The iPads large screen and interactive interface make it an ideal platform for medical imaging.

NeuroRad by RadLynx LLC is a clinical neuroradiology reference designed for a range of healthcare professionals involved in neurological imaging of the brain.

Written and designed by an American Board of Radiology certified Neuroradiologist, NeuroRad aims to improve understanding of neurological imaging and associated pathologies.

We have previously reviewed the NeuroRad Mini for the iPhone, and this is the iPad counterpart.

The main feature of this app is the interactive imaging atlases. This is split into a number of sections; Cross Sectional MRI Anatomy, Vascular territories, MR Angiography (both arterial and venous) and CT Angiography.

All three views (Saggital, Coronal and Axial) are accessible complete with labels. Navigation through the different parts is innovative and involves pinch-to-zoom multitouch gestures which scroll through the different anatomical slices. The images are high resolution and clearly labelled. Unfortunately, there was no way to turn off the labels in this section in order to test oneself.

The Vascular territory atlas covers both arterial and venous supply and is an excellent resource navigated in a similar fashion to the cross sectional atlas. A clear key illustrates the different areas of the brain supplied by each artery-key for any neurosurgeon. Labels are also included here to develop recognition of key structures

The MR Angiography section covers both the arterial and venous system. Each view has a multitude of labels which consolidates anatomical knowledge. There are also a range of views including ‘Tumble’ and ‘Spin’ which aim to improve 3-dimensional understanding.

The CT angiography also covers the three main views (Saggital, Axial and Coronal) and both arterial and venous systems. It is useful that these images are highlighted so that the path of the vessels can be visualised.

The other major section of NeuroRad for iPad is a detailed weblink and reference section. There are a decent range of weblinks covering a range of aspects related to neuroradiology from MRI images to clinical sites including journals and professional associations. This collection of weblinks (which open in Safari) is a good resource for residents and interns looking for further information.

The reference section contains some excellent information related to pathologies which may be seen on a scan. These are presented as a list of differential diagnoses which are extensive. There is very little pathophysiology explanation although references are provided for the interested resident who is looking for further reading.

Price:

• $9.99 (although currently on sale as new content is added and updated)

Likes:

• Detailed, labelled radiology atlas covering the three main views
• Excellent visualization of the vessels in the brain using both MR and CT Angiography
• Detailed differential diagnoses for a range of abnormalities seen on radiograms
• Collection of weblinks

Dislikes:

• No ability to share information/screenshots via email/social media
• No ability to turn the labels on/off in order to test oneself

Overall Rating:

• NeuroRad for iPad is a fantastic application for radiologist residents with an excellent neuroradiology atlas
• Has a range of uses for healthcare professionals ranging from student to resident
• An all-round excellent application for those interested in neurological imaging

iTunes link

by: Brian Chau, MS3

Being able to recognize key anatomical landmarks on radiological imagery is important for any medical student or clinician.

NeuroRad Mini is an app available through iTunes for users looking for a mobile reference and review guide to brain images.

NeuroRad Mini, from developer RadLynx, is a clinical MRI brain atlas for iOS devices. It features coronal, sagittal, and axial views of the brain. These are all labeled, allowing for easy viewing and review of important anatomical locations and relationships.

Designed by a senior member of the American Society of Neuroradiology, NeuroRad Mini is a more limited version of the iPad-only app, NeuroRad, also from RadLynx. NeuroRad Mini is designed to be a quick-reference guide to MRI views of the brain, while the iPad version offers more features, due to the limitations of the screen size and processing power of the iPod Touch and iPhone platforms.

I was impressed by how easy it was to navigate NeuroRad Mini on a small device such as the iPod Touch. Everything in the app loaded quickly, with little noticeable lag. Image scrolling through different cross-sectional views are fluid and accomplished by using the Multitouch contols. I could either swipe once to change to a single new view, or enable continuous image changes by dragging two fingers on screen. Just swiping to view the next image seemed to be the best way to view images through NeuroRad Mini.

NeuroRad Mini also allows the user to view labeled images of the various neuro cross-sections. This option is very useful, especially in a clinical educational setting. A simple upward swipe on the screen will turn off labels, while swiping down turns them on. The pointers to each brain region are easy to follow and visualize, even on the smaller screen of the iPod Touch. To zoom in, double-tapping the brain or tapping the magnifier glass will do the trick. I did notice that zoomed in images weren’t quite as detailed as many would like, but they are certainly still useful for learning and reference.

While some medical apps require an active Internet connection to pull images and information, NeuroRad Mini offers almost all of its content locally. This is a huge benefit, as not every user has access to a network data plan or wireless connection 24/7. Even the basic help and support pages on the app do not require active network access. Finally, for users desiring more information or assistance with NeuroRad Mini, the developer’s website offers a fairly comprehensive FAQ and user guide.

Price and technicals:

• NeuroRad Mini is available for $9.99, through iTunes
• This app requires iOS 4.3 or later and runs on the iPod Touch, iPhone and iPad
• There is also a larger version named NeuroRad available for the iPad exclusively.

Likes:

• Wonderful review of brain anatomy seen through MRI imagery
• Large selection of high-quality neuro MRI images
• Smooth navigation and superb layout
• Excellent clinical relevance
• Great customer support, both online and off

Dislikes:

• Users of older iOS devices will not be able to run NeuroRad Mini
• Limited to MRI imagery

Conclusion:

• NeuroRad Mini is a solid choice for a brain atlas utilizing MRI imagery
• It’s a must-have for any user interested in better understanding the anatomic layout of the brain in a clinical setting.

Links:

Developer
iTunes

MIM Software has announced that their Mobile MIM platform has received its second FDA 510 (k) clearance for the updated Mobile MIM 3.0 version. After a 2 and 1/2 year journey for the first FDA approval they received in December ’10, Mobile MIM has now also been approved for diagnostic X-ray and ultrasound viewing, as well as radiation treatment plan review and approval.

When we interviewed Mark Cain, CTO of MIM Software, earlier this year, he told us about how MIM made the jump to iOS,

When the iPhone SDK came out in 2008, almost on a whim, we thought we would see if we could make an imaging tool. We had good programmers but they had never written in Objective C [the programming language of iOS]. Jerimy Brockway and David Watson worked at home for 1 week and at the end of that we had a functioning prototype that convinced that this was real.

They have certainly come a long way since then.

