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Radiographers embrace digital detectors to boost workflow


Revenues gained from the North American sale of x-ray equipment will reach about $1.8 billion this year, about the same as last year. But the market is anything but simple. It covers a wide range of technologies from conventional and digital radiography to mammography, from radiography/fluoroscopy and C-arms to vascular imaging -- both cardiac and angiography.

Revenues gained from the North American sale of x-ray equipment will reach about $1.8 billion this year, about the same as last year. But the market is anything but simple. It covers a wide range of technologies from conventional and digital radiography to mammography, from radiography/fluoroscopy and C-arms to vascular imaging - both cardiac and angiography.

Digital radiography is emerging as a principal driver of this marketplace. In the first half of this year, DR sales accounted for more than 200 units and $70 million. If the second half matches this pace, revenue from DR products will surpass last year's sales by about $15 million and 40 units. The final figures might be even higher, as orders booked in the first half were about 25% ahead of sales in the first half of 2003.

With DR finally hitting its stride, the focus has shifted from going digital to making digital all it can be. That theme will be evident at the RSNA meeting.

Film giant Eastman Kodak, a long-time player in computed radiography, this year will exhibit a work-in-progress DR system, its DirectView DR 7500, a direct-capture digital product that the Rochester, NY, company believes will provide users with a higher degree of flexibility. The system is designed with single- and dual-detector options, enabling facilities of any size to configure a DR solution that meets their space, application, workflow, and budget requirements. Marketing is expected to begin in the second half of 2005.

"It's highly versatile," said Helen Titus, worldwide marketing manager for digital capture solutions, Kodak Health Imaging Group. "Hospitals can purchase it in a single-detector configuration, then add a second detector later. It's also versatile in terms of technology - there are lots of options for positioning the patient and using the system the way people are most used to working."

Features include a wall stand with retractable bucky capable of three-axis movement, enabling the capture of a wide range of upright, horizontal, and cross-table projections. The detector can be controlled manually or synchronized to the overhead x-ray tube so that push-button control automatically centers the beam to ensure accurate source-to-detector alignment.

DirectView DR 7500 features a fixed elevating table with four-way float to provide flexible patient positioning. The detector bucky can be extended from the table to accommodate extremity exams.

"Nobody has the movement of the bucky on a wall stand to the degree that we do," Titus said.

Titus estimates that the installed base of DR systems worldwide will total more than 5000 by year end, and the adoption rate is growing rapidly. The number of new systems placed in use annually will approach 4000 by 2007, she said. Kodak hopes to snag its share of the market, which the company believes may be growing by up to 30% annually, by targeting hospitals of all sizes, specifically the trauma departments and general radiography.

Helping the transition from film to digital detector is the recognition that DR offers advantages in workflow. But digital technology must be designed to optimize patient management, she said, and that goes beyond just building a digital detector into a stand.

"We're being asked by our customers to pay attention to total workflow," she said. "Part of it's at the system, and the other part is at the operator console."

Seeking to capitalize on these trends and customer demands, Swissray will introduce at RSNA 2004 its ddRCombi Trauma. The system is designed to image trauma and other emergency patients from head to toe, both AP and laterally, easily and without being moved. It features a fixed table with elevating base, four-way floating top, and automatic positioning of the detector for cross-table imaging. The ddRCombi Trauma can be controlled from a wireless handheld remote control. Fully processed images are available in five seconds.

"Hospitals are really waking up to the potential of DR, and the busiest component of a hospital is the emergency room," said Rex Harmon, Swissray vice president of marketing and public relations manager.

The ddRCombi is just the latest in a long line of Swissray DR products dating back to the late 1990s. Last year, the company introduced its work-in-progress ddRRealtime capability and the IGS1000H mobile table with elevating top. Coming up with new ideas and designs is critical to survival, according to Harmon, particularly with the proliferation of small companies now entering the DR marketplace.

"There are so many companies that buy a detector and the associated control desk and put it onto their own radiography equipment," he said. "We suddenly have an armada of mom and pop, small-time x-ray companies that are becoming digital radiography companies with local target markets. All those regional people will be a force in the marketplace."

But they will have an uphill battle, competing with some of the most established names in the radiology industry, Philips Medical Systems among them. The company's new flagship DigitalDiagnost VM will be shown for the first time as a marketable product at RSNA 2004. Unveiled during the 2003 RSNA meeting as a work-in-progress, the VM began shipping in June. Six systems are already in place, said Deborah Imling, marketing manager for the radiography business unit.

"Our customers love the ergonomics and ease of use of the system. We believe we are meeting the need for a single-detector system, which our customers have been requesting for some time," she said.

The VM epitomizes flexibility, offering CR/DR integration using a multipurpose single-detector configuration to cover a broad range of applications. Scheduling, verification, and general postprocessing can be done at a single acquisition workplace. Other features include cassette size flexibility, light weight, minimal dead borders, and wireless operation.

"The VM provides a deep digital integration with a relatively low price point - $350,000," said Scott Burkhart, director of the company's radiography and RF business units.

The VM blends manual and robotic systems, allowing the user to automate some things, such as the handling and heavy movements of the detector, in order to minimize any danger to the CR plate and risk of back injury to the radiology techs, who are at particular risk for back problems. The result is a dramatic increase in productivity over film systems and competing DR products, according to Burkhart.

"The productivity increase has been beyond what we thought it could be," he said.

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