Volume sweep imaging lung teleultrasound for detection of COVID-19 in Peru: a multicentre pilot study

• Published in: BMJ open 2022-10, Vol.12 (10), p.e061332
• Main Authors: Marini, Thomas J, Kaproth-Joslin, Katherine, Ambrosini, Robert, Baran, Timothy M, Dozier, Ann M, Zhao, Yu T, Satheesh, Malavika, Mahony Reátegui-Rivera, Christian, Sifuentes, Walter, Rios-Mayhua, Gloria, Castaneda, Benjamin
• Format: Article
• Language: English
• Subjects: Adult; Chest imaging; Child; Coronaviruses; COVID-19; COVID-19 - diagnostic imaging; Global Health; Humans; Lung - diagnostic imaging; Medical diagnosis; Pandemics; Peru - epidemiology; Pilot Projects; RADIOLOGY & IMAGING; Reproducibility of Results; RESPIRATORY MEDICINE (see Thoracic Medicine); Telemedicine; Ultrasonic imaging; Ultrasonography - methods; Ultrasound
• ISSN: 2044-6055; 2044-6055
• DOI: 10.1136/bmjopen-2022-061332

ObjectivesPulmonary disease is a significant cause of morbidity and mortality in adults and children, but most of the world lacks diagnostic imaging for its assessment. Lung ultrasound is a portable, low-cost, and highly accurate imaging modality for assessment of pulmonary pathology including pneumonia, but its deployment is limited secondary to a lack of trained sonographers. In this study, we piloted a low-cost lung teleultrasound system in rural Peru during the COVID-19 pandemic using lung ultrasound volume sweep imaging (VSI) that can be operated by an individual without prior ultrasound training circumventing many obstacles to ultrasound deployment.DesignPilot study.SettingStudy activities took place in five health centres in rural Peru.ParticipantsThere were 213 participants presenting to rural health clinics.InterventionsIndividuals without prior ultrasound experience in rural Peru underwent brief training on how to use the teleultrasound system and perform lung ultrasound VSI. Subsequently, patients attending clinic were scanned by these previously ultrasound-naïve operators with the teleultrasound system.Primary and secondary outcome measuresRadiologists examined the ultrasound imaging to assess its diagnostic value and identify any pathology. A random subset of 20% of the scans were analysed for inter-reader reliability.ResultsLung VSI teleultrasound examinations underwent detailed analysis by two cardiothoracic attending radiologists. Of the examinations, 202 were rated of diagnostic image quality (94.8%, 95% CI 90.9% to 97.4%). There was 91% agreement between radiologists on lung ultrasound interpretation among a 20% sample of all examinations (κ=0.76, 95% CI 0.53 to 0.98). Radiologists were able to identify sequelae of COVID-19 with the predominant finding being B-lines.ConclusionLung VSI teleultrasound performed by individuals without prior training allowed diagnostic imaging of the lungs and identification of sequelae of COVID-19 infection. Deployment of lung VSI teleultrasound holds potential as a low-cost means to improve access to imaging around the world.