Have you ever tired to make a difficult imaging diagnosis based on clues  from just a single image out of hundreds, if not thousands?  When was your last time telling yourself “yes, that’s got to be the case”.  I talked about the idea of formulating those fascinating images into a self-assessment activity on the AJNR website to the Editor-in -Chief when he visited Taiwan this March.  After weeks of intense discussion and emails, we refined the idea of “Classic Image of the Week” which is going live on www.ajnr.org today and will appear every Monday.

This new AJNR activity offers 5 distinct elements: 1) a classic image (or images) along with a short clinical history; 2) a single-choice quiz for voting; 3) immediate statistics on the votes (knowing how other colleagues responded); 4) a short review of the disease and/or findings; 5) a blog-like forum for those who would like to share their ideas and experience, including interesting images with other viewers.

Having been doing neuroradiology for 25 years, I feel that an imaging diagnosis is made out usually not just from the imaging “density” or “signal” change itself. It may come from a mixture of clinical and radiological knowledge, personal experience plus some anatomical relevance and a sense of pathophysiology of the diseases. Therefore, the classic images presented in the new activity welcome all kinds of diagnostic techniques (CT, MRI, radiographs, PET, etc.), classic photographs of neuropathology, or simply a graph or diagram that explain pathophysiology and spark interest.  I wish the readers may find this new activity interesting and I encourage all of you to submit cases to me. As a matter of facts, Dr. Castillo, chief editor of AJNR, has just sent  five interesting cases to me before I wrote this blog.  If you happen to read this blog, please go directly to the “Classic Image” and try yourself by voting.  My contact information is found there too.