Feasibility of intercity and trans-atlantic telerobotic remote ultrasound: Assessment facilitated by a nondedicated bandwidth connection

We discuss the concept of ultrasound imaging at a distance by presenting the evaluation of a customized, lightweight, human-safe robotic arm for low-force, long-distance, telerobotic ultrasonography. We undertook intercity and trans-Atlantic telerobotic ultrasound simulation from master stations located in New York, New York and Munich, Germany, and imaged a phantom and a human volunteer located at a slave station in Burlington, Massachusetts, using standard Internet bandwidth <100 Mbps and <50 Mbps, respectively. The data from the robotic arm were tracked for understanding the time efficiency of the human interactions at the master stations. Comparison of a beginner in ultrasound operation with a professional sonographer revealed that although proficiency in using ultrasound was not a prerequisite for operating the robotic arm, previous experience in using clinical ultrasound was associated with progressively lower probe maneuvering time and speed due to an enhanced ability of the veteran operator in adjusting the finer angular motions of the probe. These results suggest that long-distance telerobotic echocardiography over a local nondedicated Internet bandwidth is feasible and can be rapidly learned by sonographers for cost-effective resource utilization.