Skip to main content
SpringerLink
Log in

A 5G-based telerobotic ultrasound system provides qualified abdominal ultrasound services for patients on a rural island: a prospective and comparative study of 401 patients

  • Practice
  • Published:
Abdominal Radiology Aims and scope Submit manuscript

Abstract

Purpose

To explore the feasibility of a 5G-based telerobotic ultrasound (US) system for providing qualified abdominal US services on a rural island.

Methods

This prospective study involved two medical centers (the tele-radiologist site’s hospital and the patient site’s hospital) separated by 72 km. Patients underwent 5G-based telerobotic US by tele-radiologists and conventional US by on-site radiologists from September 2020 to March 2021. The clinical feasibility and diagnostic performance of the 5G-based telerobotic abdominal US examination were assessed based on safety, duration, image quality, diagnostic findings, and questionnaires.

Results

A total of 401 patients (217 women and 184 men; mean age, 54.96 ± 15.43 years) were enrolled. A total of 90.1% of patients indicated no discomfort with the telerobotic US examination. For the examination duration, telerobotic US took longer than conventional US (12.54 ± 3.20 min vs. 7.23 ± 2.10 min, p = 0.001). For image quality scores, the results of the two methods were similar (4.54 ± 0.63 vs. 4.57 ± 0.61, p = 0.112). No significant differences were found between the two methods in measurements for the aorta, portal vein, gallbladder, kidney (longitudinal diameter), prostate, and uterus; however, telerobotic US underestimated the transverse diameter of the kidney (p < 0.05). A total of 504 positive results, including 31 different diseases, were detected. Among them, 455 cases were identified by the two methods; 17 cases were identified by telerobotic US only; and 32 cases were identified by conventional US only. There was good consistency in the diagnosis of 29 types of disease between the two methods (κ = 0.773–1.000). Furthermore, more than 90% of patients accepted the telerobotic US examination and agreed to pay additional fees in future.

Conclusion

The 5G-based telerobotic US system can expand access to abdominal US services for patients in rural areas, thereby reducing health care disparities.

Graphical abstract

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3
Fig. 4
Fig. 5
Fig. 6

Similar content being viewed by others

Abbreviations

US:

Ultrasound

5G:

Fifth generation

DOF:

Degree of freedom

BMI:

Body mass index

References

  1. Hashimoto BE, Abramson SJ, Coley BD, Harris RD, Yeo L. (2012) AIUM practice guideline for the performance of an ultrasound examination of the abdomen and/or retroperitoneum. J Ultrasound Med, 31(8):1301-1312. https://doi.org/10.7863/jum.2012.31.8.1301

    Article  Google Scholar 

  2. Uschnig C, Recker F, Blaivas M, Dong Y, Dietrich CF. (2022) Tele-ultrasound in the era of COVID-19: a practical guide. Ultrasound Med Biol, 48(6): 965-974. https://doi.org/10.1016/j.ultrasmedbio.2022.01.001

    Article  PubMed  PubMed Central  Google Scholar 

  3. Lockhart ME, Robbin ML, Berland LL, Smith JK, Canon CL, Stanley RJ. (2003) The sonographer practitioner: one piece to the radiologist shortage puzzle. J Ultrasound Med, 22(9): 861-864. https://doi.org/10.7863/jum.2003.22.9.861

    Article  PubMed  Google Scholar 

  4. Mollura DJ, Soroosh G, Culp MP, et al. (2017) 2016 RAD-AID conference on international radiology for developing countries: gaps, growth, and united nations sustainable development goals. J Am Coll Radiol, 14(16): 841-847. https://doi.org/10.1016/j.jacr.2017.01.049

    Article  PubMed  Google Scholar 

  5. Adams SJ, Burbridge B, Chatterson L, Babyn P, Mendez I. (2022) A telerobotic ultrasound clinic model of ultrasound service delivery to improve access to imaging in rural and remote communities. J Am Coll Radiol; 19(1 Pt B): 162-171. https://doi.org/10.1016/j.jacr.2021.07.023

  6. Avgousti S, Christoforou EG, Panayides AS, Voskarides S, Novales C, Nouaille L, Pattichis CS, Vieyres P. (2016) Medical telerobotic systems: current status and future trends. Biomed Eng Online, 15(1): 96. https://doi.org/10.1186/s12938-016-0217-7

