THE FIGHT AGAINST COVID-19;THE ROLE & CONTRIBUTIONOF MEDICAL IMAGING.BY ELIZABETH EWUDIWA

OVERVIEW

• Introduction

• Ghana TB project

• Sub-Saharan project

• COVID-19: Contribution of medical imaging• Remote support

• E-development

• CAD4COVID installations

• Conclusion

• Q & A

WHO WE ARE

• Limited Liability company

• Established in 2016

• Subsidiary of Delft Imaging (NL)

• DI’s Service & Training Hub for Sub-Saharan Africa

• Digital medical imaging systems

• One-stop TB truck

• Delft Light

• Artificial intelligence software CAD4TB

• CAD4COVID

PROFILE PRODUCTS

WHAT WE DO IN DIGITAL RADIOLOGY

INSTALLATION &

MAINTENANCE

✓ Installation

✓ Remote/technical support

✓ Planned preventive maintenance (PPM)

✓ Corrective maintenance

CAPACITY BUILDING

✓ E-Learning

✓ Workshops

✓ User Trainings

✓ Technical Trainings

CONSULTANCY

✓ Healthcare IT

✓ Integrations

✓ Project management

SALES

✓ Digital X-ray

✓ Medical films

✓ Medical Inks

✓ Printer

✓ Cartridges

OUR PRODUCTS

Mobile TB (Screening) vanMulti-functional x-ray (Easy DR X-ray system)

Delft Light

ConsumablesCAD4TBCAD4COVID

ONE STOP TB CLINIC

Wellness on Wheels (Nigeria)

• Accelerating case detection of tuberculosis

• Bilateral governmental project (Ghanaian-Dutch/ ORIO)

• 21-million-euro budget• 35% Grant component

• 65% soft loan

• 2 years warranty period (2018 – 2020)

• 5 years maintenance period

(2020 – 2025)

GHANA“Where it started.”

Accelerating Case Detection of Tuberculosis

➢ Teleradiology (Shareable files for second reading and quality control)

➢ CAD4TB (V. 6 for 4+ years)

➢ TB screening & other diagnosis

MAIN DELIVERABLES

• 48 Multifunctional X-ray systems✓ 29 containerized solar-powered systems✓ 19 X-ray room (fixed) systems

• 2 TB Screening vans

• 2 Portable x-ray units

• Installation & Maintenance

• Capability building (User trainings)

• M & E – Research budget

• Operational budget

Components

• Multi-functional X-ray system

• Computer Aided Detection “4” TB (CAD4TB)

• PAC system

• Router

• 2 Tablets for viewing images

• Lead-shielded X-ray room

• Solar-powered

• CAD4COVID (to be installed soon)

Description: Containerized installation

OTHER INNOVATIONS

Konongo Odumase Govt Hospital (KOGH)

E-HEALTH & AFRICAN ART MEET

Kumasi South Govt HospitalNyinahin Govt Hospital

Capacity building in Ghana project

Radiologists Radiographers Camera operators Engineers IT Officers Doctors PA

Doctors

Engineers

IT Officers

CAPACITY BUILDING

✓Multiple training modalities

✓600+ students and medical practitioners

✓16 regions

✓1 E-learning platform

PAs

CAPACITY BUILDING

• 400+ participants

• Including Doctors & specialists, Clinicians.

• 3 training modalities

✓ Seminar learning

✓ Blended e-learning

✓ Exclusive e-learning

COURSE HIGHLIGHT

Chest X-ray Reading (CXR) and Tuberculosis course

227

156

26

1 2 3

Nu

mb

er

of

atte

nd

ance

Modality

UD CXR Course

Source: CXR only field data, 2020

1 = Seminar learning2 = Blended e-learning3 = Exclusive e-learning

CAPACITY BUILDING

For Radiologists:

• CAD4TB & Project set up

For Radiographers:

• Radiation & Safety

Infection Prevention

• System operation & application

COURSE HIGHLIGHT

Technical and users training

Source: Field data, 2020

15

22

45

0

5

10

15

20

25

30

35

40

45

50

1 2 3

Nu

mb

er

of

atte

nd

ance

Job function

UD Technical/user trainings

Radiologist RadiographerCamera operator

CAPACITY BUILDING

For Engineers:

• 75 engineers

• CAD4TB & Project set up

For IT officers:

• 55 IT officers

• IT Application

• control

COURSE HIGHLIGHT

Technical and users training

Source: Field data, 2020

60

50

10

0

5 5

0

10

20

30

40

50

60

70

Engineers IT Officers

UD Technical/user trainings

Local level Regional level National level

• Find a local technical representative

• Engage local rep in;

✓Installations

✓User trainings

✓1st preventive maintenance

• Train local rep for remote troubleshooting & interventions

• Act as second line support from Accra

SUB-SAHARAN PROJECTS“General mode of operation outside Ghana.”

