Emergency CT brain: preliminary interpretation with a tablet device: image quality and diagnostic performance of the Apple iPad

Laughlin, Patrick Mc; Neill, Siobhan O.; Fanning, Noel; Garrigle, Anne Marie Mc; Connor, Owen J. O’; Wyse, Gerry; Maher, Michael M.

doi:10.1007/s10140-011-1011-2

Cited by 59 publications

(45 citation statements)

References 10 publications

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“…This study has several different points in the methods compared with the previous studies (Table 6) [3,[6][7][8]. First, we tested our teleradiologic system in the realistic ED situation considering ambient lighting, subtle radiologic lesions, and currently available network.…”

Section: Discussionmentioning

confidence: 99%

“…1) [13]. The specifications of the display are shown in Table 1 [6]. The iPad 2 uses a LED backlight screen with a resolution of 1,024×768 pixels.…”

Section: The Ipad 2 Teleradiology Systemmentioning

confidence: 99%

“…Consequently, the iPad 2 is arguably one of the most updated hand-held teleradiology devices. However, just a few feasibility studies have been undertaken using it, focusing on the contrast detail and diagnostic agreement mainly under the typical illumination, 15-60 lux for computed tomography (CT), or MR reading [6][7][8][9]. But there was not any study assessing the potential of the teleradiologic displaying device under the realistic situation like suboptimal lighting, real-time network utilization, and subtle abnormal images.…”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

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

Park¹,

Lee²,

Kang³

2013

J Digit Imaging

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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.

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Section: Discussionmentioning

confidence: 99%

“…1) [13]. The specifications of the display are shown in Table 1 [6]. The iPad 2 uses a LED backlight screen with a resolution of 1,024×768 pixels.…”

Section: The Ipad 2 Teleradiology Systemmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

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

Park¹,

Lee²,

Kang³

2013

J Digit Imaging

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“…One reason for the broad acceptance of TC lies with their compact design and portability thus making TC interesting for medical or research applications too [2][3][4][5][6][7][8][9][10]. Another, if not even more important feature, is their intuitive interface with direct on-screen interaction.…”

Section: Introductionmentioning

confidence: 99%

iPad-Based Patient Briefing for Radiological Examinations—a Clinical Trial

et al. 2014

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To analyze if an iPad-based patient briefing can serve as a digital alternative to conventional documentations prior to radiological examinations. One hundred one patients referred for routine MRI were randomized into two groups, who underwent iPad-based and classic written briefing in opposite order. For each briefing completion time, completeness and correctness were noted. Patient's knowledge about the content of either briefing modality was subsequently tested. The influence of patient-related factors on the performance of the electronic briefing (EB) was analyzed. Finally, the patient's subjective impression of the EB was assessed. The mean durations were 4.4±2.2 min for EB and 1.7±1.3 min for the classic briefing (p<0.01). All iPad briefings were returned entirely filled out, whereas 11 % of the classic forms were returned with missing data. No significant differences in memorization of the briefing's information were objectified. There was a positive correlation between the duration of EB and age (r=0.53; p<0.01), whereas a negative correlation was found between computer skills and patient's age (r=−0.55; p<0.01) or duration of EB (r=−0.62; p<0.01). More than half of the study patients would prefer EB in the future; another 29 % had no preference at all. Patient briefing on iPads transfers the information for the patients equally well compared to the classic written approach. Although iPad briefing took patients longer to perform, the majority would prefer it to written consent briefings in the future. Nevertheless, measures have to be undertaken to improve the overall acceptance and performance.

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“…Nonemergent findings such as pulmonary nodules have been compared on the iPad versus the LCD standard display demonstrating no significant difference in diagnostic variability [12]. A study interrogating the utility of analyzing emergent CT brain studies was performed using the Apple iPad as a mobile tablet viewing device with promising results suggesting further evaluation [13]. These studies support the use of the mobile viewer as an accurate, reliable tool for viewing acute and non-acute medical images in various clinical settings.…”

Section: Introductionmentioning

confidence: 90%

Intra and Inter-Observer Reliability of Mobile Tablet PACS Viewer System vs. Standard PACS Viewing Station-Diagnosis of Acute Central Nervous System Events

Bhatia¹,

Patel²,

Pantol³

et al. 2013

OJRad

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Background and Purpose: The display resolution of the Apple iPad® is 1024 × 768 pixels, which is greater than that required for generating the typical CT or MRI images. The purpose of this study is to determine if specific CT and MR sequences can be interpreted accurately on mobile device/PACS software platforms when compared to a traditional stationary high resolution monitor/PACS radiological workstation. If so, this allows radiologists to provide comparable interpretation as if they were onsite at an imaging center or hospital. Materials and Methods: This study is an investigator initiated, single site, retrospective, nonrandomized, IRB approved study. Five radiologists were included in this study. Each independently interpreted specific CT and MR sequences on traditional high-resolution LCD monitors via eFilm® software as well as an iPad® mobile device using Osirix® software program. Repeat interpretations were performed, with 4 weeks minimum interval between interpretations of each patient. This investigation included: 50 patients with CTA perfusion imaging, 50 patients with MRI of the brain, and 50 patients with MRI of the spine, which were image study orders generated through emergency room requests. Subsequently, interpretive results of each radiologist for each patient were statistically compared to evaluate for intra-observer and inter-observer reliability. Results: The parameters set within the CTA perfusion brain studies demonstrated excellent intra-observer variability. All of the parameters within the MRI brain studies demonstrated excellent intra-observer variability with a Cohen's kappa value > 0.75. The Cohen's kappa values for the board certified neuroradiologist demonstrated excellent variability for all parameters; the resident radiologists had good variability, with a majority of kappa values near 0.75. Conclusions: The data and statistical analysis demonstrated that portable mobile devices such as the Apple iPad® can display adequate resolution of CT and MRI sequences to accurately diagnose acute central nervous system injuries and other non-acute pathology.

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Emergency CT brain: preliminary interpretation with a tablet device: image quality and diagnostic performance of the Apple iPad

Cited by 59 publications

References 10 publications

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

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

iPad-Based Patient Briefing for Radiological Examinations—a Clinical Trial

Intra and Inter-Observer Reliability of Mobile Tablet PACS Viewer System vs. Standard PACS Viewing Station-Diagnosis of Acute Central Nervous System Events

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