TELEMEDICINE CONFERENCE

Previously Published Papers on "Telemedicine Conference"

• Development of a Telemedical Network Supporting an Automated Flow Cytometric Analysis for the Clinical Follow-up of Leukaemia

  Authors: Claude Takenga, Rolf-Dietrich Berndt, Erling Si, Markus Diem, Guohui Qiao, Melanie Gau, Michael Brandstoetter, Martin Kampel, Michael Dworzak, Keywords: Data security, flow cytometry, leukaemia, telematics platform, telemedicine. DOI:10.5281/zenodo.1127082 Abstract: In patients with acute lymphoblastic leukaemia (ALL), treatment response is increasingly evaluated with minimal residual disease (MRD) analyses. Flow Cytometry (FCM) is a fast and sensitive method to detect MRD. However, the interpretation of these multi-parametric data requires intensive operator training and experience. This paper presents a pipeline-software, as a ready-to-use FCM-based MRD-assessment tool for the daily clinical practice for patients with ALL. The new tool increases accuracy in assessment of FCM-MRD in samples which are difficult to analyse by conventional operator-based gating since computer-aided analysis potentially has a superior resolution due to utilization of the whole multi-parametric FCM-data space at once instead of step-wise, two-dimensional plot-based visualization. The system developed as a telemedical network reduces the work-load and lab-costs, staff-time needed for training, continuous quality control, operator-based data interpretation. It allows dissemination of automated FCM-MRD analysis to medical centres which have no established expertise for the benefit of an even larger community of diseased children worldwide. We established a telemedical network system for analysis and clinical follow-up and treatment monitoring of Leukaemia. The system is scalable and adapted to link several centres and laboratories worldwide.

• The Digital Microscopy in Organ Transplantation: Ergonomics of the Tele-Pathological Evaluation of Renal, Liver and Pancreatic Grafts

  Authors: C. S. Mammas, A. Lazaris, A. S. Mamma-Graham, G. Kostopanagiotou, C. Lemonidou, J. Mantas, E. Patsouris, Keywords: Organ Transplantation, Tele-Pathology, Digital Microscopy, Virtual Slides. DOI:10.5281/zenodo.1109910 Abstract: Introduction: The process to build a better safety culture, methods of error analysis, and preventive measures, starts with an understanding of the effects when human factors engineering refer to remote microscopic diagnosis in surgery and specially in organ transplantation for the remote evaluation of the grafts. It has been estimated that even in well-organized transplant systems an average of 8% to 14% of the grafts (G) that arrive at the recipient hospitals may be considered as diseased, injured, damaged or improper for transplantation. Digital microscopy adds information on a microscopic level about the grafts in Organ Transplant (OT), and may lead to a change in their management. Such a method will reduce the possibility that a diseased G, will arrive at the recipient hospital for implantation. Aim: Ergonomics of Digital Microscopy (DM) based on virtual slides, on Telemedicine Systems (TS) for Tele-Pathological (TPE) evaluation of the grafts (G) in organ transplantation (OT). Material and Methods: By experimental simulation, the ergonomics of DM for microscopic TPE of Renal Graft (RG), Liver Graft (LG) and Pancreatic Graft (PG) tissues is analyzed. In fact, this corresponded to the ergonomics of digital microscopy for TPE in OT by applying Virtual Slide (VS) system for graft tissue image capture, for remote diagnoses of possible microscopic inflammatory and/or neoplastic lesions. Experimentation included: a. Development of an OTE-TS similar Experimental Telemedicine System (Exp.-TS), b. Simulation of the integration of TS with the VS based microscopic TPE of RG, LG and PG applying DM. Simulation of the DM based TPE was performed by 2 specialists on a total of 238 human Renal Graft (RG), 172 Liver Graft (LG) and 108 Pancreatic Graft (PG) tissues digital microscopic images for inflammatory and neoplastic lesions on four electronic spaces of the four used TS. Results: Statistical analysis of specialist‘s answers about the ability to diagnose accurately the diseased RG, LG and PG tissues on the electronic space among four TS (A,B,C,D) showed that DM on TS for TPE in OT is elaborated perfectly on the ES of a Desktop, followed by the ES of the applied Exp.-TS. Tablet and Mobile-Phone ES seem significantly risky for the application of DM in OT (p