This latest FDA 510(k) clearance for Mobile MIM 3.0 brings with it three significant new capabilities – diagnostic x-ray viewing, diagnostic ultrasound viewing, and radiation treatment plan review/approval. The latter was actually one of MIM Software’s earliest offerings, expanding to radiation oncology from its original software for PET-CT fusion. As for the X-ray viewing, Mr. Cain explained that the original 510(k) narrowed the indications for Mobile MIM based on FDA concerns,

We settled on indications for use they were comfortable with, specifically “diagnostic display of CT/PET/MRI/SPECT modalities when radiologist does not have access to a PACS workstation”. [Diagnostic] xray is not included due to the resolution (2000-4000 pixels).

In the press release, the applications for radiation oncology are described in greater detail,

Radiation oncologists can use Mobile MIM to review dose volume histograms, isodose curves, contours, and images for treatment plans – actions commonly restricted to a limited number of dedicated workstations…With the release of Mobile MIM 3.0, MIM Software also plans to launch a co-branded version of the app with its partner Accuray Incorporated. The co-branded Accuray version of the app, PlanTouch™, will have an interface that allows physicians to review and approve a CyberKnife® treatment plan via a direct link.

In our full review of Mobile MIM, we talked about its extensive toolkit for viewing/manipulating images, local and cloud storage capabilities, and other features. We have also highlighted how platforms enabling radiology viewing on tablets can be used practically by surgeons. As we not only see Mobile MIM expand its capabilities, but similar trends with competitors like ResolutionMD, its clear that mobile viewing of radiology is going to continue to expand for the foreseeable future.

Source: Press Release

By: Wouter Stomp, MD

As we recently reported, Carestream has received FDA clearance for its Vue Motion HTML5 based medical image viewer. This is a major step forward in ensuring cross-platform availability, theoretically making it accessible from any device that has a web browser.

Although other vendors have released apps for the iPad and other tablets to access their PACS systems, Vue Motion is the first web-based viewer that we know of that can be accessed from tablets without installing additional software.

We took the viewer for a spin, testing it on a variety of devices. We received access to a demo server from Carestream which had several example patients with modalities including x-ray, ultrasound, CT and MRI.

iPad

First up, of course, was the iPad. Our tests were performed on an iPad 2 as recommended by Carestream.

They recommend turning the brightness all the way up and provide a link to some calibration images from the login screen (although other than brightness there is not much that you can change on an iPad).

After browsing to the server address and entering our credentials, we were presented with a search box to look up patient studies.

Looking up patients and opening studies was fast enough. Individual studies open in a tab-based interface, which is clean and simple, devoid of any unnecessary clutter.

On the left and right are drawers with the patient history (previous studies) and study reports and notes respectively. At the bottom there are buttons for moving through the image stack, zoom, moving the image, window/level, measurements, rotating the image and reloading it. In addition there are controls for selecting the image series and a play button for moving images.

The selected action is assigned to one-finger gestures, however you can also use two fingers to pinch and zoom and move the image around.

Performance

Our tests were a bit of a stress-test, accessing the servers from the Netherlands across the translatlantic internet cables, with a high-speed internet connection (20Mb/s DSL). Images showed up almost instantly, only rarely showing a loading screen in between. Images can also be played in a movie mode which also displayed smoothly in most cases. What can be a small annoyance is that images are first loaded in low-resolution, introducing a short flicker a fraction of a second after you scroll to a different image.

The images are rendered on the server and sent to the viewer in a loss-less format with compression varying with image detail and zoom level. Typical compression was between 1:10 and 1:50. There is a button that will load the current image loss-lessly for optimal image quality, however the difference is usually imperceptible, so we would recommend just staying with the default images. Data usage may be an issue if you plan to use the viewer over 3G, however we were not able to test this as the test iPad was wifi-only.

Desktop

On the PC you are presented with exactly the same interface as on the iPad. Although it is great to have a consistent interface across all platforms, it does feel a bit clunky with its large touch-screen optimized UI elements. Other than that, it works equally as well as it does on the iPad, or as any other vendor’s flash-based webviewer. The viewer actually includes a button that launches the full advanced Carestream PACS client, however for some reason this is only available when using Microsoft internet explorer.

Other devices

It would be interesting to know if the viewer performs equally well on Android tablets, however we were unable to test this. The iPhone is a no-go, it will try to use the exact same interface as on the iPad, which obviously does not fit on the iPhone’s screen.

Quirks

We found a few small quirks while using the viewer.

• First, although the interface appears tab-based, it is actually not possible to open multiple tabs or switch back to the patient list without closing the current study.

• Secondly it was not possible to put the viewer as an icon on the iPad’s homescreen. When you try that, you are presented with a browser not supported-screen upon launching it. This is a pity as it would allow for using the app fullscreen instead of wasting valuable screen space on the URL and tab bars of the Safari browser.

Conclusion

• Vue Motion is a simple and hassle-free viewer that works almost flawlessly across multiple platforms without the need to install any software or apps.
• Carestream is probably the first vendor to offer an HTML5 based medical image viewer, but we hope other vendors will follow suit.
• In its current state, it is perfectly usable for the clinician to review images remotely or on the bed-side.

Wouter Stomp is a physician from the Netherlands, currently doing a PhD in radiology. He is also an editor

The mHealth Summit 2011 is in full swing and there are many exciting booths and demonstrations available to see. We recently reported that ResolutionMD has received FDA clearance for its mobile radiology viewing system. The platform is available as a free downloadable demo “lite” version via iTunes.

Calgary Scientific, makers of ResolutionMD, are here at the mHealth Summit and were kind enough to give the imedicalapps team a live demonstration of the app, including some of its marqee features.

The video below demonstrates what the technology can do and is a live demonstration of ResolutionMD.

 Key points about their imaging solution include:

• The imaging data is NOT copied, it is left on the source PACS (i.e. hospital or imaging center)
• A temporary copy of the data is created on a dedicated server
• The server is usually housed by the specific entity that owns the PACS
• Calgary Scientific does not sell its product directly, ResolutionMD is resold by large PACS vendors such as GE and Fujitsu
• All image processing–including 2d and 3d reconstructions–are performed on the server side, saving system resources
• A session can be opened with an iPad or various Android tablets, allowing the rendered images to be displayed
• Images can also be viewed on a web browser, which currently has more capabilities and functionality than the mobile app counterparts
• For security purposes, no data is stored on the mobile device. Instead, when the session is closed nothing is retained
• Since the images are rendered remotely, two devices can view the same images simultaneously as well as share controls

This last feature is especially exciting since a radiologist can be viewing an image on his/her iPad, send an email invite to a physician inviting him to open a simultaneous session and actually go through the slices and point at the findings of interest.

