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The reliability of tablet computers in depicting maxillofacial radiographic landmarks

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      Abstract

      Purpose

      This study was performed to evaluate the reliability of the identification of anatomical landmarks in panoramic and lateral cephalometric radiographs on a standard medical grade picture archiving communication system (PACS) monitor and a tablet computer (iPad 5).

      Materials and Methods

      A total of 1000 radiographs, including 500 panoramic and 500 lateral cephalometric radiographs, were retrieved from the de-identified dataset of the archive of the Section of Oral and Maxillofacial Radiology of the University Of Connecticut School Of Dental Medicine. Major radiographic anatomical landmarks were independently reviewed by two examiners on both displays. The examiners initially reviewed ten panoramic and ten lateral cephalometric radiographs using each imaging system, in order to verify interoperator agreement in landmark identification. The images were scored on a four-point scale reflecting the diagnostic image quality and exposure level of the images.

      Results

      Statistical analysis showed no significant difference between the two displays regarding the visibility and clarity of the landmarks in either the panoramic or cephalometric radiographs.

      Conclusion

      Tablet computers can reliably show anatomical landmarks in panoramic and lateral cephalometric radiographs.

      Related collections

      Most cited references 17

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      Oral Radiology: Principles and Interpretation.

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        The iPad tablet computer for mobile on-call radiology diagnosis? Auditing discrepancy in CT and MRI reporting.

        Tablet computers such as the iPad, which have a large format, improved graphic display resolution and a touch screen interface, may have an advantage compared to existing mobile devices such as smartphones and laptops for viewing radiological images. We assessed their potential for emergency radiology teleconsultation by reviewing multi-image CT and MRI studies on iPad tablet computers compared to Picture Archival and Communication Systems (PACS) workstations. Annonymised DICOM images of 79 CT and nine MRI studies comprising a range of common on-call conditions, reported on full-featured diagnostic PACS workstation by one Reporting Radiologist, were transferred from PACS to three iPad tablet computers running OsiriX HD v 2.02 DICOM software and viewed independently by three reviewing radiologists. Structured documentation was made of major findings (primary diagnosis or other clinically important findings), minor findings (incidental findings), and user feedback. Two hundred and sixty four readings (88 studies read by three reviewing radiologists) were compared, with 3.4 % (nine of 264) major discrepancies and 5.6 % (15 of 264) minor discrepancies. All reviewing radiologists reported favorable user experience but noted issues with software stability and limitations of image manipulation tools. Our results suggest that emergency conditions commonly encountered on CT and MRI can be diagnosed using tablet computers with good agreement with dedicated PACS workstations. Shortcomings in software and application design should be addressed if the potential of tablet computers for mobile teleradiology is to be fully realized.
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          The iPad as a mobile device for CT display and interpretation: diagnostic accuracy for identification of pulmonary embolism.

          Recent software developments enable interactive, real-time axial, 2D and 3D CT display on an iPad by cloud computing from a server for remote rendering. The purpose of this study was to compare radiologists' interpretative performance on the iPad to interpretation on the conventional picture archive and communication system (PACS). Fifty de-identified contrast-enhanced CT exams performed for suspected pulmonary embolism were compiled as an educational tool to prepare our residents for night call. Two junior radiology attendings blindly interpreted the cases twice, one reader used the PACS first, and the other interpreted on the iPad first. After an interval of at least 2 weeks, the cases were reinterpreted in different order using the other display technique. Sensitivity, specificity, and accuracy for identification of pulmonary embolism were compared for each interpretation method. Pulmonary embolism was present in 25 patients, ranging from main pulmonary artery to subsegmental thrombi. Both readers interpreted 98 % of cases correctly regardless of display platform. There was no significant difference in sensitivity (98 vs 100 %, p = 1.0), specificity (98 vs 96 %, p = 1.0), or accuracy (98 vs 98 %, p = 1.0) for interpretation with the iPad vs the PACS, respectively. CT interpretation on an iPad enabled accurate identification of pulmonary embolism, equivalent to display on the PACS. This mobile device has the potential to expand radiologists' availability for consultation and expedite emergency patient management.
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            Author and article information

            Affiliations
            [1 ]Section of Oral and Maxillofacial Radiology, Department of Oral Health and Diagnostic Sciences, University of Connecticut School of Dental Medicine, Farmington, CT, USA.
            [2 ]University of Connecticut School of Dental Medicine, Farmington, CT, USA.
            [3 ]Department of Craniofacial Sciences, University of Connecticut School of Dental Medicine, Farmington, CT, USA.
            [4 ]Section of Operative Dentistry, Department of Reconstructive Sciences, University of Connecticut School of Dental Medicine, Farmington, CT, USA.
            [5 ]Department of Diagnostic Sciences, University of Pittsburgh School of Dentistry, Pittsburgh, PA, USA.
            [6 ]Section of Orthodontics, Department of Craniofacial Sciences, University of Connecticut School of Dental Medicine, Farmington, CT, USA.
            Author notes
            Correspondence to: Prof. Aditya Tadinada. Division of Oral and Maxillofacial Radiology, Department of Oral Health and Diagnostic Sciences, University of Connecticut School of Dental Medicine, 263 Farmington Ave, Farmington, CT 06032, USA. Tel) 1-860-679-7527, Fax) 1-860-679-4760, tadinada@ 123456uchc.edu
            Journal
            Imaging Sci Dent
            Imaging Sci Dent
            ISD
            Imaging Science in Dentistry
            Korean Academy of Oral and Maxillofacial Radiology
            2233-7822
            2233-7830
            September 2015
            09 September 2015
            : 45
            : 3
            : 175-180
            4574055
            10.5624/isd.2015.45.3.175
            Copyright © 2015 by Korean Academy of Oral and Maxillofacial Radiology

            This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License ( http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

            Categories
            Original Article

            Dentistry

            radiography, panoramic, pacs (radiology), radiography, dental, digital

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