oteroh@email.chop.edu

To descriptively analyze the utilization, case characteristics, and referrers' opinion of a pediatric-specific teleradiology portal for low- and middle income countries.

This is a retrospective analysis of all cases referred to the WFPI pro-bono second-opinion teleradiology service between October 2014 and October 2018. Basic case and patient characteristics as well as feedback on usefulness and satisfaction from referrers.

A total of 668 cases (352 boys, 316 girls) with a median age 1 year 4 months (range 1 day - 18 years) were reviewed over a period of 4 years by a team of 45 volunteer pediatric radiologists. The majority (n=548) of the cases came from a single referral center (Lao Friends Hospital for Children, 82%); while the remaining 120 cases came from nine additional centers, distributed among Asia (6.7%), Africa (87.5%) and The Americas (5.8%). The median delay between receiving the case and its allocation to a radiologist was 0.73 hours (IQR: 0.26-1.87 hours). The median time delay to the first radiologist response was 5.53 hours (IQR: 2.14- 13.19 hours). The most common imaging modality submitted for interpretation was radiography (n=559, 83.7%), followed by computed tomography (n=78, 11.7%), ultrasound (n=58, 8.7%) and MRI (n=5, 0.7%). Referrers provided feedback on 94 cases (14.1%), which was overwhelmingly positive

Teleradiology offers a viable and well received option in centers with access to imaging but limited access to pediatric radiology expertise from around the world with reasonable delays in terms of time to first radiologist's response

The WFPI pediatric teleradiology platform provides pediatric radiology expertise, offering services among a wide range of modalities and from a variety of international referring institutions.