Dartmouth-backed pilot sends ultrasound over phone lines
Over-the-phone transmission of diagnostic-quality ultrasound images is possible, potentially paving the way for ultrasound examinations to be performed in poorer areas of the world, inexpensively transmitted via the Internet, and read by experienced radiologists elsewhere, a Dartmouth Medical School study shows.
The study was prompted in part by Veljko Popov, an M.D./Ph.D. student at Dartmouth Medical School who wanted to help the people in his homeland of Yugoslavia. Using a grant from the Dartmouth International Health Group, Popov and Robert Harris, M.D., associate professor of radiology at Dartmouth, visited patients at a remote hospital in Yugoslavia. They used a portable, compact ultrasound unit, donated by Dartmouth-Hitchcock Medical Center, to examine several hundred patients but the hospital had no resources to read the ultrasound scans. “Once they had the equipment, they needed an inexpensive way for the images to be read,” said Harris.
“We conducted a pilot study in which 50 thyroid, abdominal, pelvic and transvaginal images were transmitted from Yugoslavia to the U.S. to determine if real-time, low-cost tele-ultrasound was feasible,” said Popov. Real-time images were compressed to help speed the file transfer and these images were then compared to the original non-compressed images.
Two attending radiologists, one radiology resident and a medical student reviewed both sets of images, and in 64 percent of the cases, they could not tell the difference between the compressed and non-compressed images, said Harris.
“In 67 percent of the cases, they ranked the compressed images as adequate for diagnostic purposes or better than adequate,” he added. “The portable ultrasound machine we used to create the images in Yugoslavia is a relatively simple machine and, in some of the cases, the resolution problems could have been more of a problem with the original images than the compressed images.”
He said the pilot study shows that it’s possible to inexpensively send adequate images across telephone lines.
Added Popov: “Our objective is to use these technological advances in places in the world, such as in Yugoslavia, where they are not readily available.” The pilot study was a first step to achieving that goal, he said.
The next step is to employ satellite capability in an effort to expand bandwidth and speed file transfer, and connect remote areas of the world that don’t have any Internet access at all, Popov said.