The iPad as a mobile device for CT display and interpretation: diagnostic accuracy for identification of pulmonary embolism

• Published in: Emergency radiology 2012-08, Vol.19 (4), p.323-327
• Main Authors: Johnson, Pamela T., Zimmerman, Stefan L., Heath, David, Eng, John, Horton, Karen M., Scott, William W., Fishman, Elliot K.
• Format: Article
• Language: English
• Subjects: Accuracy; Adult; Aged; Aged, 80 and over; Cloud computing; Communications systems; Computed tomography; Computers, Handheld; Consultation; Diagnostic software; Diagnostic systems; Display devices; Embolisms; Emergency management; Emergency Medicine; Female; Health risk assessment; Humans; Imaging; Logistic Models; Male; Medical diagnosis; Medicine; Medicine & Public Health; Middle Aged; Mobile communication systems; Night; Original Article; Pulmonary arteries; Pulmonary Embolism - diagnostic imaging; Pulmonary embolisms; Radiographic Image Interpretation, Computer-Assisted - instrumentation; Radiology; Radiology Information Systems; Readers; Sensitivity; Sensitivity and Specificity; Tomography, X-Ray Computed
• ISSN: 1070-3004; 1438-1435
• DOI: 10.1007/s10140-012-1037-0

Recent software developments enable interactive, real-time axial, 2D and 3D CT display on an iPad by cloud computing from a server for remote rendering. The purpose of this study was to compare radiologists’ interpretative performance on the iPad to interpretation on the conventional picture archive and communication system (PACS). Fifty de-identified contrast-enhanced CT exams performed for suspected pulmonary embolism were compiled as an educational tool to prepare our residents for night call. Two junior radiology attendings blindly interpreted the cases twice, one reader used the PACS first, and the other interpreted on the iPad first. After an interval of at least 2 weeks, the cases were reinterpreted in different order using the other display technique. Sensitivity, specificity, and accuracy for identification of pulmonary embolism were compared for each interpretation method. Pulmonary embolism was present in 25 patients, ranging from main pulmonary artery to subsegmental thrombi. Both readers interpreted 98 % of cases correctly regardless of display platform. There was no significant difference in sensitivity (98 vs 100 %, p  = 1.0), specificity (98 vs 96 %, p  = 1.0), or accuracy (98 vs 98 %, p  = 1.0) for interpretation with the iPad vs the PACS, respectively. CT interpretation on an iPad enabled accurate identification of pulmonary embolism, equivalent to display on the PACS. This mobile device has the potential to expand radiologists’ availability for consultation and expedite emergency patient management.