OUR GALLERY

MALAWI

✓ 7 MOBILE SCREENING TRUCKS

MOZAMBIQUE

✓ 1 EASY DR INSTALLATION

NIGERIA

✓ X-ray system and CT-scan in Diagnostic Centre, Monrovia - 2 Portable X-ray systems for Tuberculosis Screening

✓ Portable X-ray system for Tuberculosis Screening - 10 Multifunctional X-ray systems

LIBERIA SIERRA-LEONE

OUR DIGITAL APPROACHTHE PATH TO E-HEALTH

E-DEVELOPMENT

5.3014

6.43416.07

7.225

5.3269

7.1538

0

1

2

3

4

5

6

7

8

Pre- test Mean Post-test Mean

Seminar Blended Ex.-e-learning

21.37%

19.03%

34.31%

Seminar

Blended

Ex. e-learning

0.00% 5.00% 10.00% 15.00% 20.00% 25.00% 30.00% 35.00% 40.00%

Growth rate

Seminar Blended Ex. e-learning

REMOTE SUPPORT

✓ Remote-guided Installation

✓Quick Reference guides❖Brief

❖Simple (non-technical) language

❖Pictorial

✓Guide Real Time❖Zoom

❖WhatsApp

❖Team-viewer

DELFT COVID-19 SUPPORTCOMPUTER-AIDED DETECTION “4” COVID-19 (CAD4COVID)

CAD4COVID

• Artificial intelligence (AI) software

• CE 0344 Certified

• 40 countries

• 6,000,000+ screenings

• 55 installations in Ghana

• Free installations and use

• Available in CAD4COVID-CT & CAD4COVID-Xray solution

• Optimized CAD4TB to triage COVID-19 suspects

• Top 10 innovation nomination at COVID-19 Innovation Challenge 2020 organized by the UNECA

Using artificial intelligence (AI) to detect abnormalities indicative of TB/COVID-19

Follow the link to see how it works https://www.youtube.com/watch?v=b0tiQSuOiTw

WHY CAD4COVID?

According to WHO “the use of imagingcould be useful for the diagnosis of patientswith suspected COVID-19”.

GMA urges the government to do “all it canthat test results are available in 24 hours”

• Generate a score between 0 - 100indicating the extent of COVID-19 relatedabnormalities;

• Display such lung abnormalities througha heatmap;

• Quantify the percentage of visible lungtissue that is affected;

• Show result within 20 seconds;

• Offer offline box solution cloud solution

✓ Time efficiency (less than 1 min)

✓Cost efficiency

✓ Early detection & isolation

✓ Less exposure

✓Unlimited availability

✓Mobile screening options available for remote areas

✓Mass screening efficient

COMPUTER-AIDED DETECTION “4” COVID

• Limited by age (>4years)

• No record of clinical symptoms

LIMITATIONS

X- RAY

✓ Scores aid informed clinical decisions (i.e. further testing, self-quarantine, hospitalization)

✓ Quantified percentage of visible affected lung tissue to help track disease severity and patient recovery

✓ Offsets laboratory workload & radiography expertise shortage

✓Mobile system can access to remote areas

COMPUTER-AIDED DETECTION “4” COVID

• Also used in Spain, Italy, Germany, Netherlands, Denmark, Pakistan, Indonesia, Mexico, Bolivia, Brazil, Peru, USA, South Africa, Nigeria, South Korea, etc.

LOCATIONS

X- RAY

“In Korea it is mandatory that people need tocontinue their daily lives and at the same timeprevent the spread of COVID-19. We’ve beenable to do this thanks to the supportof #CAD4COVID, a quick and easy to implementAI solution. Everywhere people could gather, notonly in the hospital, quick and valid screening forCOVID-19 should be imperative. I believe that atthe entrance of every airport, hotel, train orrestaurant, people need to be checked by thesimplicity of Artificial Intelligence by a quick andefficient chest X-ray.”

- Dr. Euy Nyong Kin,Korean Medical Foundation (KOMEF), Seoul

“The first patient with COVID-19 was admitted to theDiospi Suyana hospital. He had travelled somedistance: 1200km on his way from Lima toQuillabamba. Passing through the village of Curahuasi,he stopped breathing. The staff of the local healthstation took a COVID quick test with a positive result.The staff of the state health system brought him to themissionary hospital. His saturation was 75% and hewas gasping for air. Within seconds MRI-nurse, MelanieFriesen pushed the mobile X-ray machine onto theisolation ward. The pictures showed the characteristicalterations of the lung. Analysing the pictures withspecial software from Holland (CAD4COVID) confirmedthe diagnosis. Now the patient is on oxygen and isgetting all medications as prescribed by the protocol”

- User story from Diospi Suyana Hospital, Peru

• Radiological Society of North America

• Journal of Radiology, Performance against RT-PCR

• CT Imaging and Differential Diagnosis of COVID-19, Canadian Association of Radiologists Journal

________________________________

✓ System results comparable to 6 independent expert reader

✓ 90% of the patients had COVID-19 symptoms

✓60-70% cases of COVID-19 abnormalities were visible on the CXR.

✓Some patients had COVID-19 abnormalities, but negative RT-PCR results.

CAD4COVID PUBLICATIONS

INFO@UNIVERSALDELFT.COM

WWW.UNIVERSALDELFT.COM

THANK YOU!

UNIVERSAL DELFT (@UNIVERSALDELFT)

UNIVERSAL DELFT (@UNIVERSALDELFT)

UNIVERSAL DELFT (@UNIVERSALDELFT)

QUESTIONS & ANSWERS