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iPods Used for Medical Images 281

spagiola writes "There's a nice little story on CNN about a doctor in Geneva who has developed ways to use iPods to view medical images. His software, called Osirix (OSS, BTW) enables medical professionals to view medical images on their iPods, saving them and the hospitals they work for thousands of dollars in expensive equipment."
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iPods Used for Medical Images

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  • Evolving (Score:5, Interesting)

    by Oculus Habent ( 562837 ) * <oculus.habent@gm ... minus physicist> on Thursday October 27, 2005 @08:10AM (#13888009) Journal
    It looks like it started out as a simple, "portable hard drive" system... hardly different from the stories about storing BLAST data or Lord of the Rings clips on an iPod. The addition of the iPod's photo-display capabilities and - more significantly, I think - the iChat sharing makes this sound like a setup. I wonder when they will incorporate support for the iPod's video capabilities...
    • Obligatory: What do if I have Linux or Windows?
      • Re:Evolving (Score:3, Insightful)

        by olddotter ( 638430 )
        Is gaim compatible with iChat?

        Honestly for a Doctors office, a mac mini and other needed hardware are probably worth the investment if they need to share this data. I am sure it would be cheaper than dedicated hardware. Probably by an order of magnitude ($1,000 vs $10,000 to $50,000)

        • Yes. (Score:3, Informative)

          by SeaFox ( 739806 )
          IIRC, iChat uses libgiam for the AOL OSCAR compatability. And among the recent Google Summer of Code projects was adding support to Giam for the iChat ad-hoc instant messenger networks set up using Apple's Bonjour.
        • Re:Evolving (Score:3, Informative)

          Imagine a doctor sharing video of a cardio CT with a cardiologist 1000 miles away using less than $2500 in hardware and a DSL connection.

          This bring so many possibilties to the medical field. A specialist in Massachusetts consults with the primary care physician in Maine and a colleague in Florida, all viewing the same CT footage... A patient able to carry MRI images to a specialist.

          With a quick look at the OsiriX Documentation [wikibooks.org] it looks like it has an Export to QuickTime option, which should make it easy to
          • Re:Evolving (Score:3, Funny)

            by jargoone ( 166102 )
            looks like it has an Export to QuickTime option

            Great. I can't wait for my specialist to have to click past the "Why upgrade to Pro?" nag screen when he's waiting to do some life-saving surgery.
    • This story should be followed up by the one about the chap who discovered that a new BMW could be used to move important medical files from one location to another. After making this remarkable discovery, the entire department quickly put in purchase orders for "medical information transit devices".

      The story is sort of in the "duh" catagory...chap discovers that iPod can be used to store data, justifies purchase. (There was a /. story the IT adminstrator purchased iPod as "boot" devices.)

      As medical ima
      • by Oculus Habent ( 562837 ) * <oculus.habent@gm ... minus physicist> on Thursday October 27, 2005 @02:27PM (#13890788) Journal
        Read the article. The doctor had an iPod, and started using it to move large files around. That in itself isn't news. It's the additional details.

        They can take a patient's data with them and study it at the office, at home, at a colleague's office. This doesn't require an iPod.

        They added an image export function to put pictures in iPod-viewable format once the iPod Photo came out. That's pretty minor, but you can use it for reference, or output it to a TV for viewing. The resolution is still lower than original quality, but I can't speak to those details.

        Then they used iChat AV for full-motion video streaming to other doctors. Again, the quality is lower, but the ability to consult with other doctors in real-time with the data can be invaluable. They also used .Mac to conveniently post images - stripped of identifiers for anonymity - to protected web space for additional consultation and reference purposes.

        The real imaging work can't be done on the portable because it is very demanding... it's a 3d video of sorts. A tablet might be able to do the work, but the real point isn't using the images on-the-go, it's taking the images with you or sharing them.

