Mobile Imaging

Advance for Imaging and Radiation Oncology | The FDA has given its blessing to remote diagnostic imaging; however, purists have concerns.

On Feb. 4, radiology lurched into the future. On that day, the Food and Drug Administration (FDA) awarded MIM Software Inc. 510(k) clearance for an app that allows remote diagnostic viewing of CT, PET, MRI, and SPECT images on the iPhone, iPod touch, and iPad.

The app, known as “Mobile MIM,” enables radiologists using a handheld device to view volumetric data with multi-planar reconstruction, to use zoom, pan, window, and other tools, to measure distance and intensity values, to annotate, and to display regions of interest.

Available for free from the iTunes App Store, Mobile MIM is the first such app to be cleared by the FDA.

It’s a safe bet it won’t be the last.

“We have had many downloads,” says MIM Software’s Chief Technology Officer Mark Cain, who characterized initial reactions from the radiology community as “very positive.”

Mobile devices “are the way we are going,” notes one generally positive member of the community, Janice Honeyman-Buck, PhD, editor-in-chief of the Journal of Digital Imaging. “I think the quality is certainly good enough for those modalities for diagnostics,” she says. “Now radiologists can see those images wherever they are. It’s probably good for patients as well.”

However, that’s not to say she and others don’t have concerns about Mobile MIM and similar apps to follow.

Proper lighting

Mobile MIM is only approved for CT, MRI, and nuclear medicine images “because they are fairly low-resolution,” says Elizabeth Krupinski, PhD, chair of the Society for Imaging Informatics in Medicine. “It is not for chest, bone, or mammogram images. Under the proper ambient lighting conditions, I would tend to believe it would be fine.”

The problem is ambient lighting conditions are fairly unique to the radiology reading room, and it could be difficult to find outside environments with adequate luminance.

“My concern is people will try to view other types of images that require better contrast ratio, or they won’t view these images under the proper ambient lighting conditions and that could affect diagnostic accuracy,” says Dr. Krupinski, a research professor at the University of Arizona in the departments of radiology and psychology.

“This is for emergency interpretations when the workstation is not available and if there is a clear indication to the radiologist interpreting the image of the history of the patient, for example, ‘This patient was in a car wreck, he hit his head, so we’re looking for an aneurysm,'” she says.

With mobile apps in health care clearly “the way of the future,” it’s time to devise standards to define the limitations of image viewing on mobile devices, she adds. “We need to narrowly define what interaction is needed between the display, the user, and the environment for diagnostic viewing.”


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