As useful as it is, we know very little about the brain. We are born with 350 grams, and by the time we are adults, the brain quadruples in size to about three pounds. Thereafter, our neurons and synapses engage in a disturbing rendition of "snap, crackle, and pop," while we gallantly attempt to martial the remaining resources in the most efficient way possible.

That is the simple version. Currently, psychologists, neurologists, and radiologists are using both PET and fMRI to attempt to define exactly how the brain operates, accumulating increasing evidence that we possess a certain amount of neuroplasticity. In an interesting twist, a couple of Swiss researchers turned a 1.5T magnet on the profession to try to understand the mechanics behind the radiologist's powers of perception. Their paper was published in the September issue of Radiology.

The study builds on a small but growing body of literature that explores the link between a profession and the physiology and function of the corresponding brain. More neurons are firing in the right primary auditory cortex of a professional violinist than an amateur when both perform a particular Mozart concerto; London cabbies have a larger volume of posterior hippocampi, which store spatial representation of the environment, than control subjects. And radiologists, when looking at nonradiologic images, show peak activation in the bilateral, left-dominant, more posterior superior and inferior parietal lobule, an area that is believed to be responsible for mental rotation of objects in two- and three-dimensional space, an activity related to generating a mental picture of a visual object, the authors report. When the control subjects (lawyers, physicists, and business people) looked at these objects, the action was in the right-dominant, more anterior superior and inferior parietal lobule and postcentral gyrus, an area associated with the task of tactile discrimination of objects: the civilians, in other words, were mentally touching the object to "see" what it might be. When radiologists looked at radiologic images, there was enhanced neuronal activation in the bilateral middle and inferior temporal gyrus, bilateral medial and middle frontal gyrus, and left superior and inferior frontal gyrus. Study authors Haller and Radue report that activity in these areas is associated with visual attention and memory retrieval, suggesting that radiologists compare the radiologic image with memorized radiologic references.

Perhaps such research someday will help refine training techniques for radiologists, but because one of the planks in our platform here at Decisions in Imaging Economics is to further understanding between all stakeholders in radiology, we could not help wondering how this information impacts communications between radiologists, their associates, and staff members?

So, take heed when communicating with a radiologist:

1. Never stake your claim on the outcome of a game of Where's Waldo? You will never, ever win.
2. Never lie to a radiologist while crossing your fingers behind your back. The radiologist is capable of mentally rotating observed objects at will.
3. Finally, when making observations, it is helpful to push, pull, prod, and cajole the radiologist onto the right side of his or her brain. Otherwise you will see the forest and they will see the trees.

Cheryl Proval