• Screening of Congenital Heart Diseases with Fetal Phonocardiography

  Authors: F. Kovács, K. Kádár, G. Hosszú, Á. T. Balogh, T. Zsedrovits, N. Kersner, A. Nagy, Gy. Jeney, Keywords: Cardiac murmurs, fetal phonocardiography, screening of CHDs, telemedicine system. DOI:10.5281/zenodo.1107081 Abstract: The paper presents a novel screening method to indicate congenital heart diseases (CHD), which otherwise could remain undetected because of their low level. Therefore, not belonging to the high-risk population, the pregnancies are not subject to the regular fetal monitoring with ultrasound echocardiography. Based on the fact that CHD is a morphological defect of the heart causing turbulent blood flow, the turbulence appears as a murmur, which can be detected by fetal phonocardiography (fPCG). The proposed method applies measurements on the maternal abdomen and from the recorded sound signal a sophisticated processing determines the fetal heart murmur. The paper describes the problems and the additional advantages of the fPCG method including the possibility of measurements at home and its combination with the prescribed regular cardiotocographic (CTG) monitoring. The proposed screening process implemented on a telemedicine system provides an enhanced safety against hidden cardiac diseases.

• Smartphones for In-home Diagnostics in Telemedicine

  Authors: Nálevka Petr, Keywords: Smartphones, Actigraphy, Telemedicine, In-home Diagnostics DOI:10.5281/zenodo.1081499 Abstract: Many contemporary telemedical applications rely on regular consultations over the phone or video conferencing which consumes valuable resources such as the time of the doctors. Some applications or treatments allow automated diagnostics on the patient side which only notifies the doctors in case a significant worsening of patient’s condition is measured. Such programs can save valuable resources but an important implementation issue is how to ensure effective and cheap diagnostics on the patient side. First, specific diagnostic devices on patient side are expensive and second, they need to be user-˜friendly to encourage patient’s cooperation and reduce errors in usage which may cause noise in diagnostic data. This article proposes the use of modern smartphones and various build-in or attachable sensors as universal diagnostic devices applicable in a wider range of telemedical programs and demonstrates their application on a case-study – a program for schizophrenic relapse prevention.

• Quality Evaluation of Compressed MRI Medical Images for Telemedicine Applications

  Authors: Seddeq E. Ghrare, Salahaddin M. Shreef, Keywords: Medical Image, Magnetic Resonance Imaging, Image Compression, Discrete Wavelet Transform, Telemedicine. DOI:10.5281/zenodo.1077665 Abstract: Medical image modalities such as computed tomography (CT), magnetic resonance imaging (MRI), ultrasound (US), X-ray are adapted to diagnose disease. These modalities provide flexible means of reviewing anatomical cross-sections and physiological state in different parts of the human body. The raw medical images have a huge file size and need large storage requirements. So it should be such a way to reduce the size of those image files to be valid for telemedicine applications. Thus the image compression is a key factor to reduce the bit rate for transmission or storage while maintaining an acceptable reproduction quality, but it is natural to rise the question of how much an image can be compressed and still preserve sufficient information for a given clinical application. Many techniques for achieving data compression have been introduced. In this study, three different MRI modalities which are Brain, Spine and Knee have been compressed and reconstructed using wavelet transform. Subjective and objective evaluation has been done to investigate the clinical information quality of the compressed images. For the objective evaluation, the results show that the PSNR which indicates the quality of the reconstructed image is ranging from (21.95 dB to 30.80 dB, 27.25 dB to 35.75 dB, and 26.93 dB to 34.93 dB) for Brain, Spine, and Knee respectively. For the subjective evaluation test, the results show that the compression ratio of 40:1 was acceptable for brain image, whereas for spine and knee images 50:1 was acceptable.

