Radiopaedia Blog

Radiopaedia.org and the Royal Australian and New Zealand College of Radiologists (RANZCR)​ are collaborating to give everyone in the world an opportunity to a submit a radiology case for the RANZCR 2016 Case of the Day competition.

Each day during the RANZCR 2016 Annual Scientific Meeting (October 13 - 16) on the Gold Coast a series of cases will be featured in the Case of the Day area. The cases will also be shared across Radiopaedia's social media network and on the homepage so the whole world can join in the learning. 

The competition is open to anyone in the world, not just those living in Australia and New Zealand. This is our way of helping to make RANZCR 2016 a truly global education event.  

Prizes

All successful Case of the Day submission will receive 12 months online access to our Adult Brain MRI review course and Neuroradiology Update 2016 course, featuring Frank Gaillard, Andrew Dixon and Peter Mitchell. Prizes will also be available for delegates at the conference who complete the daily case of the day quiz. 

Dates

Submissions close on October 9, 2016 and the winners will be chosen by Radiopaedia and RANZCR in the following couple of weeks. Winners will be contacted by email, so please make sure the email listed in your Radiopaedia.org profile is correct. 

Submitting a case

To have your case considered for the RANZCR 2016 Case of the Day, simply upload an awesome case to Radiopaedia and add the tag "RANZCR2016" in the right hand column of the case edit page. We're accepting great radiology cases from any subspecialty.

For those submitting a case to Radiopaedia for the very first time, you'll find that it is really easy.  The short video tutorial below will help you with most things you need to know. It may also be worth checking out our case publishing guidelines. 

Contact

If you have any questions, please write to [email protected].

So here I am sitting in a holiday house by the seaside, my kids are (finally) asleep, my wife is back home, and it's raining and cold outside. To make matters worse the wifi here is terrible, and netflix is completely out of the question. So what is a neuroradiologist going to do? 

Well I have been thinking of creating neuroanatomy content  aimed at taking folk from knowing nothing to, well, knowing enough (more on this at a later date) so I mixed myself a martini (Hendrick's, dry, twist) and started at the start. Lobes. Simple right? 

So here is the question I immediately faced: how many lobes are there? 

We all agree on the 4 of them. 

1. frontal lobe
2. parietal lobe
3. occipital lobe
4. temporal lobe

Easy... so lets record the video right? Wrong. What about the insula? What about the cingulate gyrus and hippocampus? I've been playing this game a while, and really I feel I should know, or at least have an opinion, but the truth is it turns out this is fairly contentious stuff, maybe enough for a neuroanatomist to throw a punch after a couple of beers (or martinis). 

One source I found begins with "The insula is the fifth lobe of the brain and it is the least known" which begs the question "what about the limbic lobe?" Is the limbic lobe the sixth lobe and so little know the authors of the above manuscript didn't know about it? (yes I know I am probably using the term "beg the question" incorrectly; pedant). You see the term limbic lobe has been around since 1850's when Paul Broca, no less, coined the term. 

So I turned to Google's Ngram viewer for the answer:

And more specifically just the "limbic lobe" and "insular lobe":

Other than all the lobes taking a hit during the great depression and WWII, it looks like we can relatively safely ignore the 'limbic lobe' from this perspective, which is sort of a shame really. 

When pitting the terms against their main rivals ("limbic lobe" vs "limbic system" and "insular lobe" vs "insular cortex") we don't really see a real contest either. 

Anyway, enough of this silliness. Four lobes it is. Plus insular cortex. Plus cingulate gyrus (which since it spans both frontal and parietal lobes, I'm going to continue to think of separate). Time for bed. 

A. Prof Frank Gaillard is a neuroradiologist at the Royal Melbourne Hospital, Melbourne, Australia, and is the Founder and Editor of Radiopaedia.org.  NB: Opinions expressed are those of the author alone, and are not those of his employer, or of Radiopaedia.org. Blah blah blah.

"How much do I need to study to pass?" is a question asked by almost every radiology trainee as they approach their fellowship/board examinations. I recently passed the RANZCR part 2 examination series and thought I would share my experience. 

Techniques

Procrastination and distraction are the trainee's nemesis, but there are two techniques I used that are useful to maximize efficiency:

• pomodoro technique
  • 25 minute study blocks (same length as the viva examination) with 5-10 minute breaks in between
  • procrastinate and complete non study tasks in breaks
  • set a minimum number per day, easy to fit into the day (e.g. one before work, one at lunch (or work), and two after work = 100 minutes of study per day)
• active recall with spaced repetition: essentially reading and then self-testing knowledge at intervals

These two techniques were the key to keeping on track, keeping study guilt under control, and feeling like I could get on with life. Active recall is difficult, it requires much more effort than passive study (such as note taking) but the results are much much better. 