At this time, it is not clear if this platform will be extended to small imaging centers and physician practices with digital radiology capabilities.

by:Joshua James Harding BSc Hons (MS2)

Building on the success of the trusted and popular Case Reviews Online series, Elsevier has now brought the series to the iPad in the form of five individual apps.

The Case Reviews series utilizes various imaging techniques that allows the user a comprehensive and interactive way in which to test their knowledge of a full range of diseases. Here we take a look at how this series fares on the iPad.

There are currently five apps available in the Case Review series on the iPad.

1. MSK imaging case reviews (with over 600 images across 200 cases)

2. Thoracic imaging case reviews (with over 300 images across 164 cases)

3. Brain imaging case reviews (with over 600 images across 200 cases)

4. Spine imaging case reviews (with over 400 images across 183 cases)

5. Pediatric imaging case reviews (with over 500 images)

Review

The first thing to note is the user interface, which requires minimal explanation as it is a very basic layout and simple to use. Nothing to complain about here.

You select the “chapter” from the contents on the left of the screen. This will allow you access to a set number of cases e.g 1-50, 51-150 and so on. Once selected, the individual cases will appear with associated images to its right. You then simply select the case you wish to view.

Each case provides you with a handful of relevant scrollable images, each with a legend. The image, whether it be a CT or plain film, once selected, can be explored with the pinch and zoom finger technique to give you a better view.

It is possible to toggle on and off the legend for each image as well as image labels. These are quite useful if you are struggling with a differential as it will give you a little bit more information or will literally point you in the right direction.

Alternatively, having this information in the “off” position may present a more realistic challenge to the more astute users.

As you might expect, each case comes with a question. You can start answering the case questions at any point by pressing the Q at the bottom of the screen. The questions are in a multiple choice format and generally ask you to determine the most likely differential diagnosis from the images you have been presented with.

Once an answer has been submitted, you will see the correct and incorrect answers and an explanation for each. This is very helpful if you have not been successful in answering the question as the text below the incorrect answer will explain why it should have been included in your DDx.

Other features of the app include the ability to bookmark certain cases. This feature can be used to either log your progress or allow you to return to the next case at a later date. Alternatively, you could use it to flag common or important cases as you wish.

It is also possible to make notes on each case by clicking the pen and paper button. The notes section can be used to add any information that might be of use to you, whether it is a pneumonic or an extra detail surrounding the subject.  This is a worthwhile feature in my opinion.

Once you are satisfied with your progress, or upon returning to the app, you can access the overview screen. This screen shows you your current progress in terms of questions unanswered, questions answered and of those, how many correct or incorrect. This section is headed with an assessment start date, which can be reset along with the questions answered.  This effectively allows you to wipe the slate clean and see if you can improve upon your old score the second or third time around.

This screen also provides you with a list of your bookmarks and notes. Each section — Incorrect, questions unanswered or bookmarked — is all selectable, meaning you can view and navigate to, for instance, your saved bookmarks or questions you still need to get right.

While this app doesn’t break the mold when it comes to novel and intuitive ideas, it does provide you with a huge resource of high yield self-tests which will be invaluable to many.

I cannot help but feel, however, that all these images are not being fully utilized. A single question on choosing a DDx is all that most cases have, and I feel that simpler questions such as clinical anatomy relating to the case or pure spotter anatomy could easily be added widening the user base of the app. In its current form, I feel it would lend itself well to newly qualified doctors or those studying for board exams.

Cost:

• $19.99 each

Likes:

• The ability to add notes to each case
• High yield cases can be bookmarked
• Overview section adds a competitive edge (even if you are only competing with yourself!)

Dislikes:

• The contents of each case are not optimally organized
• The UI is somewhat dull

Conclusion:

• This app would really benefit from better content organization, currently bunched into cases 1-50 with no real relevance to their organization it is difficult to compartmentalize the cases into certain topics or regions of anatomy.
• Simply putting the cases under categories, whether they are clinically orientated e.g “fractures”, or anatomically organized e.g “upper limb” would make a huge difference and the app a lot more user-friendly.
• All in all, though, this series of apps are reliable and absolutely packed with high yield cases. For the price, you are definitely paying for the volume of content with these apps and not a lot else.
• Put simply, the apps get the job done.

iTunes MSK Imaging Case Review

iTunes Thoracic Imaging Case Review

iTunes Brain Imaging Case Review

iTunes Spine Imaging Case Review

iTunes Pediatric Imaging Case Review

The explosive growth of medical applications for smartphones, launched by the  debut of the innovative Apple iTunes App store in 2008, promises to fundamentally change the physician’s tool set. While many specialties have always been heavily dependent on technology, such as radiology and cardiology, the ubiquity of these small, interconnected computers means that every physician will soon have access to a broad array of software and hardware to help them perform their daily work.

At iMedicalApps.com, we have been reviewing the most interesting medical apps on the market today as well as watching for trends in mobile medical technology. The most popular categories thus far have been clinical reference and utility apps.  Some of the largest download numbers have been for apps that provide drug and disease reference information, such as the encyclopedic Medscape app, or medical calculators.

However, more targeted apps that are specialty specific are slowly coming on the market. Some early ones, not surprisingly, were reference and self-assessment apps for radiology. These include the popular Radiology 2.0: One Night in the ED, iRadiology and Radiopaedia apps. More substantively, mobile image viewing apps promise to liberate radiologists from their workstations, including the recently FDA approved Mobile MIM app for the iPad.

We are now seeing an increasing number of apps for surgeons coming to the app stores. Presently, this is primarily on the iOS platform although the popular ones will no doubt be coming to the Android platform. Below is a survey of notable apps currently available for surgeons. This article is concurrently published in the Journal of Surgical Radiology.

1. In The Office

SurgAware

Patients undergoing surgery are anxious and, even if they seem like they followed the preoperative counseling in the office, undoubtedly will have questions as soon as they leave. These two apps help patients navigate the informed consent process.

According to the developers of SurgAware, patients forget “70% of what is said in a doctor’s consulting room” within 24 hours. In order help them remember, SurgAware:

…puts all those risks into writing, in a format that can be emailed to anyone who needs to know. If you are a patient, you can either email the list to your doctor for discussion at your next appointment, or check to see that all topics have been covered. If you are a doctor or a nurse, you can use the list as a reference during the process of taking consent, email your patient, copy the email to yourself, and then have evidence of having disclosed the information.

Surge Aware itunes

Heart Surgery Risk

Coronary artery bypass grafting (CABG) is a commonly performed procedure. Despite the immense technical complexity, the risks to most patients are low. However, they are not the same for all patients. For patients to whom CABG has been recommended, HeartSurgeryRisk:

is designed to give patients and their families and friends an estimate of what the chances for complications or death are for a patient who is considering CABG surgery. The calculator is based on data from the Society of Thoracic Surgeons National Database© and the Online Risk Calculator©.

