by: Wouter Stomp, MD

Dynamic Approach to Abdominal Radiology is an interactive ebook on abdominal radiology for the iPad.

The app is one of the first medical textbooks for tablets that goes further in levels of interactivity than just adding a video, zoomable image, or quiz question here and there such as offered by Inkling and others.

Instead, this app offers extensively annotated, real clinical data sets, just as you would get them in the clinic.

You can browse cases by description or by diagnosis, but we would recommend keeping the diagnoses hidden until you have gone through all cases in order not to spoil the fun.

Each case includes case info, image findings, interpretation and literature references. Image quality is good and the text is well-written. History is usually concise (just like you would get in real life as a radiologist), but descriptions of findings and the interpretation are very extensive. Descriptions in the text are cleverly linked to the relevant annotations on the images.

All image sets are CT scans of the abdomen, with most sets including coronal images as well as axial and sagittal reconstructions. Manual windowing is not possible, but where appropriate, additional images with lung window are provided.

In addition to the different orientations, in many cases additional sets are included, e.g. late phase CT, MIP, angiography or follow-up scans. By default 4 sets are displayed in a 2 x 2 format alongside the text and you use double-tapping to enlarge any of the 4 image windows and then one time more to go fullscreen. For each case, you can scroll through the whole set of images of a scan and annotations can be turned on and off.

In total, 31 cases with over 10,000 images are included in the app. Image scrolling is performed by swiping over the images and is smooth at all times. You can also press and hold the gripes at the side of the image to let the program scroll for you. One place where it can be a bit tricky though is the anatomy pages, where multiple single images (drawings/diagrams) are combined in one stack, and it can be hard to scroll to a specific image.

Although the app really shines on the iPad, the translation to the small screen of the iPhone has been very well implemented. Navigation is easy and scrolling through the images is just as smooth as on the big screen. Nevertheless, the small screen is suboptimal for reviewing the images, so we would definitely recommend using the iPad instead.