title: The iPad as a mobile device for CT display and interpretation: diagnostic accuracy for identification of pulmonary embolism.
abstract: 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.
authors.affiliation: The Russell H. Morgan Department of Radiology and Radiologic Science, Johns Hopkins School of Medicine, 601 N. Caroline Street, Room 3140D, Baltimore, MD 21287, USA. pjohnso5@jhmi.edu
authors.forename: Pamela T
authors.initials: PT
authors.lastname: Johnson
authors.forename: Stefan L
authors.initials: SL
authors.lastname: Zimmerman
authors.forename: David
authors.initials: D
authors.lastname: Heath
authors.forename: John
authors.initials: J
authors.lastname: Eng
authors.forename: Karen M
authors.initials: KM
authors.lastname: Horton
authors.forename: William W
authors.initials: WW
authors.lastname: Scott
authors.forename: Elliot K
authors.initials: EK
authors.lastname: Fishman
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D034201:Computers, Handheld; D005260:Female; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D011655:Pulmonary Embolism / Q000000981:diagnostic imaging*; D011857:Radiographic Image Interpretation, Computer-Assisted / Q000295:instrumentation*; D011873:Radiology Information Systems; D012680:Sensitivity and Specificity; D014057:Tomography, X-Ray Computed