An Assessment of the iPad 2 as a CT Teleradiology Tool Using Brain CT with Subtle Intracranial Hemorrhage Under Conventional Illumination

Abstract

We examined the potential of the iPad 2 as a teleradiologic tool for evaluating brain computed tomography (CT) with subtle hemorrhage in the conventional lighting conditions which are common situations in the remote CT reading. The comparison of the clinician's performance was undertaken through detecting hemorrhage by the iPad 2 and the clinical liquid crystal display (LCD) monitor. We selected 100 brain CT exams performed for head trauma or headache. Fifty had subtle radiological signs of intracranial hemorrhage (ICH), while the other 50 showed no significant abnormality. Five emergency medicine physicians reviewed these brain CT scans using the iPad 2 and the LCD monitor, scoring the probability of ICH on each exam on a five-point scale. Result showed high sensitivities and specificities in both devices. We generated receiver operating characteristic curves and calculated the average area under the curve of the iPad 2 and the LCD (0.935 and 0.900). Using the iPad 2 and reliable internet connectivity, clinicians can provide remote evaluation of brain CT with subtle hemorrhage under suboptimal viewing condition. Considering the distinct advantages of the iPad 2, the popular out-of-hospital use of mobile CT teleradiology would be anticipated soon.

The Empirical Foundations of Teleradiology and Related Applications: A Review of the Evidence

“…The second Korean study assessed the feasibility of iPad 2 for evaluating subtle brain hemorrhaging using CT under conventional lighting conditions, which were common in remote CT readings. 95 A sample of 100 brain CT scans for head trauma or headache was selected: 50 had subtle signs of intracranial hemorrhaging, and 50 had no significant abnormality. Five emergency physicians reviewed the CT scans in two modalities, IPad and LCD monitor.…”

Radiological interpretation of images displayed on tablet computers: a systematic review

“…Emergency department physicians were used in the remaining study (Table 4). 8 Half of the studies compared the interpretation of images displayed on a tablet computer with the interpretation of images displayed on a primary picture archiving and communication system display. The remaining studies used a secondary LCD as the reference standard display (Table 5).…”

“…7 Despite the inability to calibrate the display, high levels of diagnostic accuracy have been reported when using tablet computers. [8][9][10] Hence, there is contradictory information to inform practice on the use of tablet computers for radiological interpretation.…”

A Feasibility Study of Real-Time Remote CT Reading for Suspected Acute Appendicitis Using an iPhone

“…It is smaller and weighs less than the devices used in previous studies [6,8] (dimensions of 123.8×58.6×7.4 mm, with a weight of 112 g); it also has a small screen with a diagonal dimension of 10.2 cm. The specifications of the iPhone display are shown in Table 1 [12].…”

“…The design and settings of this study were based on our previous studies [6,8]. The numbers of sample cases and readers were estimated with the multi-and single-reader sample size program for diagnostic studies (version 1.0) [9].…”