Teleradiology Service in Nepal — Remote CT, MRI and X-ray Reporting from Pokhara

What is teleradiology?

Teleradiology is the reporting of medical images by a radiologist working away from the place where the images were taken, with the scans sent securely over the internet. Kaligandaki Diagnostic and Research Center (KDRC) provides a teleradiology service in Nepal from its base in Pokhara. Hospitals, clinics and imaging centres send CT, MRI and X-ray studies to KDRC's consultant radiologists, who read them and return a written report.

Put simply, the scan stays local and the expertise travels. A patient in a district hospital is scanned on that hospital's machine. The images reach a specialist radiologist in Pokhara within minutes instead of days. The European Society of Radiology describes teleradiology as "the provision of radiology services remote from the site where the images are obtained". It also says remote reports should be of no lower quality than those of local radiologists.

Teleradiology is sometimes called online radiology reporting, remote radiology reporting or remote reading. It is part of radiology practice, not a separate product. The same professional standards apply to a remote report as to one written in the same building.

Why teleradiology matters in Nepal

Teleradiology matters in Nepal because many hospitals and clinics now own CT, X-ray or MRI equipment but do not have a full-time radiologist on site. Mountain roads, long distances and a limited number of specialists mean that films and CDs can take days to reach a reporting doctor. Patients sometimes travel to Pokhara or Kathmandu just to have an existing scan read.

Teleradiology closes that gap. It helps:

• District and community hospitals across Gandaki Province, from Syangja and Tanahun to Baglung, Myagdi and Lamjung, that have scanners but no resident radiologist.
• Private hospitals and polyclinics that need specialist reads outside their own radiologist's working hours, or during leave.
• Imaging centres that want a second opinion on complex CT or MRI studies.
• Treating doctors who need a clear written report quickly so they can decide on admission, referral or surgery.
• Patients, who avoid repeat journeys and duplicate scans.

Avoiding duplicate scans also matters for safety. CT uses X-rays, and the US FDA advises clinicians to check a patient's imaging history to avoid repeat examinations. A good report on the first scan means the patient is less likely to need another one.

How does teleradiology work?

Teleradiology works in four stages: the partner facility acquires the scan, sends the DICOM images with clinical details over a secure channel, a KDRC radiologist interprets the study, and the signed report returns to the facility. The steps below show the full workflow.

The key technical standard is DICOM (Digital Imaging and Communications in Medicine). DICOM is the worldwide standard that defines how medical images and their related data are formatted and exchanged with the quality needed for clinical use. Almost every modern CT, MRI, digital X-ray and mammography system can export DICOM studies. That is why teleradiology does not depend on the brand of scanner a hospital owns.

Images are reviewed on diagnostic viewing software, not as photographs or screenshots. The radiologist can scroll through every slice, adjust contrast windows, measure structures and build reformatted views, just as they would with a scan performed at KDRC. Phone photographs of a monitor or film are not suitable for formal reporting, because detail and slice information are lost.

What does a teleradiology report include?

A teleradiology report from KDRC follows the same structure as a report for a scan performed in our own building. It usually contains:

1. Patient and study details. Name, age, facility, date and type of examination.
2. Clinical information. The question asked by the referring doctor.
3. Technique. How the scan was done, including whether contrast was given.
4. Comparison. Which previous studies were reviewed, or a note that none were available.
5. Findings. A systematic description of each organ or region examined.
6. Impression. A short conclusion that answers the clinical question, with the most important finding first.
7. Recommendations. Suggested further imaging or specialist review where appropriate.

The impression is written for the treating doctor, who links it with the patient's symptoms, examination and blood tests. If the clinical details change, or the doctor wants to discuss the case, the radiologist can review the study again and add an addendum to the report.

Which scans can be reported through teleradiology?

Most cross-sectional and digital radiography studies can be reported remotely, provided they are sent as complete DICOM studies with clinical information. The table below shows the common modalities and what a partner should send.

Ultrasound is different. It is a real-time examination, and its accuracy depends heavily on the person holding the probe, so it is usually reported by the doctor who performs it. Patients in and around Pokhara who need ultrasound can have it at KDRC through our ultrasound service or, for homebound patients, mobile ultrasound.

What does a partner hospital need to start?

A partner facility needs a scanner that exports DICOM, a reliable internet connection, a named contact person and an agreed way to send clinical information with each study. Our team works through the setup with each facility. The table shows how responsibilities are usually shared.

Is teleradiology as accurate as an on-site radiologist?

Yes, published evidence shows that teleradiology reports can be as accurate as in-house reports when qualified radiologists use proper diagnostic workstations. A prospective study of after-hours CT scans compared 7,209 reports. Clinically important discrepancies occurred in 5.8% of teleradiology reports and 6.1% of in-house reports, with no significant difference. The authors concluded that teleradiology is a feasible way to provide after-hours radiology services.

Accuracy depends on several conditions that apply to every radiologist, remote or local:

• Complete images. All series and thin slices, not selected pictures.
• Good clinical information. The clinical question, symptoms, relevant blood results and history of surgery.
• Access to prior studies. Comparison with previous scans often decides whether a finding is new or old.
• Two-way communication. The ability to discuss a case with the treating doctor and add to the report if needed.

The ESR white paper recommends that a teleradiologist should have access to previous images, referral information and relevant clinical data. If that information is missing and cannot be obtained, the report should say so.

Who reports teleradiology studies at KDRC?

