JACC: Handheld devices for CCTA evaluation show positive results
“Historically, CCTA interpretation has been limited to dedicated stand-alone 3D imaging workstations, which are expensive and generally unavailable outside performing institutions,” the authors wrote. Recently, improved technology “creates the potential for novel platforms that permit remote viewing of medical imaging studies by mobile handheld devices when dedicated 3D imaging workstations are not available.”
Troy M. LaBounty, MD, of the Weill Cornell Medical College at New York Presbyterian Hospital in New York City, and colleagues evaluated the use of mobile handheld devices and their effectiveness to examine CT image exams from 102 patients.
Using a patient cohort from the ACCURACY trial, LaBounty and colleagues chose 102 patients with stable chest pain to undergo a 64-detector row coronary CTA and quantitative invasive coronary angiography (QCA) and evaluated each exam on a per-artery, per-patient level.
QCA identified CAS at the 50 percent threshold in 26 percent of patients and in 10 percent of the 405 arteries.
During the study, two CTA imagers evaluated patient imaging exams. Imager No. 1 had prior experience using handheld devices to interpret CCTA exams, while imager No. 2 had no prior experience. Results showed that sensitivity of each CCTA imager was the same; however imager No. 1 had a higher level of specificity.
“No differences in diagnostic performance of CCTA as interpreted by the mobile handheld device were noted for patients with higher coronary artery calcium scores or body mass index,” the authors wrote.
Heart rates greater than 65 beats/minute and intrascan heart rate variability greater than 10 beats/minute were linked to increased interpretabilities.
“These results demonstrate diagnostic performance characteristics that are on par with other noninvasive imaging modalities (such as stress echocardiography and myocardial perfusion scintigraphy),” the authors wrote.
When comparing imaging exams interpreted on dedicated workstations to handheld devices, researchers found no significant differences in variability and concluded that handheld device image review can be useful for the detection of CAS.
“Contemporary advances in the field of mobile handheld technology now permit viewing and processing of medical images anywhere an internet connection exists, which may permit sharing of studies for consultation with additional readers and which may enable remote medical image evaluation if on-site readers are unavailable,” the authors concluded.
However, the authors urged that the security of patient data must be maintained during the transmittal of data so that it stays in compliance with government regulations.