1. Tele-operated echography using a robotic probe holder (Artis), & ADSL link.
ESR – Feb
V Stephanescu1, M Georgescu2, J Blouin2, L Georgescu2,
I Mocanu1, P Arbeille2 .
1 Dept Radiology - Hopital Galate –Romania.
2 CERCOM Med Nucl Ultrasons CHU Trousseau – Tours - France

2. BACKGROUND - ECHOGRAPHY PRACTICE
ECHOGRAPHY IS OPERATOR DEPENDENT !!! => Impossible to train every subjects to get the PERFECT organ view requested for a safe diagnostic. =>Tilting or Rotating probe by 2-3 ° change a bad image of the organ to a perfect one /3 degree change the age of the fetus
Ex: Gall bladder scanned
by a Beginner (left) & a professional (right)

3. TELEECHOGRAPHY (1rst imaging after clinical exam)
=> Visualize the main abdominal organs: abdomen & Pelvis (liver, gall-bladder, pancreas, kidney, spleen, uterus, bladder,…), muscles, heart & vessels –1rst opinion).
=> Evaluate fetal growth and behaviour (1rst opinion)
Confirm suspected desease (malformation– 2nd opinion)
OBJECTIVE:
Eliminate any serious diagnosis
 (patient remains home),
Confirm severe clinical stage.
(induce immediat transfer)

4. ESA doc

5. ARTIS robotic arm holding the echo probe
INTERNET
Expert centre in Tours
& Patient site in Galate

6. Expert centre TOURS
Patient site GALATE

7. With Tele-echo 2 NOT DETECTED (lesion < 2cm ).
MEDICAL VALIDATION
Objective: check that all lesions detected by Conventional Echography are visualized by Tele-echo.
In 9 cases, Conventional echography showed lesions in the liver (angioma), kidney (size, cyst), ovarian cyst .
With Tele-echo 2 NOT DETECTED (lesion < 2cm ).
 ARTIS tele-echography delivered the right diagnosis in 7/9 pathological cases (78%) & did not detect the lesion in (22%).
Tele-echography never generated false positive diagnosis as conclusions were made only when all the organs visualized.

8. Other Technical consideration
 Mean duration of the tele-echography was 5 +/- 3 min per organ
 Number of repositioning of the robotic arm was 3+/-2 per organ
Mean duration of the conventional echography was 3+/-2 min per organ
Thus the Tele-operated Echography session was 1,5 time longer than the conventional echography.
The repositioning of the probe was very quick (1-2 sec) during the conventional echography as the sonographer translated the probe quite instantaneously and in any direction while during tele-echography the expert had to guide the operator at the isolate site.