An international multicenter study (Germany, Sweden, and Switzerland) was performed to investigate the feasibility and diagnostic reliability of standard video-conferencing (VC) technology for remote expert consultation in radiology. Three high-spatial-resolution films (hand-bone, mammography, chest) and two low-spatial-resolution image sets (liver CT and MRI) were studied (total 446 images taken from different examinations). The images were recorded by a video camera, transmitted via public broadband networks, and displayed on a video monitor. The resolution of the recorded images varied from 2.4 lp/mm to 4.8 lp/mm at maximum zoom. After 3-4 months, the images were reexamined using conventional light-box reading. Diagnostic reliability was evaluated by receiver operating characteristics (ROC) analysis. With video conferencing, there was a noticeable loss of diagnostic accuracy for the high-spatial-resolution films, whereas for liver CT and liver MRI images VC reading seemed to be satisfactory (average area value difference < 0.02).
In the frame of the EC-sponsored TELEMED project, videoconferencing was evaluated as a tool for Remote Expert Consultation (REC) in radiology. The REC environment has been established as a pan-European demonstrator for advanced telecommunication applications in medicine. Five European university hospitals have been interconnected using broadband networks at a speed of 2 Mbit/s and 140 Mbit/s. Videoconference was evaluated in more than 120 sessions. In the experiments, videoconference proved to be a useful tool for teleconsultations, providing a set of requirements identified as indispensable for medical videoconference such as remotely adjustable iris for the document camera are fulfilled. Diagnostic reliability of images recorded with our equipment proved acceptable for digitally acquired images while reliability is limited for conventional images with a high demand of spatial and contrast resolution. Regional spin-off applications that have been established at some participating sites underline the potential of videoconference in health care.
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