A new approach to teleconferencing with intravascular US and cardiac angiography in a low-bandwidth environment.

A common problem in radiology teleconferencing is the difficulty of transmitting a large volume of data over communication channels with a relatively low bandwidth. Although videoconferencing systems are easily implemented, they generally require lossy image compression, which can lead to significantly altered findings. A teleconsultation and teleconferencing system was developed that uses a store-and-forward approach with high-quality dynamic medical images obtained with intravascular ultrasonography and cardiac angiography. The system allows use of high-resolution dynamic images while preserving their original quality and can be adapted to different clinical applications with varying requirements. The system involves a standard preparation procedure to transmit images from one location to another prior to a conference; once the conference starts, however, the system becomes fully automatic and synchronizes the display and manipulation of images in both locations without further image data transmission. In general radiologic applications, the system is superior to videoconferencing systems in that it does not require specialized hardware and dedicated high-bandwidth communication links. Further investigation with large-scale studies will be required to determine whether these benefits can lead to more widespread acceptance of such a system in routine clinical practice and whether teleconferencing itself can enhance the effectiveness of clinical procedures.