Supriya Gupta MBBS, MD, Presenter: Nothing to Disclose

Sean Doyle, Abstract Co-Author: Nothing to Disclose

Anand Viswanathan, Abstract Co-Author: Nothing to Disclose

Pradheep Vemula, Abstract Co-Author: Nothing to Disclose

Thomas J. Schultz BS, 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

Utility of mobile applications for rendering emergency diagnosis in radiology are increasingly gaining momentum due to their rapid availability and ease of use. We wanted to evaluate the image quality, image download speed and speed of interpretation on iPhone for preliminary diagnosis in comparison to a PACS workstation for Telestroke cases.  

Retrospective ongoing evaluation of 33 cases of CT head cases who had come in for stroke evaluation is being done. The cases are read by 2 stroke experts independently, blinded to the initial diagnosis. The 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 some ischemic change or hemorrhage (1). Accuracy of interpretation is then compared with the PACS reports. Bland Altman analysis would be used to assess the inter-observer variability and also between the reader’s reports on i-Phone versus the PACS reports.

For 10 cases, the image quality is excellent (4-5) on iPhone, average download speed on PACS was <1 min whereas for iPhone was 7.64 mins and the average time of interpretation was 2.34 mins on PACS and 6.44 mins on iPhone. The observer’s findings on iPhone 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 only 1 outlier, depicting high agreement between the reports from PACS and i-Phone.

The image Quality and accuracy of interpretation is excellent when i-Phone is used for visualizing telestroke images, however, its use is restricted due to a slower speed and smaller field of view, resulting in more time for image navigation and evaluation.

Radiologists expectations are evolving in direction of faster download speed and better image quality for rendering rapid reads. Addressing these concerns can realize utilization of mobile imaging.

Gupta, S, Doyle, S, Viswanathan, A, Vemula, P, Schultz, T, Dreyer, K, Are We Fast Enough? iPhone Image Visualization for Acute Telestroke Cases.  Radiological Society of North America 2010 Scientific Assembly and Annual Meeting, November 28 - December 3, 2010 ,Chicago IL. http://archive.rsna.org/2010/9014277.html