Interactive internet broadcasting of a complex educational interventional radiology symposium.

THERE have been only a limited number of complex educational interventional radiology (IR) symposia featuring a combination of educational lectures, multiple-site live case presentations, discussions, and workshops. Attendance at these has ranged from a few hundred to approximately 1,000 interventional radiologists, other specialists, technologists, nurses, and industry representatives. New technologies, particularly the Internet, are potentially able to open IR symposia to a much larger audience over a worldwide distribution. This article presents experience with the interactive real-time Internet broadcasting and archiving of a complex IR symposium, the International Symposium of Interventional Radiology (ISIR), organized in Prague, Czech Republic, in June 2002. The objective of the ISIR was to update radiologists from Central and Eastern Europe on new interventional techniques and their use so they would be able to apply them to their practices. Travel grants were given to young radiologists from Eastern Europe to enable them to attend the symposium. The Internet has been used in medical education for lecturing to residents (1) and for interactive video conferencing between selected sites for transmission and discussion of prerecorded or live cases (2,3). According to our knowledge, the Prague ISIR was the first complex 3-day medical meeting broadcast in real time to a worldwide audience without an access fee in which the audience could interact with the moderators and speakers at the symposium. Since 1994, eight 3-day educational meetings have been organized annually in Prague. Starting from simple workshops, the organizers proceeded to more-complex meetings. In 1997, lectures were broadcast from Portland, OR, with use of the Internet, and local microwave (high frequency radio waves used for point to point transmission of audio, video, and data up to a distance of 30 miles)live case transmissions were added. A straight line of sight between the sending and receiving antennas is required. Multiple-site live case transmissions via ISDN (integrated services digital network, special connections that use existing telephone lines to transmit digital instead of analog sig nals) telephone lines began in 1998 (4– 6). After sufficient experience with these transmissions was gained, the program for the 2001 meeting was expanded and an attempt was made to broadcast it globally in real time on the Internet and make it available in archives. However, only parts of the workshop could be viewed in real time because of insufficient bandwidth and speed and unstable connections on the ISDN lines used for streaming the program from Prague to a server at Oregon Health & Science University. The archives reconstructed from the program videotapes and PowerPoint (Microsoft, Redmond, WA) slides on CD-ROM were accessible on the Oregon Health & Science University server and were of good quality. However, archive reconstruction was quite expensive and cost almost $20,000. Some of the faculty from the United States at previous meetings and other interventional radiologists, who were asked to view and comment on the meeting archives, raised concern about the suitability of conventional 20-minute-long lectures for viewing on computers because they found it difficult to maintain their concentration and interest for this length of time. Based on experience and viewers’ suggestions, the program of the June 2002 ISIR was organized differently than previous meetings. This 3-day program presented by 44 faculty members (18 from the United States), From the Dotter Interventional Institute (J.R., R.S., B.T.S., F.S.K), Oregon Health & Science University, 3181 SW Sam Jackson Park Road, L342, Portland, Oregon 97239-3098; and Department of Diagnostic and Interventional Radiology (M.H., J.P.), Institute for Clinical and Experimental Medicine, Prague, Czech Republic. Received December 26, 2002; revision requested February 19, 2003; accepted March 12. Address correspondence to J.R.; E-mail: roschj@ ohsu.edu. Please submit comments on archive viewing via e-mail.