Development and assessment of a telesonography system for musculoskeletal imaging

Mohammed Obaid,Haron Obaid,Qianwei Zhang,Reza Fotouhi,Scott J Adams

doi:10.1186/s41747-021-00227-z

Abstract

BackgroundTelesonography systems have been developed to overcome barriers to accessing diagnostic ultrasound for patients in rural and remote communities. However, most previous telesonography systems have been designed for performing only abdominal and obstetrical exams. In this paper, we describe the development and assessment of a musculoskeletal (MSK) telesonography system.MethodsWe developed a 4-degrees-of-freedom (DOF) robot to manipulate an ultrasound probe. The robot was remotely controlled by a radiologist operating a joystick at the master site. The telesonography system was used to scan participants’ forearms, and all participants were conventionally scanned for comparison. Participants and radiologists were surveyed regarding their experience. Images from both scanning methods were independently assessed by an MSK radiologist.ResultsAll ten ultrasound exams were successfully performed using our developed MSK telesonography system, with no significant delay in movement. The duration (mean ± standard deviation) of telerobotic and conventional exams was 4.6 ± 0.9 and 1.4 ± 0.5 min, respectively (p = 0.039). An MSK radiologist rated quality of real-time ultrasound images transmitted over an internet connection as “very good” for all telesonography exams, and participants rated communication with the radiologist as “very good” or “good” for all exams. Visualisation of anatomic structures was similar between telerobotic and conventional methods, with no statistically significant differences.ConclusionsThe MSK telesonography system developed in this study is feasible for performing soft tissue ultrasound exams. The advancement of this system may allow MSK ultrasound exams to be performed over long distances, increasing access to ultrasound for patients in rural and remote communities.

Highlights

Telesonography systems have been developed to overcome barriers to accessing diagnostic ultrasound for patients in rural and remote communities
Telesonography systems allow sonographers or radiologists based at a central site, such as an urban ultrasound clinic or tertiary hospital, to remotely perform ultrasound while patients stay in their home communities [5,6,7,8]
We describe the development of a 4DOF telesonography system to allow experts to remotely control movements of an ultrasound probe and remotely perform MSK ultrasound exams without an assistant at the patient site

Summary

Introduction

Telesonography systems have been developed to overcome barriers to accessing diagnostic ultrasound for patients in rural and remote communities. Medirob Tele (Medirob AB, Skellefteå, Sweden [12]) and ROSE (Sensing Future Technologies, Coimbra, Portugal [13]) are both commercialised 6-DOF robots for telesonography which have a jointed-arm design, and these robots may be well suited for scanning joints such as the shoulder. Another strategy that has been used to facilitate remote ultrasound imaging is adding small motors to ultrasound probes to allow users to remotely control their movement. While motorised linear array probes were used to image muscles in a limited number of patients, a disadvantage is that exams heavily relied on an assistant at the patient site who assisted with all other movements of the ultrasound probe (e.g., translation, rotation, and rocking) to complete the exam [14]

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Conclusion