Image review on mobile devices for suspected stroke patients: Evaluation of the mRay software solution

• Published in: PloS one Vol. 14; no. 6; p. e0219051
• Main Authors: Brehm, Alex, Maus, Volker, Khadhraoui, Eya, Psychogios, Marios-Nikos
• Format: Journal Article
• Language: English
• Published: United States Public Library of Science 28.06.2019; Public Library of Science (PLoS)
• Subjects: Aged; Aged, 80 and over; Angiography; Automation; Biology and Life Sciences; Blood vessels; Brain hemorrhage; Care and treatment; CAT scans; Cell Phone; Cerebral Angiography - methods; Communication; Computed tomography; Computer programs; Diagnostic software; Diagnostic systems; Digital imaging; Electronic devices; Female; Females; Health aspects; Hemorrhage; Humans; Image Processing, Computer-Assisted - methods; Intracranial Hemorrhages - diagnostic imaging; Ischemia; Male; Medical equipment; Medical imaging; Medical imaging equipment; Medicine and Health Sciences; Mobile devices; Multidetector Computed Tomography; Nuclear medicine; Occlusion; Patients; People and Places; Perfusion; Physicians; Pictures; Quality assessment; Research and Analysis Methods; Retrospective Studies; Smartphones; Software; Stenosis; Stroke; Stroke - diagnostic imaging; Stroke patients; Tumors; Work stations; Workstations; Switzerland; Germany
• ISSN: 1932-6203; 1932-6203
• DOI: 10.1371/journal.pone.0219051

Software solutions such as mRay allow review of radiological images on handheld devices. We investigated if the quality is adequate for evaluating CT scans of patients with suspected stroke. 50 patients (Median age 80 years, 28 females) were retrospectively selected. All patients had undergone multidetector CT angiography ± perfusion and presented with clinical signs of acute stroke. Out of the 50 patients, 19 had large-vessel occlusion (LVO), 5 had intracranial hemorrhage (ICH), 10 had severe intracranial stenosis of at least one major vessel, 2 had intracranial tumor and 15 had no or an unrelated pathology. One experienced neuroradiologist and one resident scored the anonymized pictures separately on two handheld devices (iPhone 7 Plus, MED-TAB) equipped with mRay Software and on a PACS workstation. Each case was reviewed on all three devices with a break in-between of at least 12 weeks. The scoring on the traditional workstation was compared with the two handheld devices, regarding detection of early ischemic signs, LVOs, CBV/CBF-mismatch, ICHs and severe stenosis. Both raters were asked to rate the diagnostic quality of both handheld devices regarding detection of LVOs, ICHs, early ischemic signs and overall. All LVOs, intracranial tumors and ICHs were detected on both mobile devices. There was no significant difference in the rating of CCT and CBF ASPECTS between all three devices, while the sensitivity for detecting a CBF/CBV-mismatch was above 80% on both devices. Both raters assessed the diagnostic quality to be sufficient on both mobile devices to base treatment decisions on. Software solutions such as mRay for handheld devices provide adequate diagnostic quality for the review of CT scans of suspected stroke patients.