This project began almost 10 years ago out of my desire to  capture a portion of the immense archive of fascinating teaching cases I was seeing during my 2 years of Neuroradiology fellowship at Mayo Clinic, Rochester (aka "The Mother Ship"). Back in 1994 when the concept began, very few people even had heard of the internet. We were using the Mosaic browser which went on to become Netscape, and Internet Explorer wasn't even a twinkle in Bill Gates' eye yet. Anyway, my thought at the time was to create a teaching file using the old Macromedia authorware (this was pre Flash, Shockwave etc). Fortunately before I went too far down that dead end, I met Steve Langer, a fellow computer geek and microbrew aficionado who was doing a post doc in physics at Mayo. He recommended using a newfangled tool called "HTML". So, I began to collect cases off the old PACS they had at Mayo (it was a miracle they even had a PACS back then), and we wrote the code by hand. (There was no such thing as Front Page or Dreamweaver either) After we managed to do 5 or so cases in a couple of months, Steve wrote a nice routine in TCL which automated the web page creation which was a boon. If only there was a way to automate the image editing, as every single image had to be cropped, resized, rewindowed, annotated and text removed (around 5000 of them). Batch processing for images didn't become available with Photoshop for a few more years.

    We worked on the project for several months until we had a version to show as a computer exhibit at RSNA in 1995, then an updated version in 1996 at RSNA and ASNR. Neuroradiology Reading Room won several awards at both meetings for the 2-3 years I showed it (although I don't remember which ones they were!), and during that time it generated quite a bit of interest as the first ever web based teaching file. In the ensuing years, several other academic institutions presented similar, better and more polished projects. Steve and I were very happy to see imitation as the sincerest form of flattery. I had visions of  creating a teaching file containing thousands of cases. The material was there, however, finishing fellowship, passing CAQ's and returning to active duty in the Navy took precedence. It was a great learning experience though.

     Note that in those days, we had no diffusion, and called FLAIR "fast inversion recovery", which I guess it is, but nobody calls it that anymore. Please let me know if you have any comments or questions, or if you remember seeing it shown at ASNR and RSNA back in the mid 90's. Thanks!


Richard M. Berger, MD
Chief of Interventional Neuroradiology and Magnetic Resonance
Clinical Assistant Professor of Radiology
University of Kansas
Wesley Medical Center
Wichita, KS