On The Move Ultrasound Diagnosis on Mobile Humayun Irshad 1, Sajjad Athar 1, Faisal Shahzad 1,2, Adnan Bashir 1,2, Dr. Farhat Jehan 3 1 Next Generation Intelligent Networks Research Center (nexgin RC), 2 National University of Computer and Emerging Sciences (FAST-NUCES), Islamabad 3 Telemedinice and e-health Training, Holy Family Hospital Rawalpindi http://rpms.nexginrc.org/ http://www.nexginrc.org/
Agenda 1 Background 2 Objectives 3 Methods 4 Comparative Studies 5 Image Processing 6 Future Goals 7 Questions 10/14/2013 Ultrasound Diagnosis on Mobile 2
Background Health care situation in Pakistan is below the international standards due to scarcity and unavailability of specialists Lack of Health Infrastructure Shortage of trained Radiologists Few Radiologists specially in remote areas Poor antenatal facilities in remote areas 10/14/2013 Ultrasound Diagnosis on Mobile 3
Solutions 1. Increase the number of radiologists and send the radiologists to remote areas 2. Use of Information and Communication Technology (ICT) to improve efficiency of existing health care facilities 10/14/2013 Ultrasound Diagnosis on Mobile 4
Idea Tools Connectivity Patients Health Care Professionals 10/14/2013 Ultrasound Diagnosis on Mobile 5
Development of system to extend the services of radiologist to remote areas
System Architecture 10/14/2013 Ultrasound Diagnosis on Mobile 7
System Features & Methodology Developed a web interface to upload ultrasound images and patient medical data Developed a web server and EMR for data storage and interaction with Mobile applications and CDSS Developed an application for radiologists to diagnosis ultrasound on mobile Implemented image processing techniques for image content enhancement, noise removal and transmission Implemented the algorithms for image zooming SMS based notification and alerts for radiologists 10/14/2013 Ultrasound Diagnosis on Mobile 8
System Flow Web Site GPRS Server EMR Ultrasound Machine Patient Doctor GSM CDSS 10/14/2013 Ultrasound Diagnosis on Mobile 9
Website 10/14/2013 Ultrasound Diagnosis on Mobile 10
Methodology Equipment InnovaSound Ultrasound System: Direct Medical Systems 3.5 MHz Probe connected to Laptop
Mobile Application Enable Doctors to view Patient History Enable Doctors to views Ultrasound Images Give Feedback back to server Server send SMS to doctor and patient about any update 10/14/2013 Ultrasound Diagnosis on PDA 12
Mobile Application 10/14/2013 Ultrasound Diagnosis on Mobile 13
Mobile Application 10/14/2013 Ultrasound Diagnosis on Mobile 14
Research Study In hospital evaluation of the system before incorporating into routine practice.
Research Study Collected data of 60 patients from the Holy Family Hospital Each record contains specific ultrasound images Two way to diagnose: Laptop Mobile 10/14/2013 Ultrasound Diagnosis on PDA 16
Results Mean Age 42 (SD 13) Male 11 Female 49
Surgical Conditions Hepatobiliary Cholelithiais 16 Chronic Liver Disease 6 Liver Abscess 2 Urinary Nephrolithiasis/ Hydronephrosis 4 Bladder Calculi 2 Hypertrophy of Prostate 7
Gynae/Obst Conditions Gynecological Fibroids 8 Adnexal mass 6 Obstetrics Antenatal Scan 9
Results Frequency Percent Valid Percent Cumulative Percent Laptop Ultrasound Diagnosis same as Mobile Telesonography 45 75.0 75.0 75.0 Laptop Ultrasound Diagnosis part of differentials of Mobile Telesonography 6 10.0 10.0 85.0 Both Diagnosis Different 9 15.0 15.0 100.0
Comparison of Diagnosis Same diagnosis 51 cases Sensitivity :85 %
Certainty Level in Correct diagnosis Level of Certainty % age very certain 88 % somewhat certain 7 % uncertain 5 %
Satisfaction Level Satisfaction of Distant Radiologist on Mobile Application 48 patients Image relevance & quality of the study
Performance Analysis 70 60 50 40 30 20 10 0 Image Size 10 KB Image Size 20 KB Average Image Access Time (Seconds) Image Size 30 KB Image Size 40 KB Image Size 50 KB Image Size 100 KB Average Image Access Time (Seconds) 10/14/2013 Ultrasound Diagnosis on PDA 24
Website 10/14/2013 Ultrasound Diagnosis on PDA 25
Website 10/14/2013 Ultrasound Diagnosis on PDA 26
Website 10/14/2013 Ultrasound Diagnosis on PDA 27
Future Work & Image Processing Image Segmentation Partitioning of digital image in segments To simplify an image into something that is more meaningful and easier to analyze Feature Extraction Extract important and relevant features for decision making Classification Classify images by observing the features and other relevant data from the EMR and Grand Chart 10/14/2013 Ultrasound Diagnosis on PDA 28
Current Working Original Background Image Noise Removed Enhancement Thresholding 10/14/2013 Ultrasound Diagnosis on PDA 29
Current Working 1-ROI and Partitioning 2-Fuzzy Mean Clustering 10/14/2013 Ultrasound Diagnosis on PDA 30
Current Working 3-Salient Edge Map 4-Contour Extraction and BDP 10/14/2013 Ultrasound Diagnosis on PDA 31
Current Working 5-Deforming Snake 6-Deforming Snake 10/14/2013 Ultrasound Diagnosis on PDA 32
Grand Chart (Femur Length Growth) 10/14/2013 Ultrasound Diagnosis on PDA 33
Grand Chart 10/14/2013 Ultrasound Diagnosis on PDA 34
Thank you Questions? 10/14/2013 Ultrasound Diagnosis on PDA 35