Abstract
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.
Similar content being viewed by others
References
Boonn WW, Flanders AE: Informatics in radiology (infoRAD): survey of personal digital assistant use in radiology. RadioGraphics 25:537–541, 2005
Flanders AE, Wiggins III, RH, Gozum ME: Handheld computers in radiology. RadioGraphics 23:1035–1047, 2003
Yamamoto LG, Williams DR: A demonstration of instant pocket wireless CT teleradiology to facilitate stat neurosurgical consultation and future telemedicine implications. Am J Emerg Med 18:423–426, 2000
Kim DK, Yoo SK, Park JJ, Kim SH: PDA-phonebased instant transmission of radiological images over a CDMA network by combining the PACS screen with a bluetooth-interfaced local wireless link. J Digit Imaging 20:131–139, 2007
Raman B, Raman R, Raman L, Beaulieu CF: Radiology on handheld devices: image display, manipulation, and PACS integration issues. RadioGraphics 24:299–310, 2004
Kim DK, Yoo SK, Kim SH: Instant wireless transmission of radiological images using a personal digital assistant phone for emergency teleconsultation. J Telemed Telecare 11([suppl 2]):S58–S61, 2005
Reponen J, Ilkko E, Jyrkinen L, Teryonen O, Niinimaki J, Karhula V, Koivula A: Initial experience with a wireless personal digital assistant as a teleradiology terminal for reporting emergency computerized tomography scans. J Telemed Telecare 6:45–49, 2000
Yaghmai V, Kuppuswami S, Berlin JW, Salehi SA: Evaluation of personal digital assistants as an interpretation medium for computed tomography of patients with intracranial injury. Emerg Radiol 10:87–89, 2003
Nakata N, Kandatsu S, Suzuki N, Fukuda K: Informatics in radiology (infoRAD): mobile wireless DICOM server system and PDA with high resolution display: feasibility of group work for radiologists. RadioGraphics 25:273–283, 2005
Toomey RJ, Ryan JT, McEntee MF, Evanoff MG, Chakraborty DP, McNulty JP, Manning DJ, Thomas EM, Brennan PC: Diagnostic efficacy of handheld devices for emergency radiologic consultation. Am J Radiol 194:469–474, 2010
McLaughlin P, McGarrigle AM, Maher MM, et al: Comparison of handheld devices for emergency radiology. Am J Roentgenol 196(4):W487–487, 2011
Melvin C, Bodley R, Booth A, Meagher T, Record C, Savage P: Managing errors in radiology: a working model. Clin Radiol 59(9):841–5, 2004
Mc Laughlin P, O Neill S, Mc Garrigle A, Coyle J, Brennan C, Maher MM Apple iPad and emergency CT brain interpretation: a phantom and clinical imaging study—presentation at the European Congress of Radiology 2011. http://www.myesr.org/cms/website.php?id=/en/past_congresses/ecr_2011/ecr_2011_book_of_abstracts.htm. Accessed 26th July 2011.
Zennaro F, Bava M, Gregori M, Ronfani L, Gustalla P Mobile teleradiology using smartphones: preliminary results—presentation at RSNA 2010. http://rsna2010.rsna.org. Accessed 26th July 2011
Mitchell JR, Sharma P, Modi J, Simpson M, Thomas M, Hill MD, Goyal M: Smartphone client–server teleradiology system for primary diagnosis of acute stroke. J Med Internet Res 13(2), 2011. doi:10.2196/jmir.1732
Modi J, Sharma P, Earl A, Simpson M, Mitchell R: iPhone-based teleradiology for the diagnosis of acute cervico-dorsal spine Trauma. Can J Neurol Sci 37(6):849–854, 2010
Choudhri AF, Carr 3rd, TM, Ho CP, Stone JR, Gay SB, Lambert DL: Handheld device review of abdominal ct for the evaluation of acute appendicitis. J Digit Imaging, 2011. doi:10.1007/s10278-011-9431-9 [Epub ahead of print]
Abujudeh HH, Boland GW, Kaewlai R, Rabiner P, Halpern EF, Gazelle GS, Thrall JH: Abdominal and pelvic computed tomography (CT) interpretation; discrepancy rates among experienced radiologists. Eur Radiol 20(8):1952–7, 2010
OsiriX DICOM viewer. http://www.osirix-viewer.com/AboutOsiriX.html Accessed 27th Jan 2012.
Acknowledgments
The authors would like to acknowledge and thank Dr. Tina Xue of the Clinical Trials and Research Unit of the Changi General Hospital, Singapore for her help with the study design.
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
John, S., Poh, A.C.C., Lim, T.C.C. et al. The iPad Tablet Computer for Mobile On-Call Radiology Diagnosis? Auditing Discrepancy in CT and MRI Reporting. J Digit Imaging 25, 628–634 (2012). https://doi.org/10.1007/s10278-012-9485-3
Published:
Issue Date:
DOI: https://doi.org/10.1007/s10278-012-9485-3