X-Ray

A 75-year-old man was referred for presurgical MDCT evaluation of a known abdominal aortic aneurysm that had been detected on screening abdominal ultrasound. A contrast enhanced CTA scan of the abdomen was performed.

Buyers pull in their horns, and future portends mix of DR, computed radiography, and traditional film

Most U.S. healthcare facilities have digital imaging technology in the form of either CR or DR. The decision is not when to go digital, but which technology is the most appropriate for each location.

Managing CR and DR implementations is a carefully orchestrated effort at Roper St. Francis Healthcare in Charleston, SC. Our healthcare system includes two hospitals in Charleston (Bon Secours St. Francis and Roper Hospital) that represent almost 600 beds, a day hospital, a hospital soon to begin construction in Mt. Pleasant, and eight outpatient facilities with imaging services in the midcoastal area of the state.

Philips Medical Systems plans to be on the U.S. market with a computed radiography system for mammography in the second half of 2008 and with a flat panel mammography system in the first half of 2009. When approved by the FDA, they will be available as part of a digital platform that can support CR and DR, the first such hybrid ever.

Two new computed radiography systems and a digital radiography unit debut this week at the Caresteam Health booth at the RSNA meeting. The CRs, dubbed the Classic and Elite, are accompanied by IT products already introduced:

Demand for digital x-ray is soaring, about 10 years later than most industry insiders predicted. Better late than never, for sure, but the reasons behind the rise of this class of products are as much economic as technological. Volume sales are bringing down the price of digital x-ray systems, just as the adoption of PACS is making digital radiography more a need than a want. Vendors are responding with more powerful equipment bearing attractive prices.

When PACS were first introduced, the vendor supplied the whole system, from the back-end servers to the front-end diagnostic workstations. Over time, the buyers of these systems realized that none of these PACS vendors actually manufactured the computers and monitors; they just resold them, often at huge markups.

One of the world's major suppliers of flat-panel x-ray detectors will boost its manufacturing capacity 40% this year. By the end of the decade, Trixell-the French joint venture among Siemens, Philips, and Thales-expects to double its current capacity.

A newly constituted company drawn from the remnants of a past innovator in digital imaging aims to put a CT-like twist on general radiography. Fischer Medical Technologies plans to update the general radiography platforms that were once the foundation of its predecessor, Fischer Imaging, with novel digital detectors, inexpensive processors, and conebeam rendering software. Its top executive hopes the products it creates will change the way surgeons operate.

Demand for digital and computed radiography has boomed of late, and there’s no sign of pulling back among U.S. hospitals.

CR vendor Radlink debuted at the 2006 RSNA meeting a value-priced system designed to help physician offices convert from film to digital radiography. The Pro Imaging will leverage the company’s existing lines, which include the CR Pro computed radiography system, hardware to digitize existing x-ray films, and software for managing practice workflow and data.

Innovative x-ray technologies bolster early detection and shorten gap between DR and CT

The inherent advantages of digital radiography make it a growing favorite among radiology and other departments that use x-rays for diagnostic purposes. Speed, convenience, and quick review of images give DR an edge over rival computed radiography. Yet CR can perform some exams that are still beyond the scope of DR. This give and take is apparent in the orthopedics outpatient clinic at Strong Memorial Hospital in Rochester, NY, which manages between 250 and 300 patients per day using three DR and five CR systems.

The pending FDA approval of FujiFilm’s computed radiography-based mammography system will radically change how the company approaches the U.S. market not only in CR but in PACS. Company strategists plan to position two CR products -- the single-plate reader ClearView-1m (mammography) and the multicasssette reader ClearView-CSm -- as dual-purpose devices capable of converting analog mammography systems to digital, while amplifying the capacity of and backing up already installed CR devices. Fuji will simultaneously market a mini-PACS for mammography that can be integrated with currently installed PACS, increase the capabilities of these PACS, and eventually replace them.

When digital radiography began to take hold, it seemed computed radiography -- the phosphor-based means to a digital end -- would be dropped by the wayside. Conventional wisdom held that it would be only a matter of time. But nothing like that has happened.

Low-dose CT appears well-suited to the task of diagnosing lung cancer at an early stage. But it faces challenges regarding small nodule detection, and it may not be as widely available for screening. Several research groups suggest that digital radiography-further enhanced by computer-aided detection and digital subtraction techniques-could overcome CT's shortcomings in this setting.

As manufacturers continue to vie for position in the digital imaging marketplace, they are reluctant to give competitors an edge. Consequently, computed radiography vendors are beefing up their technology to rival digital radiography in image quality and productivity, while digital radiography suppliers develop smaller, more compact products to challenge CR in affordability and flexibility.

Computed radiography’s new needle-like phosphor imaging plate technology provides comparable diagnostic performance with only half the radiation exposure required by its predecessor, according to a study presented Sunday. Findings suggest the gap between CR and digital radiography is shrinking as well.

Moving from film-based radiography to digital x-ray imaging typically involves a choice between two quite different technologies, computed versus digital radiography. Now Agfa is offering an alternative halfway between the two.

Eastman Kodak will unveil a top-of-the-line, multicassette computed radiography system at this week’s meeting of the American Healthcare Radiology Administrators in San Antonio. Earlier this summer, the company unveiled a value-oriented single-cassette CR reader designed for budget-strapped hospitals, imaging centers, and physician practices.

Computed radiography has long had a financial edge over its flat-panel competitor, digital radiography. Radiography departments can convert to digital with the introduction of a single high-performance CR reader, as opposed to swapping film-based units for those with DR plates.

Fujifilm Medical Systems has combined its customizable Flex UI digital x-ray software application with the convenience of PDAs to introduce the FCR Pocket ID at the RSNA meeting. With the Pocket ID, patient data can be accessed quickly and verified at the patient's bedside, permitting caregivers to increase efficiency while reducing the potential for medical errors, according to the company.

Digital radiography has more than arrived. It is overwhelming film-based systems. And GE Healthcare has the proof, announcing at the RSNA meeting the 4000th shipment of its Revolution digital x-ray detector-based system.