Radiology untethered: 4G technology promises new levels of mobility

Launch of the new fourth-generation network from cellular wireless companies will enable radiologists to upload and download images more than 10 times faster than they have been able to in the past. While wireless mobile applications for imaging are still a distinct minority, the faster speeds could open the door for preliminary reads or image demonstrations on smartphones and iPads.

Verizon Wireless, the nation’s largest wireless provider, could be the first out of the gate with their new fourth-generation (4G) network, launching in 38 U.S. markets by the end of the year. Users will be able to download 5 to 12 megabits per second and up upload between 2 and 5 Mbps.

The 4G cellular wireless service is expected to provide a comprehensive and secure all-IP–based solution whereby ultrabroadband Internet access, gaming services, and streamed multimedia may be provided to users. It’s not unique to Verizon, but a direction other wireless providers are moving in, as well.

“For on-call radiologists, this may be useful if they need to do a quick preliminary evaluation of imaging. But diagnostic resolution is still needed at a desktop-based computer in the end,” said Dr. Garry Choy, founder of RadRounds, a radiology networking site. “I use my cellphone and iPad for images, but not to interpret them. I demonstrate images to colleagues or patients.”

The new 4G network will allow people to do everything faster, according to John Maschenic, director of enterprise solutions for healthcare and retail at Verizon.

“In today’s 3G environment, to push a 5 to 25-meg (megabyte) image puts a lot more stress and strain on the network to complete it in a timely fashion,” he said “When you get to 4G, because of the speed we’ll be offering, that becomes a very easy task for individual radiologists to do.”

4G promises high-quality service for next-generation multimedia support with real-time audio, high-speed data, HDTV video content, and mobile TV.

Verizon wireless uses evolution data optimized (EV-DO), which allows faster speeds for downloads and uploads. Prior to EV-DO, download speed was between 600 kilobits per second and 1.1 Mbps. The uplink was between 500 Kbps and 800 Kbps.

“4G sounds very promising and will certainly have an impact on the mobility of a radiologist’s preliminary read,” said Frank Burkhardt, director of North and Latin American operations at Aycan Medical Systems, a medical imaging technology firm. “As data volume increases and remote technologies such as the iPad slowly enter into the medical imaging space, every speed increase means progress.”

(Commenting on an article about the use of the iPad in imaging, Aycan representative Steven Popp cited test statistics indicating that the iPad exceeds the values for all medical displays except mammography.)

The increase in 4G’s speed is exponential when compared with 3G, according to Maschenic. He said it’s as if we’re moving from a two-lane highway to an eight-lane highway, which allows all the cars on the road to get to their destinations more quickly.

Ultimately, the move to 4G allows for more mobility, and what would be traditionally done in the hospital or the doctor’s office could potentially be done at home.

“If you take something as simple as an ultrasound, today you go to the office to do the ultrasound. Tomorrow the ultrasound will come to you,” Maschenic said. “Those images will be sent and shared with an ob/gyn, pediatrician-whoever-to be able to look at and review in real-time.”

While the radiologist may be able to view the images in real-time, Dr. Arun Krishnaraj, a clinical fellow at Harvard, said he would find it difficult to comfortably view multiplanar multisequence MRs on a mobile device.

“Some images-like chest x-rays where you can use gestures to blow up certain portions, and routine CTs-may allow for wet reads, but real diagnostic work and tough cases I think will need to be viewed on multiple displays or large displays for the time being,” he said. “However, I never thought people would actually watch movies on 3-inch phone screens.”

Verizon said they will sell 4G to radiology clinics, which could mean anything from the radiologist having “behind the firewall” access to patient data, to a remote location where they can call in a consult from another clinic, to the radiologists all having high-speed data cards in their laptops so they can access information while out of the office.

Really, though, it’s hard to say exactly what healthcare will look like with the use of 4G because new applications and devices will be created.

But if you think back to the early days of the Internet when people used dial-up, we wouldn’t have many of the applications we currently do because the technology wouldn’t have allowed for it, Maschenic said.

“Facebook, Twitter, YouTube would never exist if we were still on those dial-up modems,” he said. “Technology advancements change the business models and applications that are available for people to use.”