iPhone radiology app to diagnose appendicitis

Originally published in MedPage Today

by Kristina Fiore, MedPage Today Staff Writer

For years, the pager and cell phone have summoned on-call radiologists to the emergency room. Now this leap in technology: an iPhone App that lets radiologists diagnose a patient remotely, wherever they may be.

iPhone radiology app to diagnose appendicitis Using a $20 iPhone application called OsiriX, radiologists made correct diagnoses of appendicitis in 124 of 125 computed tomography (CT) scans, Asim Choudhri, MD, of Johns Hopkins University in Baltimore, and colleagues reported here at the Radiological Society of North America meeting.

“This new technology can expedite diagnosis and, therefore, treatment,” Choudhri said. “We knew that recent advances in handheld device technology allowed viewing of medical imaging. But it is unproven whether viewing on a small screen allows a reader to reliably and reproducibly obtain information.”

So the researchers identified 25 abdomen and pelvis CT scans of patients with right lower abdominal pain who had either surgery or follow-up confirmation that they did not have appendicitis.

Next they had five blinded radiologists interpret each scan via the application on their iPhones.

The 15 cases of acute appendicitis were identified with more than 99% accuracy, the researchers said. Only one reader on one scan judged incorrectly, leading to a false negative.

The 10 patients who did not have appendicitis were diagnosed correctly on every iPhone interpretation, resulting in no false positives, the researchers said.

A total of eight appendicoliths were correctly identified on 35 of 40 interpretations (88%), they added.

Results from the iPhone readers were compared with readings by two gastrointestinal specialists who reviewed the images at a hospital workstation with normal sized equipment.

The two specialists correctly identified all those with appendicitis and all those without appendicitis: their findings were considered the “gold standard” for comparisons in the study.

Choudhri said radiologists can receive an 80-image scan in one to five minutes on an iPhone, depending on the type of connection available — WiFi or 3G cellphone service, respectively.

He noted that OsiriX is not approved by the Food and Drug Administration and said he would not recommend any final diagnoses be made using the iPhone technology. Rather, the device should be used to guide further diagnostic modalities, Choudhri said.

“The results are fairly impressive,” said RSNA spokesman Joseph Tashjian, MD, of St. Paul Radiology. Tashjian said the application would help a referring physician manage patients and might “be very beneficial” for patients to have their own records when visiting another facility.

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