Remote reading of coronary CTA exams using a tablet computer: utility for stenosis assessment and identification of coronary anomalies

Abstract

The feasibility of remote reading of coronary CT examinations on tablet computers has not been evaluated. The purpose of this study is to evaluate the accuracy of coronary CT angiography reading using an iPad compared to standard 3D workstations. Fifty coronary CT angiography exams, including a spectrum of coronary artery disease and anatomic variants, were reviewed. Coronary CT angiography exams were interpreted by two readers independently on an iPad application (Siemens Webviewer) and a clinical 3D workstation at sessions 2 weeks apart. Studies were scored per vessel for severity of stenosis on a 0-3 scale (0 none, 1 <50 %, 2 ≥50-69 %, 3 ≥70 %). Coronary anomalies were recorded. A consensus read by two experienced cardiac imagers was used as the reference standard. Level of agreement with the reference for iPad and 3D workstations was compared. Multivariate logistic regression was used to analyze the relationship between agreement and display type and to adjust for inter-reader differences. For both readers, there was no significant difference in agreement with the reference standard for per-vessel stenosis scores using either the 3D workstation or the iPad. In a multivariable logistic regression analysis including reader, workstation, and vessel as co-variates, there was no significant association between workstation type or reader and agreement with the reference standard (p > 0.05). Both readers identified 100 % of coronary anomalies using each technique. Reading of coronary CT angiography examinations on the iPad had no influence on stenosis assessment compared to the standard clinical workstation.

Evaluation of Coronary Artery Disease and Coronary Anomalies with a Handheld Smartphone

“…The study cohort consisted of 50 patients with coronary CTA exams performed in the ED, selected to represent a range of CAD severity and coronary anomalies. We used the same coronary CTA cases and acquisition parameters as those in our previous study [13]. A radiology technologist anonymized and then imported the test cases from the hospital PACS into the syngo.via server (Siemens Medical Solutions).…”

“…Tablet computers with larger screens than the iPhone had been evaluated for the diagnosis of pulmonary embolism, and to evaluate brain CT and spinal MRI [10][11][12]. We recently demonstrated that the diagnostic accuracy of coronary CTA is comparable between the iPad and a standard workstation [13]. It is not yet established whether the iPhone is sufficient for reviewing coronary CTA exams.…”

Coronary computed tomography angiography in acute chest pain: A sustainable model with remote support

“…However, unanimous consensus on the large-scale use of this protocol has not been reached yet, considering several disadvantages and limitations of its applicability in clinical practice [10], like the need for trained cardiac radiologists who provide 24/7 service in the ED. A possible solution to this problem could be the wide and effective diffusion of client platforms, which may enable the remote real-time consultation of CCTA images by dedicated cardiac radiologists in support to local general radiologists [11,12].…”

64-Slice spiral double-low CT to evaluate the degree of stenosis and plaque composition in diagnosing coronary artery disease

“…In recent years, the incidence and fatality rate of coronary heart diseases in China have increased. Coronary heart disease seriously threatens the physical and psychological health ( 2 ). Thus, effective prevention and treatment of coronary heart disease is an important topic.…”