DOI:10.2214/AJR.08.1330
AJR 2008; 191:1272
© American Roentgen Ray Society
Gestalt: Radiology's Aunt Minnie
Ferris M. Hall and
N. Thorne Griscom
Beth Israel Deaconess Medical Center Harvard Medical School Boston,
MA
Children's Hospital Boston Boston, MA
We enjoyed the article by Koontz and Gunderman
[1] on the radiologic
implications of Gestalt theory. The authors note that "the Gestalt
theory of modern psychology is grounded in the ideas that holistic rather than
atomistic approaches are necessary to understand the mind, and that the mental
whole is greater than the sum of its component parts.... that perceptions are
not constructed in a `bottom-up' fashion... but are instead perceived
globally, in a more `top-down' fashion." These descriptions seem
remarkably applicable to the well-known radiologic entity of Aunt Minnie.
As used by radiologists, an Aunt Minnie, or Aunt Minnie approach, is a
constellation of observations that the experienced reader finds virtually
pathognomonic of an entity, usually an unusual or unexpected disease. The term
was explained by radiologists at Children's Hospital Boston, where E. B. D.
Neuhauser was chair [2], as a
diagnosis based on having seen similar images many times but one that was
usually difficult to explain systematically to a less-experienced and some
times incredulous colleague. This subliminal or subconscious pattern
recognition is similar to a person being able to recognize his or her Aunt
Minnie amid a large group of somewhat similar women, although finding it
difficult to analyze rationally or to explain verbally just how this was
accomplished. In short, an Aunt Minnie is a diagnosis or recognition largely
by gestalt. We believe that with time, and particularly with the publication
of the Aunt Minnie's Atlas
[3] and the popularity of the
Aunt Minnie Website, the original meaning of the term has been slightly
expanded so that it is now applied to any classical constellation of
findings.
The term "Aunt Minnie" has been attributed to two iconic
figures in radiology history: Ed Neuhauser
[2,
4] and Ben Felson
[3,
5]. It seems the term was
coined by Neuhauser, but Felson did much to popularize it
[2,
4,
5]. Neither man apparently had
an aunt named Minnie [5,
6].
References
- Koontz NA, Gunderman RB. Gestalt theory: implications for radiology
education. AJR 2008;190
:1156
–1160[Abstract/Free Full Text]
- Teele RL, Griscom NT. Aunt Minnie (letter).
Radiology 1998;208
: 829–830[Medline]
- Berlin L. Aunt Minnie's atlas and imaging-specific diagnosis. (book
review) Radiology 1997;204
: 278[Free Full Text]
- Berlin L. Aunt Minnie. (reply to letter)
Radiology 1998;208
: 830[Medline]
- Reeder, M. What's an Aunt Minnie. (interview at 2004 annual meeting
of Radiological Society of North America)
www.youtube.com/watch?v=FsCcnkkMOvU.
Accessed June 2008
- Applegate KE, Neuhauser DV. Whose Aunt Minnie? (letter)
Radiology 1999;211
: 292[Free Full Text]
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