It seems like we have crossed the healthcare frontier and the only thing left to conquer is analog or film based x-ray systems. MRI's, CT's, Ultrasound, PET, Bone Densitometry, Mammography and most diagnostic imaging systems output digital data, that is except for Radiography and Fluoroscopy. Most existing radiography systems are still analog and put out either x-ray film and/or analog video.
Although most mobile C-arms are now being produced with digital output capability, most existing C-arms, X-ray systems and R/F systems have not yet been upgraded. When you consider that today there are more x-ray studies done than any other modality study, we should concede, we are way overdue in moving to electronic Rad and Fluoro. These upgrades should probably be initiated before all others at medical facilities today. The sooner digital conversion takes place the sooner cost savings will be realized and productivity will be enhanced. So when we ask the question "When should we convert to digital X-ray"? The answer should be "now" or "as soon as possible".
There are many reasons why the conversion should take place, but first and foremost, as always, is cost savings. The cost to purchase, process, duplicate, archive and access film is enormous. Although the actual cost of film is relatively inexpensive, the cost of a film processor, its maintenance, replacement, chemicals and dark room facilities is not cheap. Then, the cost of filing and storing film, retrieving and/or duplicating, film further compounds the cost. Now, add in the time it takes to process and possibly re-shoot, because of poor quality, and the time it takes to transport the film study to the physician or technician and you probably can cost justify the purchase of a digital solution in less than two years. The last factor is the amount of time saved during the procedure itself, thereby increasing the number of patients able to be x-rayed in a given time period. Actual throughput for a single system can probably easily accommodate 8-10 studies per hour, probably an increase of 30% over a film based system.
The bigger question is how do you make this conversion? If you have not had much time to look into digital conversion, you will find there are quite a few options. Although the technology was developed several years ago, it continues to evolve and price continues to change as well. The least expensive and most popular solution is Computer Radiography (CR) or digital radiography systems of . These systems consists of cassettes/phosphorous plates, a reader/converter and a computer workstation. The cassettes/plates are inserted into the table or the chest bucky, similar to inserting a film cassette.
The plate is exposed to x-ray, the cassette is removed and inserted into the reader/converter, which reads the exposed plate and produces a digital image. The plate is then erased and ready to be used again in the same process. The image is available at the computer workstation for viewing, transfer to a radiologist and/or transfer to a Picture Archiving and Communications System (PACS). CR systems range in price from low performance systems (one plate processed every 60 seconds) at $30K- $40K to high performance systems (multiple plates processed in 30 seconds) at $90K-$100K.
Although CR is less expensive, the time to load and transport cassettes around, combined with 30-60 second processing times result in lost productivity and throughput when comparing it to Direct Radiography (DR). These systems generally use flat panel detectors that are permanently fixed into the table and/or chest bucky. They also come with a computer workstation and acquisition/viewing/manipulation software. The DR process is very fast and simple. The x-ray exposure is shot and the detector converts it immediately to a electronic image available within 5-15 seconds for viewing at the computer workstation.
However you must pay the price for speed and simplicity. A single panel DR system can costs $100k-$140K. If you have a table and chest stand and you require two detectors, you will need to add another $80K, resulting in a DR system costing 2 or 3 times more than a new x-ray system, which might cost $75K for a high performance and major brand. DR Fluoro/Spot systems are also available to retrofit R/F and Angio systems. These systems are deployed by adding a CCD camera at the image intensifier, a computer workstation, acquisition/viewing/manipulation software and digital R/F system monitor. These systems cost $65K-$80K.
Although all of the solutions discussed are relatively expensive, there are opportunities to reduce costs. We offer a CCD flat panel DR detector system for under $50K. We have sold many refurbished CR systems under $30K and refurbished DR Fluoro/Spot systems under $40K. We have also replaced older X-ray and R/F systems with late model high frequency systems (suggested when upgrading to digital) at half the price of a new system.
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