 at home and used them for a lecture that I gave during the
meeting.
For good measure, throughout the week I ran a videotape explaining how
I made the nuclear medicine teaching file. This tape was professionally
made by Point One Production and -- you guessed it -- edited with the
NewTek Video Toaster.
HOW It ALL WENT
In a word, excellently! The exhibit ran for five full days, from
approximately 8:30 A.M. to 6:00 P.M. The equipment worked splendidly
although both HyperBook and Scala had some problem with the disk based
2.04 software on the Amiga 3000. (For HyperBook, there is a 1.01
upgrade which is supposed to take care of this problem. Scala, on the
other hand, is supposed to work o.k. with the 2.04 software as long as
it is ROM based. I have not had the chance to check any of this out).
Although most of the visitors to the exhibit were other
radiologists, there also were a substantial number of technologists
who stopped by. Technologists are the people who actually perform the
studies and those who visited seemed impressed with the teaching
potential of the Amiga on their more practical level. Many
radiologists-in-training stayed a considerable length of time studying
the teaching cases.
The exhibit was definitely a "hands on" experience and because the
Amiga is so easy to use, people had no difficulty just sitting down and
using the teaching file program. There was much interest in how the
images were digitized for the teaching file. This surprised me because
image digitization is the first step in teleradiology which is the process
of sending images obtained at one hospital to a second hospital or to a
radiologist's home for an emergency interpretation. Nonetheless, I was
able to give a live demonstration of the process using my black and white
Panasonic video camera and FrameGrabber256. People were also impressed
with the low cost of the system.
WHAT WAS ACHIEVED
This was a major meeting of educated and sophisticated professionals.
Most of the Radiologists who visited my exhibit had never seen an Amiga
before. They came away impressed with the ease of use, the quality of
the graphics and the affordability. Many wanted to buy my teaching
application and most were disappointed that it couldn't run on the Mac.
I felt that it was very important to show the Amiga's processing
power across platforms. People were very impressed with AMAX and also
with Consultron's Dos-2-Dos. FrameGrabber256 came off very well, as i
already mentioned. images on the FireCracker24 got good reviews,
especially those I grabbed at home with my Video Toaster.
I was also able to show the large amount of affordable hardware
and software available for the Amiga.
FINAL THOUGHTS
There are many of these. First and foremost, we in the Amiga
community must get out and publicly show others what the Amiga can do
and more importantly, what we can do with the Amiga. Showing each
other what we are doing is all well and good but it will not expand
the base of Amiga's being sold. And indeed this is what we must in
the long run achieve. The size of the Amiga market ultimately
determines the software and the hardware that can be developed
profitably.
Maybe we all can't show off our computer and what we do
with it to 50,000 people, but we all have the opportunity to show it
to our friends, neighbors, school mates, and co-workers. We have to
break into the "it's either an IBM or a Mac" by saying, "There's a
third choice and it's an Amiga!" Or why not just be truthful and say,
"When it comes to my money, I want the best I can get. And, when it
comes to computers, I choose an Amiga."
Of course, marketing is Commodore's job. On the other hand, by
promoting the Amiga and the use we make of it, we validate and promote
ourselves. And, this validation is very important because our self
respect is tied up with it. And this is true whether we use the Amiga
to play games or to design aircraft--or both!
Amiga publications have a very important role to play. In
addition to telling us the latest hardware and software, they need to
tell us what other users are doing with the Amiga so we can get some
ideas about what we can do. It is very important for them to report
not only what software and hardware was used but specifically how it
was used.
In short, what we do can affect the long term prospects of the
Amiga.
March, 1992