Smart phones let speedy diagnosis of severe appendicitis

vIndianz.com (Nov. 30, 2009) — Radiologists can precisely diagnose severe appendicitis from an isolated location with the utilization of a handheld apparatus or mobile phone operational with unique software, according to a study offered at present at the annual meeting of the Radiological Society of North America (RSNA).

RSNA “The goal is to improve the speed and accuracy of medical diagnoses, as well as to improve communications among different consulting physicians,” said the study’s lead author, Asim F. Choudhri, M.D., fellow physician in the Division of Neuroradiology at Johns Hopkins University in Baltimore. “When we can make these determinations earlier, the appropriate surgical teams and equipment can be assembled before the surgeon even has the chance to examine the patient.”

Appendicitis, or inflammation and infection of the appendix, is a health crisis requiring surgical removal of the organ. Undiagnosed or left untouched, the inflamed appendix will rip apart, causing toxins to spill into the abdominal cavity and potentially causing a grave infection. Appendicitis be able to take place at any age but is most widespread in people between the ages of 10 and 30, according to the National Institutes of Health.

Normally, a patient arriving at the emergency room with assumed appendicitis will go through computed tomography (CT) and a physical examination. If a radiologist is not instantly available to understand the CT descriptions or if session with a specialist is required, diagnosis is deferred, increasing the danger of rupture. Transmitting the images over a mobile device allows for instantaneous consultation and diagnosis from a remote location.

“This latest technology can advance diagnosis and, therefore, treatment,” Dr. Choudhri said.

For the study performed at the University of Virginia in Charlottesville, CT examinations of the abdomen and pelvis of 25 patients with pain in the right lower abdomen were reviewed over an encrypted wireless network by five radiologists by an iPhone G3 equipped with OsiriX Mobile medical image viewing software. All of the patients had surgical verification or follow-up evaluations to verify whether or not they had appendicitis.

“The scans can be interpreted in full resolution with very minute panning, and the software allows the reader to zoom and regulate the contrast and brightness of the image,” Dr. Choudhri said. “The radiologist is evaluating authentic raw image data, not snapshots.”

Fifteen of the 25 patients were appropriately identified as having acute appendicitis on 74 (99 percent) of 75 interpretations, with one fake negative. There were no false positive readings. In eight of the 15 patients who had appendicitis, calcified deposits within the appendix were properly recognized in 88 percent of the interpretations. All 15 patients had signs of inflammation near the appendix that were properly acknowledged in 96 percent of interpretations, and 10 of the 15 had fluid near the appendix, which was properly identified in 94 percent of the interpretations. Three abscesses were properly recognized by all five readers.

“The iPhone interpretations of the CT scans were as exact as the interpretations viewed on committed picture archiving and communication system (PACS) workstations,” Dr. Choudhri said.

Dr. Choudhri pointed out that patient privacy concerns would have to be addressed prior to any handheld mobile device could be measured practical for clinical use, but noted that this method has enormous prospective for improving emergency room care.

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Smart phones let speedy diagnosis of severe appendicitis

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