Heart Surgery Risk itunes

ShoulderDecide MD

One of the most challenging aspects of communicating surgery with patients is explaining anatomy. Whereas, the names of anatomical structures are the lingua franca of surgeons, they are almost uniformly foreign to patients. Therefore, many apps are available to help bridge this gap. One such series is available from OrcaMD  which makes patient counseling apps for orthopedics and plastic surgery. Some surgeons also use general anatomy apps, such as the well known Netter Flash Cards. According to the ShoulderDecide MD’s developers:

The purpose of ShoulderDecide is to educate the non-medically trained patient about their shoulder problems. It aims to enhance understanding of common conditions of the shoulder area while answering in an informed, practical guide which conditions may require surgical treatment.

Shoulder Decide itunes

2. Surgery Planning

PreOpEval

Once the decision for surgery is made, then the real preparation work begins. For many patients, it is important to anticipate how their existing medical conditions could possibly complicate surgery and anesthesia. Preoperative testing could range from a basic history and physical all the way to invasive cardiac testing. In many surgeons’ offices, what constitutes adequate pre-surgical testing is based more on local tradition than evidence. According to the developers of PreOpEval, it helps guide testing:

… based upon the guidelines on this topic from the American College of Cardiology & American Heart Association of 2007 and 2009, the Institute for Clinical Systems Improvement of 2006, and the American College of Chest Physicians of 2008…

The app addresses such common questions as:- who needs bloodwork before surgery?- who needs an EKG or a CXR?- how do I handle patients on Warfarin, Aspirin, and Clopidogrel?- which patients are recommended to get perioperative B-blockers or statins?- which active cardiac conditions preclude surgery?- how long after MI should a patient wait before surgery?

Pre Op Eval itunes

iTraycer

For surgical sales reps, managing inventory of implants and trays can be challenging. Although not intended for direct use by surgeons, iTraycer is an interesting solution that helps these very mobile reps manage and locate their equipment by:

providing tracking and real-time tracing of medical trays, devices and implants, including lot numbers, part numbers, from manufacturer to patient.

iTravcer itunes

3. Night Before

Zollinger

Reading up on tomorrow’s case is not just for residents, reviewing “old” texts often brings forth new appreciation even for practicing surgeons . Now, with the availability of major surgical textbooks in app format, these resources can be available anywhere. For general surgeons, the Zollinger series is a well known reference, covering almost every major abdominal procedure and hernia repairs. According to the the app publisher, the Zollinger apps:

…allow you to access step-by-step instructions and superb line drawings for numerous general surgical procedures. Many procedures also include fully-narrated, slideshow presentations outlining each step in the procedure, from Intro and Indications through Post-Operative Care.

Campbell’s Orthopedics

For orthopedic surgeons the most ubiquitous surgical technique text is undoubtedly Campbell’s Orthopedics. Now in its 10th edition and still going strong, it was one of the early textbooks to be adapted to app format. That also allowed multiple videos to be included, which contributes to the hefty 870Mb download. It does not include every procedure in the paper text but, according to the publisher,  the app format allows user to:

• Navigate through 242 techniques and more than 1000 corresponding images with the flick of a finger
• View almost 20 high quality procedure videos
• Bookmark techniques for convenient reference
• Quickly locate any technique in the entire app using the comprehensive search index

Current Diagnosis and Treatment Surgery

For residents and students preparing for surgery and even for surgeons, this large volume contains information on diseases most likely to be treated surgically. According to the app publisher, it offers:

• Wide-ranging coverage that encompasses general surgery and all the important subspecialties including otolaryngology, urology, gynecology, orthopedics, plastic and reconstructive surgery, and pediatrics
• More than 600 informative photographs and illustrations
• Detailed treatment algorithms
• Completely rewritten chapters on Wound Healing, Anesthesia, Otolaryngology/Head & Neck Surgery, The Heart, Neurosurgery, Gynecology, and Orthopedic(s)

AO Surgery Reference

For orthopedic surgeons involved in trauma care, the principles of operative fracture management developed by the “AO”of Switzerland remain the benchmark. Their fracture classification scheme and treatment algorithms have been disseminated throughout the globe. Now they are available in two free apps. The AO Surgery Reference, according to the publishers, recognizes this important fact about surgeons:

The idea behind this service is the realization that reference in daily clinical life is often difficult. Frequently, there is little time during a hospital day to consult books or journals, or even to perform a literature search in order to gather evidence for a decision. The AO Surgery Reference allows surgeons to access much of the body of surgical knowledge for reference purposes during their clinical work.

A second app, the Müller AO Classification of Fractures – Long Bones, makes the sometimes complicated AO fracture classification scheme approachable by converting it into a series of simple screens and touch controls.

Cardiac catheterization, developed for clinical use by the German physician Werner Forssmann in the 1930s –when he catheterized himself through his own forearm– remains the gold standard for the investigation — and in some cases, management — of a variety of cardiac and coronary conditions.

While these procedures are primarily performed by cardiologists and supervised cardiology fellows, an appreciation for cardiac catheterization represents a valuable skill for internal medicine residents as well as medical students interested in cardiology.

The CathSource app, developed by Drs. Bilhartz and Mahjoobi (cardiologists from Texas A&M) of ECGsource LLC and sponsored by Scott & White Healthcare, aims to assist healthcare professionals in the understanding and recognition of cardiac pathology via cardiac catheterization multimedia.

ECGsource LLC develops materials to help medical trainees prepare for the cardiology boards, and originally focused on EKG interpretation (their EKG database now features over 500 unique EKG’s).

ECGsource LLC has since expanded to offer materials providing instruction on echocardiograms and catheterizations, developing similar EchoSource and CathSource databases.  Similar to their ECGsource app, the CathSource app is a scaled-down version of (or supplement to) the full database (which costs $99/year for individuals) at ECGsource.com.

Read below the jump to learn more about how the CathSource app can deepen your appreciation for cardiac catheterization procedures with virtual cath images and videos.

The CathSource app’s user interface is impressively streamlined, offering only two options along the bottom bar—index and images.

