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Prenatal diagnosis of congenital heart disease using four-dimensional spatio-temporal image correlation (STIC) telemedicine via an Internet link: a pilot study
Open accessAbstract
OBJECTIVE: To assess whether the spatio-temporal image correlation (STIC) acquisition technique can be taught to a general obstetrician by e-mail; whether STIC volume datasets can be transmitted over the Internet; and whether STIC volume datasets analyzed offline at a remote setting can be used to confirm or exclude major cardiac defects (TELE-STIC). METHODS: This was a prospective study involving 50 pregnant women with gestational ages ranging between 20 and 36 weeks. These patients were selected by two general obstetricians (operators) working in geographically remote areas of Chile. Although both obstetricians were users of equipment capable of four-dimensional (4D) ultrasound with STIC, they lacked skill in the performance of fetal cardiac examination. A dedicated web disk was created to upload the acquired volume datasets using an Internet broadband connection. Offline analysis was performed by a single investigator experienced in fetal echocardiography (the administrator). RESULTS: A telemedicine link via the Internet was possible in all cases. Seventy-seven volume datasets were sent to the web server. A complete cardiac examination according to set criteria was achieved by the administrator in 86% of the cases scanned by one operator and 95% of the cases scanned by the other operator. Three patients had cardiac defects confirmed postnatally, two fetuses had extracardiac anomalies and one fetus had a suspected cardiac defect unconfirmed by second-opinion TELE-STIC. There were two isolated major congenital heart defects. Both patients were given advice by e-mail and teleconference using a web camera about the likely outcome and benefits of scheduling in utero transport to a tertiary care center. CONCLUSIONS: STIC volumes can be obtained by operators inexperienced in fetal echocardiography, transmitted via the Internet, and their analysis enables recognition of most of the structures and views necessary to assess fetal cardiac anatomy. The preliminary use of TELE-STIC allowed us to demonstrate that some intracardiac anomalies can be ruled out and others confirmed, allowing perinatal management to be tailored accordingly.
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“These changes include earlier treatment and appropriate escalation of care to tertiary centers (37).”
From Tele-Ultrasound in Resource-Limited Settings: A Systematic Review (2019) · cites this paper as [37]
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In the citing paper
“Tele-ultrasound has demonstrated success in producing high quality, diagnostically significant images which alter management, decrease time to treatment, and provide more cost-effective care, especially when coupled with supporting data such as electrocardiogram, chest radiography, laboratory results, and clinical history (29, 30, 33, 35, 37, 48).”
From Tele-Ultrasound in Resource-Limited Settings: A Systematic Review (2019) · cites this paper as [37]
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“Tele-ultrasound has demonstrated success in producing high quality, diagnostically significant images which alter management, decrease time to treatment, and provide more cost-effective care, especially when coupled with supporting data such as electrocardiogram, chest radiography, laboratory results, and clinical history (29, 30, 33, 35, 37, 48).”
From Tele-Ultrasound in Resource-Limited Settings: A Systematic Review (2019) · cites this paper as [37]
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“Image acquisition can be taught from a distance via the internet and a telemedicine platform is reliably able to transmit high quality images (29, 34, 37, 38).”
From Tele-Ultrasound in Resource-Limited Settings: A Systematic Review (2019) · cites this paper as [37]
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“In an attempt to overcome such challenges, ultrasound training programs have taught non-experts either to independently perform obstetric ultrasounds to screen for high-risk pregnancies (52–55) or to utilize tele-ultrasound (29, 34, 37, 38).”
From Tele-Ultrasound in Resource-Limited Settings: A Systematic Review (2019) · cites this paper as [37]
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“Tele-ultrasound has demonstrated success in producing high quality, diagnostically significant images which alter management, decrease time to treatment, and provide more cost-effective care, especially when coupled with supporting data such as electrocardiogram, chest radiography, laboratory results, and clinical history (29, 30, 33, 35, 37, 48).”
From Tele-Ultrasound in Resource-Limited Settings: A Systematic Review (2019) · cites this paper as [37]
Experimental — accuracy not yet measuredThe check wasn’t confident either way, so it gives no verdict — never disputed.
In the citing paper
“Tele-ultrasound has demonstrated success in producing high quality, diagnostically significant images which alter management, decrease time to treatment, and provide more cost-effective care, especially when coupled with supporting data such as electrocardiogram, chest radiography, laboratory results, and clinical history (29, 30, 33, 35, 37, 48).”
From Tele-Ultrasound in Resource-Limited Settings: A Systematic Review (2019) · cites this paper as [37]
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Citations
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Metadata
- Authors
- Viñals, F., Mandujano, L., Vargas, G., & Giuliano, A.
- Affiliations
- Clínica Alemana (CL)
- Hospital la Serena (CL)
- Corresponding author
- Viñals, F.
- Venue
- Ultrasound in Obstetrics & Gynecology
- Publisher
- Wiley
- Published
- 2004-12-08
- Volume
- 25
- Issue
- 1
- Pages
- 25-31
- ISSN
- 0960-7692 (ISSN-L)
- 1469-0705
- OpenAlex
- W2043946340
- Cited by
- 147
- References
- 23
- Citations by year
- 2026: 2 · 2025: 4 · 2024: 1 · 2023: 2 · 2022: 3 · 2021: 4 · 2020: 4 · 2019: 6 · 2018: 4 · 2017: 7 · 2016: 7 · 2015: 8 · 2014: 4 · 2013: 11 · 2012: 10
- FWCI
- 7.55
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- Ultrasound in Obstetrics and Gynecology (publishedVersion)
- PubMed (publishedVersion)
- Funders
- Fetal Medicine Foundation (1 037 116)
- Topics
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Congenital Heart Disease Studies
- Health Sciences › Medicine › Pediatrics, Perinatology and Child Health › Prenatal Screening and Diagnostics
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Telemedicine and Telehealth Implementation
- Keywords
- congenital heart disease, prenatal diagnosis, spatiotemporal image correlation, 4D ultrasound, fetal echocardiography, telemedicine, second opinion, perinatal care
- MeSH terms
- Chile, Developing Countries, Education, Medical, Continuing, Female, Fetal Diseases, Fetal Heart, Heart Defects, Congenital, Humans, Obstetrics, Pilot Projects, Pregnancy, Prospective Studies, Radiology, Ultrasonography, Prenatal, Teleradiology, Echocardiography, Four-Dimensional, Internet
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