MEDEV

School of Medical Sciences Education Development

Introduction

The increased demand by owners and breeders for more specialised diagnostic services in veterinary medicine has led to the daily use of diagnostic imaging techniques.

Although advanced imaging techniques are now increasingly available, standard radiography remains the most accessible and frequently used modality, being both informative and cost effective for a wide range of clinical conditions.

The ability to interpret radiographs correctly is a skill that must be learnt in order to reduce the risk of misdiagnosis, which carries important implications for prognosis and treatment. However, practice, essential to the development of competency, is currently limited by cost, health and safety considerations.

The increased number of students gives a real place to the e-learning and self teaching programs which are widely used in the undergraduate veterinary medicine. Diagnostic imaging is a specialty which particularly lends itself to e-learning, since the majority of the course information can be transferred to the student using interactive self-teaching programs based on digital images.

This three-month mini-project started in September 2004. It aimed at establishing the basis for a radiographic digital bank of feline radiograph, of radiographic images of normal and abnormal radiographic anatomy.

This bank of images is based on the archive of radiographic films available in the Diagnostic Imaging Service of the Royal (Dick) School of Veterinary Studies.

Initial planning focused on finding the most effective way of selecting radiographs from archive. We selected the feline cases from the small animal imaging data base (i.e. from the 14.06.01 to the 25.08.04) – 516 cats’ radiographs reports were found. We looked for the areas commonly radiographed and their associated conventional radiographic views, currently used in handbooks of radiography.

As only a few normal cases are actually recorded in the imaging data base, to make use of this search, cases number and reports were organised and classified depending on the area considered and pathologic findings.

Each of these pathologic cases was associated with a summary of the main imaging findings based on the report that was given to the clinician. Even though this was not initially planned, it was thought to be useful as it will allow a more rapid and efficient research of the pathological cases when it is the digital bank is enhanced with pathologic images.

This bank could provide the groundwork for an extended project, based on clinical cases.

When a case was reported as being within normal range, the radiographs were viewed (a number of the x-rays were missing, since they were digitised only if all the required views were all present and if the quality of the x-ray was good enough).

Thorax, carpus, and cervical spine are still missing as the digital image quality was not judged high enough to be catalogued and used as reference. Catalogued images will have multiple uses, with some integrated in packages aimed at learning radiographic anatomy. It was decided to work on individual images in order to highlight and label the structures, with labels that can be switched on and off, instead of writing descriptions of the normal images.

This was thought to be useful in order to provide the groundwork for an interactive learning program on basic radiographic anatomy. Even if this work was more time consuming and needed more expertise (radiology and graphic software knowledge).

Students just beginning to learn radiographic anatomy will be able to prepare for film reading practicals and make a better use of these sessions, in view of the restricted time allowed for this activity. It is hoped that interactive images will also provide the basis for a more complete interactive radiographic atlas.

Work is in progress on fully labelled images for interactive flash animations with structures highlighted. The abdomen, shoulder, stifle, pelvis and hips, skull and lumbar spine are complete.

The images of this central bank are catalogued as learning objects and shared through CLIVE. In Edinburgh , the repository Intralibrary is used to allow rapid retrieval of images for incorporation in lectures and constitute a teaching reference archive by the teaching staff. In future we will be aiming at the integration of these images in interactive self-directed learning programs, which will be accessible for veterinary students through VLEs. Pathological images will continue to be collected and the interactivity of the existing images completed.