Wireless Personal Digital Assistant Device as a Teleradiology Terminal: initial experiences with emergency cases.

Jarmo Reponen, M.D., Eero Ilkko, M.D., Virpi Karhula, Med Phys,  Lasse

Jyrkinen, Med Eng, Antero Koivula, Med Phys , Osmo Tervonen M.D.

Department of Diagnostic Radiology, Oulu University Hospital, FIN-90220

Oulu, Finland

Introduction

The development of GSM cellular networks has made mobile data transfer available in over 50 countries. Personal digital assistant devices and intelligent phones has made it possible to have network connections  with a pocket-size terminal. The purpose of this study was to test such a device in emergency teleradiology.

Materials and Methods

A private secure access point to the hospital network from the GSM network was established using a PPP-server. Computerized tomography (CT) images were compressed with JPEG -compression and pushed from a DICOM compatible workstation to a teleradiology server for consultation.  Data calls to the server were made with a Nokia Communicator (Nokia Ltd, Helsinki, Finland) intelligent GSM phone was equipped with an image viewer and a Celesta MDO (CCC Ltd, Oulu, Finland) FTP-software.

After notification of an emergency case, a neuroradiologist made a data call, logged into the server and viewed each of the 21 patient cases. 20 of these were head scans and one was a sinus scan. All the images in a series were transmitted. The distribution of diagnoses was: infarction 11, atrophy 2, hemorrhage 4, aneurysm 1, infection 1 and tumour 2 cases. Image transmission times were recorded. The neuroradiologist rated images for quality and gave a radiology report. The original films were then read for comparison.

Results

Image transmission to the terminal took on the average one min per image. In one of the cases the image quality was good enough for "final report" and in 20 cases the quality was suitable for "preliminary report". No case was in category "not suitable for diagnosis". The report given from the images was identical with final report in 18 cases (86%) and not identical in 3 cases (14%). The differences were: 1) a possible density loss at nucleus lentiformis was not seen, 2) a small lacuna infarction at the right capsula interna region was not found, 3) a pineal cyst was not found.

Discussion and Conclusion

Teleradiology transmission even to pocket-size terminals is possible today. The quality of the images is enough for preliminary reports in emergency CT cases like hemorrhages and large brain infarctions. The resolution of terminal displays is still too limited to see very small changes. These initial results give us a  model of future mobile specialist consultations. Before full acceptance of this new technology, image transfer should become faster and terminal image display quality should increase.

References

1. Reponen J., Ilkko E., Jyrkinen L., Karhula V., Tervonen O., Laitinen J., Leisti E-L., Koivula A., Suramo I. Wireless Radiologiacal Consultation with Portable Computers - technical aspects and initial experiences. In: Lemke H.U. et al.(eds.). Proceedings of CAR´97, 638-643, 1997.

Corresponding Author:

Dr. Jarmo Reponen

Department of Diagnostic Radiology

Oulu University Hospital

P.O Box 25

FIN-90220 OULU

fax: +358-8-3155420

e-mail: jarmo.reponen(at)oulu.fi

Oral presentation at EuroPACS'98, Barcelona, Spain