    Article  PubMed  PubMed Central  Google Scholar 

  7. Adams SJ, Burbridge B, Obaid H, Stoneham G, Babyn P, Mendez I. (2021) Telerobotic sonography for remote diagnostic imaging: narrative review of current developments and clinical applications. J Ultrasound Med, 40(7): 1287-1306. https://doi.org/10.1002/jum.15525

    Article  PubMed  Google Scholar 

  8. Villani S, Pana J, Madubuobi H, Browne IL, Kimbrow LA, Reece SCM. (2023) Telerobotic sonography for remote diagnostic imaging. J Ultrasound Med, 42(6): 1375–1376. https://doi.org/10.1002/jum.16149

    Article  PubMed  Google Scholar 

  9. Sun YK, Li XL, Wang Q, Zhou BY, Zhu AQ, Qin C, Guo LH, Xu HX. (2022) Improving the quality of breast ultrasound examination performed by inexperienced ultrasound doctors with synchronous tele-ultrasound: a prospective, parallel controlled trial. Ultrasonography, 41(2): 307-316. https://doi.org/10.14366/usg.21081

    Article  PubMed  Google Scholar 

  10. Li XL, Sun YK, Wang Q, Chen ZT, Qian ZB, Guo LH, Xu HX. (2022) Synchronous tele-ultrasonography is helpful for a naive operator to perform high-quality thyroid ultrasound examinations. Ultrasonography, 41(4): 650-660. https://doi.org/10.14366/usg.21204

    Article  PubMed  PubMed Central  CAS  Google Scholar 

  11. Adams SJ, Burbridge BE, Badea A, Langford L, Vergara V, Bryce R, Bustamante L, Mendez IM, Babyn PS. (2017) Initial experience using a telerobotic ultrasound system for adult abdominal sonography. Can Assoc Radiol J, 68 (3): 308-314. https://doi.org/10.1016/j.carj.2016.08.002

    Article  PubMed  Google Scholar 

  12. Georgescu M, Sacccomandi A, Baudron B, Arbeille PL. (2016) Remote sonography in routine clinical practice between two isolated medical centers and the university hospital using a robotic arm: a 1-year study. Telemed J E Health, 22(4): 276-281. https://doi.org/10.1089/tmj.2015.0100

    Article  PubMed  Google Scholar 

  13. Avgousti S, Panayides AS, Jossif AP, Christoforou EG, Vieyres P, Novales C, Voskarides S, Pattichis CS. (2016) Cardiac ultrasonography over 4G wireless networks using a tele-operated robot. Healthc Technol Lett, 3(3): 212-217. https://doi.org/10.1049/htl.2016.0043

    Article  PubMed  PubMed Central  Google Scholar 

  14. Arbeille P, Capri A, Ayoub J, Kieffer V, Georgescu M, Poisson G. (2007) Use of a robotic arm to perform remote abdominal telesonography. AJR Am J Roentgenol, 188(4): W317-322. https://doi.org/10.2214/AJR.05.0469

    Article  PubMed  Google Scholar 

  15. Arbeille P, Zuj K, Saccomandi A, Ruiz J, Andre E, de la Porte C, Carles G, Blouin J, Georgescu M. (2016) Teleoperated echograph and probe transducer for remote ultrasound investigation on isolated patients (Study of 100 Cases). Telemed J E Health, 22(7): 599-607. https://doi.org/10.1089/tmj.2015.0186

    Article  PubMed  Google Scholar 

  16. Duan B, Xiong L, Guan X, Fu Y, Zhang Y. (2021) Tele-operated robotic ultrasound system for medical diagnosis. Biomedical Signal Processing and Control, 70(1):102900. https://doi.org/10.1016/j.bspc.2021.102900

    Article  Google Scholar 

  17. He T, Pu YY, Zhang YQ, Qian ZB, Guo LH, Sun LP, Zhao CK, Xu HX. (2023) 5G-Based Telerobotic ultrasound system improves access to breast examination in rural and remote areas: a prospective and two-scenario study. Diagnostics, 13(3): 326. https://doi.org/10.3390/diagnostics13030362

    Article  CAS  Google Scholar 

  18. Zhang YQ, Yin HH, He T, Guo LH, Zhao CK, Xu HX. (2022) Clinical application of a 5G-based telerobotic ultrasound system for thyroid examination on a rural island: a prospective study. Endocrine, 76(3): 620–634. https://doi.org/10.1007/s12020-022-03011-0