The CathSource app includes the following topics via the index (the sections on IVUS and OCT were added with the latest update to Version 1.2):

• Normal Coronary Anatomy
• Anomalous Coronary Arteries
• Coronary Artery Aneurysms
• Standard Views of Angiography
• Coarctation of the Aorta
• Femoral Artery Access for Angiography
• Radial Artery Access for Angiography
• Intravascular Ultrasound (IVUS)
• Optical Coherence Tomography (OCT)
• Fractional Flow Reserve (FFR)
• Hemodynamics: Intracardiac Pressures
• Hemodynamics: Intracardiac Waveforms
• Hemodynamics: Cardiac Output
• Hemodynamics: Intracardiac Shunts
• Hemodynamics: Aortic Stenosis
• Hemodynamcis: Aortic Regurgitation
• Hemodynamics: Mitral Stenosis
• Hemodynamcis: Mitral Regurgitation
• Hemodynamcis: Constriction
• Hemodynamics: Restriction

As an example, here we explore aortic coarctation, finding the topic through the searchable index. The page for aortic coarctation includes well-written sections on overview, presentation and prognosis, and evaluation and management, with references cited in the text.

The most intriguing and unique feature of the CathSource app is, of course, the catheterization films.  Note the associated caption explaining what to look for and appreciate on the film.

The catheterization films, as seen here, are solid-quality, include the associated tracing, and can be easily navigated and paused.

As a second example, we show the section on the hemodynamics of aortic stenosis.  This section, while without an associated catheterization film, includes several formulas and other images.  This section discusses the Gorlin and Hakki formulas, the correlation between mean and peak-to-peak valvular gradients, gradient measurement, and aortic valve resistance, including citations where appropriate.

This section of the hemodynamics of aortic stenosis includes several good-quality images (which cannot, however, be selected or zoomed while viewed via the topic) referenced in the text to help users understand the presented material.

The other aspect of the app facilitates the more convenient searching and viewing of images and films otherwise embedded in the various topics found in the index.  As seen here, the captions for each image are included on the search screen before selecting the particular image or film.

Here we show a representative figure which illustrates a normal right-dominant coronary anatomy, which can be zoomed and panned, unlike when it is embedded in a topic.

And finally, here we show a representative catheterization still-image depicting the left main anatomy, with vessels labeled.

Price:

• The CathSource app costs $3.99 on the iTunes app store.

Likes:

• Over 30 high-quality, easily-navigated catheterization videos and 65 images
• Impressive breadth of cardiac pathology discussed in the app
• Developed by interventional cardiologists with references cited in the text
• Customized for both the iPhone and iPad

Dislikes:

• - A quiz or tutor mode featuring cases and films with associated questions may have been a nice feature for the app to consolidate mastery of the presented material (as with the full-fledged CathSource database)
• - Images and figures cannot be zoomed when viewed via the topic, only via “images”

Summary:

• The CathSource app represents a worthwhile purchase for residents or medical students interested in cardiology, as it uses catheterization films and associated figures to help depict and discuss cardiac pathology as seen via cardiac catheterization.
• The app could potentially be useful for patient education as well, due to the plethora of cardiac cath videos and pictures — helping patients get an in-depth understanding of their upcoming procedure.

iTunes Link: http://itunes.apple.com/us/app/cathsource/id420847275?mt=8

One of the most frustrating parts of medicine is trying to get access to a patient’s radiology studies that were performed at an outside hospital or from a completely different geographic area, especially when time is lacking.

Most films are standardized and can be viewed on a DICOM machine — but they require patients to carry around CDs, not ideal and practical. And if you want to get an image from another hospital system, often times you have to get a courier to get the actual CD, or just get the results faxed to you. Again, not ideal situations.

Often times, this lack of continuity leads to repeat radiology studies being performed, especially in acute settings.

But, what if all the medical images were stored on a central cloud? And physicians could share those images with each other, and even better, patients could control who had access to all of their medical images.

This cloud based solution is one step closer to reality with two key announcements by MIM software yesterday.

MIM software, the makers of the first FDA approved radiology viewing app for physicians, Mobile MIM, just released a medical imaging app aimed directly at patients, and a new cloud service called MIMCloud 2.0, enabling medical imaging to be readily stored and shared securely via a cloud service.

VueMe, the latest offering by MIM software, allows patients to store and share their medical images on the cloud, and interfaces with the physician centered FDA approved Mobile MIM app. The app uses MIMCloud 2.0, a cloud based service that stories all the radiology images — the MIMCloud 2.0 service facilitates exchange of the images from physicians to patients, and vice versa.

Basically, physicians can now send medical images they have stored on the MIMCloud 2.0 to a patient’s iOS device (iPhone or iPad) — enabling patients to keep a record of their medical images, and allowing them to share their own images with whoever they please.  Especially useful when coordination between specialists needs to occur.

Now, an OB/GYN physician can send a medical image, such as a still shot ultrasound image of a pregnant female’s child, directly to the expectant mother’s smart phone.  Even more revolutionary, the mother has the ability to share that images with her primary care physician or any other physician she pleases.

This last example is where the functionality of the app truly shines: Patients can use VueMe and share their images with other physicians who use the MIMCloud 2.0. Instead of a patient having to take a manilla folder or CD with radiology results — they can use a cloud service to store their images, and beam them to other specialists who might not have immediate access to their medical imaging.

Mobile MIM, the radiology app for physicians, was a huge hit in its own right — mainly due to it’s FDA approved status, allowing physicians to feel comfortable using the app for diagnostic purposes. Even to this day, Mobile MIM remains the only FDA approved radiology viewing app. Along with its FDA approved status, Mobile MIM also earned tremendous accolades from iMedicalApps in an in depth review we did earlier in the year:

MobileMIM and MIMCloud are a great way to view, store and share radiology imaging.  Mobile MIM is a great piece of iOS software engineering, with remarkably fluid navigation throughout even large study sets. The ability to perform mutli-planar imaging and locate a structure in three planes simultaneously is very useful. Using MIMCloud to share imaging studies greatly simplifies communication and removes an important pain point, while the updates to uploading studies coming with MIMCloud 2.0 will also be very welcome.

We understand MIM has received much attention from physicians following the announcement of their FDA clearance. From this experience, it seems the attention is well deserved.

Clearly, cloud storage of not only radiology images, but patient records, is, and should be the future.  If Mobile MIM and VueMe can continue to gain significant mind share, patient records stored in a universal cloud, and not EHR silos, should be the next logical step forward.

iTunes: http://itunes.apple.com/us/app/vueme/id437850916?mt=8

Details about MobileCloud 2.0, including payment structure: https://mim-cloud.appspot.com/landing/index

By Brian Wells, MSM, MPH

Surgical Radiology is an app that aims to teach appropriate surgical radiology interpretation skills for surgeons and trainees.

It emphasizes the clinical implications for imaging findings and prompts the user to identify the imaging abnormality and suggest treatments, where appropriate.

