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Apple iPhone and OsiriX Mobile help diagnose appendicitis

12/1/2009 by: Darleen Hartley - Get more from this author


Could eating an apple cause an appendicitis attack? Probably not, but an Apple iPhone can help determine if the condition of your appendix is dangerous. Perhaps the radiologist is at a cocktail party when you double over in pain. Images transmitted to his iPhone make it possible to immediately diagnose an emergency situation from a location outside the xray lab.

Such was the topic of a presentation by Dr. Asim F. Choudhri, an expert in medical informatics, and a fellow physician in neuroradiology at Johns Hopkins University near Washington DC. He was speaking before the Radiological Society of North America, a 94 year old professional organization dedicated to education and research related to medical imaging.

OsiriX DICOM viewer
OsiriX DICOM viewer logo

The iPhone 3G is coupled with a DICOM [Digital Imaging and Communications in Medicine] viewer – OsiriX Mobile. "This new technology can expedite diagnosis and, therefore, treatment," Dr. Choudhri claims. Misdiagnosed and untreated appendicitis can cause ruptures, with toxins escaping into the body, leading to a serious infection.

CT scan Calcification of AppendicolithCT (computed tomography) images of the patient are presented on the iPhone in full resolution, and can be zoomed, with brightness and contrast controls, pertinent to reading an x-ray. Dr. Choudhri explains the benefit: "The radiologist is evaluating actual raw image data, not snapshots."

Picture Archiving Communication System (PACS) technology brought radiology into the digital age by allowing the display, transmission, and storage of digital medical images. Two former University of California, Los Angeles (UCLA) radiologists, Dr. Antoine Rosset and Dr. Osman Ratib, were responsible for creating OsiriX, an open source program for multi-modal and multi-dimensional visualization on the Mac. OsiriX runs natively on both Intel-based and PowerPC-based Macs. The latest version is Leopard compatible.

Apple computers at UCLA function as full-fledged DICOM, PACS workstations. Using a plug-in, OsiriX becomes fully integrated with iChat AV in Mac OS X.  Edward Zaragoza, MD, an associate clinical professor of radiological sciences at UCLA and the clinical director in radiology at the Santa Monica UCLA Medical Center and Orthopaedic Hospital, said: “We can switch from a live, face-to-face video conference to showing medical images inside the iChat window itself.”

Speaking with Radiology Today, Elizabeth Kerr, PhD, director of the science and medicine markets for Apple, said: “Macs in medicine is a growing trend which has really taken off thanks to OsiriX.”

Pain in your lower right abdomen is usually the first noticeable symptom of appendicitis, accompanied with fever, nausea and vomiting. Diagnosis is difficult. Doctors will do a CBC looking for a high white blood cell count, followed by a sonogram or CT scan. In the US, 250,000 appendicitis cases are reported annually and acute appendicitis is the most common reason for emergency abdominal surgery.

The New England Journal of Medicine, unfortunately, reports that many cases of undiagnosed appendicitis and unnecessary appendectomies occur each year. The CT scan has improved diagnostic accuracy. The Apple iPhone and medical image viewing software have improved the speed of verification and subsequently, has lead to more appropriate, and often less traumatic and expensive, treatment.



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Comments:

Use as a medical device by: Anonymous on 12/1/2009
OsiriX Mobile is a very good iPhone App which utilises the capabilities of a mobile device for physicians. It's a perfect partner for the "big" OsiriX software.


There is no FDA-cleared CE-marked version of OsiriX Mobile available. Which makes it difficult to specify professional usecases for the software.

In most industry nations the use of software for medical purposes for patients, in diagnosis, therapy or surgery is considered as a medical device. For example: in terms of classification, OsiriX is a class II medical device in the European Union and the USA.

aycan is offering OsiriX PRO as an FDA-cleared and CE-labeled version of OsiriX as medical device class II with support and comprehensive documentation.

Stephan P0pp
http://www.aycan.de
Too late for mine by: Anonymous on 12/1/2009
If this would have been around three years ago, it might have saved me many hours of pain.

Interesting article.
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