    Article  PubMed  PubMed Central  CAS  Google Scholar 

  19. Adams SJ, Burbridge B, Chatterson L, McKinney V, Babyn P, Mendez I. (2022) Telerobotic ultrasound to provide obstetrical ultrasound services remotely during the COVID-19 pandemic. J Telemed Telecare, 28(8): 568–576. https://doi.org/10.1177/1357633X20965422

    Article  PubMed  Google Scholar 

  20. Ye R, Zhou X, Shao F, Xiong L, Hong J, Huang H, Tong W, Wang J, Chen S, Cui A, Peng C, Zhao Y, Chen L. (2021) Feasibility of a 5G-based robot-assisted remote ultrasound system for cardiopulmonary assessment of patients with coronavirus disease 2019. Chest 2021; 159:270-281. https://doi.org/10.1016/j.chest.2020.06.068

    Article  PubMed  CAS  Google Scholar 

  21. Salem S, Cargill Y, Fong K. (2016) Joint CAR/SOGC statement on performing ultrasound examinations of the female pelvis. J Obstet Gynaecol Can, 38(1): 84-93. https://doi.org/10.1016/j.jogc.2015.10.001

    Article  PubMed  Google Scholar 

  22. Salomon LJ, Alfirevic Z, Bilardo CM, Chalouhi GE, Ghi T, Kagan KO, Lau TK, Papageorghiou AT, Raine-Fenning NJ, Stirnemann J, Suresh S, Tabor A, Timor-Tritsch IE, Toi A, Yeo G. (2013) ISUOG practice guidelines: performance of first-trimester fetal ultrasound scan. Ultrasound Obstet Gynecol, 41(1):102-113. https://doi.org/10.1002/uog.12342

    Article  PubMed  CAS  Google Scholar 

  23. Salomon LJ, Alfirevic Z, Da Silva Costa F, Deter RL, Figueras F, Ghi T, Glanc P, Khalil A, Lee W, Napolitano, R, Papageorghiou A, Sotiriadis A, Stirnemann J, Toi A, Yeo G. (2019) ISUOG practice guidelines: ultrasound assessment of fetal biometry and growth. Ultrasound Obstet Gynecol, 53(6):715-723. https://doi.org/10.1002/uog.20272

    Article  PubMed  CAS  Google Scholar 

  24. Adams SJ, Babyn P, Burbridge B, Tang R, Mendez I. (2021) Access to ultrasound imaging: a qualitative study in two northern, remote, Indigenous communities in Canada. International journal of circumpolar health, 80(1):1961392. https://doi.org/10.1080/22423982.2021.1961392

    Article  PubMed  PubMed Central  Google Scholar 

  25. Khov N, Sharma A, Riley TR. (2014) Bedside ultrasound in the diagnosis of nonalcoholic fatty liver disease. World J Gastroenterol. 20(22): 6821-6825. https://doi.org/10.3748/wjg.v20.i22.6821

    Article  PubMed  PubMed Central  Google Scholar 

  26. Kamin RA, Nowicki TA, Courtney DS, Powers RD. (2003) Pearls and pitfalls in the emergency department evaluation of abdominal pain. Emerg Med Clin North Am, 21(1):61-72. https://doi.org/10.1016/s0733-8627(02)00080-9

    Article  PubMed  Google Scholar 

  27. Shah K, Wolfe RE. (2004) Hepatobiliary ultrasound. Emerg Med Clin North Am, 22(3): 661-73. https://doi.org/10.1016/j.emc.2004.04.015

    Article  PubMed  Google Scholar 

  28. Moore CL, Carpenter CR, Heilbrun ML, Klauer K, Krambeck AC, Moreno C, Remer EM, Scales C, Shaw MM, Sternberg KM. (2019) Imaging in suspected renal colic: systematic review of the literature and multispecialty consensus. J Urol, 202(3): 475-483. https://doi.org/10.1097/JU.0000000000000342

    Article  PubMed  Google Scholar 

  29. Recker F, Weber E, Strizek B, Gembruch U, Westerway SC, Dietrich CF. (2021) Point-of-care ultrasound in obstetrics and gynecology. Arch Gynecol Obstet, 303(4): 871-876. https://doi.org/10.1007/s00404-021-05972-5

    Article  PubMed  PubMed Central  Google Scholar 

  30. Papp Z, Fekete T. (2003) The evolving role of ultrasound in obstetrics/gynecology practice. Int J Gynaecol Obstet, 82(3): 339-346. https://doi.org/10.1016/s0020-7292(03)00224-8

    Article  PubMed  CAS  Google Scholar 

Download references

Acknowledgements

We would like to acknowledge the effort and support of all authors in the study.