        The costs are negligible because the equipment is there... they have the Mac to use Osirix. That means they have the iChat software. They were using their own iPods. Sure, some medical facilities might end up buying a few iPods for this use... is that so terrible? I think the additional costs of training and deployment for Windows Tablet PCs and a different DICOM viewer far outweigh the costs of iPods... if they even have to buy them. Remember, for most of the uses - excepting the iPod-viewable photos and videos - any portable drive would do.
  • by Anonymous Coward
    it took some time to find it, didn't it?
  • So they managed to change their program to store files on the ipod, as well as pictures that the ipod could view? Which would have been really hard to do.

    Somebody is in love with the Ipod.
  • by Anonymous Coward on Thursday October 27, 2005 @08:11AM (#13888015)
    Several patients diagnosed with "just a scratch".
  • Not what it seems (Score:3, Informative)

    by Anonymous Coward on Thursday October 27, 2005 @08:13AM (#13888022)
    Not exactly what TFA says, they don't 'use' the iPod to 'view', they store the images on the iPod in file mode, so the article could re-written to say:

    Some people have created sofware which allows images to be stored on an external hard drive.

    In other words....

    Nothing to see here, this is not the video/photo ipod in action.
    • by Seehund ( 86897 ) on Thursday October 27, 2005 @08:34AM (#13888107) Homepage Journal
      Exactly. Yet another fellow physician stores DICOM files on removable media. This time the media brand is "iPod", and thus it gets on the frontpage of Slashduh.

      Idiocy.

      And Osirix is a Free equivalent to the Osiris DICOM handler. It has nothing to do with "enabling medical professionals to view medical images on their iPods". Regardless of what imaging and analysis software you use (and you use it on a PC/workstation!), it doesn't give a crap about the trademark of your storage media!
    • The iPod can be mounted via USB just like any other external drive. So why is changing the program from saving to drive C by default to drive F anything special?
    • Re:Not what it seems (Score:5, Interesting)

      by Maset ( 190867 ) on Thursday October 27, 2005 @08:51AM (#13888185)
      *sigh*

      RTFA:

      'After we figured out that the iPods were a practical way of carrying these images, Apple brought out the photo iPod a few months later. That meant the images could also be viewed on the devices.'
  • by broggyr ( 924379 ) <{broggyr} {at} {gmail.com}> on Thursday October 27, 2005 @08:14AM (#13888032)
    Wouldn't they have to be 'secured' to compy with HIPAA regulations in any way? iPods are easily pocketed, and I would think an iPod with Medical Imaging files on it would be at risk...

    • Wouldn't they have to be 'secured' to compy with HIPAA regulations in any way?

      You didn't even read the summary, did you? "There's a nice little story on CNN about a doctor in Geneva..."

      That should have been your first clue, but either way you should have RTFA. If you had, you would have seen that the first paragraph of the article includes GENEVA, Switzerland (CNN). To the very best of my knowledge, Switzerland is not subject to HIPAA.

      • Let's try to interpret people to mean something that's not incredibly unreasonable. Yes, Switzerland doesn't have the specific law referred to as HIPAA. She does have medical privacy laws nonetheless. These would almost certainly affect the use of the iPod in medicine. You shouldn't be so focused on a small error in the GP that you ignore the broader point about the conern for medical privacy. If someone said to me, "How could doing X be legal in Switzerland? The Banking Act prohibits it." I wouldn't
    • The risk of theft for the device is definitely greater than that of say a laptop simply because the iPod is more popular and probably more easily converted to cash. But the risk can be minimized by taking care not to store information that can be used to identify individual patients. Using patient id numbers as keys to lookup tables which would be stored in a central database in a secure server. I don't know how much patient info is stored in the current data format right now, but in the U.S. at least there
    • if it's not personally identifiable information, then probably not. most medical images aren't labelled up "mrs smith, SSN xxxxxxxxx"
    • You can set the iPod to require a 4-digit access code. I don't know at what level it locks things out or how secure it really is, but at least there is a little protection.
  • by J. T. MacLeod ( 111094 ) on Thursday October 27, 2005 @08:16AM (#13888040)
    How this is more cost-effective--or more effective, period--than low-cost color PDAs with CF microdrives. Surely the higher resolution, larger screen, and more flexible OS would be better?

