Diagnostic performance of a teleradiology system in primary health care

Open health care needs proper basic radiological services. Teleradiology makes it possible to get the radiologist's consultation in rural and remote areas and allows the transmission of images between hospitals. A microcomputer-based teleradiology system using a 512 x 512 x 8 bit image matrix with image-processing capabilities and obtainable at a cost of US$ 20,000 was evaluated in daily practice. Images from 372 conventional roentgen examinations were digitized and transmitted via a 64 Kbits/s telephone line from a rural health center to a university hospital, where they were interpreted by two radiologists. The original radiographs were interpreted later and the two reports compared to evaluate the diagnostic performance of system. Slight deterioration of image quality was noticed, though the images were non-diagnostic only in a few cases. The image-processing capability of the system was assessed as useful. Major discrepancies between CRT and film readings were noted in 3.9% of the cases interpreted. The accuracy of CRT readings was about 2% poorer in chest examinations and 5% poorer in bone examinations than in film readings. The teleradiology system proved sufficient for consultation in most conventional radiographs in daily practice, although a system based on a 1024 x 1024 matrix is desirable.