title: Remote reading of coronary CTA exams using a tablet computer: utility for stenosis assessment and identification of coronary anomalies.
abstract: The feasibility of remote reading of coronary CT examinations on tablet computers has not been evaluated. The purpose of this study is to evaluate the accuracy of coronary CT angiography reading using an iPad compared to standard 3D workstations. Fifty coronary CT angiography exams, including a spectrum of coronary artery disease and anatomic variants, were reviewed. Coronary CT angiography exams were interpreted by two readers independently on an iPad application (Siemens Webviewer) and a clinical 3D workstation at sessions 2 weeks apart. Studies were scored per vessel for severity of stenosis on a 0-3 scale (0 none, 1 <50 %, 2 ≥50-69 %, 3 ≥70 %). Coronary anomalies were recorded. A consensus read by two experienced cardiac imagers was used as the reference standard. Level of agreement with the reference for iPad and 3D workstations was compared. Multivariate logistic regression was used to analyze the relationship between agreement and display type and to adjust for inter-reader differences. For both readers, there was no significant difference in agreement with the reference standard for per-vessel stenosis scores using either the 3D workstation or the iPad. In a multivariable logistic regression analysis including reader, workstation, and vessel as co-variates, there was no significant association between workstation type or reader and agreement with the reference standard (p > 0.05). Both readers identified 100 % of coronary anomalies using each technique. Reading of coronary CT angiography examinations on the iPad had no influence on stenosis assessment compared to the standard clinical workstation.
authors.affiliation: Department of Radiology and Radiological Sciences, The Johns Hopkins University School of Medicine, Baltimore, MD, USA. stefan.zimmerman@jhmi.edu.|Department of Radiology and Radiological Sciences, Johns Hopkins Hospital, The Johns Hopkins University School of Medicine, 600 N. Wolfe St, Hal B172, Baltimore, MD, USA. stefan.zimmerman@jhmi.edu.
authors.forename: Stefan L
authors.initials: SL
authors.lastname: Zimmerman
authors.affiliation: Department of Radiology and Radiological Sciences, The Johns Hopkins University School of Medicine, Baltimore, MD, USA.
authors.forename: Cheng T
authors.initials: CT
authors.lastname: Lin
authors.affiliation: Department of Radiology and Radiological Sciences, The Johns Hopkins University School of Medicine, Baltimore, MD, USA.
authors.forename: Linda C
authors.initials: LC
authors.lastname: Chu
authors.affiliation: Department of Radiology and Radiological Sciences, The Johns Hopkins University School of Medicine, Baltimore, MD, USA.
authors.forename: John
authors.initials: J
authors.lastname: Eng
authors.affiliation: Department of Radiology and Radiological Sciences, The Johns Hopkins University School of Medicine, Baltimore, MD, USA.
authors.forename: Elliot K
authors.initials: EK
authors.lastname: Fishman
mesh_terms: D034201:Computers, Handheld / Q000592:standards; D003251:Constriction, Pathologic / Q000000981:diagnostic imaging*; D017023:Coronary Angiography / Q000379:methods*; D003331:Coronary Vessels / Q000000981:diagnostic imaging*; D006801:Humans; D015999:Multivariate Analysis; D019114:Remote Consultation / Q000592:standards*; D012189:Retrospective Studies
keywords: Coronary CT angiography; Coronary artery disease; Emergency department; Mobile device; Tablet; iPad