PDAs deliver on primary orthopedic reads

Radiologists are increasingly turning to personal digital assistants, but mostly for data handling. That may change as research confirms the possibility of interpreting scans from the handheld wireless devices.

Dr. Henrik E. Gregersen of Aalborg University Hospital in Denmark conducted a study to determine whether radiologists can make primary diagnoses using their PDAs. He chose 40 orthopedic studies, which included CT, MR, computed radiography, and digital radiography. He interpreted the images from both a wireless PDA and a workstation, with a span of one to two weeks separating each reading.

Gregersen's findings were concordant in 90% of the cases. Using the PDA, he missed a small cyst and a rib fracture in a trauma patient. Interestingly, he saw two instances of soft-tissue calcification on the PDA but not on the workstation. He caught the calcifications on the PDA only because of the need to zoom and scroll on the wireless device as opposed to the workstation, he said.

"As an old radiologist, I am used to seeing the x-ray in one image. So I overlooked those calcifications," Gregersen said.

Many types of studies do not work well on PDAs because of the necessity to scroll and pan with the small devices. But these analytic tools do not work against interpreting orthopedic studies, he said.

The study succeeded because the application running on the PDA (EasyViz from Medical Insight, Copenhagen) allows access at all times to full-resolution DICOM data and to a complete set of analysis functions commonly used by radiologists, according to Gregersen. In essence, the PDA was exactly like his workstation.

"The only difference was that the PDA screen was smaller, but this is not a major limitation in my opinion," he said.

Gregersen cautioned that radiologists require time and much practice with new technology before adopting it into their daily workflows. More than 1000 PDAs are in use at Aalborg University Hospital, but they are mostly in the hands of younger doctors, he said.

"The early adopters of these systems generally have grown up with mobile and digital tools and hence are more comfortable using them in the workplace," he said.