Teleultrasound useful for making clinical decisions in pediatrics emergencies in remote settings

A new study conducted by Baptiste Morel and his team shows that remote ultrasound can help in pediatric emergencies, especially in remote medical facilities.

The findings have been published in the Journal of Ultrasound in Medicine and Biology.

Ultrasound is now the recommended first-line examination for abdominal disease in children. However, pediatric radiologists are not always on site. Especially when working on-call. Researchers therefore conducted this study with the aim of evaluating the reliability of the innovative virtual 3-D telescoping abdominal ultrasound in this setting.

Between December 2020 and May 2021, a prospective study was conducted and his 103 children undergoing ultrasound for abdominal pain were recruited. Trauma cases were excluded. Four 3D images of him were taken using a Smart Sensor 3D device (Canon Medical Systems, Ohtawara, Japan). Each remote ultrasound examination was blinded secondarily by 2 radiologists (1 senior, 1 resident) using Fusion software (Canon Medical Systems). Acquisition acceptance and quality were assessed on the Likert scale.

The major findings of this study were:

1. Ultrasonography was normal in 66 (64%), abnormal in 36 (35%), and unclear in 1 (1%).

2. In over 95% of cases, records were obtained without objection from the child, their parent, or the operator.

3. Acquisition quality was rated as good to excellent in 84% and 70% of cases, respectively. Sensitivities for chief radiologists and residents were 86% and 84%, respectively.

4. Comparing the results of the standard scan and telescan, the specificity was 95% and 92%, the positive predictive value was 92% and 86%, and the negative predictive value was 92% and 91%.

5. Cohen's kappa coefficients for diagnosis obtained with standard and remote ultrasonography were 0.82 and 0.71, respectively.

6. Interrater Cohen's kappa coefficient was 0.84.

7. The intraclass correlation coefficient between standard abdominal examination and reformatted 3D tele-ultrasound images was 0.99 for the following quantitative variables in pathological cases:

In conclusion, a tele-ultrasound approach could help improve access to imaging and clinical decision-making. This includes minimizing and reducing delays in moving patients to the emergency room for serious illness.

Reference:

Morel, B., Hellec, C., Fievet, A., Taveau, C. S., Abimelech, M., Dujardin, P. A., Brunereau, L., & Patat, F. (2022). Reliability of 3-D Virtual Abdominal Tele-ultrasonography in Pediatric Emergency: Comparison with Standard-of-Care Ultrasound Examination. In Ultrasound in Medicine & Biology. Elsevier BV. https://doi.org/10.1016/j.ultrasmedbio.2022.07.004