Funding

This work was supported in part by the National Natural Science Foundation of China (Grant 82202174), the Science and Technology Commission of Shanghai Municipality (Grants 18441905500 and 19DZ2251100), Shanghai Municipal Health Commission (Grants 2019LJ21 and SHSLCZDZK03502), Shanghai Science and Technology Innovation Action Plan (21Y11911200), and Fundamental Research Funds for the Central Universities (ZD-11-202151), Scientific Research and Development Fund of Zhongshan Hospital of Fudan University (Grant 2022ZSQD07).

Author information

Author notes

  1. Ya-Qin Zhang, Li-Ping Sun and Tian He have contributed equally.

Authors and Affiliations

  1. Department of Medical Ultrasound, Center of Minimally Invasive Treatment for Tumor, Shanghai Tenth People’s Hospital, School of Medicine, Tongji University, Shanghai, 200072, China

    Ya-Qin Zhang, Li-Ping Sun, Tian He, Le-Hang Guo, Hui Liu, Guang Xu, Hui Zhao, Qiao Wang & Jing Wang

  2. Shanghai Engineering Research Center of Ultrasound Diagnosis and Treatment, Shanghai, 200072, China

    Ya-Qin Zhang, Li-Ping Sun, Tian He, Le-Hang Guo, Hui Liu, Guang Xu, Hui Zhao, Qiao Wang & Jing Wang

  3. Department of Medical Ultrasound, Shanghai Tenth People’s Hospital Chongming Branch, Shanghai, 200072, China

    Kai-Feng Yang & Guo-Chao Song

  4. Department of Ultrasound, Zhongshan Hospital, Institute of Ultrasound in Medicine and Engineering, Fudan University, Shanghai, 200032, China

    Ya-Qin Zhang, Bo-Yang Zhou, Hui-Xiong Xu & Chong-Ke Zhao

Authors
  1. Ya-Qin Zhang
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Li-Ping Sun
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Tian He
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Le-Hang Guo
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Hui Liu
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Guang Xu
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Hui Zhao
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. Qiao Wang
    View author publications

    You can also search for this author in PubMed Google Scholar

  9. Jing Wang
    View author publications

    You can also search for this author in PubMed Google Scholar

  10. Kai-Feng Yang
    View author publications

    You can also search for this author in PubMed Google Scholar

  11. Guo-Chao Song
    View author publications

    You can also search for this author in PubMed Google Scholar

  12. Bo-Yang Zhou
    View author publications

    You can also search for this author in PubMed Google Scholar

  13. Hui-Xiong Xu
    View author publications

    You can also search for this author in PubMed Google Scholar

  14. Chong-Ke Zhao
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding authors

Correspondence to Hui-Xiong Xu or Chong-Ke Zhao.

Ethics declarations

Conflict of interest

The authors declare that they have no conflict of interest.

Guarantor

The scientific guarantors of this publication are Hui-Xiong Xu and Chong-Ke Zhao.

Statistics and biometry

No complex statistical methods were necessary for this paper.

Informed consent

This prospective trial was supported by the ethics board of the institution. All patients gave informed consent.

Ethical approval

This prospective trial was supported by the ethics board of the institutional (Ethics No. SHSY-IEC-5.0/22K149/P01).

Study subjects or cohorts overlap

No study subjects or cohorts have been previously reported in other studies.

Additional information

Publisher's Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Springer Nature or its licensor (e.g. a society or other partner) holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law.

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Zhang, YQ., Sun, LP., He, T. et al. A 5G-based telerobotic ultrasound system provides qualified abdominal ultrasound services for patients on a rural island: a prospective and comparative study of 401 patients. Abdom Radiol 49, 942–957 (2024). https://doi.org/10.1007/s00261-023-04123-5

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00261-023-04123-5

Keywords

Search

Navigation