New research unveiled at the ESC Congress 2024 in London, UK demonstrates that remote echocardiograms conducted over a 5G cellular network yield equally precise results as those carried out in-person by cardiologists.
“Comprehensive echocardiographic exam with a 5G cellular network and robotic arm-based remote system is feasible with relatively good diagnostic accuracy,” said study author Dr Yu Liu, Zhongshan Hospital, Shanghai, China.
The use of robotic arm-assisted remote echocardiograms for teleconsultation has shown great promise in improving access to cardiac expertise for patients in rural and smaller urban areas. However, previous studies have highlighted challenges such as network delays and inadequate control of the robotic arm equipment.
In a recent study, researchers evaluated the feasibility and diagnostic accuracy of a 5G cellular network and robotic arm-based remote echocardiographic system for outpatient clinics located 20 kilometers away from Zhongshan Hospital. A total of 51 patients from the outpatient cardiology clinic participated in the study, undergoing standard comprehensive echocardiography using the remote system and then the conventional echocardiographic platform at Zhongshan Hospital.
The order in which patients were examined on the remote and conventional instruments was randomly determined to ensure a fair comparison. There was no interval between the two examinations, and examinations of the same patient were performed by experienced but different cardiologists, who were blinded to each other’s diagnosis, ensuring impartiality.
The doctor who used the remote system was also randomly allocated and had not been previously specifically trained, underlining the unbiased nature of the study. The examinations were in real-time, and diagnoses were made immediately after the examinations, providing accurate and timely results.
From the 51 patients, the image quality was sufficient for diagnosis in 50 patients (24 (48%) female), showcasing the effectiveness of the remote system. A single patient was excluded because some key views could not be obtained using the remote system, emphasizing the high success rate of 98% of the examinations.
Around one-third (17 patients) had a heart problem identified using conventional in-person echocardiography, highlighting the importance of accurate diagnosis. This included various conditions such as valvulopathy, cardiac surgery follow-ups, hypertrophic cardiomyopathy, abnormal left ventricular wall motion, and congenital heart disease, emphasizing the diverse range of heart issues that can be effectively diagnosed using the remote system.
Echocardiograms conducted with the robotic arm yielded the same diagnosis as conventional in-person echocardiography in 98% of cases. The only missed diagnosis was a papillary muscle level obstruction. However, the time for image acquisition using remote echocardiography was significantly longer, approximately 50% more than conventional methods (24 mins 36 secs vs. 16 mins 15 secs).
An earlier version of the robotic arm has been approved for clinical use in abdomen scanning in China, Europe, Australia, and Singapore due to its simpler scanning maneuvers. However, the authors suggest that a larger, multi-center study involving local hospitals and referral centers should be conducted to determine the viability of this new technology.
“This system would increase the accessibility of better medical resources as patients may travel less to get a diagnosis and medical advice from cardiologists based in referral centers,” lead author Xianhong Shu, also of Zhongshan Hospital, said.
She adds there are further potential advantages, “A remote robotic echo system may help protect more health professionals from the risk of exposure during pandemics like COVID-19 as the cardiologist may not need to be in close contact with the patient if only echocardiogram consultation is required.”
