Title
Testing telediagnostic thyroid ultrasound in Peru: a new horizon in expanding access to imaging in rural and underserved areas
Date Issued
01 December 2021
Access level
open access
Resource Type
journal article
Author(s)
Marini T.J.
Weiss S.L.
Gupta A.
Zhao Y.T.
Baran T.M.
Garra B.
Shafiq I.
Oppenheimer D.C.
Ortega R.L.
Quinn R.A.
Kan J.
Dozier A.M.
Tamayo L.
Carlotto C.
Publisher(s)
Springer Science and Business Media Deutschland GmbH
Abstract
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.
Start page
2699
End page
2708
Volume
44
Issue
12
Language
English
OCDE Knowledge area
Ingeniería médica
Subjects
Scopus EID
2-s2.0-85105574089
PubMed ID
Source
Journal of Endocrinological Investigation
ISSN of the container
03914097
Sponsor(s)
We thank Medical Imaging Ministries of the Americas and Medical Innovation and Technology for allowing the publication of their illustrated poster and video. We thank Dr. Deborah Rubens, Dr. Michael Potchen, and Dr. Gretchen Birbeck for their mentorship, global health knowledge, and thyroid ultrasound expertise. We thank Nadezhda Kiriyak, Sarah Klingenberger, Jane Lichorowic, and Gwen Mack for their assistance with the figures and illustrations.
Sources of information:
Directorio de Producción Científica
Scopus