Improving the quality of breast ultrasonography performed by inexperienced ultrasound doctors with synchronous tele-ultrasound: a prospective, parallel controlled trial
Yi-Kang Sun1, Xiao-Long Li1, Qiao Wang1, Bo-Yang Zhou1, An-Qi Zhu1, Chuan Qin2, Hui-Xiong Xu1, Le-Hang Guo1
1Department of Medical Ultrasound & Tumor Minimally Invasive Treatment, Shanghai Tenth People’s Hospital;, shanghai, China
2Department of Ultrasound, Central Hospital, Karamay 834000, China, Karamay , China
Corresponding Author: Le-Hang Guo ,Tel: +86 18796228273, Fax: 021-66307539, Email:
Received: April 10, 2021;  Accepted: August 15, 2021.  Published online: August 15, 2021.
This prospective study was aimed to explore the value of synchronous tele-ultrasound (US) to aid inexperienced US doctors in breast US examination.
A total of 99 patients were enrolled, and two inexperienced trainee US doctors TA and TB, and one US expert doctor completed the US examinations in turn. TA completed the US examinations independently, while TB was instructed by the expert using synchronous tele-US. Subsequently, the expert performed on-site US examination in person. Separately, they selected the most clinically significant nodule as the target nodule. The consistency with the expert and the image quality were compared between TA and TB to evaluate tele-US. Furthermore, TB and the patients evaluated tele-US by filling questionnaires.
TB demonstrated a higher consistency with the expert in terms of target nodule selection than TA (93.3% vs. 63.3%; P<0.001). TB achieved good inter-observer agreement (ICC>0.75) with the expert on 5 US features (5/9, 55.6%), while TA only on 1 (1/9, 11.1%) (P=0.046). TB’s image quality was higher than TA’s in gray value, TGC, depth, color Doppler adjustment, and the visibility of key information (P=0.018, <0.001, <0.001, =0.033, and =0.006, respectively). The comprehensive assessment score was higher for TB than TA (3.96±0.82 vs. 3.09±0.87, P<0.001). Tele-US was helpful in 69.7% US examinations and had a training effect in 68.0%. 63.6% patients accepted tele-US and 60.6% patients were willing to pay.
Tele-US can help inexperienced US doctors to perform breast US examinations.
Keywords: Telemedicine; Tele-ultrasound; Breast ultrasonography; Synchronous tele-ultrasound
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