Design and implementation of a digital teleultrasound system for real-time remote diagnosis

Abstract

We present the design and implementation of a digital image capture and distribution system that supports remote ultrasound ezaminations and, in particular, real-time diagnosis for these ezaminations. The system was designed in conjunction with radiologists and staff in the Department of Radiology at the University of Virginia hospital. Based on readily available microcomputer components, our teleultmsound system handles the acquisition, digitizing, and reliable transmission of still and moving images generated by an ultrasound machine. The digital images have a resolution of 640A80 with an 8-bit color plane, can be captured at rates up to 30 frames/sec, and are compressed and decompressed in real-time using specialized hardware. While scalable to communications networks of any transmission speed, initial deployment is envisioned for 1.5 Mbit/s T-1 leased lines. To achieve realtime still image distribution and to reduce the bandwidth necessary for motion video, the teleultrasound design employs lossy image compression based on the JPEG standard 141.The effects of JPEG compression on diagnostic quality are being studied in a sepamte signal detection study with the Department of Radiology at the University of Virginia. 1: IntroductionHealth care reform is a critical social issue today. While much emphasis is given to the need for quality health care for all citizens, the high costs of medical care under the current system make universal health care a difficult challenge. The most advanced equipment and highly trained professionals are generally located in large urban hospitals in order to ensure cost-effective use of these expensive resources. However, uniform health coverage requires that high quality care be readily available to all citizens, including those people living in smaller cities and rural areas. Under the current system, providing access to medical specialists for patients in sparsely populated areas often results in inconvenience and/or inefficient use of resources.Most commonly, a patient seeking care will travel to see a medical specialist at the urban hospital. These trips can require hours of travel time for a relatively short examination, and thus are neither convenient nor an efficient use of the patient's time. A different approach is to have the physician travel to remote clinics as a circuit rider. This solution wastes the physician's time with travel. A third conventional approach has been to provide medical imaging capabilities at outlying health centers, but then physically transport these images 2921063-7125/95 $4.00 0 1995 IEEE

Image Quality in Real-Time Teleultrasound of Infant Hip Exam Over Low-Bandwidth Internet Links: a Transatlantic Feasibility Study

“…Most studies to date have assessed performance of transmitted images by testing radiologist diagnostic performance and all have proved that diagnostic is possible by application of teleultrasonic systems [35][36][37][38][39][40].…”

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A robotic wrist for remote ultrasound imaging

“…The concept of remote ultrasound first appeared in the article by Sublett et al [5] who presented the design and implementation of a digital imaging and distribution system that supports remote ultrasound examinations. A technician manipulated an ultrasound probe on the patient in consultation with a radiologist at the remote site.…”

Implementation and Field Experiments of a Remote Medical-Care Supporting System

“…There are many research works in the field of remote medical diagnosis and medical information. In [1], a digital teleultrasound system for real-time remote diagnosis was designed and implemented. The digital image capture and distribution system can support remote ultrasound examinations and, in particular, real-time diagnosis for these examinations.…”