Radiology on Handheld Devices: Image Display, Manipulation, and PACS Integration Issues

Raman, Bhargav; Raman, Raghav; Raman, Lalithakala; Beaulieu, Christopher F.

doi:10.1148/rg.241035127

Cited by 44 publications

(25 citation statements)

References 19 publications

(10 reference statements)

Supporting

Mentioning

Contrasting

Order By: Relevance

“…For airway smooth muscle mass analysis, total area and a-SMA-positive area were measured from three endobronchial biopsy sections at each time point for each patient using ImageJ (30). Samples that were considered inadequate were excluded from analysis.…”

Section: Sample Analysismentioning

confidence: 99%

Airway Inflammation after Bronchial Thermoplasty for Severe Asthma

et al. 2015

View full text Add to dashboard Cite

Rationale: Bronchial thermoplasty is an alternative treatment for patients with severe, uncontrolled asthma in which the airway smooth muscle is eliminated using radioablation. Although this emerging therapy shows promising outcomes, little is known about its effects on airway inflammation.Objectives: We examined the presence of bronchoalveolar lavage cytokines and expression of smooth muscle actin in patients with severe asthma before and in the weeks after bronchial thermoplasty.Methods: Endobronchial biopsies and bronchoalveolar lavage samples from 11 patients with severe asthma were collected from the right lower lobe before and 3 and 6 weeks after initial bronchial thermoplasty. Samples were analyzed for cell proportions and cytokine concentrations in bronchoalveolar lavage and for the presence of a-SMA in endobronchial biopsies.Measurements and Main Results: a-SMA expression was decreased in endobronchial biopsies of 7 of 11 subjects by Week 6. In bronchoalveolar lavage fluid, both transforming growth factor-b 1 and regulated upon activation, normal T-cell expressed and secreted (RANTES)/CCL5 were substantially decreased 3 and 6 weeks post bronchial thermoplasty in all patients. The cytokine tumor-necrosisfactor-related apoptosis-inducing ligand (TRAIL), which induces apoptosis in several cell types, was increased in concentration both 3 and 6 weeks post bronchial thermoplasty.Conclusions: Clinical improvement and reduction in a-SMA after bronchial thermoplasty in severe, uncontrolled asthma is associated with substantial changes in key mediators of inflammation. These data confirm the substantial elimination of airway smooth muscle post thermoplasty in the human asthmatic airway and represent the first characterization of significant changes in airway inflammation in the first weeks after thermoplasty.

show abstract

Section: Sample Analysismentioning

confidence: 99%

Airway Inflammation after Bronchial Thermoplasty for Severe Asthma

et al. 2015

View full text Add to dashboard Cite

show abstract

“…A portable high-resolution display screen, running image viewing software, would be a key requirement to allow off-site radiologists to provide second line support to on-call trainee residents interpreting inhospital emergency studies, allowing safe and timely communication of important radiological findings to the clinician that may affect the patient's treatment while at the same time removing restrictions in physical location. In recent years, mobile computing devices such as laptop personal computers, personal digital assistants (PDA) and smartphones have been introduced into the broader consumer electronics market, and their wireless mobility has been explored for use in medical teleconsultation [1][2][3][4][5][6][7][8][9][10][11]. However, although laptop computers have large screens and computing power, they are hampered by excess weight and short battery life.…”

Section: Introductionmentioning

confidence: 99%

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

et al. 2012

View full text Add to dashboard Cite

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.

show abstract

“…Jayesh Modi, Pranshu Sharma, Alex Earl, Mark Simpson, J. Ross Mitchell, Mayank Goyal have been addressed by many investigator [1][2][3]12,13 . However, patient confidentiality, especially when medical information is downloaded on a portable device, remains a significant concern.…”

Section: Iphone-based Teleradiology For the Diagnosis Of Acute Cervicmentioning

confidence: 99%

iPhone-Based Teleradiology for the Diagnosis of Acute Cervico-Dorsal Spine Trauma

Modi

Sharma

Earl

et al. 2010

Can. j. neurol. sci.

View full text Add to dashboard Cite

An instant image transfer system can be used to support rapid medical and imaging decision making in an emergency situations when doctors are away from the hospital [1][2][3] . There are several Web-based picture archiving and communication systems, which allows access to a patient's radiological images from outside the hospital 1 . However, they are felt to be not appropriate for use in time-critical emergency cases as mentioned in previous studies 4,5 . Handheld devices like smart-phones and personal digital assistants (PDAs) have become increasingly prevalent in modern society [6][7][8] and 46% of attending physicians and trainees 9 and 45% of radiologists are using handheld devices [8][9][10] . However, ABSTRACT:Objective: To assess the feasibility of iPhone-based teleradiology as a potential solution for the diagnosis of acute cervico-dorsal spine trauma. Materials and Methods: We have developed a solution that allows visualization of images on the iPhone. Our system allows rapid, remote, secure, visualization of medical images without storing patient data on the iPhone. This retrospective study is comprised of cervico-dorsal computed tomogram (CT) scan examination of 75 consecutive patients having clinically suspected cervico-dorsal spine fracture. Two radiologists reviewed CT scan images on the iPhone. Computed tomogram spine scans were analyzed for vertebral body fracture and posterior elements fractures, any associated subluxation-dislocation and cord lesion. The total time taken from the launch of viewing application on the iPhone until interpretation was recorded. The results were compared with that of a diagnostic workstation monitor. Inter-rater agreement was assessed. Results: The sensitivity and accuracy of detecting vertebral body fractures was 80% and 97% by both readers using the iPhone system with a perfect inter-rater agreement (kappa:1). The sensitivity and accuracy of detecting posterior elements fracture was 75% and 98% for Reader 1 and 50% and 97% for Reader 2 using the iPhone. There was good inter-rater agreement (kappa: 0.66) between both readers. No statistically significant difference was noted between time on the workstation and the iPhone system. Conclusion: iPhone-based teleradiology system is accurate in the diagnosis of acute cervicodorsal spinal trauma. It allows rapid, remote, secure, visualization of medical images without storing patient data on the iPhone.RÉSUMÉ: Téléradiologie basée sur le iPhone pour le diagnostic du traumatisme aigu de la colonne cervicale et dorsale. Objectif : Le but de l'étude était d'évaluer la faisabilité de la téléradiologie basée sur le iPhone comme ressource pour le diagnostic du traumatisme de la colonne cervicale et dorsale. Méthodologie : Nous avons développé une ressource qui permet la visualisation d'images sur le iPhone. Notre système permet la visualisation rapide, à distance et sécurisée d'images médicales sans sauvegarder les informations concernant le patient dans le iPhone. Cette étude rétrospective inclut l'examen de tomodensitométrie ...

show abstract

Radiology on Handheld Devices: Image Display, Manipulation, and PACS Integration Issues

Cited by 44 publications

References 19 publications

Airway Inflammation after Bronchial Thermoplasty for Severe Asthma

Airway Inflammation after Bronchial Thermoplasty for Severe Asthma

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

iPhone-Based Teleradiology for the Diagnosis of Acute Cervico-Dorsal Spine Trauma

Contact Info

Product

Resources

About