THE AMIGA STARS AT YET ANOTHER MEDICAL CONVENTION

The Saga Continues

My various expansion boards were so delighted to return home from the annual meeting of the Radiological Society of North America held last December in Chicago that they practically jumped inside my Amiga computers. Little did they know that six months later, they would be unceremoniously yanked from their Zorro slots and sent to Los Angeles, there to show their multimedia capabilities at yet another major medical gathering -- the annual meeting of the Society of Nuclear Medicine.

Nuclear Medicine

Nuclear medicine is a branch of Radiology concerned mainly with the diagnosis (and sometimes the treatment) of various diseases. Unlike other areas of Radiology, images are produced by radiation internal to the patient, given in the form of extremely small doses of radioactive material. Rather than merely telling what is inside the human body (anatomy), nuclear scans excel at giving information about how well the various parts of the body are working (physiology).

Nuclear Medicine Personnel

Nuclear medicine physicians and technologists are widely regarded as the "computer people" within the hospital. Because nuclear medical images are produced and analysed digitally, this radiological subspecialty has always attracted technically oriented people. Nuclear medicine personnel are strong advocates of technology and are unusually open-minded about new computers and instrumentation in medical diagnosis and education. For these reasons, other hospital staff respect their opinion regarding computers and seek out their advice and recommendations. Nuclear medicine personnel are therefore important people to reach regarding the Amiga and its multimedia potential.

The 39th Annual Meeting of the Society of Nuclear Medicine

Held at the Los Angeles convention center June 8 -12, 1992, the meeting featured numerous review courses as well as the latest results of research. Manufacturers of nuclear imaging devices, computers, and radiopharmaceuticals had extensive displays. A smaller area was devoted to scientific posters and exhibits. And, it was here for the first time that there were non-commercial exhibits of physician- developed educational computer programs. Of the 15 exhibits, one was based on the Amiga (mine), 13 on MacIntosh, and one on the IBM.

A Computer-based Renal Nuclear Medicine Teaching File

In a computer-based teaching file system, the computer becomes a book and every screen becomes a page in that book. Unlike a regular book, pages have active areas. When one selects an active area, an answer to a question can appear or perhaps an image will be displayed. It all depends on the programming.

In my teaching file, I had 46 actual teaching pages. Each page contained a thumb-nail sketch of a nuclear scan which, when selected, could display either a larger, more detailed 16 level greyscale image using native Amiga graphics or a 256 greyscale image using a GVP IV24 graphics board. By selecting other areas on the screen, the reader could obtain the patient's clinical history, nuclear scan interpretation, CAT scan and ultrasound images when available, and answers to a series of relevant questions. Because "lists" were used, the screen was uncluttered.

In accordance with accepted teaching methodology, each screen, or case, was designed to teach one concept. Similar cases were "linked" together so that the reader could experience the advantages of non-linear learning. A central list of references was accessible from any page in the book. Because the program kept track of the reader's progress, losing one's place became a thing of the past. Unique features of the teaching file included its ability to print out questions and answers for later review and the use of voice for instruction.

Details, details, details

Commodore, which clearly does support its users, graciously loaned three Amiga computers (two 3000's and one 2000) and four monitors (three 1960's and one 1084S). I sent five boxes (220 lbs.!) of my own boards, disks, and peripherals to the meeting. I included a VCR so that I could show a videotoaster-edited tape on how one can integrate images and text to create a teaching file.

I chose Gold Disk's Hyperbook for my authoring system, because of its simplicity, flexibility, reasonable price, and ease of use. Whatever limitations it has are easily overcome using ARexx which is, in fact, how I learned to use ARexx!

The 256 greyscale nuclear images were captured using Progressive Peripherals FrameGrabber256 attached to a Panasonic black and white CCTV camera. Because these images are on transparencies, they were placed between a light source (viewbox) and the camera for frame capture. Art Department Professional (ASDG) was used to scale the images, convert them to 24 bits, and expand their dynamic range. These processed images were stored on Syquest88 removable hard drives which I have found very convenient and reliable both with the GVP combo SCSI and also the SCSI standard on the Amiga 3000.

