…and radiologists are working to incorporate it into mainstream radiology workflow. That became the Monday’s theme at RSNA. It’s interesting how the number of iPhone applications has mushroomed at RSNA this year — including diagnostic applications.

Research reported at RSNA showed that radiologists could use iPhones with the OsiriX Mobile viewer application to accurately diagnose acute appendicitis. Asim F. Choudhri, MD, presented results from a study done at the University of Virginia.

OsiriX Mobile is a DICOM viewer based on the well known open source OsiriX viewer. Radiologists can review and manipulate all the images in the study similarly to how they would at a traditional PACS workstation instead of viewing a few static images sent as jpeg files. The iPhone can present CT images at the full resolution they are acquired by the modality.

OsiriX Mobile and the open source OsiriX viewer are not FDA approved, nor is the iPhone approved for diagnostic applications. Aycan Medical Systems offers OsiriX Pro, a fully supported, FDA-approved version of the DICOM viewer.

In the study, five radiologists reviewed CT exams of the abdomen and pelvis exams of 25 patients over an encrypted wireless network. In the retrospective study, the 15 of patients who had acute appendicitis were correctly diagnosed on 74 of the 75 interpretations, with one false negative. There were no false positives.

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

In an interview, Choudhri said that confirming what a radiologist sees on the iPhone matches what’s he or she sees on a PACS workstation is the first step toward bringing such a handheld system into routine clinical use to provide access to images when a radiologist is away from the office. If a radiologist is immediately available, the exam can be interpreted in the usual manner via the system. If not, the full DICOM images can accessed via a a radiologist’s iPhone for a quick diagnosis. Choudhri noted the exam should still be read in the normal fashion until the handheld review is further vetted, but using the phone provides an effective way to speed treatment in an emergency situation. Images can also be sent to the surgeon in this manner, providing information for planning the likely treatment.

The potential value of such a handheld PACS is clear enough that vendors are increasingly adding OsiriX Mobile and OsiriX applications to their systems.

• CoActiv Medical Systems showed and other showed their OsiriX Mobile capabilities at RSNA.

• MacPractice showed its suite of Mac based applications for running a radiology practice.

• Barco imaging showed an iPhone application designed to remotely check and calibrate its monitors.

• And that’s just what I saw today at RSNA. What have you seen?