It is a free app written for the iOS platform (iPhone & iPad), developed by Drs. Dangleben and Lee at the Lehigh Valley Health Network, a Level I Trama Center in Pennsylvania with a general surgery residency.

When using the app, the user is shown a pop up image, and you’re prompted to find the pathology. When the user taps on the image, the diagnosis pops up. A multiple choice question related to the image then populates the screen. To make it more interesting, a timer in the top right hand corner, and counts down from 30 seconds . Users can compare their scores using iOS’s native Gamecenter — one of the first times we’ve seen a medical app use the gaming platform from Apple.

After displaying a loading screen, the Surgical Radiology app displays a menu consisting of Dept. of Surgery, Surgical Trivia, Help, Credits and Learning Objectives.

The Dept. of Surgery listing displays information on the Lehigh Valley Health Network in General Surgery and the Chairman’s Message.

Help lists the App, features, How to Play and Game Centre.  Credits displays a list of the physicians responsible for the application.

The learning Objectives section yields a list of four learning objectives.

The Surgical Trivia is the question and answer section of the application and will likely be the most valuable. This section first gives an image with an associated clinical vignette and asks the user to press on the abnormality in the image. The user is then given a multiple choice question and 30 seconds with which to provide a response. The images allow for unlimited attempts. However, the user is given four total attempts on the multiple choice with each incorrect response removing a chance.

It should be noted that these attempts are per question. That is, the question can only be attempted once in a session so if one does not choose correctly on the first attempt, a second attempt at the question will not be allowed. The questions provided are well written with clear answers. Based on my sampling of questions, they address key topics, such as Meckelís diverticulum, aneurysms, volvulus, fractures and trauma.

During my usage, I found some of the imaging questions difficult simply because of how precise you have to be when pressing on the screen. If you touch close to a small abnormality but not directly on it, it will count this as wrong and you may be misled to think your solution was not correct. That said, the images provided are clear and take advantage of the high resolution display of the iPhone 4.

It should also be noted that this application natively supports the iPad. On the physically larger display of the iPad, I did not encounter difficulty in selecting abnormalities in imaging. This leads to the possibility that the developers could add pinch and spread motions for zooming on images to the iPhone platform to improve usage for the end user.

One small irritation: each correct response plays a clapping sound effect and each incorrect response plays what I would describe to be a spring/bounce sound effect. I found these irritating after just a few minutes of questions and silenced my phone to continue working with the application. The developers should consider adding a setting to disable sound effects in future versions.

Strengths:

• Works on iPhone and iPad in native modes
• Provides an image interpretation and question and answer format for learning
• Covers a variety of surgical cases and imaging findings
• Allows on-the-go learning or reinforcement of knowledge related to surgical conditions
• Works with Appleís Game Center to allow for recording of scores and competition
• Developed by physicians at an accredited surgery program with University affiliation
• It is free

Weaknesses:

• Subtle findings may not be registered on initially tapping on the iPhone version
• The correct response is not displayed after selecting an incorrect response in the multiple choice
• Sound effects become annoying after a few minutes of play (subjective)

Conclusions:

• Provides an entertaining way to learn surgical radiology
• Images are clear and easy to read on the iPhone 4 or iPad (lower resolution iPhone not available for testing)
• As a free application, it provides great value to the end user
• Application is recommended for download based on price and value to end user

YouTube video of the application

iTunes Link

Price: Free

By: Wouter Stomp, MD

IMAIOS’ mobile application is an atlas of human anatomy for iOS which we reviewed just two months ago.

Although we were impressed, and in fact considered it one of the best anatomy apps in the app store, there were some key drawbacks. The app however has just received a major update fixing many of the issues we encountered and here we will be giving you our second impression.

Our most important gripes with the initial version were the lack of an iPad version, the high price, and the constant need for an internet connection for the subscription-based app. The update addresses all of these issues to some extent.

First, and most importantly, IMAIOS is now also available as an iPad app, making full use of the available screen space.

Secondly, the price of the subscription based version of the app has dropped to zero (still requiring a $69 a year subscription). The third point has been partly resolved by making use of the multitasking functions in iOS 4, requiring a login only when the app has completely closed.

The full list of changes:

• It is now a universal app with specific features for the iPad
• Download size has decreased to 360 Mb instead of 950 Mb thanks to better image compression
• Better image quality
• New anatomy modules: coronary angiography, thoracic wall, mediastinum, chest and elbow
• Ability to switch language in the app, 7 languages available
• Thanks to iOS 4, you can login when an internet connection (Wifi) is available, and use it even if you do not have internet later if you do not close the application (thanks to multitasking).

After using it for two weeks, we can say that the updated app is really a joy to use (when used on the iPad). Whereas the previous version felt a bit gimmicky due to the large amounts of information cramped on the small iPhone screen, on the iPad it is perfectly usable.

The images are crisp and clear, and even with over 100 labels in view, it doesn’t feel cramped. In portrait mode the app works just like the iPhone version where label text is only  displayed as you click on them, while in landscape mode, all active labels are shown at both sides of the display, as can be seen in the images.

Conclusion:

The price drop for the subscription based version is a good thing, as you already need to pay a substantial annual fee. However, more importantly, we can say the iPad version is actually worth the price, contrary to the iPhone version. The large screen makes the iPad perfectly suited for this app and at this point it could replace some of the equally expensive paper anatomy books.

The scrollable CT and MRI images with different types of contrast are something a traditional book cannot provide, giving it additional value in the clinical situation. The new anatomy modules and the decreased download size are some nice extras.

All-in-all this is a very welcome update that  brings a lot of extra value, especially for iPad owners, and strengthens its position as one of the best anatomy apps in the app store.

iTunes Link: http://itunes.apple.com/us/app/imaios-mobile/id352444826?mt=8

Other pictures:

[Ed. Check tomorrow for an interview with Mark Cain, CTO of MIM Software.]

One of the most attractive uses for an iPad in the clinical setting is the potential to view radiologic imaging at the point of care. While the graphics capabilities of even the first iPhone were enough to be able to adequately display multi-slice imaging, there were two critical pieces missing to make the iPad a viable mobile radiology workstation: FDA approval and a simple way to store and transfer images to the iPad.

MIM Software, a radiology software company, seems to have neatly solved both these problems by pairing their viewer, Mobile MIM, with MIMCloud, their cloud based radiology (DICOM) viewing and sharing web application and by obtaining the first ever FDA clearance for mobile imaging software in February 2011. The story of their FDA approval process will be highlighted in an interview with Mark Cain, CTO of MIM Software tomorrow.

