TITLE:
Intra and Inter-Observer Reliability of Mobile Tablet PACS Viewer System vs. Standard PACS Viewing Station-Diagnosis of Acute Central Nervous System Events
AUTHORS:
Aashim Bhatia, Sandip Patel, Gustavo Pantol, Yen-Ying Wu, Michael Plitnikas, Christopher Hancock
KEYWORDS:
Teleradiology; Telemedicine; Cloud Network; PACS; Mobile Device; Emergency; Acute Stroke
JOURNAL NAME:
Open Journal of Radiology,
Vol.3 No.2,
June
20,
2013
ABSTRACT: 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.