iPad Can Aid Doctors in Evaluating Spinal Images: Study

The Apple iPad is capable of allowing physicians to review Magnetic Resonance images of spinal emergencies, according to a study in the August issue of the journal Academic Radiology.

The Apple iPad was up to the task of reviewing Magnetic Resonance images of emergency spinal injury cases, a study published in the journal Academic Radiology revealed.

MRIs are used in radiology to examine the ligaments and pathology of the spinal cord.

In the journal's August issue, Jonathan P. McNulty, head of teaching and learning for diagnostic imaging programs at University College Dublin, along with colleagues found that the iPad was equal to a secondary-class LCD in diagnostic accuracy. A secondary-class monitor is used for evaluations other than a primary diagnosis, according to the American Association of Physicists in Medicine (AAPM).

The other authors of the report were Dr. John Ryan, a lecturer in diagnostic imaging at University College Dublin, Dr, Louise Rainford, head of diagnostic imaging in biological imaging research at University College Dublin and Dr. Michael Evanoff of the American Board of Radiology.

For the study, 13-board certified radiologists examined 31 MR images on a ViewSonic VP201m LCD (with an nVidia GeForce 7100 graphics card) and the iPad. On both screens, they found evidence of compression, hemorrhaging or edema (accumulation of fluid in connective tissue) of the spinal cord in 13 instances. Meanwhile, 18 control images came up negative for the conditions.

Sensitivity and specificity of the images on the iPad were greater than or equal to that of the ViewSonic VP201m display, according to the study. The differences were not statistically significant, however.

The iPad had about double the maximum luminance of the ViewSonic unit. The larger display size and superior contrast ratio of the iPad over other mobile devices makes it suitable for additional study, according to the report.

Researchers ran Ziltron iPad software on both the ViewSonic monitor and Apple tablet to compare the diagnostic capabilities of the devices. Ziltron iPad uses a receiver operating characteristic (ROC) methodology, which involves evaluating the degree of sensitivity and specificity of a screening tool in finding a disorder. Ziltron also exports data to Excel for additional analysis.

"The 3G and WiFi capabilities and the wide range of DICOM viewing software available for the iPad mean that it has great potential in terms of accessing radiological images remote from the radiology department or indeed remote to the institution particularly in situations requiring an urgent review," McNulty told eWEEK in an email.

"The iPad performed with equal diagnostic accuracy when compared with the secondary-class LCD device after [Dorfman-Berbaum-Metz] multireader-multicase analysis, demonstrating the iPad as an option to aid initial review of MR spinal emergency cases," the authors wrote.

Dorfman-Berbaum-Metz (DBM) is a method of statistical analysis of multiple readers, or displays.

"As evidenced by these findings, the iPad may represent a possible solution to the evaluation of MR images and diagnostic decision-making in spinal emergency cases when reviewed by experienced radiologists without access to secondary-class displays," the authors wrote. "It also reinforces the [U.S.] Food and Drug Administration decision to give clearance for the use of the iPad for diagnostic decision-making while using an appropriate software application.€

The FDA has already cleared apps such as MIM Software's Mobile MIM for viewing radiology images on the iPhone and iPad. The application allows doctors to make diagnoses on a mobile device such as the iPhone or iPad without having to travel to a workstation.

The iPad 2 has proven to be equal to other LCD monitors for diagnosing tuberculosis, according to a recent study by the University of Maryland.

In the UMD study, results of a chest X-ray were equal€”200 positive and 40 negative€”when five radiologists tested images on iPad 2 tablets and on a 27-inch Mac monitor, according to FierceMobileHealthcare.

The iPad shows great potential as far as viewing images and accessing content, but for clinical medical applications, software companies will need to incorporate features such as gesture-based computing, natural language speech recognition, unified communications and video conferencing for use on the iPad, according to a Jan. 31 Spyglass Consulting Group report.