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READING ROOM WITH A VIEW DOUGLAS GREEN, MD

Do We Need a Radiology Zoo?

There already exists a Galaxy Zoo.Maybe we need a Radiology Zoo, too.

The Galaxy Zoo was born at a pubinOxford in 2007 [1]. Twophysicistswrestling with how to classify the930,000 galaxies in the Sloan DigitalSkySurvey cameupwithGalaxyZoo,a website where interested amateurscould help out. After an online tuto-rial, amateurs were ready to classifygalaxies by whether they were ellip-tical or spiral, the directions in whichtheir arms spiraled, and other partic-ulars. The volunteers’ results closelymatched those of professional as-tronomers. When they were let looseon all 930,000 galaxies, the volun-teers classified them in a small fractionof the time it would have taken thetwo physicists.

Galaxy Zoo is a “collective intelli-gence platform,” a digital space wherevolunteers can help solve a chal-lenging problem [2]. This kind ofplatform is often associated with an“affinity space,” a digital communitywhere people with a shared interestpost ideas and ask questions.

The Galaxy Zoo volunteers madediscoveries that led to peer-reviewedpublications [3]. The volunteers’reward was their own satisfaction andpride in contributing to importantscience, as well as a strengthened senseof community in the affinity space.Clear scientific importance is a re-quirement if researchers expectenthusiastic and dedicated help ontheir collective intelligence projects.Also needed are good instructionaltools [4], which can be taped lectures,documents, or even direct communi-cation with experts.

Could collective intelligence plat-forms help with radiology research?

Probably. Consider the exampleof the National Lung Screening Trial,in which 75,126 thoracic CT scanswere performed over 3 rounds ofscreening, with positive results (a

noncalcified nodule �4 mm indiameter or other abnormalities thatwere suspicious for lung cancer) in18,146 scans [5]. Radiologists re-viewed CT scans and characterizedlung nodules larger than the 4-mmthreshold by location, size, margin(spiculated, smooth, poorly defined,indeterminate), and attenuation (softtissue, ground glass, mixed, fluid orwater, fat) [6].

The National Lung Screening Trialrequired large amounts of time fromhighly paid medical professionals.Given the high monetary and politicalstakes, the participation of radiologistswas essential. However, with moderntechnology, suchasmaximum-intensityprojection images to facilitate noduledetection and clear instructions onnodule characterization, one wonderswhether nonmedical amateurs mighthave been able to analyze the thousandsof nodules in this Radiology Zoo at afraction of the cost.

The importance of the scientificquestion at the heart of this RadiologyZoo was clear and compelling: weneeded to know if early detectioncould reduce cancer mortality. Vol-unteers for future Radiology Zoos onthis same issue could be recruitedfrom a pool of citizen stakeholders:heavy smokers, cancer patients, orfamily members of cancer victims.Volunteers might be engaged byeducational material posted onan affinity space, where discussionthreads might range from smokingcessation to regional variation inincidence of fungal granulomas.

The success of the Galaxy Zooproject depended on access to imagesfrom the Sloan Digital Sky Survey.Open access to medical images wouldbe needed for a Radiology Zoo, and ofcourse, HIPAA requirements for pri-vacy would have to be addressed.

Not every question can beaddressedwith collective intelligence;

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networked volunteers are not goingto come upwith a unifiedfield theoryfor physics, but they crunchedthrough 930,000 galaxies, and theymight put a dent in a work list of75,126 thoracic CT scans.

Tech pundit Clay Shirky calls thisforce of amateur volunteers the“cognitive surplus” and estimates thatthe networked public has 1 trillionhours of free time at its disposal everyyear [7].

The challenge for medical scien-tists, radiologists included, is toharness this force with compellingand well-designed projects. Comingsoon to a Zoo near you?

ACKNOWLEDGMENT

The author would like to acknowl-edge David Godwin, MD, for hishelp with manuscript review.

REFERENCES

1. Nielsen M. Reinventing discovery: the newera of networked science. Princeton, NewJersey: Princeton University Press; 2012.

2. Gee JP. Feature: games and impact. February12, 2013. Available at: http://www.astd.org/Publications/Newsletters/LX-Briefing/LXB-Archives/2013/02/Feature-Games-and-Impact.Accessed August 26, 2013.

3. Galaxy Zoo. The story so far. Available at: http://www.galaxyzoo.org/#/story. Accessed May 5,2012.

4. Gee JP. What video games have to teach usabout learning and literacy. Presented at: ASU/GSV Education Innovation Summit; 2012.Available at: http://vimeo.com/channels/390827/40633166. Accessed June 21, 2013.

5. The National Lung Cancer Screening TrialResearch Team. Reduced lung-cancer mor-tality with low-dose computed tomographicscreening. N Engl J Med 2011;365:395-409.

6. Aberle DR, Berg CD, Black WC, et al. TheNational Lung Screening Trial: overview andstudy design. Radiology 2011;258:243-53.

7. Shirky C. How cognitive surplus will changethe world. TED. June 2010. Available at:http://www.ted.com/talks/clay_shirky_how_cognitive_surplus_will_change_the_world.html. Accessed August 26, 2013.

Douglas Green, MD, University of Washington, Department of Radiology, 1959 NE Pacific Street, Seattle, WA 98195-0001;

e-mail: dougreen@uw.edu.

ª 2014 American College of Radiology

36.00 � http://dx.doi.org/10.1016/j.jacr.2013.08.007