RESUMO
OBJECTIVE: To evaluate the performance of three tele-echography systems for routine use in isolated medical centers. METHODS: Three systems were used for deep (abdomen, pelvis, fetal) and superficial (muscle, thyroid, carotid artery) examinations: (a) a robotic arm (RA) holding an echographic probe; (b) an echograph with a motorized probe (MP); and (c) remote guidance (RG) where the patient site operator performed the examination assisted by an expert via videoconference. All systems were tested in the same medical center located 60 km away from the university hospital. RESULTS: A total of 340 remote echography examinations were performed (41% RA and MP, 59% RG). MP and RA allowed full control of the probe orientation by the expert, and provided diagnoses in 97% of cases. The use of RG was sufficient for superficial vessel examinations and provided diagnoses in 98% of cases but was not suited for deep or superficial organs. Assessment of superficial organs was best accomplished using the MP. DISCUSSION: Both teleoperated systems provided control of the probe orientation by the expert necessary for obtaining appropriate views of deep organs but the MP was much more ergonomic and easier to use than the RA. RG was appropriate for superficial vessels while the MP was better for superficial volumic organs.
RESUMO
PURPOSE: The objective of this study was to design and validate a "Tele-Operated UltRasound System" ("TOURS") to perform ultrasound examinations on patients located in isolated areas. MATERIALS AND METHODS: A commercially available portable echograph was modified to allow functions (Doppler, two-dimensional, three-dimensional, elastography, etc.) and settings (gain, depth, freeze, record, etc.) to be teleoperated through an Internet connection. Specialized probes were developed that contained motorized transducers that could be teleoperated to change the transducer orientation. The system was installed and tested in four medical centers 50 km, 60 km, 1,800 km, and 7,000 km away from the university hospital. RESULTS: Using the teleoperated system, 100 examinations were performed on the abdomen and pelvis (36%), vascular structures (42%), and small parts (thyroid and muscle, 22%), and 15 were performed on fetuses. During these examinations the expert sonographer was able to teleoperate the echograph and motorized probe to obtain images of sufficient quality for diagnoses in 97% of the cases. The average time for one examination was 17 ± 4 min. This new system (dimensions of 400 cm(3) and weighing 430 g) was found to be more ergonomic that a robotic arm previously developed by us for tele-echography (dimensions of 35 × 40 × 40 cm(3) and weighing 3-4 kg). In addition, the teleoperation of the echograph settings and functions allowed for greater ease in acquiring images, resulting in faster examinations with improved quality images. CONCLUSIONS: The results of this study demonstrate that the teleoperated echograph and probe system developed by our research group can be successfully used for ultrasound examinations in areas isolated from trained sonographers.