I chose a GVP IV24 graphics board to display the 24 bit images because it can use the same monitor connected to the computer without the user needing to turn the board "on." Medical images generated by the IV24 looked "first-class" on the Commodore 1960 monitors. Because I did not have my GVP IV24 upgraded for the IVU interface in time for the meeting, I was unable to demonstrate frame capture with this unit.

While surely not an essential feature, my teaching file does access music on compact disks which I think increases the enjoyment of studying. For this, I used the CD ROM hardware and software from Xetec, which as usual, performed flawlessly.

At the meeting, I emphasized the need to keep track both of the numerous medical images (which I did with ImageFinder from Zardoz) and the patients (which I did with SuperBase Professional 4.0 from Oxxi).

Because digitizing transparencies is only one way of capturing medical images on personal computers such as the Amiga, I used an Amiga 3000 to run a Scala (Digital Visions) slide show on two other ways of achieving the same result. I made several screens with DPaintIV incorporating images either scanned in with my Sharp JX-100 scanner (ASDG software) or captured by my videotoaster (Newtek -- just in case you've hidden under a rock for the last couple of years). I included a morphing sequence using DPaintIV as well as an animation demonstrating normal kidney drainage as a function of time. There was even a screen with color cycling.

The last Amiga, another 3000, was running the latest version of AMAXII (ReadySoft) with the 128k Mac ROMS still on the cartridge rather than on their new board. I felt I had to show the cross- platform capabilities of the Amiga with so many Macs at the meeting. I also used this computer as part of my FrameGrabber256 (Progressive Peripherals) digitizing set-up.

How was it received?

In a word -- spectacularly! Physicians and technologists were impressed with the amount of hardware and software available for the Amiga. There were many conversations that began with "Now I know why that friend I have is so enthusiastic about his Amiga." Some were ready to buy both my teaching application and the Amiga on the spot including one physician from overseas who wanted to purchase 10 systems for his hospital.

People loved the Scala slide show with its color cycling, morphing and animations. There was a lot of "How did you do that?" as Scala did its magic. In particular, attendees loved the animations. And why not? Only one Mac was running an animation and had images so blocky that they looked pitiful.

Voice instruction as an innovative part of the teaching file was well received. Unsurprisingly, the Macs were silent. The poor, lone IBM, needless to say, has known for a long time to keep its mouth shut.

Where do we go from here?

My Amiga medical teaching application has received more interest than I could have hoped for. I have received an invitation to present my teaching application at the European Congress of Radiology in Vienna, September, 1993 as well as the opportunity to place my program on display at The Learning Center for Interactive Technology which is part of the National Library of Medicine in Bethesda, Maryland.

First I want to finish adding about 15 more teaching cases and really polish up the program. I've considered putting it on CD ROM although it would prevent adding new cases to the teaching file which really was one of my goals. I also have what I think are some fascinating new applications that I would like to develop. I'd like to become much better at ARexx and I'd like to try my hand at CanDo (Inovatronics).

Final Thoughts

If you want to experience the excitement and satisfaction of creating something new, something that never existed before, take the plunge and try it. Get the best tools you can afford, take care of them, learn how to use them, and see what others have built with them.

If your creative effort involves a computer then know that you made an excellent choice in the Amiga. Even the Amiga 500 is a capable machine. Every single program that I used for my teaching application is available commercially and will run on an Amiga 500. I also want you to know that you don't have to be some kind of "computer genius" (whatever that might mean) to use the excellent multimedia authoring systems we are blessed with on the Amiga.

Know finally, that you must be willing to work hard to meet your goals. Your Amiga will meet you more than halfway and will reward your hard work by making you look good.

September, 1992

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