E1209. Imaging Manifestations of Advanced Head and Neck Diseases Aboard the Africa Mercy
  1. Yeli Pi; University of Alberta
  2. Dean Jeffery; Medical Imaging Consultants; University of Alberta
  3. Jacob Jaremko; Medical Imaging Consultants; University of Alberta
  4. Lucy Jamieson; Medical Imaging Consultants; University of Alberta
  5. Gregory Raymond; Medical Imaging Consultants; University of Alberta
The Africa Mercy, which was once a rail ferry, now operates as the largest non-governmental hospital ship. Manned by a volunteer crew of around 400 individuals, the ship is complete with multiple operating rooms, patient ward, ICU and diagnostic imaging department with teleradiology interpretation. The ship travels along the coast of Africa and provides medical service to some of the most underserved populations in the world. For example, the most recent field services were to Senegal, Guinea and Cameroon, nations with only 0.69, 0.83 and 0.88 medical doctors per 10,000 people respectively. In comparison, Canada and the United States boast just above 23 and 26 medical doctors per 10,000 people. The purpose of this educational exhibit is to overview the role and logistics of remote diagnostic imaging interpretation aboard the Africa Mercy, and highlight pathologies with unique or atypical imaging manifestations. Through these cases, we hope to instill an appreciation and understanding of the impact of remote teleradiology services in the care of underserved populations.

Educational Goals / Teaching Points
This case-based educational exhibit will be targeted towards residents, students and interested staff members. The exhibit will contain a variety of challenging head and neck cases scanned on the Africa Mercy, demonstrating the atypical imaging appearances of common conditions as a result of extremely delayed presentation. Wherever possible, we also include anonymized patient and specimen photos to provide clinical and pathologic correlation. Cases featured include: Pleomorphic adenoma, Ranula, Goitre, Ameloblastoma, Neurofibroma, and Lymphatic malformation.

Key Anatomic/Physiologic Issues and Imaging Findings/Techniques
Featured cases typically demonstrate trans-spatial pathology with gross distortion of normal anatomy. We illustrate the approach to these challenging cases by identifying the affected anatomic regions and highlighting pertinent imaging findings that lead to a differential diagnosis. Through this process, the exhibit will review normal boundaries and contents of the deep spaces of the head and neck, as well as common conditions affecting the various compartments. The usual imaging appearance will also be contrasted with the presented cases.

Timely access to radiologic services is extraordinarily difficult in underserviced populations, and patients may be burdened with disease for years after symptom onset. The partnership between non-governmental organizations such as Mercy Ships and radiologists providing remote interpretation of diagnostic imaging offers tremendous value and impact towards patient care. When faced with challenging cases, taking an anatomic approach will help learners generate appropriate differential diagnoses.