    It's true that high-capacity microdrives are more expensive, but that's still a lot of photos at that resolution.

    However it compares, it awfully neat, though, and a good example of how technology can be a real life-improvement above pure entertainment.
    • I was wondering about this too, but I think there are a couple of reasons.

      First, Compact Flash isn't comparable to a 30, 40, or 60 gig HD. It sounds like they're dealing with some high res 2D and 3D images that would probably max out a 4 gig CF pretty quickly.

      Secondly, I think Ratib & Rosset the software with the intention of using it on iPods the medical personnel already had, not with the intention of buying new hardware for it.

      I'm sure a lot of doctors already have PDAs, but again the file size/stor
  • Article (Score:4, Informative)

    by kevin_conaway ( 585204 ) on Thursday October 27, 2005 @08:17AM (#13888041) Homepage
    Before anyone gets into a tiff about viewing the images on a small iPod screen, I suggest you read the article. The physicians are merely STORING the images on the iPod and then hooking the iPod up to a personal computer (w/nice monitor) to view the images.

    To sum up, RTFA
  • This is cool but... (Score:2, Interesting)

    by Anonymous Coward
    It just seems like they were looking for a bit of an excuse to use Mac technology. What I've got a bit of a problem with is using .Mac for a place to store medical images for sharing amongst colleagues. I don't know if that would really meet with security and confidentiality requirements for this kind of data. What they really need to do is set up their own secure server. Which raises this somewhat offtopic question: Does anyone know how to set up their own .Mac webdav server and tricking Tiger into thinkin
    • Of course that presumes their IT personal can set up a more secure site than Apple. How is .mac not secure (or less secure)?

      OTOH I have a problem with them using .mac because 1) it doesn't offer much space, and 2) it tends to be pretty darn slow (at least for me). I'm sure their are places that offer more space much cheaper and with better access. What I'm not so sure of is if those alternatives would be as drop-dead easy to use for their purposes without "professional" help.
  • Viewing/manipulating/storing visual medical data on a high-end desktop computer makes sense to me. I'd presume that such machines would exist in hospitals, and in doctor's offices, but I am lost as to any reason for the ipod, even after reading the article. Many people, during commutes by train/plain or what not, listen to music, watch video, or play games on devices such as ipods. Do physicians instead flip through MRI scan output to pass the time? I wouldn't feel comfortable knowing my doctor is walking
    • You may have RTFM'd, but they do mention that they're dealing with quantities of data that won't fit on a DVDR. Many hospitals don't have giant fat broadband links to habitually transfer that kind of data with them either. So they're mainly using the iPod as a really convenient 40Gb-60Gb portable hard drive that travels with the patient or doctor because a bunch of them from a publicity-hungry Apple (who probably give them a discount) is a lot cheaper than installing that fat hospital network.
      • Over here in the US, we put MRI's on DVD's (and CD's) all of the time. Unless you are manipulating the images, the actual data burden of an MRI isn't all that high. The standard presentation form for an MRI is an approximately 13 x 19" piece of film, on which are printed around 20 "slices" of information. (Can't recall exact number at the moment). That's about 20 3 x 4 inch grey scale images. Not the last word in bandwith hogging pixel numbers.
    • "I wouldn't feel comfortable knowing my doctor is walking around with digital imaging of my insides on the same device he's currently using to listen to music."

      These images are VERY bandwidth intensive -- at least for smaller hospitals and otherwise. CDs and otherwise might not work...DVDs might these days.

      BUT why would you feel and different knowing your doctor is listening to the same device that he has your images on?

      I know in my office, I specifically had to choose PDAs and other equipment that could b
      • DVDs might these days

        But then you have to wait several times as long to burn the DVD vs. copy to HD.
        And a DVD would be harder to carry around.
        Plus, IMO, the HD solution is more re-usable, even compared to DVD-RW media.

