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

Volumetry versus linear diameter lung nodule measurement: an ultra-low-dose computed tomography lung cancer screening study

BACKGROUND: The DutchBelgian Randomized Lung Cancer Screening Trial (NELSON) used a volume-based protocol and significantly reduced the prevalence of false-positive results (2.1%). AIM: To compare the performance of manual linear diameter and semi-automated volumetric nodule measurement in the pilot project Moscow Lung Cancer Screening ultra-low-dose computed tomography pilot study. MATERIALS AND METHODS: The study included individuals with a lung nodule of at least 4 mm on baseline-computed tomography of the Moscow lung cancer screening between February 2017 and February 2018, without verified lung cancer diagnosis until 2020. The radiation dose was selected individually and did not exceed 1 mSv. All scans were assessed by three blinded readers to measure the maximum and minimum transversal nodule diameter and extrapolated volume. As a reference value of size and volume, the average value from the results of expert measurements was obtained. A false-positive nodule was defined as a nodule 6 mm/100 mm3 and a false-negative nodule as a nodule 6 mm/100 mm3. RESULTS: Overall, 293 patients were included (166 men; mean age, 64.6 5.3years); 199 lung nodules were 6 mm/100 mm3 and 94 were 6 mm/100 mm3. Regarding volumetric measurements, 32 [10.9%; 4 false-positive, 28 false-negative], 29 [9.9%; 17 false-positive, 12 false-negative], and 30 [10.2%; 6 false-positive, 24 false-negative] nodule discrepancies were reported by readers 1, 2, and 3 respectively. For linear diameter measurement, 92 [65.5%; 107 false-positive, 85 false-negative], 146 [49.8%; 58 false-positive, 88 false-negative], and 102 [34.8%; 23 false-positive, 79 false-negative] nodule discrepancies were reported by readers 1, 2, and 3 respectively. CONCLUSIONS: The use of lung nodule volumetry strongly reduces the number of false-positive and false-negative nodules compared with nodule diameter measurements, in an ultra-low-dose computed tomography lung cancer screening program

Double-reading mammograms using artificial intelligence technologies: A new model of mass preventive examination organization

BACKGROUND: In recent years, the availability of medical datasets and technologies for software development based on artificial intelligence technology has resulted in a growth in the number of solutions for medical diagnostics, particularly mammography. Registered as a medical device, this program can interpret digital mammography, significantly saving time, material, and human resources in healthcare while ensuring the quality of mammary gland preventive studies. AIM: This study aims to justify the possibility and effectiveness of artificial intelligence-based software for the first interpretation of digital mammograms while maintaining the practice of a radiologists second description of X-ray images. MATERIALS AND METHODS: A dataset of 100 digital mammography studies (50 absence of target pathology and 50 ― presence of target pathology, with signs of malignant neoplasms) was processed by software based on artificial intelligence technology that was registered as a medical device in the Russian Federation. Receiver operating characteristic analysis was performed. Limitations of the study include the values of diagnostic accuracy metrics obtained for software based on artificial intelligence technology versions, relevant at the end of 2022. RESULTS: When set to 80.0% sensitivity, artificial intelligence specificity was 90.0% (95% CI, 81.798.3), and accuracy was 85.0% (95% CI, 78.092.0). When set to 100% specificity, artificial intelligence demonstrated 56.0% sensitivity (95% CI, 42.269.8) and 78.0% accuracy (95% CI, 69.986.1). When the sensitivity was set to 100%, the artificial intelligence specificity was 54.0% (95% CI, 40.267.8), and the accuracy was 77.0% (95% CI, 68.885.2). Two approaches have been proposed, providing an autonomous first interpretation of digital mammography using artificial intelligence. The first approach is to evaluate the X-ray image using artificial intelligence with a higher sensitivity than that of the double-reading mammogram by radiologists, with a comparable level of specificity. The second approach implies that artificial intelligence-based software will determine the mammogram category (absence of target pathology or presence of target pathology), indicating the degree of confidence in the obtained result, depending on the corridor into which the predicted value falls. CONCLUSIONS: Both proposed approaches for using artificial intelligence-based software for the autonomous first interpretation of digital mammograms can provide diagnostic quality comparable to, if not superior to, double-image reading by radiologists. The economic benefit from the practical implementation of this approach nationwide can range from 0.6 to 5.5 billion rubles annually

Определение точности оценки фракции жира с использованием Dixon: экспериментальное фантомное исследование

