Date Published: November 19, 2009
Publisher: Public Library of Science
Author(s): Arie Meir, Boris Rubinsky, H. Peter Soyer. http://doi.org/10.1371/journal.pone.0007974
Abstract: Medical technologies are indispensable to modern medicine. However, they have become exceedingly expensive and complex and are not available to the economically disadvantaged majority of the world population in underdeveloped as well as developed parts of the world. For example, according to the World Health Organization about two thirds of the world population does not have access to medical imaging. In this paper we introduce a new medical technology paradigm centered on wireless technology and cloud computing that was designed to overcome the problems of increasing health technology costs. We demonstrate the value of the concept with an example; the design of a wireless, distributed network and central (cloud) computing enabled three-dimensional (3-D) ultrasound system. Specifically, we demonstrate the feasibility of producing a 3-D high end ultrasound scan at a central computing facility using the raw data acquired at the remote patient site with an inexpensive low end ultrasound transducer designed for 2-D, through a mobile device and wireless connection link between them. Producing high-end 3D ultrasound images with simple low-end transducers reduces the cost of imaging by orders of magnitude. It also removes the requirement of having a highly trained imaging expert at the patient site, since the need for hand-eye coordination and the ability to reconstruct a 3-D mental image from 2-D scans, which is a necessity for high quality ultrasound imaging, is eliminated. This could enable relatively untrained medical workers in developing nations to administer imaging and a more accurate diagnosis, effectively saving the lives of people.
Partial Text: During the last century, major advances in medical technology have led to substantial improvements in health care. This has come at a cost; the health care technology has become complex and expensive which, in turn, has led to a very wide disparity in health care delivery between those who have the financial resources to benefit from the advanced medical technology and those that do not. The ultimate outcome of this situation is that the majority of the world population does not have access to advanced medical technology and advanced health care. For instance, according to WHO reports, “Around 95% of medical technology in developing countries is imported, much of which does not meet the needs of national health care systems. Over 50% of equipment is not being used, either because of a lack of maintenance or spare parts, because it is too sophisticated or in disrepair, or simply because the health personnel do not know how to use it.” . This situation is particularly acute in the field of medical imaging, which is required for correct diagnostic in about 20% to 30% of cases worldwide and which is not available to over 60% of the world population . The challenges in diagnostic imaging in developing countries include: a severe lack of safe and appropriate diagnostic imaging services because of the cost and complexity of the devices as well as a severe lack of technical skills and trained radiographers/technologists leading to a large number of images being misread or of poor quality and therefore of no diagnostic use .
The system architecture aligned with the proposed general paradigm is shown to contain two major components: Mobile Console and Remote Expert System (Fig. 1a). The mobile console with its sensors acts as the data acquisition device which collects the raw data from the patient, and sends it to the remote server for processing. The processing server is capable of transforming the large amount of otherwise meaningless measurements into a human understandable form such as an image or diagnosis.
We’ve shown in this work the feasibility of performing a 3D ultrasound scan using an inexpensive ultrasound transducer designed for 2-D, a mobile device, a remote processing station and a wireless connection link between them. Acquiring 3D ultrasound data removes the requirement of having a highly trained expert since hand-eye coordination process becomes obsolete. This enables medical workers in developing nations to administer a more accurate diagnosis, effectively saving the lives of people who would have otherwise been misdiagnosed.
We will describe here the details of the 3-D ultrasound system implemented in this study using the general raw data transfer and data processing algorithm described in Fig. 1. Ultrasound imaging utilizes acoustic waves for the mapping of internal organs and tissues from changes in acoustic impedance between the tissues. Ultrasound works by sending acoustic pulse waves towards the mapped organ and then reconstructing the echoes of those waves into a visual image used for medical diagnosis. Due to the relatively compact size and low power consumption, ultrasound provides an important alternative to other medical imaging modalities such as CT and MRI.