Utility of mobile devices in the computerized tomography evaluation of intracranial hemorrhage

Abstract

Abstract Aim: To evaluate the utility of a mobile device to detect and assess intracranial hemorrhage (ICH) on head computed tomographys (CT) performed in the emergency setting. Materials and Methods: 100 head CT scans were randomly selected from our emergency radiology database and anonymized for patient demographics and clinical history. The studies were independently interpreted by two experienced radiologists in a blinded manner, initially on a mobile device (iPad, Apple computers) and subsequently, at an interval of one week, on a regular desktop workstation. Evaluation was directed towards detection, localization and characterization of hemorrhage. The results were assessed for accuracy, sensitivity, specificity and positive predictive value. Statistical significance was ascertained using Fisher′s exact test. Results: 27 of the examinations were positive for ICH, of which 11 had multiple hemorrhages. Of these there were 17 subdural, 18 intraparenchymal, 8 subarachnoid, 4 intraventricular and 2 extradural hemorrhages. In 96 of the studies there was complete concurrence between the iPad and desktop interpretations for both radiologists. Of 49 hemorrhages, 48 were accurately detected on the iPad by one of the radiologists. In the remaining case, a tiny intraventricular hemorrhage was missed by both radiologists on the iPad as well as on the workstation, indicating that the miss was more likely related to the very small size of the hemorrhage than the viewer used. Conclusion: We conclude that in the emergency setting, a mobile device with appropriate web-based pictue archiving and communication system (PACS) is effective in the detection of intracranial hemorrhage present on head CT.