The BerlinCase viewer: COVID-19 imaging educational app was designed as a multicentre collaborative effort between Western Australia, Germany and Italy during the initial heavy outbreak in Europe in early 2020. With increasing use of imaging in aiding diagnosis and the heavy burden on health systems at that time, it was released as a free app for iPad and iPhone for radiologists and appropriate frontline clinicians to better familiarise themselves with the CT imaging spectrum of COVID-19.

Dr Yuranga Weerakkody, radiologist, Perth*

The app drew on the clinical and programming experience and expertise of the three radiologists and their clinical and technical support staff. Prior to this collaborative effort, BerlinCaseViewer had been a medical training application, mainly focusing on musculoskeletal rheumatic diseases. It shifted its focus in times of need on the lung manifestations of COVID-19. As a socially responsible gesture, all versions are released as a free-to-use app. 

For better user engagement, the app was designed as a question-and-answer case-based interactive platform with links to important radiology journal publications embedded up to the level initial release (April 2020). These cases are presented as easily scrollable stacks as well as annotations as the user progresses through a case. 

A large number of COVID-19 positive cases from Italy (generously made available by Dr Fabio Macori) were selected. Several mimic cases are also carefully selected to help clinicians realise the differences and similarities with certain overlap of non-COVID-19 cases.

The app is currently pitched at high-level hospital clinicians. Several revisions and upgrades planned.

Example case of the COVID19 quiz with a multiple choice question. Further series of the CT scans are only shown after the questions are answered.

Imaging findings depicting features annotated by coloured overlays in some cases.

Imaging was not used as a first-line diagnosis in Australia due to low manageable numbers of critically ill patients. However, it was indicated under guidelines by several international bodies such as Fleischner Society for medical triage of patients suspected of having COVID-19 who present with moderate-to-severe clinical features and a high pretest probability of disease in resource-constrained environments such as Europe in early 2020.

Regardless of circumstances, our view was that better familiarisation with the imaging spectrum of COVID-19 would prove beneficial to appropriate frontline clinicians and radiologists generally. The app is currently available in English and free to download from the AppStore and with the full version using 470MB of file space and with a light version using 80MB. 

So far, there has been a very positive response worldwide both in terms of downloads as well as reviews. It recently highlighted as a feature Article in in October 2020.

Key messages
  • An imaging app was collaboratively developed
    in early 2020
  • It enables radiologists and appropriate frontline clinicians to aid COVID-19 diagnosis
  • The app remains free to use.

To learn more about this project and to download the app visit Feedback is highly appreciated.

*The author acknowledges Prof Kay-Geert Hermann, Professor of Radiology, Charité Medical School, Berlin, and Dr Fabio Macori, Radiologist, Ospedale Santo Spirito, Rome. 

Author competing interests – the author helped develop the app.