Objective. Quantitative assessment of Dixon two-point and three-point technologies operation using phantom modeling in the range from 0 to 70%.Materials and methods. To simulate substances with different concentrations of the fat phase we chose direct oil-in-water emulsions. Tubes with ready-made emulsions were placed in a phantom. Emulsions based on vegetable oils were presented in the range from 0–70%. The phantom was scanned on an Optima MR450w MRI tomograph (GE, USA) in two Dixon modes: the accelerated two-point method “Lava-Flex” and the three-point method “IDEAL IQ”. A scan was performed on a GEM Flex LG Full RF coil. We calculated fat fraction (FF) using two formulas.Results. There is a linear relationship of the determined values when calculating the fat concentration in “IDEAL IQ” mode and using the formula based on Water and Fat. The accuracy of body fat percentage measurement in “IDEAL IQ” mode is higher than in “Lava-Flex” mode. According to the MR-sequence “Lava-Flex” draws attention to the overestimation of the measured values of the concentration of fat in relation to the specified values by an average of 57.6% over the entire range, with an average absolute difference of 17.2%.Conclusion. Using the “IDEAL IQ” sequence, the results of the quantitative determination of fractions by formulas were demonstrated, which are more consistent with the specified values in the phantom. In order to correctly quantify the fat fraction, it is preferable to calculate from the Water and Fat images using Equation 2. Calculations from the In-phase and Out-phase images provide ambiguous results. Phantom modeling with direct emulsions allowed us to detect the shift of the measured fat fraction.Цель исследования: оценка эффективности работы двухточечной и трехточечной МРТ-последовательностей Dixon при фантомном моделировании для определения жировой фракции в диапазоне от 0 до 70%.Материал и методы. Для моделирования веществ с разной концентрацией жировой фазы были выбраны прямые эмульсии типа “масло в воде”. Пробирки с эмульсиями помещались в цилиндрический фантом. Эмульсии на основе растительных масел были представлены в диапазоне от 0 до 70%. Сканирование выполнялось на МР-томографе 1,5 Тл Optima MR450w (GE, США). Было проведено сканирование в двух режимах Dixon: двухточечный метод “Lava-Flex” и трехточечный метод “IDEAL IQ”. Было выполнено сканирование на РЧ-катушке GEM Flex LG Full. Фракция жира определялась расчетным методом.Результаты. При расчете концентрации жира по данным последовательности “IDEAL IQ” по формуле, использующей данные изображений Water и Fat, определена линейная зависимость измеренных значений от заданных. Точность измерения процентного содержания жира в режиме “IDEAL IQ” выше, чем в режиме “Lava-Flex”. По данным МР-последовательности “Lava-Flex” обращает на себя внимание завышение измеряемых значений концентрации жира по отношению к заданным в среднем на 57,6% на всем диапазоне при средней абсолютной разнице 17,2%.Заключение. С помощью последовательности “IDEAL IQ” были продемонстрированы результаты количественного определения фракций по формулам, в большей степени соответствующие заданным величинам в фантоме. Для корректного количественного определения фракции жира предпочтительнее проводить расчеты по данным изображениям Water и Fat с использованием формулы (2). Расчеты по изображениям In-phase и Out-phase предоставляют неоднозначные результаты. Фантомное моделирование с использованием прямых эмульсий позволило определить смещение в значениях измеряемой фракции жира

Experience and Results of Teleconsultations in Daily Clinical Practice

This presentation was given at the Med-e-tel 2005 Conference in Luxembourg on April 8th, 2005.eHealth and Developing Countries (2):In 2000-2004 in our organisation were carried out about 200 teleconsultations. We were forced to develop main indices for teleconsultations: determination of diagnosis and treatment tactics in cases of infrequent, serious or atypically flowing diseases; necessity to perform new and/or infrequent surgical (medical or diagnostic), procedure etc. Lessons learned will be presented in brief.Donetsk Research and Development Institute of Traumatology and Orthopaedics, Department of Informatics and Telemedicine, Ukraine

Artificial intelligence in the diagnosis of thoracic aortic aneurysms in a retrospective chest computed tomography scan analysis

