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Current Clinical Concerns in CT: Introduction

Elliot K. Fishman, MD

In 1999 when www.ctisus.com was introduced, we felt that visitors to the site would appreciate having their own user's forum. We created a series of ten different forums addressing different areas in the body from kidney to liver to pancreas, as well as topics of interest including 3-D imaging and volume rendering. Despite our best intent, these imaging chat rooms were not used frequently. With the growth of the rest of our website, it became clear that the user's chat room was not what our users found to be of interest or value. We therefore decided to eliminate this portion of our website. However, we thought that perhaps a different approach to a user's forum might be one in which the users could ask questions, and it was clear who the responder would be, which in this case was Elliot K. Fishman. Although, this may at first as a second glance seem a bit pompous, it became clear to us that if the user had a question, that a response from [email protected] was not a reliable source. On the other hand, a Professor of Radiology at a well-known Medical Institution like Johns Hopkins Hospital could be a source of information that one might consider legitimate. The introduction of "Ask the Fish" was met with user interest and has become very successful. At the current time, we obtain up to 20 or 25 questions per week, and this part of the website continues to grow in use and in interest.

One of the things we have noted in this section is that questions are being focused on common themes, ranging from technology to contrast to specific clinical applications. Users tend not to have global questions, but specific questions that often impact their practice of CT and patient care. We also noted that over time, the questions in technology moved from 4-slice to 8-slice to 16-slice to 64-slice technology. Questions regarding techniques have similarly migrated, though common questions regardless of the scanner type used tend to revolve around such processes as pulmonary embolism and artifacts. In order to get a better handle on the most important issues to our users, we decided to review a one- year period of where a total of 417 questions were presented and categorize these questions. It is somewhat amazing how quickly things have changed. If one would read www.ctisus.com during the more recent September to November quarter 2004, the number of questions in reference to 64-slice scanning is impressive. Yet during the time of the survey less than nine months ago, 64-slice CT scanning was presented at RSNA to which many people felt that it was more vaporware than reality. However, within one year of RSNA, there are 4 vendors selling 64-slice CT scanning and over 100 institutions will have the technology by early 2005.


This exhibit presents the 50 most popular topics addressed from February 2003 and February 2004, including approximately 250 questions with answers. The majority of the references presented here were not provided at the original time the question was posed, but have been incorporated to enhance the educational value of this exhibit. Many of these answers, however, are for the most part as we delivered them and were not rewritten, to give the user a feel of how the website is a very close and personal experience between the user and the responder. Also, we want to make clear that changes in technology particularly regarding 16 and 64 slice CT make some of the questions seem quickly outdated. Nonetheless, in these situations, we still left all of the questions based on their popularity in order to give users of this exhibit a feel for the direction and changes we have seen.


We believe that the exhibit is a good representation of what any developer or society must understand in developing a website and whether they want user interaction with the site. We hope that our experience on the web will help increase this knowledge for everyone.

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