Handheld Device Review of Abdominal CT for the Evaluation of Acute Appendicitis

Choudhri, Asim F.; Carr, Thomas M.; Ho, Christopher P.; Stone, James L.; Lambert, Denis

doi:10.1007/s10278-011-9431-9

Cited by 49 publications

(28 citation statements)

References 17 publications

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“…Researchers investigating the accuracies of a smartphone client-server teleradiology system compared to a dedicated workstation for acute stroke diagnosis reported specificity of 100 %, sensitivity of 94-97 %, and accuracy rates of 98-99 % [15]. We did not restrict the selection of emergency cases by diagnosis or body region, e.g., stroke, spine trauma, or acute appendicitis as in these studies [8,[15][16][17] but included a range of common emergent pathologies encountered in our hospital, including large angiographic studies with post-processed images. Our results suggest that the iPad is a viewing platform that has high levels of reporting concordance compared to PACS, regardless of the body region scanned, imaging protocols, and diagnosis.…”

Section: Discussionmentioning

confidence: 99%

The iPad Tablet Computer for Mobile On-Call Radiology Diagnosis? Auditing Discrepancy in CT and MRI Reporting

et al. 2012

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Tablet computers such as the iPad, which have a large format, improved graphic display resolution and a touch screen interface, may have an advantage compared to existing mobile devices such as smartphones and laptops for viewing radiological images. We assessed their potential for emergency radiology teleconsultation by reviewing multi-image CT and MRI studies on iPad tablet computers compared to Picture Archival and Communication Systems (PACS) workstations. Annonymised DICOM images of 79 CT and nine MRI studies comprising a range of common on-call conditions, reported on full-featured diagnostic PACS workstation by one Reporting Radiologist, were transferred from PACS to three iPad tablet computers running OsiriX HD v 2.02 DICOM software and viewed independently by three reviewing radiologists. Structured documentation was made of major findings (primary diagnosis or other clinically important findings), minor findings (incidental findings), and user feedback. Two hundred and sixty four readings (88 studies read by three reviewing radiologists) were compared, with 3.4 % (nine of 264) major discrepancies and 5.6 % (15 of 264) minor discrepancies. All reviewing radiologists reported favorable user experience but noted issues with software stability and limitations of image manipulation tools. Our results suggest that emergency conditions commonly encountered on CT and MRI can be diagnosed using tablet computers with good agreement with dedicated PACS workstations. Shortcomings in software and application design should be addressed if the potential of tablet computers for mobile teleradiology is to be fully realized.

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Section: Discussionmentioning

confidence: 99%

The iPad Tablet Computer for Mobile On-Call Radiology Diagnosis? Auditing Discrepancy in CT and MRI Reporting

et al. 2012

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“…Several previous reports have demonstrated that there is no difference in the diagnostic accuracy for CT readings between smartphones and typical PACS workstations in various diseases [7,18,[20][21][22]. However, to the best of our knowledge, this is the first study to demonstrate the diagnostic Bperformance^of remote CT reading for acute appendicitis using a smartphone, which has good concordance with the performance of the PACS workstation LCD monitor under bright ambient lighting in a Brealistic ED setting^and using Breal-time data transmission^with a 3G network.…”

Section: Discussionmentioning

confidence: 63%

“…The iPhone 5 provides a similar image viewing quality compared to the clinical LCD monitor [7,18,[20][21][22]. The iPhone 5 has sufficient pixel pitch to support the radiology images at their original size and sufficient brightness and contrast to meet the ACR guideline recommendations for medical monitors [24].…”

Section: Discussionmentioning

confidence: 99%

“…However, considering that the smartphone is currently a worldwide, handheld display technology and that the third-generation (3G) mobile network is more accessible compared with wireless fidelity (Wi-Fi) or long-term evolution (LTE) in most countries, an examination of the feasibility of remote CT reading using a smartphone with 3G is necessary. Although a previously published study demonstrated the feasibility of the iPhone as a remote CT reading tool for acute appendicitis [7], it did not consider real-time remote image transmission with a wireless network or suboptimal illumination similar to the emergency room clinical setting. Furthermore, given the preliminary nature of that study because of the insufficient number of reviewers and radiologic images, the findings had weak power for generalization.…”