BACKGROUND: Aortic aneurysms, known as silent killers, are frequently asymptomatic, leading to vessel rupture and death. Annual rates for ruptures, stratifications, and sudden deaths are up to 3.6%, 3.7%, and 10.8%, respectively. Timely diagnosis and early treatment save a patients life. The use of artificial intelligence (AI) technologies helps to detect aortic aneurysms, which significantly improves the quality of diagnosis and saves patients lives. AIM: To assess the efficiency of using AI technologies to detect thoracic aortic aneurysms on chest computed tomography (CT) and determining the possibility of using AI technologies as an assistant to the radiologist during the primary description of radiological images. METHODS: The study retrospectively assessed the results of AI technologies aimed at detecting thoracic aortic aneurysms on chest CT scans. No contrast enhancement was performed primarily. The sample consisted of 84,405 observations of patients over the age of 18 years; of these, 86 scans with thoracic aortic aneurysms were selected according to AI data. The selected examinations were retrospectively assessed by radiologists and vascular surgeons for the probable presence of a thoracic aortic aneurysm. In 44 cases, an aortic aneurysm was initially detected by the radiologist. In 31 cases, an aneurysm was not initially described by the radiologist, 6 were excluded from the sample (due to the absence of the radiologists report in the Unified Radiological Information Service), and 5 scans had false-positive results according to AI findings. RESULTS: The use of AI technologies allows detection and labeling of pathological changes in the aorta on the images. AI technologies increase the detectability of thoracic aortic aneurysms in the description of chest CT scans by 38.8%. The incidence of ascending aortic aneurysm was 0.3%, which corresponded to the literature data of 0.16%1.6%. According to the results, 22 surgical interventions for aortic stenting were performed. CONCLUSIONS: The use of AI in the primary chest CT description may help increase the detectability of clinically significant pathological conditions, such as thoracic aortic aneurysm. Further development of routing for this category of patients in the cito mode for surgical treatment is relevant. Expansion of retrospective screening by chest CT scans using AI systems will improve the quality of diagnosis of concomitant pathologies and prevent adverse outcomes for patients

APPROACHES FOR A MODEL OF POPULATION UROLOGICAL SCREENING BASED ON TELEMEDICINE TECHNOLOGIES

Background. The prostate cancer wins a first place among men oncological diseases by rates of an incidence and mortality. The late detection is a main reason of high mortality (approximately 52,0% patients starts treatment after more than 1 year of symptoms existence). A screening allows improve detection dramatically, but current methods of screening almost impossible to use widely. System of oncological urology needs new effective approaches for population screening. Aim. To develop empirical approaches for a model of population urological screening with a telemedicine as a key element. Material and methods. The research are backgrounded on systemic approach. Methods of analysis, synthesis and information modeling were used. Methodological documents recognized by WHO used for model evaluation. Results and discussion. National program of an urological screening should be backgrounded on methods of selective staged examinations of target population group, telemedicine technologies must be a key integrative element. The formal information model of prostate cancer telemedicine screening was developed. The key element of the model is an information system which consist from: - web-questionnaires and online risk assessment forms, - Electronic health records module, - Laboratory module, - PACS. The model was developed according to criterion for screening programs recognized by WHO. Conclusion. Approaches for an urological screening organization had been developed empirically. All issues joints the formal information model of prostate cancer telemedicine screening. The model are valid according to WHO methodological documents. Further researches will be focused on model introduction and evaluation in the field

Bowel Preparation for Imaging Studies: Systematic Review

The authors performed a systematic review to summarize data on the approaches and methods of bowels preparation for radiography, radiology and ultrasound studies. The review included 15 articles on computed tomography (CT) and 30 articles on magnetic resonance imaging (MRI). Due to the limited evidence, researches on X-ray and ultrasound (US) studies are not included in the review; the authors just summarized the main provisions for these modalities. The bowels preparation must be completed before making the CT colonography (diet, bowel cleansing within max. 24 hours, marking the residual content). For purification, solutions of low-volume polyethylene glycol (PEG) 2 L with ascorbate complex and electrolytes, bisacodyl and other medications were used. The choice of a specific drug regimen of bowels cleansing should be based on a personalized approach to patient, balance, consideration of studies purpose and reasons. The bowels preparation must be completed before making the MRI (two ways: complete cleansing (most often with low-volume polyethylene glycol 2 L solutions with ascorbate complex and electrolytes or diet, followed by contrasting the residual content). There is no reliable information on the benefits of each particular approach. The insufficient evidence is due to the lack of comparative studies. When performing the MRI of men's small pelvic, doctors use antispasmodics, for women they prefer diet, mechanical cleansing, suppositories with bisacodyl or magnesia, followed by rehydration on the day of studies. There is currently no reliable data on the need in bowels preparation before making the following studies: CT of abdominal cavity and small pelvis (except for the large intestine), excretory urography, metro(hystero)salpingography, ultrasound of the large intestine. PEG solutions with electrolytes have relative advantages in preparing bowels for radiation studies (possibility of using in cases when the prescription of other laxatives is contraindicated)