Performance of a Web-based, realtime, tele-ultrasound consultation system over high-speed commercial telecommunication lines

Abstract

A Web-based, realtime, tele-ultrasound consultation system was designed. The system employed ActiveX control, MPEG-4 coding of full-resolution ultrasound video (640 x 480 pixels at 30 frames/s) and H.320 videoconferencing. It could be used via a Web browser. The system was evaluated over three types of commercial line: a cable connection, ADSL and VDSL. Three radiologists assessed the quality of compressed and uncompressed ultrasound video-sequences from 16 cases (10 abnormal livers, four abnormal kidneys and two abnormal gallbladders). The radiologists' scores showed that, at a given frame rate, increasing the bit rate was associated with increasing quality; however, at a certain threshold bit rate the quality did not increase significantly. The peak signal to noise ratio (PSNR) was also measured between the compressed and uncompressed images. In most cases, the PSNR increased as the bit rate increased, and increased as the number of dropped frames increased. There was a threshold bit rate, at a given frame rate, at which the PSNR did not improve significantly. Taking into account both sets of threshold values, a bit rate of more than 0.6 Mbit/s, at 30 frames/s, is suggested as the threshold for the maintenance of diagnostic image quality.

A Tele-ultrasound System for Real-time Medical Imaging in Resource-limited Settings

“…In this way, a single radiologist can extend the benefits of their training to patients in multiple, geographically disparate clinics, and the standard of care can be raised in rural and underdeveloped locales without requiring the additional resources to support on-site radiology. Previous work in this area has proved that both low-bandwidth transmission of ultrasound images ( [1]- [2]) and real-time remote ultrasound consultations ( [3]- [4]) are feasible.…”

Tele-obstetric ultrasound: analysis of first-trimester ultrasound images transmitted in realtime

“…16 Several studies have been conducted to investigate the accuracy of realtime tele-ultrasound. 3,4,5,8,9,10,17,18 The high maternal and neonatal morbidity and mortality rates around the world indicate the need for prenatal obstetric ultrasound, especially in the first trimester when evaluating the NT that, when correlated with the CRL contributes to detect chromosomal and structural malformations in both low-risk and high-risk populations. 13,14,19 In Brazil, the relative shortage of sonographers in small towns and remote areas demonstrates the importance of implementing a tele-obstetric ultrasound system to ensure access for patients who need this service.…”

The Feasibility of Real-Time Transmission of Sonographic Images from a Remote Location over Low-Bandwidth Internet Links: A Pilot Study

“…This connection enabled real-time transfer and analog-to-digital conversion of both video stream and still images from the portable sonography machine to the PC. We used Microsoft AmCap and VidCap software packages, both available free of charge, to view these images on the PC [1]. With both applications, it was possible to record video clips from the examination in an audio video interleave (AVI) file format at approximately 1 MB/s.…”