RSNA: iPad 2 measures up in CT colonoscopy review
CHICAGO—The iPad 2 (Apple) proved comparable to a standalone iMac workstation, although more time-consuming, in viewing CT colonoscopy (CTC) datasets, according to research conducted by Emanuele Neri, MD, assistant professor, diagnostic and interventional radiology at the University of Pisa in Italy, and colleagues, and presented Nov. 27 at the 97th Scientific Assembly and Annual Meeting of the Radiology Society of North America (RSNA).

Researchers retrospectively reviewed 23 CTC exams. The images were acquired using low-radiation dose and all datasets were wirelessly imported in DICOM format from a Macintosh desktop connected to the hospital PACS to an iPad 2 running OsiriX HD. Two experienced raters read the CTC datasets independently on the iMac and on the iPad 2, and assessed them for image quality and length of time to read. All lesions detected on the iMac also were identified on the iPad 2, according to the study, and their segmentation was correctly assessed in all cases, although the interpretation was more time-consuming on the iPad 2.

“The iPad 2 performed well, since it allows a fast review in 2D. However, it requires a constant magnification of the colonic segments that are explored,” said Neri. “This is quite a time-consuming task. A well-trained radiologist is able to read the exam faster than a beginner.”

The iPad 2 will not substitute for standalone workstations, because they have large displays and multiple image processing tools, among other advantages, according to Neri, whereas the iPad’s advantage is its portability. Nevertheless, the iPad 2 may be used for discussions of cases in multidisciplinary sessions.

“In our hospital, multidisciplinary groups of physicians meet weekly to discuss cases to review CT and MRI studies and plan the therapeutic approach,” said Neri. “In this meeting, the radiologist with the iPad is a new figure; he brings the images, can discuss the case in a plenary session and share the images with clinical colleagues playing an active role in the management of the case. We should exploit this advantage.”

With the iPad 2 capable of managing slides, if connected to a projector the device could be used in place of a standard laptop for teaching activities, Neri noted. “In my teaching activity to medical students, I like to use the iPad 2 that has the same functionalities and advantages of a laptop,” he said. “Moreover, I can shift from one application to another, thus from the projection of slides to the presentation of the case with a DICOM viewer.”

Neri noted there were few cases to provide a significant sensitivity and specificity assessment, and no 3D evaluation or computer-aided detection. “The longer time needed for reading of CTC suggests that the iPad 2 is not optimized for primary reporting, but can be suitable for preliminary 2D reading of CTC examinations,” the researchers wrote.