iPhone enables accurate, fast diagnosis of acute appendicitis

If you want to diagnose appendicitis, there's an app for that.

Radiologists may soon be able to use an Apple iPhone application to view CT images when traditional imaging software is inconvenient or inaccessible, according to a study presented Monday at the 2009 RSNA meeting. The researchers found radiologists were able to accurately diagnose acute appendicitis from a distant location using the OsiriX Mobile application.

"The software allows the reader to zoom and to adjust the contrast and brightness of the image," said Dr. Asim F. Choudhri, a neuroradiology fellow at Johns Hopkins University. "The radiologist is evaluating actual raw image data, not snapshots."

The study, performed at the University of Virginia in Charlottesville, found that 15 of 25 patients referred to CT scanning for right lower quadrant abdominal pain were correctly diagnosed with acute appendicitis on 74 of 75 interpretations, with only one false negative and no false positives. In eight of the 15 patients who had appendicitis, 88% of interpretations correctly identified calcified deposits in the appendix.

"The iPhone interpretations of the CT scans were as accurate as the interpretations viewed on dedicated PACS workstations," Choudhri said.

According to Choudhri, the iPhone application may be most useful to residents or trainees who need immediate faculty feedback on complicated cases. While e-mail messages of single images have been used in the past, OsiriX Mobile allows imagers to scroll through a full data set, he said.

On new iPhones, which utilize the 3G network, data streaming can be as fast as three seconds per image-or only one second per image when logged into a wireless broadband network, according to Choudhri.

The new software appears promising in expediting diagnosis. However, patient privacy issues still need to be addressed before widespread clinical use can be practiced, Choudhri said. The iPhones utilized in the study were kept in a locked location, but password, virtual private network, or firewall protection may also be employed to protect patient privacy.

Since the general public can also download OsiriX Mobile, the application may enable patients to more easily access their own images.

"This can allow patients to be a part of their healthcare process," Dr. Choudhri said.

He added that the software might reduce the need for costly reimaging procedures because patients can easily present data to their physicians if they switch hospitals.