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Of MRIs and iPods

Once the darling only of on-the-go music lovers, iPods have become another tool of choice for radiologists who need to store, transport, and interact with digital images.

Dr. Osman Ratib had a problem. As a radiologist, he dealt with mountains of digital images which needed to be tracked, stored, and shared on a regular basis – but he didn’t have a good way to easily transport everything he needed.

The computer systems at the University of California at Los Angeles Medical Center where he works as the vice chairman of information systems were good, but they weren’t always close by. He needed a small, portable device that came with big storage capabilities in order to get his patients’ images from one place to the next.

Enter the Apple iPod.

Ratib and his programming partner Dr. Antoine Rosset set about developing a software application that uses the iPod and other off-the-shelf Macintosh equipment to manipulate, manage, and move medical imaging data between departments and workstations.

“With the size of the files and sometimes thousands of [medical] images, we had problems fitting that onto a CD, or even into a computer,” says Ratib.

While the iPod is most commonly associated with digital music, Ratib saw the cigarette pack-sized device as the perfect vehicle for transferring medical images: they are small, handy, and come with 40-gigabytes or more

Having the iPod as their portable component was key as Ratib and Rossett set about creating a customized software solution that would enable radiologists to easily and less expensively carry their data.

That solution: OsiriX.

The software is an open source application that runs Mac OS X, version 10.3 or higher, but its real power comes from in the functionality it opens up on hardware. It automatically recognizes and lists the medical images stored on the iPod. Now, iin much the same manner that people scroll through a playlist, radiologists can scroll through a list of patients or view their records through iPod’s iPhoto application. 

Those images can then be uploaded back to a Mac using a FireWire connection. After that, doctors can view images from a variety angles.

It’s a rather mind-boggling breakthrough considering radiologists normally work on $100,000, customized workstations made by the likes of Philips Medical Systems or McKesson Information Solutions. The price has severely limited the number of stations available, Ratib says, which means specialists may be wasting time running down to another department to view a scan. With OsiriX, they can now use desktop computers for diagnostics.

The pair started working on OsiriX in December 20003, and within a few months, decided to release their creation into the world. Silently and with no fanfare, they posted the application on their website in April 2004. In less than two months, they’d racked up several thousand page views and received scores of emails from interested doctors.

Dr. Michael L. Richardson, a radiologist and professor with University of Washington’s Medical Center, had been following Ratib and Rosset’s work for several years. As soon as he found about the OsiriX, he downloaded a version of the software.

Based on a Web-based survey Ratib conducted last year, he believes Richardson is one of some 6,000 doctors around the globe using the tool. But what shocked even Ratib is the way OsiriX has spread. What started a tool for radiologists, has found its way into other parts of the hospital.

The same survey of 2,000 users indicates that while OsiriX has found its largest following among radiologists – who make up 26 percent of its users – researchers (18 percent), surgeons (14 percent), and cardiologists (12 percent) are also tinkering with the application.

But it’s not just a novelty, a one-time joyride for medical hackers. Thirty-seven percent of the respondents say they use it every day, and 24 percent say they are likely to develop plug-ins or other upgrades to better serve their needs.

While critics have leveled criticism about the iPod application, Ratib says that the patient’s personal data is stripped out and assigned an anonymous identification during transport.

“It’s not an issue of what technology you use,” Ratib says, “but what you do with it.”

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