A feasibility study of a protocol for teleradiology diagnostic breast ultrasound has been successfully completed in Kamuli, Uganda, according to a study presented this week in Washington, D.C., at the annual meeting of the American Roentgen Ray Society (ARRS).
The feasibility study, tested in October 2011, was sponsored by Imaging the World, a nonprofit organization dedicated to bringing diagnostic imaging to underserved areas. The organization has multiple obstetrical imaging programs currently in operation in Uganda, and plans to expand both its obstetrics imaging and breast imaging programs.
Chris Duncan, a fourth-year medical student at the University of Vermont in Burlington, explained at a poster presentation how their medical protocol was developed for diagnosing early- to mid-stage breast cancers. In Uganda, most women with the disease are not diagnosed until breast cancer has reached late stages.
The protocol focuses on breast ultrasound as an initial diagnostic tool for evaluating palpable breast masses. The exam should be done by a mid-level healthcare provider such as a nurse or physician's aide.
The ultrasound scan uses a volume-based technique that captures cine clips that can be transmitted for remote interpretation. The images are compressed, uploaded to a server through a cellular telephone network, and interpreted remotely by a radiologist.
After the images are interpreted, results are sent to the clinic where the ultrasound was performed. If a patient needs a biopsy, she is referred to a local hospital. Imaging the World trained local surgeons to perform both fine-needle and core biopsies using ultrasound guidance. If the biopsy confirms cancer, the patient is referred to a major tertiary referral hospital.
Duncan said the Imaging the World team involved with the feasibility study is currently working with the Ugandan health department and other federal government officials about implementing the program. Approval is needed to proceed.
The trip also emphasized the need for patient education. Duncan said he learned that some women in Kamuli believe cancer is contagious, surgery spreads cancer throughout the body, or cancer is the result of curses, evil spirits, and the supernatural.
