Supriya Gupta MBBS, Presenter: Nothing to Disclose

Sean Doyle, Abstract Co-Author: Nothing to Disclose

Thomas J. Schultz BS, Abstract Co-Author: Nothing to Disclose

Garry Choy MD, Abstract Co-Author: Nothing to Disclose

Anand K. H. Singh MD, Abstract Co-Author: Nothing to Disclose

Keith J. Dreyer DO, PhD, Abstract Co-Author: Medical Advisor, General Electric Company Medical Advisor, Siemens AG Medical Advisor, Nuance Communications, Inc Medical Advisor, Carestream Health, Inc Medical Advisor, Vital Images, Inc Medical Advisor, Amirsys, Inc Medical Advisor, Life Image Inc Medical Advisor, McKesson Corporation Medical Advisor, Merge Healthcare

Anecdotal reports exist of iPad’s use in operating rooms to view patient images during surgery. Due to its higher screen resolution, its potential exists far beyond the OR. We evaluated chest radiographs on iPad based image viewer –RadPad - for image quality, image download speed, speed of interpretation and accuracy of interpretation as compared to a PACS workstation.

Retrospective ongoing evaluation of 30 cases of chest radiographs following tube placement in ICU is being performed. The cases are read by a chest radiologist blinded to the initial diagnosis on RadPad and after 1 week on a PACS workstation. Image quality is graded on a scale of 1-5 (5-excellent diagnostic quality image, 4 – less than diagnostic but good quality, 3 – good only for a preliminary report, 2- not adequate for a preliminary opinion, 1- not acceptable). The speed of download is rated on a scale of 1-5 (5- excellent speed, almost instantly;4- good speed, better than PACS; 3- speed equivalent to a PACS workstation , 2- speed less than a PACS workstation but not slow; 1- very slow). The observer readings are recorded as normal (0) and presence of pneumothorax or hemorrhage (1). Accuracy of interpretation is then compared with the PACS reports. Bland Altman analysis would be used to assess the intra-observer variability between the readers’s reports on iPad versus the PACS reports.

For 10 cases, image quality is excellent (5) on RadPad, average download speed was <1 min for both PACS and RadPad. There is no statistically significant difference in the average time of interpretation (1.2 mins on PACS and 1.44 mins on iPad). The observer’s findings on iPad and PACS workstation were highly concordant (r=0.9122, p=0.0001). Bland Altman analysis revealed that most of the values fell within the 95% Confidence Intervals with no outliers, depicting high agreement between the reports from PACS and iPad.

The image quality and accuracy of interpretation is excellent when iPad-based application is used for visualizing chest radiographs and it can potentially aid radiologists for making clinical decisions as there is no delay in downloading images onto the device and time taken to interpret the image is nearly equivalent to the PACS workstation.

Radiologist’s expectations are evolving in direction of better image quality for rendering rapid reads. Addressing these concerns can realize utilization of mobile imaging.

Gupta, S, Doyle, S, Schultz, T, Choy, G, Singh, A, Dreyer, K, First among Equals: Comparison of Image Quality between iPad and PACS Workstation for Detecting Pneumothorax on Chest Radiographs.  Radiological Society of North America 2011 Scientific Assembly and Annual Meeting, November 26 - December 2, 2011 ,Chicago IL. http://archive.rsna.org/2011/11007239.html