        Other factors for the iPod would include the ability to add voice notes/dictation to go along with the images. Something a "generic" external drive wouldn't work well for.
    • If instead it's just a need to transfer data from their office to home, or between hospitals, why not use something more appropriate, such as a burned CD, or much better, through an networked inter-hospital database over an encrypted connection.

      I don't know about this guy, but my cousin is a doctor at a major Swedish hospital. This hospital is rolling out thin clients, removing all PC:s with hard drives and CD drives. They do this for reasons of security and ease of administration. So far so good. According
  • by graemecoates ( 592009 ) on Thursday October 27, 2005 @08:26AM (#13888070) Homepage
    There are things we have in place to ensure security and patient confidentiality. There are rules to go by. It's not the tools that pose a security risk -- it's the users. The software has a function that enables the physician to strip the image of any personal data that identifies the person, like their name, their date of birth etc. As long as that is done then it is a secure, anonymous system.

    Good to see they have addressed the risk of patient data being leaked (iPod being nicked or left on the bus), but the article isn't entirely clear on what the procedure for stripping the patient data is - does the user have to do it themselves, or does the software force you to do it each time you upload an image?

    Still a very cool use - though maybe not one that could be easily rolled out across all areas of medicine unless it needs virtually zero technical know-how...

  • by jeffs72 ( 711141 ) on Thursday October 27, 2005 @08:27AM (#13888073) Journal
    HIPPA is an utter pain in the ass from a compliance perspective, mainly because provisions in it make it very easy to litigate on. Are the images stored in 128 encrypted format on the IPOD? Does the software do journaling to document the identity of those who view it?

    Shame really, our legal system is going to make adoption of new tools (in medicine in particular) difficult.

    Still a neat concept. She should win an award or something just for outside the box thinking.

  • by LaughingCoder ( 914424 ) on Thursday October 27, 2005 @08:27AM (#13888074)
    Using an iPod to store medical images is not a very good idea. There is no security, and no data integrity. And iPods are much more likely to be stolen than, say, a burned CD. All of that said, having a portable storage medium for medical images makes some sense. Perhaps this is yet another application for USB thumbdrives. Add some encryption (TrueCrypt) and an application (Osiris) that can be run from the drive and you might have a nifty little product.
  • by spectasaurus ( 415658 ) on Thursday October 27, 2005 @08:28AM (#13888083)
    I work in medical imaging, and I have used Osirix. It is easily one of the best open source image display programs around. The other most notable is Amide, but I digress. Osirix works well for scientists and others looking to save money, but I think physicians would have a difficult time saying it is better then the commercial vendors software. Commercial workstations are tens of thousands of dollars, and while the price is extremely inflated, you do often get a lot of functionality for that money. Osirix is no substitute for that. Osirix works fine as a third display terminal or something in the doctor's office, but I wouldn't want any radiologists I know using it as their primary reporting station.

    The part about the iPods is interesting too. Having ready and portable access to images is neat, but of course, this is not used as a primary reporting tool. It is useful to take to conferences to share interesting cases, etc, but not for any other great purpose.
    • I think you may be aware of these factors, but others need to know.

      The cost may seem inflated to the uninitiated, but I think that has to do with the small market to support specialized development, which means FAR fewer units with which to spread devel cost. There may be extra regulations for products intended for medical use, not to mention liability insurance. Liability insurance is a killer here, if some quack lawyer and quack expert can show that the program missed something that they say should have
  • by ewg ( 158266 ) on Thursday October 27, 2005 @08:29AM (#13888086)
    Plus, the doctors can have musical discussions with their patients, everything from "Doctor, doctor, gimme the news" to "I can see clearly now, the pain is gone"...
    • everything from "Doctor, doctor, gimme the news" to "I can see clearly now, the pain is gone"...

