Using Rayscape CXR AI in a screening program for tuberculosis

Tuberculosis (TB) is an infectious and contagious disease that killed tens of millions of people in the latest century and starting with 2015 is a public health priority in Romania. According to a report realized by World Health Organization (WHO), Romania had in 2018 the highest incidence of TB cases per 100,000 inhabitants in the European Union.

Since 2016, WHO has started a series of projects in high-incidence countries, aiming to detect TB in vulnerable population groups at high risk of disease. In Romania, the National Institute of Pneumoftiziology Marius Nasta coordinates such a national screening project. Through mobile caravans moving in rural areas, the project aims to detect early cases of TB in vulnerable communities.

Rayscape is deployed on these caravans, helping the medical staff to analyze chest X-rays faster and more efficiently. Since Rayscape already had the capability to detect TB incorporated into it, we have tweaked the application in such a way that it would be focused on the pathology – the software outputs a confidence score that indicates TB probability. Based on this first screening, patients perform further medical investigations to confirm the suspicion of TB.

Due to the limited number of radiologists available, caravans are operated by technicians trained to make the x-rays that will only be later on analyzed by radiologists and pneumologists. Rayscape helps them in performing screening by giving the confidence score that indicates the probability of infection. If this score is higher than a certain threshold, the technicians collect sputum samples for the tests – if they come back positive the radiologist will confirm the Rayscape diagnostic with priority. Moreover, giving the big number of patients that are coming for X-rays, our software helps instantly analyze all the X-rays made.

On the other hand, for people from these areas, preventive medicine is not an option. Many of them don’t have the resources, the time, or the willingness to test their health condition once in a while. This screening program brings them closer to imaging investigations and gives them the chance to prevent certain diseases that could affect their lives. Even if our software is mainly used in this program for the TB Score, we offer the radiologists full access to all the functionalities. Thus, they can identify if the patients have any other pathologies that require additional medical investigation.

"In the first months of this screening program, we were with the caravans in a small rural community near Bucharest. After we scanned a few people, Rayscape discovered on a patent’s X-ray some pathologies highly correlated with lung cancer. He had no idea that he could be suspect of lung cancer. I think that this screening program and Rayscape software really saved that man’s life." - Radiologic Technologist on the screening caravans

Asked if Rayscape helped them in this national screening program, the medical staff working on this project affirmed that it certainly did. Giving the huge amount of X-rays, the constant flow of patients, and the gravity of this pathology, an AI-based software helps doctors to be more efficient, to prioritize those in need, and therefore, to help more people.