Digital radiology solutions for TB diagnostics in low- to middle-income countries: technology landscape report

Abstract

Chest x-rays have played a historic role in TB diagnostics, especially in the case of pulmonary TB (PTB), which is one of the most common presentations of all forms of the disease. Although chest x-rays are not the gold standard for confirming a diagnosis of TB, they do offer high sensitivity for detecting PTB-related abnormalities in lungs (opacities, scars, pleural effusion, etc.). Additionally, because chest x-rays can enable rapid examination with onsite interpretation, chest radiography has been recognized as a powerful screening test for TB, especially in low- and middle-income countries with higher burdens of the disease. Advancements in digital chest radiography have revolutionized the process of image acquisition whilst maintaining high diagnostic quality as well as consistency of images produced. Developments in x-ray detector technology, digital image storage and computer-aided detection are added features that substantially cut down the cost of producing chest radiographs by eliminating the need for film-based radiography/processing chemistry. An additional benefit of digital radiography is a reduction in the number of specialized staff needed throughout the image-taking and interpretation process, particularly as specialized staff is often scarce. This report aims to inform the landscape of digital chest radiography for TB diagnosis in low- and middle-income countries through a market and literature analysis