Telesonography In Emergency Medicine : A Systematic Review

Funding: No specific funding was received for this work; however LE’s salary was paid from funding for the SatCare trial into remotely supported prehospital ultrasound, provided by the European Space Agency in collaboration with ViaSat (contract SC16005). The specific roles of this author are articulated in the ‘author contributions’ section. These funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.Peer reviewedPublisher PD

Tele-ultrasound imaging using smartphones and single-board PCs

BACKGROUND: Mobile devices are widely available and their computational performance increases. Nonetheless, medicine should not be an exception: single-board computers and mobile phones are crucial aides in telehealth. AIM: To explore tele-ultrasound scope using smartphones and single-board computers MATERIALS AND METHODS: This study focused on capturing ultrasound videos using external video recording devices connected via USB. Raspberry Pi single-board computers and Android smartphones have been used as platforms to host a tele-ultrasound server. Used software: VLC, Motion, and USB camera. A remote expert assessment was performed with mobile devices using the following software: VLC acted as a VLC server, Google Chrome for OS Windows 7 and OS Android was used in the remaining scenarios, and Chromium browser was installed on the Raspberry Pi computer. OUTCOMES: The UTV007 chip-based video capture device produces better images than the AMT630A-based device. The optimum video resolution was 720576 and 25 frames per second. VLC and OBS studios are considered the most suitable for a raspberry-based ultrasound system owing to low equipment and bandwidth requirements (0.640.17 Mbps for VLC; 0.5 Mbps for OBS studio). For Android phone OS, the ultrasound system was set with the USB camera software, although it required a faster network connection speed (5.20.3 Mbps). CONCLUSION: The use of devices based on single-board computers and smartphones implements a low-cost tele-ultrasound system, which potentially improves the quality of studies performed through distance learning and consulting doctors. These solutions can be used in remote regions for field medicine tasks and other possible areas of m-health

Developing a mHealth-based portable ultrasound platform for breast cancer screening

Background Breast cancer is amongst the 10 most common cancers globally. The disease burden is increasing rapidly in Sub-Saharan African countries, where women living in rural and or remote areas are particularly prone to be diagnosed with late-stage breast cancer. This is due to the limited availability of advanced screening and diagnostic options. Ultrasound is a feasible screening tool for breast cancer, due to its portability, affordability and accuracy. The integration of mHealth with portable ultrasound enables the provision of screening services in rural and remote areas, through electronic consultation by a non-specialist with a specialist for interpretation and reporting of the ultrasound results. This project developed an application for a mHealth-based portable ultrasound platform that could be used by a non-specialist to provide breast cancer screening services with remote specialist support. Methods A systematic review of the literature was conducted for the period of 2004 to 2019 to gather evidence on the use of mHealth-based portable ultrasound platforms for improved access to ultrasound services like breast cancer screening. The evidence from the literature was used to design and develop a prototype of an application for a mHealth-based portable ultrasound platform suitable for breast cancer screening. The prototype application was integrated with a mobile-based portable ultrasound from Philips Lumify. Images generated by scanning a phantom breast using the portable ultrasound were uploaded onto the application and downloaded from the application to demonstrate the concept. Results The systematic review showed only two clinical conditions (obstetrics and cardiovascular disease) which used a mHealth-based portable ultrasound platform. The outcomes from the studies showed improved access to the respective ultrasound services in terms of patient management, early detection, improved quality of care and increased patient attendance, which resulted in access to other services. The integration of the prototype application with a mobile-based portable ultrasound resulted into a mHealthbased portable ultrasound platform prototype intended for breast cancer screening. The ability to upload images onto the platform and download images from the platform satisfied the design requirements for the platform. Conclusion A mHealth-based portable ultrasound prototype was developed, which has potential for improving access to breast cancer screening services. Further research including testing of the application with health professionals and patients is recommended to strengthen the feasibility of the concept

A Feasibility Study of Smartphone-Based Telesonography for Evaluating Cardiac Dynamic Function and Diagnosing Acute Appendicitis with Control of the Image Quality of the Transmitted Videos

Our aim was to prove the feasibility of the remote interpretation of real-time transmitted ultrasound videos of dynamic and static organs using a smartphone with control of the image quality given a limited internet connection speed. For this study, 100 cases of echocardiography videos (dynamic organ)—50 with an ejection fraction (EF) of ≥50 s and 50 with EF <50 %—and 100 cases of suspected pediatric appendicitis (static organ)—50 with signs of acute appendicitis and 50 with no findings of appendicitis—were consecutively selected. Twelve reviewers reviewed the original videos using the liquid crystal display (LCD) monitor of an ultrasound machine and using a smartphone, to which the images were transmitted from the ultrasound machine. The resolution of the transmitted echocardiography videos was reduced by approximately 20 % to increase the frame rate of transmission given the limited internet speed. The differences in diagnostic performance between the two devices when evaluating left ventricular (LV) systolic function by measuring the EF and when evaluating the presence of acute appendicitis were investigated using a five-point Likert scale. The average areas under the receiver operating characteristic curves for each reviewer’s interpretations using the LCD monitor and smartphone were respectively 0.968 (0.949–0.986) and 0.963 (0.945–0.982) (P = 0.548) for echocardiography and 0.972 (0.954–0.989) and 0.966 (0.947–0.984) (P = 0.175) for abdominal ultrasonography. We confirmed the feasibility of remotely interpreting ultrasound images using smartphones, specifically for evaluating LV function and diagnosing pediatric acute appendicitis; the images were transferred from the ultrasound machine using image quality-controlled telesonography