      Well, well, well, you're feeling fine...

      aside: I was tremendously amused, cracking into the medical computer systems in VtM: Bloodlines, to find a staff appraisal for a terrific doctor who 'has never lost a patient. No-one can succeed like Doctor Robert.'

      Anyway. I've got this coconut here, but I think it needs something to add to the flavour. Any ideas? Doctor?

    • "I've got a fever and the only prescription is more cowbell."
  • From the article: "IChat may not always provide the best video-quality images, depending on the network bandwidth available, but it's cheap and easy to use in comparison with the alternatives."

    Just what I want to hear from my doctor: this isn't the best, but it's cheap!

    And using Apple's .Mac for MEDICAL DATA BACKUP?! If this were done in the U.S., the HIPAA laws [hhs.gov] (Health Insurance Portability and Accountability Act) would slap him down very, very fast. And sure, $100/yr gets him 80gb of data... but why

  • When the doctor says "That pixel is your heart. From the looks of it, it is functioning perfectly." then I think it might be time for a second opinion.

  • There is not only other hardware already out which does the same thing (and problably better) but he also says he can use "Apples Dot Mac" system to store images of patients to share with colleagues. No privacy problems there. And this was actually reported back in DECEMBER OF 2004. [rsna.org] If you bother to read that article, the poor guy only has a 20GB HD on his laptop, so he thinks the 40GB on his iPod is some miracle. Idiot. Plus he uses iChat (I'm sure that is really secure to use over the Internet) to sh
  • "...saving them and the hospitals they work for thousands of dollars in expensive equipment."

    Or Just looking for a way to have your patient buy you an iPod.
  • I patent (Score:2, Funny)

    by JustOK ( 667959 )
    I've got the patent on iTumours and iSurgery.
  • Before this gets modded flamebait, i want to offer the disclaimer that i'm a thorough mac addict. That said, though i hate it when stock analysts harp on the half empty side of apple's decisions, I'm also getting tired of tech journalists using articles to imply that because a common feature or use (often implemented better and cheaper with other products) is available on an ipod it's somehow something new and great. Personally I look at it as financially wasteful. If it's storage portability a flash dri
  • The PSP has a bigger, higher-res screen and built-in wireless networking. Was the iPod really the best choice of commodity devices?
    • And how big does that cluster of PSP's need to be to hold 40 GB of data?

      Its being used as an external HD, not as a display.
      • Sorry, should have RTFA:
        "CDs aren't big enough, memory sticks are not big enough"
        And I think that, even thought there are HDDs, the PSP will only address 4Gb (certainly that's the most storage I've seen). Still two inch screen...
  • Gifts from hospitals (Score:5, Interesting)

    by Dan East ( 318230 ) on Thursday October 27, 2005 @09:08AM (#13888280) Homepage Journal
    This is interesting. My first thought was why not use an external HDD - it would cost a fraction of the price, and would not be nearly as appealing a target for thieves.

    Having worked in a hospital for a number of years, the real purpose behind this is evident. Hospitals like to give doctors stuff. Expensive stuff like PDAs and wristwatches, as well as basic stuff like umbrellas, pens, satchels and the free food and drinks well stocked in the physician break rooms. Hospitals make their money by having patients, and besides the Emergency Department, all patients are admitted to the hospital (or referred to for various procedures) by doctors. So hospitals like to give things to physicians to thank them for making them money. In the USA laws exist, and have been strengthened in the last several years, seriously limiting what hospitals can provide for physicians. This is of course to keep these gifts from becoming outright bribes.

    Now in the case of these iPods we see a loophole. A way for the hospital to purchase really, really nice gifts for their doctors, under the pretense that it has some medical use. Quite interesting indeed.

    Dan East
  • People complain about trying to view a TV show on an iPods tiny screen, do I really want my doctor trying to decipher my MRI on that thing? And yes, I realize they are also used for storage - I just wonder if there is a better solution for this sort of thing (Pocket PC, etc.)
  • We've hooked an iPod shuffle to our new phone system [betabug.ch]. When customers are on hold now, they get to listen to cool music not some synthiepop mozart castration. No pictures on the phone system though.

