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Viable Telemedicine Technology for Ultrasound

From Explorations
April 1, 1997

I n a time of rising health care costs, telemedicine offers the promise of delivering high-quality medical care over great distances. While most telemedicine schemes involve elaborate teleconferencing systems, requiring expensive, high-bandwidth telephone lines or satellite connections, the system being developed by Alfred Weaver, a professor of computer science, is more utilitarian, but no less effective. By harnessing the power of personal computers and modems, Weaver and his colleagues Spencer Gay and Samuel Dwyer, in the department of radiology, have developed a system that transmits clinically acceptable ultra-sound images.

"Our goal is to give radiologists a tool for boosting their productivity, while improving the level of health care services available to people in their own communities," Weaver declares. His teleultrasound system is capable of quickly compressing and sending full-color, full-motion video clips as well as still images from outlying clinics to radiologists at a central hospital, who can read them just minutes after they are taken.

"One of the first hurdles we faced was cost," Weaver recalls. "Two years ago when we first embarked on this project, the technology was too expensive. With personal computer prices dropping, we can now offer a system for well under $10,000, a price that would be affordable for most hospital systems. It consists of a Pentium PC platform on each side of the line, equipped with a modem or other communications device and a dedicated hardware board to compress images.

As Weaver envisions it, technicians at local clinics would take ultrasound images much as they do today using the same equipment. Then, instead of being recorded on analog devices like radiographic film or Super VHS videotape, these images would be translated into digital computer files. The technicians would then transmit these files to the radiologists' computer, who would pull them up to read them.

One advantage of the system is what Weaver calls "its scalable architecture." In other words, it adjusts to the quality of the phone link between hospital and clinic, whether it is a state-of-the art ATM fiber optic line or a conventional ISDN connection over ordinary phone lines. The only difference is speed. Over an ATM network, it takes just 0.1 second to transmit a 30-second video clip; over an ISDN line, it takes two minutes.

Another advantage of Weaver's system is that the technology used for recording and displaying video clips is identical to that used for still images, making it easier for radiologists to conduct more extensive evaluations of blood flow or fetal health.

One hurdle was finding compression technology that could be used to send these very large files in acceptable times without losing valuable diagnostic information. Weaver and graduate student Arvind Visawanthan took a variety of typical ultrasound images, from uterine fibroid masses to deep venous thromboses, and processed them using the MPEG compression standard. They asked radiologists attending a meeting of the Radiological Society of North American to identify the resulting images and rate their quality. Most radiologists through the images were at least acceptable and many thought they were excellent.

Weaver's group is looking for a commercial partner to help bring the system to market. "The trend is for hospitals like ours to provide health care to an ever-widening area," Weaver says. "Our teleultrasound system allows hospitals to expand their base while dramatically increasing the speed of routine diagnoses."


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