New Ultrasound Telediagnostic System for <scp>Low‐Resource</scp> Areas

Marini, Thomas J.; Oppenheimer, Daniel C.; Baran, Timothy M.; Rubens, Deborah J.; Toscano, Marika; Drennan, Kathryn; Garra, Brian S.; Miele, Frank R.; Garra, Gail; Noone, Sylvia Jacobo; Tamayo, Lorena; Carlotto, Claudia; Trujillo, Leslie; Waks, Erin; Garra, Katie; Egoavil, Miguel S; Berrospi, Joel; Castañeda, Benjamín

doi:10.1002/jum.15420

Cited by 25 publications

(43 citation statements)

References 37 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Another obvious application of lung US is in rural or economically impoverished areas, where access to medical imaging may be limited, and in low-and middle-income countries where the modality has already demonstrated efficacy (74). Similar to other uses for US, lung US is also well-suited to tele-US and remote reading (75)(76)(77). Because pneumonia is the leading killer of children from birth to 5 years of age worldwide, with nearly 1 million associated deaths per year and over 100 million hospitalizations per year, the use of lung US could be a powerful tool in promoting global health for aid organizations (74,(78)(79)(80)(81)(82)(83).…”

Section: Future Directions and Medical-legal Perspectivesmentioning

confidence: 99%

Lung Ultrasound: The Essentials

Marini

Rubens

Zhao

et al. 2021

Radiology: Cardiothoracic Imaging

Self Cite

View full text Add to dashboard Cite

L ung US has dramatically increased in popularity over the last decade and is routinely performed at the patient's bedside, especially in the emergency department and the intensive care unit (ICU) (1-3). Formal training in the performance and interpretation of lung US, however, is not a traditional component of radiology residency education in the United States. As this modality becomes an imaging staple, the diagnostic radiologist should be fluent in lung US performance and interpretation to maintain relevance and assist the ordering clinician. In this imaging essay, the essentials of lung US are described and radiographic correlation for lung US imaging findings on chest radiographs and chest CT images is provided. A discussion of the role of lung US in health care delivery and the future directions of lung US is also included. Utility of Lung USLung US is radiation-free, low-cost, rapid, and portable, allowing real-time examination of pulmonary structures. Meta-analyses suggest that compared with chest radiography, lung US may have higher sensitivity and similar specificity for detection of pleural effusion, pneumonia, pneumothorax, and pulmonary edema (Table ) (4-7). It is increasingly used in the ICU to detect these diseases. Critical care providers have adopted the bedside lung US in emergency (BLUE) protocol as a standardized approach to lung US in the ICU. This protocol can be performed in less than 3 minutes at the bedside and has a diagnostic accuracy greater than 90% for asthma and/ or chronic obstructive pulmonary disease, pneumonia, pneumothorax, pulmonary edema, and pulmonary embolism (1,8). The accuracy for pulmonary embolism derives from the protocol directing the provider to examine the deep venous structures if there is no sign of pulmonary disease. Many practitioners have advocated for the regular use of lung US in the ICU to decrease the use of chest radiography, which is associated with This copy is for personal use only. To order printed copies, contact reprints@rsna.org Although US of the lungs is increasingly used clinically, diagnostic radiologists are not routinely trained in its use and interpretation. Lung US is a highly sensitive and specific modality that aids in the evaluation of the lungs for many different abnormalities, including pneumonia, pleural effusion, pulmonary edema, and pneumothorax. This review provides an overview of lung US to equip the diagnostic radiologist with knowledge needed to interpret this increasingly used modality.

show abstract

Section: Future Directions and Medical-legal Perspectivesmentioning

confidence: 99%

Lung Ultrasound: The Essentials

Marini

Rubens

Zhao

et al. 2021

Radiology: Cardiothoracic Imaging

Self Cite

View full text Add to dashboard Cite

show abstract

“…Presets of the ultrasound machine are used which further obviate the need for technical skill or adjustments of the ultrasound machine. The probe is swept at a rate of 1-2 cm/s and produces an image every 1-2 mm [13]. Additional arcing (fanning) of the probe at the beginning and at the end of each sweep maximizes visibility.…”

Section: Thyroid Vsimentioning

confidence: 99%

“…Thyroid, obstetric, right upper quadrant, and lung VSI protocols have all been tested with encouraging results [13,[38][39][40]. Training data from these studies suggest that effective VSI training is easily completed in less than 8 h. The thyroid VSI protocol can be performed within 10 min and is recommended to be performed with a highfrequency probe.…”

Section: Thyroid Vsimentioning

confidence: 99%

“…To address these problems, a new telediagnostic system utilizing ultrasound volume sweep imaging (VSI) has been previously piloted (Fig. 1) [13]. In this system, images are obtained by individuals without prior ultrasound experience after a few hours of training on ultrasound VSI protocols which are based on simple external body landmarks.…”

Section: Introductionmentioning

confidence: 99%

“…Our previous pilot of the teleultrasound system found that the thyroid gland was well evaluated with VSI thyroid ultrasound [13]. In the vast majority of pilot examinations, the Fig.…”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Testing telediagnostic thyroid ultrasound in Peru: a new horizon in expanding access to imaging in rural and underserved areas

Marini

Weiss

Gupta

et al. 2021

J Endocrinol Invest

Self Cite

View full text Add to dashboard Cite

Purpose Thyroid ultrasound is a key tool in the evaluation of the thyroid, but billions of people around the world lack access to ultrasound imaging. In this study, we tested an asynchronous telediagnostic ultrasound system operated by individuals without prior ultrasound training which may be used to effectively evaluate the thyroid and improve access to imaging worldwide. Methods The telediagnostic system in this study utilizes volume sweep imaging (VSI), an imaging technique in which the operator scans the target region with simple sweeps of the ultrasound probe based on external body landmarks. Sweeps are recorded and saved as video clips for later interpretation by an expert. Two operators without prior ultrasound experience underwent 8 h of training on the thyroid VSI protocol and the operation of the telemedicine platform. After training, the operators scanned patients at a health center in Lima. Telediagnostic examinations were sent to the United States for remote interpretation. Standard of care thyroid ultrasound was performed by an experienced radiologist at the time of VSI examination to serve as a reference standard. Results Novice operators scanned 121 subjects with the thyroid VSI protocol. Of these exams, 88% were rated of excellent image quality showing complete or near complete thyroid visualization. There was 98.3% agreement on thyroid nodule presence between VSI teleultrasound and standard of care ultrasound (Cohen’s kappa 0.91, P < 0.0001). VSI measured the thyroid size, on average, within 5 mm compared to standard of care. Readers of VSI were also able to effectively characterize thyroid nodules, and there was no significant difference in measurement of thyroid nodule size (P = 0.74) between VSI and standard of care. Conclusion Thyroid VSI telediagnostic ultrasound demonstrated both excellent visualization of the thyroid gland and agreement with standard of care thyroid ultrasound for nodules and thyroid size evaluation. This system could be deployed for evaluation of palpable thyroid abnormalities, nodule follow-up, and epidemiological studies to promote global health and improve the availability of diagnostic imaging in underserved communities.

show abstract