MIM Mobile is a free download from the App store and runs on both iPhone and iPad. As the video portion of this review will demonstrate, the app is very well engineered with amazingly fluid navigation–even with images containing hundreds of slices. It also performs mutli-planar reconstructions out of the box, meaning that the same body part can be visualized in three planes simultaneously. These are invaluable tools for evaluating imaging abnormalities and for planning surgery. When you take into account that they were executed on a device with limited physical memory and no virtual memory , they are even more remarkable. This might be why MIM was on stage with Steve Jobs at the unveiling of the iPhone software development kit in 2008 and why MIM Viewer was one of the few non-Apple apps highlighted in the recent iPad 2 commercial, as we recently noted .

Mobile MIM

Use of the Mobile MIM app is straightforward. The iPad version of the app opens to a two column display (in landscape), with options on the left and a list of studies on the right. Your MIM Cloud studies are listed but downloaded only when tapped. One nice feature is that downloading continues in the background, even if the app is closed, using the iOS 4.0 multi-tasking features. This is helpful for time-consuming downloads of large studies over 3g.

Once an item is downloaded to the device, it is stored locally, with no need to reconnect to the internet to view it again. This can use up local storage but the total local storage is always displayed at the top. Images can be deleted by swiping. On my iPad, the application was quite stable, although I did often receive low memory warnings that suggested rebooting the device may free up more memory. I typically dismissed these warnings and the app continued to work, although, perhaps some features were disabled as a result.  Which ones were disabled was never specifically explained.

When an item is tapped, it opens in the viewer. Controls at the bottom allow for changing between window presents (bone, brain, liver, etc.). Images will by default open in multi-planar view (as shown below) unless the feature is disabled. My testing seems to imply that the app automatically determines whether this is possible depending on the number of slices and thus the amount of memory required. The iPad2 with its additional on-board memory will probably allow larger image sets.  In my testing, though, multiplanar view seems to be limited to a minority of studies, usually those with less than 30 slices, eliminating most CT sets. Mark Cain reports that the iPad2, with its increased memory, allows for much larger studies, even up to 200 slices, to be seen with multi-planar reconstruction.

Additional viewing features include distance measurement, an ROI measurement which allows for the radiodensity of a portion of the image to be measured in “Hounsefiled” units or in the case of PET studies, the Standardized Uptake Value (SUV – which quantifies glycolytic activity). Colors can be assigned by pixel values to substitute for the default grey scale (CLUT or color look up table), to make subtle differences more apparent (see above example). Tapping on the patient’s name in the top left hand corner will expand an overlay with image details, such as acquisition time and technique.

Navigating among series is performed with a quick flick across the screen. Alternatively, the list of series can be viewed by tapping on one of the tool bar icons. There sometimes seemed to be slight lag with activation of these controls, perhaps reflecting memory usage. On other issue with the viewer is that the image list is not grouped by patient.  This would have simplified locating a particular study when there are more than a handful of studies.

To see Mobile MIM in action, check out this video:

MIMCloud

While other iPad radiology viewers are now available, such as OsiriX HD, Aycan xr.ay, Merge & ResolutionMD, one feature that sets MIM apart is that it offers MIMCloud, an integrated, cloud-based DICOM service that makes storage and sharing of imaging studies very simple. The other solutions either require direct (WiFi) transfer of images to the iPad from a desktop workstation or directly from a radiology department server (Picture ArChiving System or PACS). Once in MIMCloud, any image study can be downloaded to the iPad. Clearly, the download will be faster on WiFi, where it takes usually less than a minute. Using a cellular 3G connection took 7-8 minutes to download a mid-sized (35Mb) MRI study in my tests.

In addition to downloading to the iPad, images can also be viewed from any web browser using the platform-independent Java MIM Viewer (below). One very useful feature of MIMCloud is the ability to share images with other account holders. Setting up an account is free and since there is an included a web-based viewer, it means that you can refer a study to another physician simply by entering their email address.

Since the DICOM data can be downloaded from the MIMCloud, this means that exchanging imaging CD ROMs between doctors can now effectively be a thing of the past.

The MIMCloud web application is fairly workman-like, with just the necessary options available to manage studies and share them with other physicians. Like the mobile app, each study gets its own row.  Since the studies are not grouped by patient and names are only displayed as initials, the list is difficult to browse. A search feature makes it easier to locate a particular study.

A more challenging problem at the current time is that uploading a DICOM study to the cloud via the downloadable Java app is still clunky. The uploader only recognizes studies if they are stored in a physical folder, so if you are using OsiriX as I am, the study first needs to be exported to a folder on a disk. After that, each sequence seems to generate a warning dialog that it is a “non-standard orientation” meaning that it cannot run unattended for the several minutes it takes to upload a complete study. The Java app seems to also be something of a memory hog.

Mark Cain has specified that the upcoming revision to MIMCloud will address both these concerns. In particular, a new Java background service will be built that will represent itself as a “DICOM node” to any PACS server, including OsiriX. (A DICOM node is a kind of a standard “address” in DICOM-speak). Thus, in the future any study can be directed to MIMCloud with just a few clicks and uploading will occur in the background. Collaborating physicians’ MIMCloud accounts can even be designated as “nodes” so that a study can be sent directly to their accounts without intervening steps. This will greatly simplify the process and will be a welcome upgrade.

Pricing

The pricing schema is a bit complex. As mentioned above, the app itself is free. Charges are incurred when a study is uploaded to MIMCloud or downloaded to a mobile app for viewing or when viewed using the web-based MIMViewer.

According to Mark Cain, after the April 2011 MIMCloud 2.0 update, the pricing will be as follows:

• Transfer charges will be gone, charge by GB stored only
• Viewing charge is per study (not device)
• $1 for iPhone view
• $2 for iPad view
• $2 for MIMviewer (workstation software launched from mimcloud)
• $4 for MIMviewer Pro (adds diagnostic tools for radiologists)
• Cost per study is one time (many people view with iPhone, still just $1 once)
• Cost per study will be charged at the highest viewing cost. e.g. 5 users user iPhone, one user uses MIMviewer; final cost is $2

For radiology departments, bulk pricing and invoicing are available. Personally, I would prefer a monthly subscription fee instead of a per study fee. Perhaps in the future that will be offered as an option.

Conclusion

MobileMIM and MIMCloud are a great way to view, store and share radiology imaging. The Mobile MIM is a great piece of iOS software engineering, with remarkably fluid navigation throughout even large study sets. The ability to perform mutliplanar imaging and locate a structure in three planes simultaneously is very useful. Using MIMCloud to share imaging studies greatly simplifies communication and removes an important pain point, while the updates to uploading studies coming with MIMCloud 2.0 will also be very welcome.

