Vo Luan Nguyen Quang, Codlin Andrew, Ngo Thuc Doan, Dao Thang Phuoc, Dong Thuy Thi Thu, Mo Huong Thi Lan, Forse Rachel, Nguyen Thao Thanh, Cung Cong Van, Nguyen Hoa Binh, Nguyen Nhung Viet, Nguyen Van Van, Tran Ngan Thi, Nguyen Giang Hoai, Qin Zhi Zhen, Creswell Jacob
Friends for International TB Relief, Ha Noi 100000, Vietnam.
IRD VN, Ho Chi Minh City 700000, Vietnam.
Trop Med Infect Dis. 2021 Sep 4;6(3):163. doi: 10.3390/tropicalmed6030163.
X-ray screening is an important tool in tuberculosis (TB) prevention and care, but access has historically been restricted by its immobile nature. As recent advancements have improved the portability of modern X-ray systems, this study represents an early evaluation of the safety, image quality and yield of using an ultra-portable X-ray system for active case finding (ACF). We reported operational and radiological performance characteristics and compared image quality between the ultra-portable and two reference systems. Image quality was rated by three human readers and by an artificial intelligence (AI) software. We deployed the ultra-portable X-ray alongside the reference system for community-based ACF and described TB care cascades for each system. The ultra-portable system operated within advertised specifications and radiologic tolerances, except on X-ray capture capacity, which was 58% lower than the reported maximum of 100 exposures per charge. The mean image quality rating from radiologists for the ultra-portable system was significantly lower than the reference (3.71 vs. 3.99, < 0.001). However, we detected no significant differences in TB abnormality scores using the AI software ( = 0.571), nor in any of the steps along the TB care cascade during our ACF campaign. Despite some shortcomings, ultra-portable X-ray systems have significant potential to improve case detection and equitable access to high-quality TB care.
X线筛查是结核病预防与治疗中的一项重要工具，但由于其不可移动的特性，过去其应用受到限制。随着近期技术进步提高了现代X线系统的便携性，本研究对使用超便携式X线系统进行活动性病例发现（ACF）的安全性、图像质量及检出率进行了早期评估。我们报告了操作和放射学性能特征，并比较了超便携式X线系统与两个参考系统的图像质量。图像质量由三名人工阅片者及一款人工智能（AI）软件进行评分。我们将超便携式X线系统与参考系统一起用于社区ACF，并描述了每个系统的结核病治疗流程。超便携式系统在公布的规格和放射学公差范围内运行，但X线采集能力除外，其比报道的每次充电最大100次曝光量低58%。放射科医生对超便携式系统的平均图像质量评分显著低于参考系统（3.71对3.99，<0.001）。然而，我们使用AI软件检测到结核病异常评分无显著差异（=0.571），在ACF活动期间结核病治疗流程的任何步骤中也无显著差异。尽管存在一些缺点，但超便携式X线系统在改善病例发现及公平获得高质量结核病治疗方面具有巨大潜力。
