Chandrashan Perera

A Review of m-Health in Medical Imaging

OBJECTIVE The increasing capabilities of camera-equipped mobile phones have led to a growing body of evidence regarding their use in medical imaging across a broad range of medical specialties. This article reviews the current evidence for the use of mobile health (m-health) in medical imaging. MATERIALS AND METHODS We performed a structured review of the published literature regarding m-health in medical imaging using the Medline, PubMed, and Web of Science databases (January 2002-August 2013). The two authors independently extracted data regarding type of specialty, purpose, and study design of publications. RESULTS In total, 235 articles were identified. The majority of studies were case reports or noncomparative product validation studies. The greatest volume of publications originated in the fields of radiology (21%), dermatology (15%), laboratory techniques (15%), and plastic surgery (12%). Among these studies, m-health was used as diagnostic aids, for patient monitoring, and to improve communication between health practitioners. With the growing use of mobile phones for medical imaging, considerations need to be given to informed consent, privacy, image storage and transfer, and guidelines for healthcare workers and patients. CONCLUSIONS There are several novel uses of mobile devices for medical imaging that show promise across a variety of areas and subspecialties of healthcare. Currently, studies are mostly exploratory in nature. To validate these devices, studies with higher methodological rigor are required.

Nonmydriatic digital ocular fundus photography with iPhone 3G.

utes, in which his right eye would quiver. During his initial evaluation, the patient was unable to reproduce the twitching movement. His symptoms were attributed to superior oblique myokymia based on his description of vertical jumping of his eye producing vertical oscillopsia. The patient was reassured that his condition was benign given the absence of other neurological features. He began treatment with gabapentin and was then lost to follow-up. The patient did not return until 2011, when the episodes started to become more frequent, occurring 5 out of every 7 days. During this visit, he was able to reproduce the eye movement disorder by supraduction, causing an excyclotorsion, lasting about 1 minute (video, http: //www.jamaophth.com). This is the opposite of what is expected for superior oblique myokymia, in which infraduction triggers incyclotorsion. The decision was made to perform 1.5-T magnetic resonance imaging of the brain and orbits given that this type of movement had not been described in the literature and the patient had a significant medical history, including human immunodeficiency virus and factor 11 deficiency. The patient contracted human immunodeficiency virus from a contaminated blood transfusion in the early 1980s and was being treated with 2 forms of antiretroviral therapy, emtricitabine/tenofovir and raltegravir. After normal findings on magnetic resonance imaging, he began treatment with timolol maleate, which provided no relief. The patient more recently tried oxcarbazepine, with no improvement initially.

Letter by Chakrabarti and Pererato Regarding Article, “Smartphone Teleradiology Application Is Successfully Incorporated Into a Telestroke Network Environment”

We read with great interest the study by Demaerschalk et al1 in the September edition of Stroke, regarding the validity of smartphone-based assessment of brain computerized tomography scans in the context of acute stroke syndromes. We commend the authors on their excellent study and believe it would be enhanced by discussion of the following issues. The ability to view images on a smartphone of sufficient quality to detect subtle pathology remains a valid concern. The authors demonstrate a high level of agreement for identification of intracranial hemorrhage, neoplasm, or any radiological contraindication to thrombolysis on an iPhone 4 display compared with PACS and desktop. However, the level of agreement diminishes for early ischemic changes and hyperdense artery sign. This may be partially attributed to the small sample size, but …