• Telemedicine and Medical Informatics: The Global Approach

  Authors: F. Lievens, M. Jordanova, Keywords: E-Health/telemedicine, networking, medical informatics. DOI:10.5281/zenodo.1072768 Abstract: Telemedicine is brought to life by contemporary changes of our world and summarizes the entire range of services that are at the crossroad of traditional healthcare and information technology. It is believed that eHealth can help in solving critical issues of rising costs, care for ageing and housebound population, staff shortage. It is a feasible tool to provide routine as well as specialized health service as it has the potential to improve both the access to and the standard of care. eHealth is no more an optional choice. It has already made quite a way but it still remains a fantastic challenge for the future requiring cooperation and coordination at all possible levels. The strategic objectives of this paper are: 1. To start with an attempt to clarify the mass of terms used nowadays; 2. To answer the question “Who needs eHealth"; 3. To focus on the necessity of bridging telemedicine and medical (health) informatics as well as on the dual relationship between them; as well as 4. To underline the need of networking in understanding, developing and implementing eHealth.

• A Multimedia Telemonitoring Network for Healthcare

  Authors: Hariton N. Costin, Sorin Puscoci, Cristian Rotariu, Bogdan Dionisie, Marinela C. Cimpoesu, Keywords: Healthcare, telemedicine, telemonitoring, ECG analysis. DOI:10.5281/zenodo.1331103 Abstract: TELMES project aims to develop a securized multimedia system devoted to medical consultation teleservices. It will be finalized with a pilot system for a regional telecenters network that connects local telecenters, having as support multimedia platforms. This network will enable the implementation of complex medical teleservices (teleconsulations, telemonitoring, homecare, urgency medicine, etc.) for a broader range of patients and medical professionals, mainly for family doctors and those people living in rural or isolated regions. Thus, a multimedia, scalable network, based on modern IT&C paradigms, will result. It will gather two inter-connected regional telecenters, in Iaşi and Piteşti, Romania, each of them also permitting local connections of hospitals, diagnostic and treatment centers, as well as local networks of family doctors, patients, even educational entities. As communications infrastructure, we aim to develop a combined fixmobile- internet (broadband) links. Other possible communication environments will be GSM/GPRS/3G and radio waves. The electrocardiogram (ECG) acquisition, internet transmission and local analysis, using embedded technologies, was already successfully done for patients- telemonitoring.

• 3D Segmentation, Compression and Wireless Transmission of Volumetric Brain MR Images

  Authors: K. Aloui, M. S. Naceur, Keywords: Medical imaging, level-sets, compression, meshessimplification, telemedicine, wireless transmission. DOI:10.5281/zenodo.1058629 Abstract: The main objective of this paper is to provide an efficient tool for delineating brain tumors in three-dimensional magnetic resonance images and set up compression-transmit schemes to distribute result to the remote doctor. To achieve this goal, we use basically a level-sets approach to delineating brain tumors in threedimensional. Then introduce a new compression and transmission plan of 3D brain structures based for the meshes simplification, adapted for time to the specific needs of the telemedicine and to the capacities restricted by wireless network communication. We present here the main stages of our system, and preliminary results which are very encouraging for clinical practice.

• Comparison of Valuation Techniques for Bone Age Assessment

  Authors: N. Olarte L, A. Rubiano F, A. Mejía F., Keywords: Atlas, Bone Age Assessment, Hand and Wrist Radiograph, Image Processing DOI:10.5281/zenodo.1329681 Abstract: This comparison of valuation techniques for bone age assessment is a work carried out by the Telemedicine Research Group of the Military University - TIGUM, as a preliminary to the Design and development a treatment system of hand and wrist radiological images for children aged 0-6 years to bone age assessment . In this paper the techniques mentioned for decades have been the most widely used and the statistically significant. Althought, initially with the current project, it wants to work with children who have limit age, this comparison and evaluation techniques work will help in the future to expand the study subject in the system to bone age assessment, implementing more techniques, tools and deeper analysis to accomplish this purpose.