An article published in the open-access journal PLoS One describes a new technique that uses cell phones for medical imaging purposes. According to the authors, the new technology, developed by engineers at the University of California, Berkeley, could improve the accessibility of medical imaging to billions of people around the world.

The World Health Organization has reported that about 75% of the world's population is without access to ultrasounds, X-rays, magnetic resonance images, and other medical imaging technology that can detect tumors, diagnose tuberculosis infections, and monitor pregnant women. Researcher Boris Rubinsky (UC Berkeley professor of bioengineering and mechanical engineering and leader of the development team) said that, "Medical imaging is something we take for granted in industrialized countries. Imaging is considered one of the most important achievements in modern medicine. Diagnosis and treatment of an estimated 20 percent of diseases would benefit from medical imaging, yet this advancement has been out of reach for millions of people in the world because the equipment is too costly to maintain. Our system would make imaging technology inexpensive and accessible for these underserved populations."

According to Rubinsky, we have not found a feasible, long-term solution in donating medical imaging devices to poor regions. "More than half of the medical equipment in developing countries is left unused or broken because it is too complicated or expensive to operate and repair," he notes. "We set out to develop something that locals could sustain on their own, as well as something that is relevant to local economies and technologies."

There are three main components in medical imaging devices: data acquisition hardware (connected to the patient), image processing software, and a display device. If these three component pieces have to be combined into a solitary unit, the cost of the machine is substantially increased. This led Rubinsky and his team to physically separate these components, keeping the processing software required to convert the raw data into an image at an off-site and central location that has the resources to operate and maintain it. The central location could act as a hub that serves several remote sites where simpler machines can gather data from the patients.

Cell phones, after collecting data from a data acquisition device, can be used to upload raw data to the hub that will be converted into an image. The cell phone would then act as a display after the server sends the image back to it. "This design significantly lowers the cost of medical imaging because the apparatus at the patient site is greatly simplified, and there is no need for personnel highly trained in imaging processing," said Antoni Ivorra, a post-doctoral researcher and co-author of the study. He added that, "The data acquisition device can be made with off-the-shelf parts that somebody with basic technical training can operate. As for cell phones, you could be out in the middle of a remote village and still have cell phone access. They're so prevalent because so little infrastructure is required to maintain wireless networks."

To demonstrate the use of cell phones as remote medical imaging devices, the researchers provided an example with electrical impedance tomography (EIT) - a medical imaging technique based on the idea that electrical signals are transmitted differently in diseased tissue than in healthy tissue. Medical imaging centers around producing a map based on the physical properties of tissue such as tumors, muscle and fat. In EIT, the difference in resistance to electrical currents is converted into an image or map of the particular test tissue.

The researchers created a simple data acquisition device that was built from commercially available parts and contained 32 stainless steel electrodes. Half of the electrodes were electrical current input sensors and the other half measured the voltage. For the demonstration, the device was connected to a gel-filled container, similar to breast tissue containing a tumor. The device transmitted 225 voltage measurements to a cell phone via a USB cable, and then the data were sent via dial-up to a central computer that could process the raw data. After an image was constructed, it was sent back to the cell phone for analysis.

Rubinsky noted that, "This could open up whole new avenues of health care for the developing world. Health professionals in rural clinics could affordably get the tools they need to properly diagnose and treat their patients."

Concerns such as dropped calls and screen sizes have been considered, and co-author Yair Granot responds that, "there is no medical application that would not allow us to redial a line. Transmitting voice signals is actually more challenging than sending this imaging data, so it shouldn't be a serious problem." Rubinsky adds that, "People are able to watch full movies on their iPods."

"In my opinion, this concept would be valuable for developed nations as well," concludes Rubinsky. "One of the main problems of medical care is the increased cost of health care. It may be worthwhile to consider this as a way of reducing the cost of medical imaging."

A New Concept for Medical Imaging Centered on Cellular Phone Technology
Granot Y, Ivorra A, Rubinsky B
PLoS ONE (2008). 3(4): e2075.
doi:10.1371/ journal.pone.0002075
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Written by: Peter M Crosta