Experts Offering Free Pediatric Teleradiology Globally Welcome More Users

By Will Boggs MD

July 15, 2019

NEW YORK (Reuters Health) - The World Federation of Pediatric Imaging (WFPI) provides expert pediatric teleradiology to referrers around the world, and encourage wider use of their services.

"During peak use, the network received over 60 cases per month, and volunteers from all around the world stepped up and provided expert interpretations to each of those studies, which is testament of how these services could be scaled up if the demand was to increase dramatically," Dr. Hansel J. Otero from Children's Hospital of Philadelphia and Perelman School of Medicine at the University of Pennsylvania told Reuters Health by email.

WFPI is a nonpolitical, nonprofit organization. It began offering pro bono pediatric teleradiology services in 2014 using the Collegium Telemedicus system (, a commercially available telemedicine network that is freely available for humanitarian purposes.

Dr. Otero and colleagues describe the initial experience in a report online July 3 in the Journal of the American College of Radiology.

Between 2014 and 2018, 668 cases were interpreted by a total of 45 volunteer pediatric radiologists from 14 different countries, with most practicing in academic centers.

The median delay between receiving the case and its allocation to an interpreting radiologist was 0.73 hour, with only 20 cases having an allocation delay of more than 24 hours.

The median time delay to the first radiologist response was 5.53 hours, which has decreased since the implementation of an automatic allocation approach after this interim analysis.

Modalities submitted for interpretation include conventional radiography (83.7% of cases), CT (11.7%), ultrasound (8.7%) and MRI (0.7%), with some cases including multiple imaging modalities in a single submission.

Among the 94 referrers providing feedback, 95.7% reported that interpretations were performed by an appropriate expert, and most found the interpretation to be sufficiently quick (92.6%) and well adapted for the local environment (96.8%).

The referrers were able to follow the advice in 82.6% of cases, found the imaging interpretation useful in 90.4%, and stated that the teleradiology services had educational benefit in 90.4%.

The few cases of negative feedback include those in which the radiologist was not able to access the images (3.2%), cases in which the radiology response arrived after the patient was discharged or left against medical advice or died (6.4%), and those in which the local environment did not have resources to follow up on imaging or surgical recommendations (2.1%).

Dr. Otero mentioned several obstacles to providing these teleradiology services. He said that "for a start, reaching out to remote locations in need of teleradiology services is not easy, as there is no central information center or easy way to advertise them. Second, sites must have a system in place to send cases in a way that is least disruptive to their workflow and local work force."

"Some potential referring hospitals/projects have a radiologist on staff but are overwhelmed by the day-to-day case load and unable to spend extra time in complex cases or lack pediatric radiology training/skills," he added. "Last, but as important, sending the images still requires reliable Internet connectivity, which is a major issue in many sites and a major barrier for more timely teleradiology services."

Dr. Otero hopes this report will "let people know that this service is available and hopefully encourage more traffic through the teleradiology platform, but also (will) disseminate the idea that building a network of volunteers to provide expert teleradiology opinions is not only possible but achievable and well accepted by the end users."


J Am Coll Radiol 2019.