iPad vs. secondary-class LCD monitors: Its a draw

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Spinal MRI on iPad - 394.12 Kb
T1-weighted sagittal image from positive cervicodorsal spine MRI as viewed on the iPad. Source: Academic Rad 2012;19:1023-8

When reviewing spinal emergency cases on MRI, increased mobility doesn’t have to come at the cost of reduced reader accuracy as no statistical difference was seen in a multi-reader comparison of diagnostic accuracy between the iPad and a DICOM calibrated secondary-class LCD monitor, according to a study published in the August issue of Academic Radiology.

“Since its launch in April 2010, the iPad itself has generated significant interest in terms of its role in medicine and its potential application for the display of radiological images,” wrote Jonathan P. McNulty, MSc, of University College Dublin, and colleagues. Spinal emergencies in particular could benefit from the rapid initial review of an experienced radiologist using an iPad, noted the authors.

Secondary-class displays—displays designed for purposes other than providing primary diagnosis—have been shown to be a financially viable option for early review of MRIs. To compare how the iPad stacks up to a secondary-class LCD display with regard to diagnostic accuracy of spinal MRI exams, the authors conducted a multireader-multicase analysis in which 13 board-certified radiologists reviewed 31 MR cases on both display types. Among the MR cases used in the study, 13 were positive for one of four possible presentations: spinal cord compression, cauda equine syndrome, spinal cord hemorrhage or spinal cord edema. The remaining 18 MRIs served as controls.

Results showed that in multiple types of comparisons—random readers/random cases, fixed readers/random cases and random readers/fixed cases—there were no statistically significant differences between the iPad and secondary-class display in terms of area under the curve, sensitivity or specificity.

“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,” wrote the authors. “It also reinforces the Food and Drug Administration decision to give clearance for the use of the iPad for diagnostic decision-making while using an appropriate software application.”

McNulty and colleagues hope to expand their research by including more cases featuring additional pathologies.