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Tablet PCs: For many purposes in imaging, we do not need the fullcomputing power of a desktop or a laptop. Recently, several stylish andlightweight tablets, with touch-screen interface and large displays with goodresolution, have been developed for utilities such as quick browsing,shopping for and reading e-books, processing/sending emails, creating andediting documents, taking and storing several photos/images, etc. usingquality applications. Tablets replace the mouse with the facility of swipingacross the screen, enabling rapid scrolling through websites, pages on books,stored photos, videos etc. Tablets also enable connectivity tobroadband/Wi-Fi, 2G/3G/4G, Bluetooth (EDR) and other networks and also tolaptop/desktop. They are usually provided with built-in back and front highresolution (megapixel) cameras, which dispense with external cameras.Besides, other features, such as the built-in earphone/speaker and facilityof 1080p video recording/playing, are also provided. However, there areusually no USB ports to connect an external camera, iPOD or Flash Drive.Also, DVDs and CDs cannot be read/played with tablets; nor are they readilycompatible with scanners/printers, etc. (although the iPAD2 tablet can beremotely connected to Wi-Fi operable printer). Three of the popular tablets,with comparable features, which are useful for medical imaging, are: AppleiPAD2, Samsung Galaxy 10.1 and Lenovo Ideapad K1. The first of them (thelatest product, iPAD3, is in the offing) has been widely used globally now.Apple uses the same operating system (the iOS5 or its updated versions) fortheir iPAD, iPHONE and iPOD Touch devices (see below) whereas the other twouse the Android (Honeycomb) system. The iOS5 has several features viz., theiCloud, iMessage, Notification Center, etc. The iCloud software automaticallytransfers the iPAD contents (documents, photos, etc.) to the Apple remoteserver (with facility of free storage upto 5GB) where they are accessible bythe other enrolled Apple devices (e.g., iPHONE). Similarly, the iMessageenables to send texts to an iPHONE. The Notification Center displays thealerts and reminders. All the three devices have large-size screens (9.7 -10.1 inch) of excellent pixel resolution (iPAD2:1024 x 768; the other two:1280 x 800) capable of providing sharp and crisp displays of medical images(still pictures or videos). Their other features include: battery life (talktime) of 10 hrs., 16 - 64 GB memory storage, micro SD card, dual-core 1GHzprocessors (iPAD2: Apple A5; the other two: Nvidia Tegra 2), etc. Moredetails are available from their technical literature. It must be noted thatthe memory storage capacities available in tablets are less than those iniPODs and laptops (with typical storage capacities up to 160GB and 500GBrespectively). With the built-in accelerometer, three-axis gyroscope, andcompass all working together, one can rotate tablets in a vertical-to-nearhorizontal plane (features also shared by smartphones, see below) to displayin portrait or landscape mode, or even upside down, and the display fits towhatever one is watching, reading, or seeing.
