Telemedicine network for ultrasound screening of HCC

Aims: Hepatocellular carcinoma (HCC) is actively diagnosed in chronic liver diseases (CLD) patients through screening programs, using a sensitive and easily accepted method – ultrasonography (US) and AFP determination.

Aim: To test a new and improved tele-screening system for HCC using US image transmission and image analysis, whishing to: (a) early identify any suspicious focal liver lesion; (b) create a viable ultrasound tele-screening protocol for HCC; (c) create a health grid for CLD and HCC; (d) develop the system for risk identification based on an interactive, predictive analysis and pre-classification of US images.

Methods: The tele-sonography network consists in many internet connected ultrasound remote terminals situated in the GP's office and a core located in a tertiary health care facility. A dedicated software recognizes, analyzes and pre-classifies the images on normal-abnormal principle. Only abnormal images will be furthermore analyzed by human experts. The system is designed as a Computer Aided Monitoring System (CAMS) helping the diagnosis procedures.

Results: US screening and surveillance protocols for patients with CLD were developed, according to clinical condition (chronic hepatitis±focal liver lesions; cirrhosis±focal liver lesions). 5 locations were identified, in remote areas of north Romania. A total number of 30.000 patients undergo US examiantion. A short training in US examination of the liver and HCC screening was given to medical professionals (doctors and/or nurses)

Conclusion: Screening for HCC using telesonography may became a valuable tool for better understanding of the disease and provide new evidences in large series of patients.