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
• 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
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.”
✓ 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
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
❖Team-viewer
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
WWW.UNIVERSALDELFT.COM
THANK YOU!
UNIVERSAL DELFT (@UNIVERSALDELFT)
UNIVERSAL DELFT (@UNIVERSALDELFT)
UNIVERSAL DELFT (@UNIVERSALDELFT)