MIR Faculty and Resident Set Up Essential Tools for Doctors in Guatemala

by Knvul Sheikh, Staff Writer, for[MD]

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Ultrasounds, X-rays and mammograms are some of the radiological services that nearly two-thirds of the world’s population does not have access to, according to the World Health Organization. Spurred by this statistic, the international aid group RAD-AID has been working to improve radiology resources in low- and middle-income countries around the world. Now, radiologists at Washington University’s Mallinckrodt Institute of Radiology have also joined the effort.

Last year, a group led by Radiology Assistant Professor Kathryn Robinson, MD, set up a local chapter of RAD-AID at Mallinckrodt. Together, they initiated a collaboration with the Instituto de Cancerología (INCAN) in Guatemala City, Guatemala. And by sharing their expertise with doctors at INCAN, Robinson and her team have helped provide the training and tools necessary to improve the medical care patients receive on a daily basis.

Kathryn Robinson, MD

“The absence of good radiology services can play a critical part in global health disparities,” said Robinson. “It’s something that we don’t think about in America, but in some countries if the doctor doesn’t have access to a simple X-ray, or a radiologist who can correctly interpret an X-ray, they may not be able to make important treatment decisions like whether a fracture requires surgery or a cast.”

On their first visit to Guatemala City, Robinson’s team quickly realized that radiologists at INCAN did not have an adequate picture archiving and communication system (PACS), which is standard practice in U.S. hospitals for viewing and storing digital image files. A survey of the hospital and conversations with clinicians at INCAN showed that implementing a PACS system could help speed up diagnoses and improve patient care.

“Having a functioning radiology department without a PACS can be very difficult, especially in the hospital we were working in, which is a cancer hospital,” said Lauren Saling, MD, a fourth-year radiology resident who accompanied Robinson on the trip. “It’s essential to have older [radiology] studies to make comparisons in patients with a cancer diagnosis.”

At INCAN, clinicians were looking at patients’ images on film. As a result, image handling and diagnosis took much longer. Images could also easily get disorganized or lost. Robinson and her team decided to find a sustainable way of solving the problem.

On a second trip to Guatemala in October 2016, the group helped local radiologists set up a PACS system using donations from RAD-AID and the resources that they had. “The experience taught me to think on my feet and work with a community to improve healthcare for everyone,” Saling said.

Before RAD-AID was established, many other radiology professionals and charitable institutions had tried to help fund radiology services. By connecting those efforts with medical schools, eager volunteers, and taking into consideration various local needs, RAD-AID enabled services that not only helped resource-limited hospitals but also worked with their specific limitations.
“It’s easy to provide equipment, such as the technology needed for a mammogram,” Robinson said. “But if a hospital doesn’t have a physician with the training to do the biopsy or whatever procedure is needed next, then you’re not helping much. Through RAD-AID we’re able to do both.”

Other RAD-AID projects have helped establish mobile clinics that connect patients undergoing breast and cervical cancer screening with hospitals that can provide follow-up care in India. In Ethiopia, a group helped set up MRI scanners and trained technologists on how to read the MRI images.

The projects provide an excellent outlet for radiology faculty and residents to offer their services, and the group has grown to include more than 6100 volunteers from 100 countries since it began in 2008.

“Radiologists are not just a bunch of doctors sitting in dark rooms looking at images,” Saling said. “I think there is a lot of interest in global health among people coming in to radiology — and medicine in general — and expanding community access to medical care helps both physicians and patients.”