Further viva techniques are discussed in Frank's blog "How to prepare for radiology oral exams: essential techniques".

Results

I kept track of of how many minutes I studied, tutorials and lectures attended, and practice viva exams performed for the 258 days (approximately 8.5 months) in the lead up to my fellowship exams (although I "started" studying 8 months prior to this, just not effectively):

• 430 hours solo study (not including tutorials, lectures, courses, etc)
  • average 166 minutes/day leading up to the written exams
  • average 74 minutes/day in the 10 weeks between the written and viva exams
• 25 lectures
• 114 film tutorials
• 34 practice viva examinations (individual and in series)

I hope this gives some outline to what is needed. If you've done your fellowship/board examinations add your estimate or tracked time in the comments below, it'd be interesting to know!

Dr Henry Knipe is a radiology registrar at The Royal Melbourne Hospital in Australia, and is a managing editor at Radiopaedia.org. Twitter: @DrHenryK.

 NB: Opinions expressed are those of the author alone, and are not    those of his employer nor of Radiopaedia.org. 

A few months ago an update has been published to the WHO classification of CNS tumors (which supersedes the 4th edition of the blue book, 2007 - although officially this version is not considered a 5th edition), which includes a substantial shift in approach, one which will have great implications in years to come.

For the first time molecular characteristics of tumors are included and in many case are more important than the histological features of various tumors.

This naturally has resulted in a flurry of activity, getting up to speed with some of the new nomenclature and updating relevant parts of the site as well as writing some missing articles. Although no doubt there are many other subtle changes in the classification which have not been captured (this would require reading the whole book, and updating every single tumor article) I hope this has captured the most notable changes. 

Frank

New articles

• epithelioid glioblastoma
• diffuse leptomeningeal glioneuronal tumor
• diffuse midline glioma, H3-K27M-mutant
• ependymoma RELA fusion positive

Updated articles

• WHO classification of CNS tumors
• diffuse brainstem glioma
• embryonal tumor with abundant neuropil and true rosettes
• ependymoma
• fibrillary astrocytoma
• glioblastoma
• medulloblastoma
  • medulloblastoma - WNT
  • medulloblastoma - SHH
  • medulloblastoma - group 3
  • medulloblastoma - group 4
• medulloepithelioma
• oligoastrocytoma
• oligodendrogliomas
• primitive neuroectodermal tumors of the CNS
• protoplasmic astrocytoma

A. Prof Frank Gaillard is a neuroradiologist at the Royal Melbourne Hospital, Melbourne, Australia, and is the Founder and Editor of Radiopaedia.org.  NB: Opinions expressed are those of the author alone, and are not those of his employer, or of Radiopaedia.org.

As you all hopefully know, we are committed to the continued development of the Radiopaedia.org site whilst keeping our content free for all to access. This development is, however, ever more expensive as the sheer size and complexity of the site grows, and we are reliant primarily on advertising to pay the bills. 

For some time now many of you have been able to help us by contributing a few dollars a month by becoming a Radiopaedia Supporter. This is awesome, and it has allowed us to build new features (e.g. new search results and diagnostic certainty) and keep working on substantial back-end improvements. 

I have, however, never felt comfortable with supporters contributing to our mission both financially and being subjected to ads, but unfortunately we did not yet have the infrastructure to make this not be the case.

Now, as a result of substantial back-end work, all that has changed and from now own our supporters will have an ad-lite or ad-free experience depending on the level of support. 

• Felson supporters (bronze) will have an ad-free mobile experience (when our upcoming 'responsive' site is deployed).
   

• Hounsfield supporters (silver) will additionally have no ads in full-screen presentation mode (quiz mode) - perfect for tutorials or self study.
   

• Roentgen supporters (gold) will enjoy a completely ad-free Radiopaedia.org on both mobile and desktop. ​

So again, to all of you who are current supporters "Thank you!" and enjoy a cleaner, faster, less distracting ad-lite / ad-free Radiopaedia.org.

Frank

A. Prof Frank Gaillard is a neuroradiologist at the Royal Melbourne Hospital, Melbourne, Australia, and is the Founder and Editor of Radiopaedia.org.  NB: Opinions expressed are those of the author alone, and are not those of his employer, or of Radiopaedia.org.