KDRC teleradiology studies are reported by consultant radiologists Dr. Bishworaj Bastakoti and Dr. Nawaraj Paudel, who have been with the centre since its inception. A radiologist is a medical doctor who has completed at least four years of radiology training after medical school and specialises in interpreting medical images.

Dr. Bishworaj Bastakoti completed his radiology residency at the National Kidney and Transplant Institute, Manila, and is a Diplomate of the Philippine College of Radiology. He is a member of the Nepal Radiologist Society and has been registered with the Nepal Medical Council as a radiologist since 2016.

Dr. Nawaraj Paudel completed his residency at East Avenue Medical Centre, Manila. He is a former assistant professor of radiology at Universal College of Medical Sciences and has been involved with Gandaki Medical College. He is a member of the Nepal Radiologist Society and has been NMC-registered since 2016. Full profiles are on our doctors page.

Both radiologists report CT and MRI daily on KDRC's own 192-slice CT scanner and open-type MRI. That everyday experience carries over to studies sent from partner facilities.

How are patient data and privacy protected?

Patient images and reports are sent only through a secure transfer channel agreed and tested with each partner, and are handled confidentially like any medical record. International guidance from the European Society of Radiology sets out the main principles:

• Patients should be told when their images may be reported by a teleradiology service.
• Transmission methods must reliably protect patient data.
• Agreements between the facility and the reporting service should cover confidentiality, privacy and network security.
• Secure storage of images remains the responsibility of the organisations involved.

Partners should avoid sending identifiable images through personal messaging apps. Our team will agree the transfer method, who may access studies and how reports are returned before routine reporting begins.

How are urgent findings communicated?

Urgent and critical findings are communicated directly to the referring facility as soon as they are seen, not left waiting in a written report. Each partner names a reachable contact for this purpose. The table below shows examples of findings that need a direct call.

Teleradiology supports, but never delays, emergency care. A patient with suspected stroke, major trauma, severe chest pain or breathing difficulty should be stabilised and treated or transferred according to local emergency protocols while the scan is being reported.

Teleradiology vs an on-site radiologist vs sending films

Teleradiology gives a facility specialist reporting without employing a resident radiologist, and is much faster than couriering films or CDs. The comparison below summarises the options.

An on-site radiologist remains essential for procedures such as image-guided biopsy, fluoroscopy and ultrasound. Teleradiology complements local staff rather than replacing them.

Many facilities use a mix. A local doctor or radiologist handles procedures and routine work, while teleradiology covers complex CT and MRI studies, second opinions and times when no local radiologist is available. Others use teleradiology for nearly all cross-sectional imaging because recruiting a full-time radiologist in a smaller town is difficult. Whichever model you choose, the aim is the same: a timely, accurate report that helps the treating doctor act, and fewer patients making long road journeys only to have an existing scan read.

What teleradiology means for patients

For patients, teleradiology means a specialist reads your scan without you having to travel, and your own doctor receives the report. If you were scanned at a hospital or clinic outside Pokhara, your images may be reported by KDRC radiologists. Your treating doctor still explains the result and decides on treatment.

If the report recommends further imaging that your local facility cannot provide, you can book it at KDRC in Pokhara, for example CT angiography, MRI or a CT-guided biopsy. Bring your earlier report and images so the radiologist can compare them. Patients who are too unwell to travel by ordinary vehicle can use KDRC's ambulance service.

Keep a copy of every report and, where possible, the images on CD or another digital copy. When you see a new doctor or have a follow-up scan, these records allow a direct comparison. That comparison often shows whether a finding is stable, improving or changing, and it can spare you an unnecessary repeat scan. If you live in or near Pokhara, you can also ask your doctor whether teleradiology in Pokhara, through KDRC, can review a scan done elsewhere before you travel.

How much does teleradiology reporting cost?

Teleradiology reporting is priced per partnership, because the cost depends on the type and number of studies, how complex they are and how urgently reports are needed. The main factors are:

• Modality and region. A chest X-ray takes less time to report than a multi-region CT or MRI.
• Volume. Regular partners sending many studies have different arrangements from occasional users.
• Urgency. Priority reporting for emergency cases is agreed in advance.
• Complexity. CT angiography, cancer staging and second-opinion reviews need more time.

To discuss pricing for your facility, call 061-553538 or 9856077433, or email kaligandaki.dc@gmail.com.

Why choose KDRC's teleradiology service in Nepal?

KDRC combines experienced consultant radiologists, daily experience with advanced CT and MRI, and a base in Pokhara that serves Gandaki Province and the rest of Nepal.

• Consultant radiologists trained in Manila residency programmes and NMC-registered since 2016.
• Advanced imaging experience from reporting a 192-slice high-resolution Siemens CT and an open-type MRI every day.
• Clear onward pathway. Patients needing further imaging, biopsy or FNAC can be seen at the same centre.
• Personal setup. Our team agrees the transfer channel, reporting priorities and urgent-call process with each partner.

How to start a teleradiology partnership with KDRC

To start, call 061-553538 or 9856077433, email kaligandaki.dc@gmail.com, or send a message through our contact page. We will discuss your equipment, expected study volume and reporting needs. Then we set up and test the secure transfer channel with sample studies, agree priorities and the urgent-call process, and begin routine reporting. KDRC is on Shantipath, Amarsingh Chowk, Pokhara-10, Kaski. You are welcome to visit and see how studies are reported. See all of KDRC's diagnostic services.