Imaging the World develops medical procedures and technologies to enable medical imaging in remote villages around the world. ITW’s focus is to improve medical imaging and health care in rural areas by deploying small ultrasound scanners to under-served remote populations.

ITW identifies communities that historically have had little access to health care technology or are great distances from health care technologies and procedures. ITW trains non-medical personnel (community members) to perform basic ultrasound scans and transmit images to an image storage and display server via the internet using cellular technology or a local Wi-Fi connected to an internet access point.  The images are then viewed by volunteer radiology professionals. An email or text (SMS) summary is then automatically and immediately sent back to the rural community.  Health concerns are potentially detected much earlier, giving patients time to travel to clinics with more advanced health care options, including surgery.  The result is improved patient outcomes and saved lives.

ITW works with clinics and hospitals in the region of the rural community to ensure that they have the equipment and training to offer definitive diagnostic tests to those patients sent to them because of an abnormal screening ultrasound study.

Key to this program is the use of breakthrough advances in ultrasound volume imaging capability. Simple scanning protocols using this technology have been designed at the University of Vermont and can be used by community members with little to no education. The protocols show pertinent anatomy to allow visualization of various common diseases such as thyroid nodules, gallstones, kidney obstruction, cystic ovarian tumors and placenta previa. Preliminary tests of these protocols show that they yield high quality images.

What need does ITW address?

Medical imaging has revolutionized medical care in the USA and other technologically advanced societies. Now medical diagnosis is, to a very large extent, dependent on advanced imaging with Ultrasound (US), Computed Tomography (CT) and Magnetic Resonance Imaging (MRI). However, most people in rural/remote villages in both developing nations as well as in developed nations have limited or no access to advanced medical imaging.

CT and MRI technology usually is not feasible in remote rural villages due to: 1) expensive equipment, 2) extensive site preparation to set up equipment, and 3) the personnel and infrastructure required to operate such equipment. On the other hand, Ultrasound equipment is relatively inexpensive, requires little or no site preparation and, as demonstrated by the ITW project, can be made useful without experienced personnel and infrastructure.

How is ITW’s ultrasound outreach program different from other ultrasound outreach programs?

Most existing ultrasound outreach programs use a traditional model: a skilled ultrasound operator scans a patient and creates images of key organs looking for abnormalities in the images on the monitor of the ultrasound system. This model requires ultrasound operators to have extensive education that can take 6 months to two years. This is prohibitive for making ultrasound available to remote villages worldwide.

To solve this problem ITW has developed special ultrasound scanning methods (called protocols) which can be taught to a person with no knowledge of internal anatomy in a few days. In ITW’s system, the operator sweeps the ultrasound probe across a region of the body guided solely by external landmarks such as the lower edge of the ribs and the upper edge of the hip bone. The images created during such a sweep (60-100 typically) contain the organs of interest. The large number of images contained in each sweep are sent using a special form of image compression that retains the high quality of the images while compressing them so that they can be sent quickly even by a low quality cell phone connection. The images are sent to an international computer server where an ultrasound expert views the images and determines whether the organs contained within those images are normal or not.

Special simple, low cost ultrasound machines are being developed for ITW that will allow ITW to equip many more sites that would be possible with traditional (and costly) ultrasound systems.

ITW’s model solves the problems that have prevented wider use of ultrasound for diagnosis in developing countries. ITW’s model will make basic, high quality ultrasound easily available to everyone, everywhere.