Teleradiology

In medicine we mean by teleradiology any operation that transferred in the radiological images over a telecommunications device to a remote location ( Image Transfer).

Teleradiology after RöV

In a narrower sense teleradiology is the imaging study of a human being under the responsibility of a specialized physician (usually a radiologist ), who is not at the place of execution. The responsible radiologist stands by electronic file transfer (eg, encrypted Internet tunneling or phone connection) directly with the requesting and implementing entity in connection. This form of teleradiology is in § 3, paragraph 4 of the X-ray Ordinance (RöV ) is defined and is also referred to as " Teleradiology after RöV ".

Teleradiology after RöV also allows smaller hospitals, computer tomography (CT ) to offer without getting a specialized physician must be on site. Especially in the night, on Sundays and public holiday service offers benefits. Tele radiology solutions have been proven in several years of productive use in various places. The legislature has however made ​​significant obstacles to the use of teleradiology by RöV, the consequences are often lengthy approval process.

Requirements

• A corresponding equipment or facilities must be available ( examination apparatus and teleradiology equipment at the examination as well as a teleradiology receiving device on Auswertort ).
• At the examination must be a professional who can operate the device technically.
• There must be a fast, stable line for transmitting the image data.
• On the receiver side, a radiologist must be the expert assessed the images and its results communicated back.

Expiration

Before examining the question and the type of desired examination is submitted. The radiologist checks the justifying indication and establishes the study program. The investigation is carried out. After the execution of the image data set is transmitted to the radiologist. The radiologist sends its findings to the requesting unit back ( via electronic mail, fax or telefonischem dictation, sometimes directly by phone conversation with the requesting clinician ).

Teleconsultation

The second major application of teleradiology is the teleconsultation. In this form of teleradiology is always a responsible radiologist at the place of execution. In particularly hard to diagnose or doubtful cases, the responsible radiologist for the creation of the finding another opinion, for example, that of a specialist at a university hospital, ask. Due to the electronic transmission of the image data is eliminated the still widespread delivery of images, such as by taxi. Since this form is always a responsible radiologist at the place of execution, the legal hurdles are considerably lower than in the teleradiology after RöV.

Transferred amounts of data

Method

Typical image resolution

Kilobytes per image (lossless compressed)

Images per examination

Megabytes per examination

Chest x-ray

2048 × 2400 × 16

Ca 1600

1 or 2

1.6 or 3.2

CT

512 × 512 × 16

200

50 to 100

10 to 20

MRI

256 × 256 × 8

20

50 to 100

1-2

Sonography

512 x 512 x 8

100

10 to 50

1-5

The figures are intended as guidelines only.

Larger amounts of data because here in part color images and / or video sequences, particularly in the sonography ( ultrasound examination ) must be transferred in circumstances arise. However, teleradiology applications in ultrasound are also rather rare, because the derivation of a good ultrasound image you need an experienced examiner, who then also his pictures usually can judge for yourself.

Standardization of teleradiology

Come today for image transmission in the context of teleradiology (as of 2006) as well as no more proprietary solutions used, but standard DICOM protocols. Unlike in the past, it is no longer necessary that both communication partners use teleradiology software from the same manufacturer. However, need some configurations ( AE title, port, host name or IP address, router setting) be made before the initial communication so that especially in sporadic teleconsultation with changing partners, problems can arise.

To solve this problem, the German Roentgen Society has adopted a recommendation for standardization of teleradiology in Germany in May 2004. According to this recommendation is the use of OpenPGP encrypted DICOM e- mail are for image transmission standard in teleradiology.

For Medical Devices Act ( MPG) compliant teleradiology systems that support this standard, offered by the industry.

Since March 2009, the DIN 6868-159 regulates the acceptance and constancy testing in teleradiology after RöV.