DIAGNOSTIC EFFICACY OF SMARTPHONE BASED DICOM VIEWERS FOR EVALUATION OF CBCT SCANS

Abstract

<h3>BACKGROUND</h3> Viewing cone beam computed tomography (CBCT) scans at multiple locations and on multiple devices continues to present challenges. Several clinicians use smartphones to look at specific images for reference, especially intraoperatively. Currently, smartphone use is limited to viewing selected images or small videos at best. No applications were available until recently to view DICOM files on smartphones. The evolution of DICOM viewer apps for smartphones is a new feature. No studies currently exist that have tested the diagnostic efficacy of such platforms or their ease of use. <h3>OBJECTIVE(S)</h3> The objective was to evaluate the diagnostic efficacy of 2 smartphone-based DICOM viewers in their ability to depict anatomy and pathology of the maxillofacial region. <h3>STUDY DESIGN</h3> An Android-compliant DICOM viewer app was used on an Honor 6X smartphone and an IOS-compliant app was used on an iPhone 11 to evaluate 7 CBCT scans. Scans were evaluated for anatomy and pathology. Five anatomic landmarks were identified in each plane and scored. The scoring criteria were as follows: (1) cannot be visualized, (2) visualized but not of diagnostic quality, and (3) well visualized and of diagnostic quality. The same scale was used to evaluate pathology. These scans were also evaluated on a PACS monitor that served as the gold standard for comparative evaluation. Two oral radiology residents evaluated the images on all 3 modalities and a comparative evaluation was done using Cohen's kappa analysis. <h3>RESULTS</h3> The quality of the scan was comparable on both devices. Both apps demonstrated scans in axial, sagittal, and coronal planes and were of diagnostic quality. However, the IOS app had features that improved the ease of use and allowed simultaneous visualization and navigation including measurement capability. <h3>DISCUSSION/CONCLUSIONS</h3> Smartphone-based DICOM viewers can facilitate visualization of anatomy and pathology in the maxillofacial region and can serve as valuable adjuncts for viewing CBCT scans.