A simple telemedicine system using a digital camera

Abstract

Radiographs on a viewing box were photographed at a remote hospital in South Africa using a digital camera with a resolution of 1024 x 768 pixels at 24-bit colour depth. The resultant images were stored in JPEG format and transmitted as email attachments to be read on a PC monitor by radiologists in Durban and Cape Town. Twenty-seven images were received, of which 23 were of diagnostic quality (85%). The mean file size was 120 kByte. For quality control purposes, 100 chest radiographs were photographed at a base hospital and read by a radiologist blinded to the diagnosis. In this study 96 images were of diagnostic quality (96%) and the correct diagnosis was made in 90 cases (94%). Incorrect readings were made in six cases (6%): small pulmonary nodules (less than 1 cm in diameter) were missed in five cases and in one case early apical tuberculosis was missed. Digital camera technology permits simple, inexpensive telemedicine. Limited spatial resolution is a concern when reading chest images with small pulmonary nodules and infiltrates.

Feasibility of using teleradiology to improve tuberculosis screening and case management in a district hospital in Malawi

“…Notably, several studies have demonstrated that JPEGs obtained by digital photography of film radiographs using limited image compression are sufficient for diagnosis in most instances; additionally, rates of discrepancy between radiologists are the same whether teleradiology images or regular X-ray images are being interpreted. 10,12,15 In our experience, most images were classified as good and conclusive. Importantly, final diagnoses and case management were not based solely on the radiologist's report.…”

“…Our findings are consistent with those of other studies in resource-limited settings. [10][11][12]14 Our study has several limitations. We established no specific criteria for requesting teleradiology.…”

Paediatric radiology seen from Africa. Part I: providing diagnostic imaging to a young population

“…6). Plain radiographs can also be photographed and recreated in JPEG (Joint Photographic Experts Group) format [45,46]. JPEG images can then be converted into DICOM (Digital Imaging and Communication in Medicine) format; a PACS conversion facility is essential to the process.…”

“…For MSF facilities, computed radiography systems are therefore recommended over the use of filmscreen radiography to take advantage of opportunities for teleradiology consultation. At MSF facilities that have access to only film screen radiography, films are photographed with digital cameras for use in teleradiology [45,46].…”

Telemedicine in veterinary practice

“…Human telemedicine is developing in South Africa. Teleradiology has a relatively long history, with CT scanners linked to academic hospitals 7 and more recently with the development of e-mail services 8 . Teleneurology 13 , teleophthalmology 6 , telepathology 4 and teledermatology are all established services in some centres.…”