Section: Introductionmentioning

confidence: 99%

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

2015

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We aimed to evaluate the feasibility of an iPhone-based remote control system as a real-time remote computed tomography (CT) reading tool for suspected appendicitis using a third-generation (3G) network under suboptimal illumination. One hundred twenty abdominal CT scans were selected; 60 had no signs of appendicitis, whereas the remaining 60 had signs of appendicitis. The 16 raters reviewed the images using the liquid crystal display (LCD) monitor of a picture archiving and communication system (PACS) workstation, as well as using an iPhone connected to the PACS workstation via a remote control system. We graded the probability of the presence of acute appendicitis for each examination using a five-point Likert scale. The overall sensitivity and specificity for the diagnosis of suspected appendicitis using the iPhone and the LCD monitor were high, and they were not significantly different (sensitivity P=1.00, specificity P=0.14). The average areas under the receiver operating characteristic curves for all CT readings with the iPhone and LCD monitor were 0.978 (confidence interval 0.965-0.991) and 0.974 (0.960-0.988), respectively, and the two devices did not have significantly different diagnostic performances (P=0.55). The inter-rater agreement for both devices was very good; the kappa value for the iPhone was 0.809 (0.793-0.826), and that for the LCD monitor was 0.817 (0.801-0.834). Each rater had moderate-tovery good intra-observer agreement between the two devices. We verified the feasibility of an iPhone-based remote control system as a real-time remote CT reading tool for identifying suspected appendicitis using a 3G network and suboptimal illumination.

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“…operating system-specific with own application (App) iOS (Apple) 5 operating system-specific with own application (App) iOS (Apple) and Android (Google) 1 not operating system-specific, web-based without (optional) app with web browser 8 not operating system-specific, web-based with (optional) app iOS (Apple) 2 not operating system-specific, web-based with (optional) app iOS (Apple) and Android (Google) 2 [10], CT scans in cases of appendicitis [11] and computed tomography angiograms (CTA) of the pulmonary arteries for diagnosing pulmonary embolisms [5,12]. Nearly all studies found no significant differences in terms of diagnostic quality among the systems being compared.…”

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confidence: 99%

Features and Limitations of Mobile Tablet Devices for Viewing Radiological Images

Grunert¹

2014

Fortschr Röntgenstr

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Purpose: Mobile radiological image display systems are becoming increasingly common, necessitating a comparison of the features of these systems, specifically the operating system employed, connection to stationary PACS, data security and rang of image display and image analysis functions. Material and methods: In the fall of 2013, a total of 17 PACS suppliers were surveyed regarding the technical features of 18 mobile radiological image display systems using a standardized questionnaire. The study also examined to what extent the technical specifications of the mobile image display systems satisfy the provisions of the Germany Medical Devices Act as well as the provisions of the German X-ray ordinance (R?V). Results: There are clear differences in terms of how the mobile systems connected to the stationary PACS.?Web-based solutions allow the mobile image display systems to function independently of their operating systems. The examined systems differed very little in terms of image display and image analysis functions. Conclusion: Mobile image display systems complement stationary PACS and can be used to view images. The impacts of the new quality assurance guidelines (QS-RL) as well as the upcoming new standard DIN?6868???157 on the acceptance testing of mobile image display units for the purpose of image evaluation are discussed. Key Points: ??The examined mobile image display systems differ very little in terms of image display and analysis functions. ??The use of web-based software allows the mobile image display systems to function independently of their operating systems. ??Individual PACS suppliers enable the mobile systems to connect to the network via their own internet server. ??With zero-footprint technology, no patient data remains on the viewing system once the application is closed. Citation Format: ??Grunert JH. Eigenschaften und Einschr?nkungen mobiler radiologischer Bildwiedergabesysteme. Fortschr R?ntgenstr 2015; 187: 173???179

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Handheld Device Review of Abdominal CT for the Evaluation of Acute Appendicitis

Cited by 49 publications

References 17 publications

The iPad Tablet Computer for Mobile On-Call Radiology Diagnosis? Auditing Discrepancy in CT and MRI Reporting

The iPad Tablet Computer for Mobile On-Call Radiology Diagnosis? Auditing Discrepancy in CT and MRI Reporting

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

Features and Limitations of Mobile Tablet Devices for Viewing Radiological Images

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