Radiologists and residents collect radiological images and related information of interesting and/or educationally valuable cases on a daily bases, for a number of purposes including teaching, learning, research, fulfilling requirements, etc. Many teaching file databases/software are available, however, the most widely used tools are still the file system offered by the operating system and Microsoft PowerPoint. The popularity of file systems lies in their wide availability and ease of use. PowerPoint is the most widely used presentation software in class rooms and conferences for its visual appeal and relative ease of use. Case presentations in the format of PowerPoint can be directly used for case conferences or lectures. Both approaches suffer from multiple problems including lack of database management and search capabilities.

The majority of the existing teaching file databases are web-based software systems that are installed in web severs housed in computers of institutions. These systems offer great capabilities and availabilities to our community and are playing extremely important roles in radiology education. One excellent example of such system is the Medical Imaging Resource Center (MIRC) developed by RSNA.

The MIRC software is freely available for use by the medical imaging community. It has a comprehensive set of functions that can be used to set up a teaching file system for public or private use. The system can provide all kinds of digital information, including teaching files, clinical and technical documents, electronic presentations, and imaging datasets for research and clinical trials. The MIRC server software is an Internet based system that employs Tomcat as a web server and provides query and storage services that are accessed via the Internet. MIRC framework supports communities of cooperating libraries, individually managed by healthcare and educational institutions, whose content can be accessed by a user as if it were a single library. In addition, the MIRC provides several software tools which are not part of the MIRC site software but extremely useful as stand-alone applications in MIRC-related projects. It is desirable to see an increase in participation of institutions in the MIRC community.

However, currently, the online institutional teaching file systems are not as useful for individuals as for institutions due to a number of reasons. For example, a faculty member may want to “hide” his/her cases until the board review so that residents have previously unseen cases on which to practice. A resident may be afraid of losing his/her collection of teaching file cases that are stored in the institutional database upon graduation. It is thus reasonable and necessary for individuals to have their own teaching databases. In fact, most personal teaching file cases are not stored in the online database systems.

In our institution, only a small fraction of case files are in our institutional teaching file system and vast majority of them, tens of thousands of files, are spread across personal folders and personal computers in a variety of formats including large collections of image, text and PowerPoint files. These files are not suitable for structured query and are not directly reusable in different presentations or for different audience. Many teaching files have multiple versions that are used for different purposes. It consumes a tremendous amount of time and resource to create and maintain such files. Although the authors of such case files maintain true ownership and flexibility to design their case presentations, however, it is quite difficult to incorporate these cases into a centralized fully-searchable database such as the MIRC, even through the owners may be willing to contribute selected cases.

Therefore, it is desirable to have a true personal radiology teaching database system to meet the needs of individuals and ultimately to promote the use of centralized institutional systems. Such a software system should offer the following functionality:

1) True portable personal database application that runs on personal computers with different operating systems (Windows, Mac OS, Unix, Linux, etc.);
2) Easy to install and simple to use;
3) High performance and full-functioning query and retrieval capabilities;
4) Multi-format import/export capabilities (i.g. XML, MIRC, DICOM, PowerPoint);
5) Build-in structured disease and anatomy databases, which provides a standard and controlled vocabulary;
6) Simple but powerful image editing and annotation tool tailored for the creation of teaching files and radiographic atlases;
7) Configurable conference and presentation tools;
8) Exporting capabilities to allow exchanges of cases and knowledge among personal databases as well as between personal databases and institutional servers such as the MIRC.

To our knowledge, no such software system is currently freely available. A few commercial products are available, however, these are not widely used. These programs are not free, not open source and not platform independent. Their functionalities are rather limited. These programs do not contain human anatomy nor disease databases that are essential for radiographic atlas capability. The goal of XPrad project is to implement a full functional portable personal teaching file case database system. We believe such a software system will be not only extremely useful for trainees and educators in the radiology community but also an important supplement to Internet and server based institutional teaching file systems such the MIRC by providing easy file exchanging interfaces and in turn promote the usage of such large scale frameworks.

As you can see, at present, XPrad goals are only partial achieved. It is our hope that our efforts will be useful to the community. Your support is essential to the success of XPrad. Please provide feedback and suggestions for future improvement.