    One customer even asked if he could get the music from our phone system on CD.
    • Which is illegal to do in the US. You have to pay royalties to play commercial music. You may also have to in other countries. Just fyi. The "synthiepop mozart castration" type of music exists because the music is royalty free once the initial purchase is complete.

  • "Mrs. Davis, I have the results of your tests. Wait, that's not it. That's the latest G-Unit..."
  • I'm sure there's a pretty good reason why they spend "thousands of pounds on equipment" in hospitals rather than using TINY MUSIC PLAYERS to view medical photographs. Last time I checked, medical imaging displays were all carefully calibrated and had their settings locked so that mal-adjustment couldn't cause information to be lost or invisible just because the display is a bit to bright/dark or has poor colour reproduction. I'm pretty sure iPods aren't built to this quality.

    Next thing you'll be telling me
  • Dangerous (Score:2, Insightful)

    by srchestnut ( 717652 )
    Carrying around images and viewing them FROM the ipod on a computer is one thing but I don't want my radiologist to diagnose me from a 2in square screen.
  • Whats wrong with USB memory sticks?
  • by altek ( 119814 ) on Thursday October 27, 2005 @09:32AM (#13888428) Homepage
    I can say that there are a LOT of things wrong with this article. This is pre-school journalism at its best. Hear me out...

    My job title is PACS Administrator, which means I run the servers, network, diagnostic systems, etc for medical imaging in Radiology and other departments in a major healthcare organization.

    Let me tell you, there are A LOT of problems with something like this. Some of this will be redundant, but I'm trying to capture everything into one post. First of all, the iPod is seen as a generic external hard drive. Big deal, they made their free DICOM viewer software have the ability to export to an external drive. Second, this is a MAJOR patient confidentiality issue, and I believe is considered legal under HIPAA, but if a physician, clinician, etc lost the iPod, they could go to JAIL. I'm not kidding.

    Also, they also allude to actually viewing images on the photo iPods. I cannot imagine any image that could even be useful to a non-Radiology (referring phsyician, surgeon, etc) on those screens. About the lowest quality image that is useful even for referrals or comparisons is a 2MP monitor that displays at least 1280 resolution. Anything less than that is pretty much medically worthless, and for Radiologists, you typically need a 3MP display for proper detail, not to mention special graphics hardware.

    I'm not quite sure if this CNN article is a cry for publicity from the developers of OsiriX, or Apple. The product page for Osirix barely even mentions the iPod functionality (in the changelogs), yet I doubt Apple would bother publicizing this.

    As for the journalistic integrity, c'mon... I mean, the reporter spelled DICOM (format for medical image storage and transfer), "Diacom". They even spell out what it stands for after that, I don't see any A's in there!

    Conclusion: you should all be very scared of careless happy-go-lucky doctors and clinicians running around with your patient data on their iPod at the gym trying to see whether you have a brain tumor while jogging in the park, when someone steals their iPod and sells it on eBay!
    • The author of the article (Osman Ratib) is one of the software developpers. He even appears on the photo of TFA, look at the caption. This is some kind of publicity stunt for their software.

      We can also use Apple's Dot Mac system as a shared disc for storing images, for back up. You pay $100 a year and you get 80GB of space. In the same way my mother can access photos of my children if I give her access to my personal Dot Mac system, my colleagues can access images of my patients.

      Any medical department th

  • Pornographers embracing iPod [nwsource.com]:

    When Apple Computer unveiled the video-capable version of its popular iPod music player this month, it trumpeted the fact that users could download Pixar short films and top music videos, along with recent episodes of "Lost" and "Desperate Housewives."

    But video clips of a spicier nature quickly became available as free, iPod-friendly downloads. That created an immediate problem for parents already scrambling to keep abreast of their teenagers' computer routines...........

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