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Smart phones: These devices are pocket mobile phones with gigabytestorage and displays with moderate resolution making them superior to iPODsfor many imaging applications. Apple introduced the first of these iPHONEdevices, which has undergone further generation developments (iPHONE 4S isthe latest model). Smart phones with similardisplay/storage/browsing/transmission features and built-in megapixelcamera(s) have been recently marketed also by other companies. These, withcomparable features for medical imaging, include (operating systems inbrackets): Samsung Galaxy S2(Android 2.3 Gingerbread)/S3, Nokia Lumia 800(Windows 7), Google Galaxy Nexus (Android 4), HTC Sensation XL (AndroidGingerbread), Motorola Razr, (Android 2.3.5), Sony Ericsson Xperia pro(Android Gingerbread) and many others.The iPOD Touch (4th generation) mayalso be included among these devices in spite of its lack of phone facility.The screen sizes and display (AMOLED or retina types) resolutions range from3.5 to 4.7 inches and 800 x 480 to 1280 x 720 pixels respectively. Thebattery life (talk time) is in the range of 6 - 14 hrs. All of them have goodstorage capacities (8 - 64GB/micro SD card)). More details are available fromthe manufacturers' technical literature. They share many of the featuresof tablets, such as broadband/Wi-Fi, 2G/3G/4G, GPRS, Bluetooth, etc.networking, video recording and viewing, ease of display orientation etc.,stated earlier. For instance, the iPHONE/iPOD Touch share the iCloud andiMessage features of the iPAD2. With an external wireless router, the iPODTouch can send/receive the message through Wi-Fi network (the author hassuccessfully used the Belkin [sup][5] Wireless N Router SURF N300, inconjunction with the Mumbai Mahanagar Telephone Nigam Limited (MTNL)broadband (speed up to 2Mb/sec.) network modem described in the earlierpaper). Smart phones enable radiologists to access patient images (videos,movies or photos) at any point (at home with the iPOD Touch, where thewireless router/modem may be located), from hospital professionals throughother Apple devices or the internet and share these and/or converse withother medical professionals. Although the size of the screen is less thanthat of the tablet, the resolution offered is adequate for analyzing andinterpreting images (using the MIM software, see below) at home or on-the-go.For better image details, an HDTV (with fast response for viewing videos asstated earlier) can be connected. The iPHONE 4S and some other smart phoneshave another impressive feature: SIRI - a software-based personal assistantwhich enables simple voice-based commands. The iPHONE 4S is perhaps the mostexpensive of all smart phones. Mobile devices have made ubiquitous access topatient data a reality for many physicians treating patients at thepoint-of-care or on a consultative basis. They provide accessibilityespecially in an emergency situation. One can also use them for consultation,collaboration, and teaching purposes.
MIM software: The FDA (USA) during February 2011 approved iPADdevices and iPHONE type mobile phones (and by implication also laptops) toview CT scans, Nuclear Medicine-based (SPECT and PET scans) and MRI images.Very recently, the approval has been extended to viewing X-ray and Ultrasoundimages and for Radiation treatment planning studies as well. The FDA,however, clarified that these devices should not be used as a replacement fora proper medical workstation, but the picture details they provide are goodenough to be used for when doctors want to analyze images on-the-go or athome. The Mobile MIM software (also approved by the FDA), developed by acompany called MIM Software Inc., [sup][6] allows medical professionals tosend the sophisticated medical imagery to an iPAD, iPHONE, or iPOD Touch toanalyze them. This important mobile technology provides physicians with theability to immediately view images and make diagnoses without having to beback at the workstation or wait for film. It allows the physician to measuredistance on the image and image intensity values and display measurementlines, annotations and regions of interest. The software program is used forthe registration, fusion, and/or display for diagnosis of medical images fromthe following modalities: SPECT, PET, CT, MRI, X-RAY and ULTRASOUND. Thesoftware is not to be used for mammography. Mobile MIM provides wireless andportable access to medical images. The MIM Cloud feature [sup][7] accessesimages from any internet connection; enhances teleradiology andmulti-institution reading operations; shares images with referringphysicians, partner institutions, and patients; collects or contributesimages for clinical trials; distribute images to other users, etc. Thissoftware, along with another, VueMe, designed specifically for patients canbe downloaded from Apple stores. The author could download a variety ofsample patient images (US, X-ray, CT/PET and MRI/PET fused images, RTplanning, etc.) on his iPOD Touch and successfully use the several controlsto manipulate these images, e.g., window/level, zoom/pan,crosshairs-localization, multi-planar reconstruction; built-in tools toverify lighting; select Measure, Annotate and SUV with variable ROI; displayDVH and isodose curves; cycle between the image series (includes fusion andMIP movies) and the three plane views with coordinate display, etc. Theinitial gray-scale calibration with test pattern for best image viewing andcolor range selection for image display are other novelties of this software.Unlike the OSIRIX software, which is tuned towards the Mac, the MIM softwareis compatible with both Mac and Windows systems. 350c69d7ab
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