June 16, 2008 Macs in Medicine By Beth W. Orenstein Radiology Today Vol. 12 OsiriX started the Apple rolling in radiology, but the machines are starting to turn on across healthcare. These days, approximately 25,000 physicians—about one third of them radiologists—are viewing medical images on Apple’s Macintosh computers. While that’s just a small fraction of the whole, it is significant because the physicians themselves are driving the movement toward Macs when only a few years ago they had no choice but to use expensive, dedicated PC workstations. Those physicians are in turn being supported by several partner companies such as PACS makers Meta Fusion of Saratoga, Calif., and aycan Medical Systems of Rochester, N.Y., and providers of diagnostic imaging displays such as Quest International of Irvine, Calif. The growing interest in Macs in radiology mirrors what’s happening with Macs in general.

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In May, Apple reported strong sales, shipping 2.29 million Macs during the second quarter, an increase of 51% over one year ago. International Data Corp., a global provider of market intelligence, also reported that Apple’s market share is growing at a rate 3.5 times the overall PC market growth. Apple has never pursued the corporate market, let alone medical imaging. Its focus has been consumers and education. But observers believe that as more people (including physicians) use iPods, iPhones, and Macs at home, their enthusiasm for Apple products is spilling over to the workplace. It also has helped that since 2006, when Apple switched to Intel processors, users have been able to run Microsoft Windows on their Macs.

Tapping Graphic Potential Macs’ growth in radiology departments has been fostered by the development of OsiriX, an open-source DICOM viewer comparable to the software on high-end imaging, proprietary vendor workstations. In late 2003, Osman Ratib, MD, PhD, then a professor and the vice chair of information systems for the department of radiological sciences at UCLA, and Antoine Rosset, MD, a radiologist from the University of Geneva and Ratib’s former student, sought to develop a sophisticated, easy-to-use computing platform for interactively viewing the large data sets that the latest generations of their MR, CT, and PET/CT scanners were producing. Ratib had worked on OsiriX, which was also a DICOM-compliant, open-source, cross-platform viewer for images, but was limited to viewing single, simple images. They rewrote OsiriX from scratch, incorporating existing open-source imaging tool kits so it would be comparable to the software that previously had only been found on high-end imaging workstations costing $40,000 to $150,000.

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Elizabeth Kerr, PhD, director of the science and medicine markets for Apple, says the movement toward Macs in medicine has been a growing trend for the past couple of years, but it has really taken off in the last six to 12 months, thanks to OsiriX. “OsiriX running on Mac Operating System X (OS X) in clinical settings is one of the solutions leading the charge,” she says. Rosset believes one reason the OsiriX platform has gained so much interest among his radiology colleagues is that the price is right—it’s free. Also, Mac computers, while sometimes perceived as pricier than PCs, are nowhere near the cost of the proprietary PACS viewing workstations that imaging facilities must buy for their radiologists. Kerr says some of the early adopters include major medical institutions such as the Hartford Hospital in Connecticut. The hospital found the Mac/OsiriX combination was the perfect solution, even in its stroke center, which generates huge files on each patient, she says.