Testing telediagnostic thyroid ultrasound in Peru: a new horizon in expanding access to imaging in rural and underserved areas.

Autor: Marini TJ; University of Rochester Medical Center, 601 Elmwood Ave, Box 648, Rochester, NY, 14642, USA., Weiss SL; University of Rochester Medical Center, 601 Elmwood Ave, Box 648, Rochester, NY, 14642, USA., Gupta A; University of Rochester Medical Center, 601 Elmwood Ave, Box 648, Rochester, NY, 14642, USA., Zhao YT; University of Rochester Medical Center, 601 Elmwood Ave, Box 648, Rochester, NY, 14642, USA., Baran TM; University of Rochester Medical Center, 601 Elmwood Ave, Box 648, Rochester, NY, 14642, USA., Garra B; Medical Imaging Ministries of the Americas, 10810 Lake Minneola Shores, Clermont, FL, 34711, USA., Shafiq I; University of Rochester Medical Center, 601 Elmwood Ave, Box 648, Rochester, NY, 14642, USA., Oppenheimer DC; University of Rochester Medical Center, 601 Elmwood Ave, Box 648, Rochester, NY, 14642, USA., Egoavil MS; Medical Innovation and Technology, Calle Los Libertadores 635, 15046, San Isidro, Peru., Ortega RL; University of Rochester Medical Center, 601 Elmwood Ave, Box 648, Rochester, NY, 14642, USA., Quinn RA; University of Rochester Medical Center, 601 Elmwood Ave, Box 648, Rochester, NY, 14642, USA., Kan J; University of Rochester Medical Center, 601 Elmwood Ave, Box 648, Rochester, NY, 14642, USA., Dozier AM; University of Rochester Medical Center, 601 Elmwood Ave, Box 648, Rochester, NY, 14642, USA., Tamayo L; Medical Innovation and Technology, Calle Los Libertadores 635, 15046, San Isidro, Peru., Carlotto C; Medical Innovation and Technology, Calle Los Libertadores 635, 15046, San Isidro, Peru., Castaneda B; Pontifica Universidad Catolica del Peru, Av. Universitaria 1801, 15088, San Miguel, Peru. castaneda.b@pucp.edu.pe.
Jazyk: angličtina
Zdroj: Journal of endocrinological investigation [J Endocrinol Invest] 2021 Dec; Vol. 44 (12), pp. 2699-2708. Date of Electronic Publication: 2021 May 10.
DOI: 10.1007/s40618-021-01584-7
Abstrakt: Purpose: Thyroid ultrasound is a key tool in the evaluation of the thyroid, but billions of people around the world lack access to ultrasound imaging. In this study, we tested an asynchronous telediagnostic ultrasound system operated by individuals without prior ultrasound training which may be used to effectively evaluate the thyroid and improve access to imaging worldwide.
Methods: The telediagnostic system in this study utilizes volume sweep imaging (VSI), an imaging technique in which the operator scans the target region with simple sweeps of the ultrasound probe based on external body landmarks. Sweeps are recorded and saved as video clips for later interpretation by an expert. Two operators without prior ultrasound experience underwent 8 h of training on the thyroid VSI protocol and the operation of the telemedicine platform. After training, the operators scanned patients at a health center in Lima. Telediagnostic examinations were sent to the United States for remote interpretation. Standard of care thyroid ultrasound was performed by an experienced radiologist at the time of VSI examination to serve as a reference standard.
Results: Novice operators scanned 121 subjects with the thyroid VSI protocol. Of these exams, 88% were rated of excellent image quality showing complete or near complete thyroid visualization. There was 98.3% agreement on thyroid nodule presence between VSI teleultrasound and standard of care ultrasound (Cohen's kappa 0.91, P < 0.0001). VSI measured the thyroid size, on average, within 5 mm compared to standard of care. Readers of VSI were also able to effectively characterize thyroid nodules, and there was no significant difference in measurement of thyroid nodule size (P = 0.74) between VSI and standard of care.
Conclusion: Thyroid VSI telediagnostic ultrasound demonstrated both excellent visualization of the thyroid gland and agreement with standard of care thyroid ultrasound for nodules and thyroid size evaluation. This system could be deployed for evaluation of palpable thyroid abnormalities, nodule follow-up, and epidemiological studies to promote global health and improve the availability of diagnostic imaging in underserved communities.
(© 2021. The Author(s).)
Databáze: MEDLINE
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