We understand MIM has received much attention from physicians following the announcement of their FDA clearance. From this experience, it seems the attention is well deserved.

By: Wouter Stomp, MD

IMAIOS’ mobile application is an atlas of human anatomy for the iPhone, and is available in three different packages: IMAIOS Mobile, e-Anatomy In App and IMAIOS Lite. They are the mobile equivalent of the anatomy part of the main IMAIOS website, a subscription-based service.

Also they are some of the most expensive anatomy apps available in the crowded app store. This review discusses the three different apps, their strengths, their differences, and whether they are worth the price.

The IMAIOS website is an online resource that features anatomy modules, e-courses on MRI physics, and clinical cases. The anatomy modules are organized by body part and imaging modality, including drawings, x-ray, CT and MRI images.

All modules contain labels organized by categories which can be individually enabled or disabled. Subscriptions to the website cost $8.99 for one day, $24.99 for one month and $69.00 for an annual subscription.

Pricing & Specs

As mentioned above, the iPhone app comes in three flavors: IMAIOS Mobile, e-Anatomy In App, and IMAIOS Lite. IMAIOS Mobile is meant for subscribers of the main website. It costs $29.99 and requires both an internet connection and a paid premium individual subscription. It contains 26 of the 33 anatomy modules from the website with over 4,000 images and 6,000 anatomy labels. Although the app requires an internet connection, this is only used to confirm the subscription status; all images are included in the app, making the app come in at a hefty 950 Mb (only download it when on a high speed connection).

e-Anatomy In App is the version for people without a subscription, allowing you to buy individual modules from within the app. It costs $3.99 and comes with the brain axial MRI and cranial nerves illustration modules fully activated. 22 other modules are included but are in demo-mode until they are purchased as part of one of three different packages (head and neck, thorax, abdomen and pelvis, and musculoskeletal), each costing $69.99, bringing the total cost for the whole deal to $213.96. Because all modules are included in the download, this one also comes in at 950Mb.

Finally, IMAIOS Lite is basically the demo version of the app, a relatively small 27.3Mb download containing just four modules. It costs $3.99 and includes the upper and lower limb diagrams and radiological anatomy. The e-Anatomy In App and IMAIOS Lite apps can both be used offline.

Analysis

For this review we used the IMAIOS Mobile app in combination with a one-month subscription. Installing over WiFi took several tries because of the large size of the app, so we would recommend downloading through iTunes if possible. After starting the app you are greeted with a welcome screen where you have to enter your IMAIOS username and password. After checking your subscription status you are taken to a screen listing all individual modules, sorted by anatomical region. After selecting a body part then you can select a individual body part for viewing.

The viewing screen has three tabs: views, labels and search. In the views tab, you can scroll through images by either moving your finger up and down or pressing left and right arrow icons. Images can be zoomed by pinching and images have sufficient resolution to actually do so. The amount of labels displayed on the screen at one time can be overwhelming, but helpfully, anatomy labels can be turned on and off by categories. The search tab displays all the available labels in the current module. Pressing one takes you to an image displaying the label. Again, because of the huge amount of label pins it can sometimes be hard to see which pin a label corresponds to.

Image quality is very good, the images can be zoomed in quite a bit without loosing too much detail. Flicking through the images goes smooth and without any noticeable loading time. Labels are available for just about any anatomical structure you can think of. Most images are available in two or three different orientations, making it a handy reference when looking at CT or MRI scans. 3D reconstructions of the lower limb arteries can be rotated by scrolling through the stack, giving a very good impression of the twists and turns they make. And where the scans are helpful for recognizing specific anatomy, the diagrams provide a solid basis to learn it from the ground up.

So is this the one anatomy app that rules them all?

Well we still have some gripes. One of the largest disappointments we ran into during reviewing this app is that it’s not available for the iPad. The iPhone’s screen feels cramped once you enable more than one or two categories of labels. Also what device would be more natural for easily browsing through large series of high-res images than the iPad?

The other major gripe is the price. Either you will need a subscription or you will have to pay at least $59.99 to see just one third of all the content. On the other hand, Monster Anatomy HD, an app we have reviewed before, and probably the app’s closest competitor, costs $18.99 for only the lower limb anatomy. Cheaper, but not that much cheaper when you consider the extra amount of content IMAIOS has. The last negative point we experienced was the internet connection that was needed for authentication. While it’s only needed during app startup, in our experience it can sometimes be hard to establish a connection deep within the hospitals, where this app is most likely to be used.

Pros

*Most comprehensive anatomy app available
*High-quality images from all body parts and modalities, including diagrams, X-ray, CT, MRI and 3D angiography reconstructions
*Labels for virtually any anatomic entity
*User-friendly app

Cons

*No iPad version!
*High price
*Internet connection needed for the subscription-based app

Conclusion

IMAIOS, in either one of its three varieties, is probably the best anatomy app currently available in the app store. However it also comes at a premium price and whether it’s worth it depends on your individual situation. For subscription members, the download would be a no-brainer if not for the $29.99 they still have to pay, which is not prohibitive, but a bit of a let-down if you are already paying for a premium subscription.

The e-Anatomy In App version comes at a somewhat reasonable price of $69.99 if you are only interested in one part of the body, however the complete package is in our eyes too large of an investment for a mobile app. A sensible price for such an app would be similar to that of the Lite app, at $3.99 for four modules.

The second let-down is the lack of an iPad app. This is one of those apps that would be perfectly suited for the iPad with its high-res images and abundance of labels, and it would certainly boost the value-for-money. All-in-all this is a great app, but whether it is worth the cost is very dependent on how interested you are in anatomy.

For medical students, it’s probably too pricey, but for people working in fields like radiology, surgery or pathology, where anatomy plays a big role, it could be a good investment.  If an iPad version was to be released, the picture would become different, because it could then actually replace costly paper anatomy books — we can only hope.

iTunes links:

IMAIOS Mobile

e-Anatomy In App

IMAIOS Lite

Wouter Stomp is a physician from the Netherlands, currently doing a PhD in radiology

Just this past week, the developers of OsiriX HD customized the radiology app to work on the iPad.  OsiriX is one of our favorite DICOM radiology image viewers, and we’ve talked in length about it before.  We reviewed the iPhone version over a year ago, and recently gave an example of how OsiriX on the desktop can be integrated with DropBox to view radiology images in the operating room.

OsiriX website

OsiriX on iTunes

Cost: $29.99