Magnetic resonance imaging: for whom and why

New modern methods of research to help accurately diagnose and plan to establish the correct treatment.

One of the most effective methods is an MRI - magnetic resonance imaging. MRI - it is one of the best and most accurate ways to diagnose pathology in the soft tissues of the body. Yet there are contraindications to undergo this procedure. However, progress does not stand still, and that number every year is getting smaller.

Year of foundation magnetic rezonanskoy tomography in medical circles, is considered to be 1973rd, and this despite the fact that in 1960 the Soviet scholar V. Ivanov proposed a method and apparatus for tomographic method for studying the internal organs and tissues using nuclear magnetic resonance - NMR tomography. As a result, the inventors of MRI officially became Peter Mansfield and Paul Loterbur who received for his contributions to science in the 2003 Nobel Prize in medicine. Apart from these, a significant contribution to the development of MRI has made Damadyan Raymond, who studied the principles of operation and created the first commercial MRI scanner (who also holds a patent on MRI).

By the way, his final title was reserved for an MRI since 1986, after the Chernobyl disaster: then evolved in humans radiophobia made it extremely difficult to use the word "nuclear" in the name of the medical device. But in any case it does not negate the very essence of the method in the staff of MRI radiofrequency coils pick up the special response of the nuclei of hydrogen atoms in the body, in a special combination of electromagnetic waves in a constant magnetic field of high tension. Unlike computed tomography and conventional X-rays, MRI uses no ionizing radiation, which can lead to the formation of free radicals, causing massive loss of cells.
Why use MRI?

Magnetic resonance imaging is mainly used for the diagnosis of changes in soft tissues. In addition, this research method to visualize the brain and spinal cord and other internal organs with the highest quality, inaccessible to X-ray, ultrasound or CT scan. MRI plays an important role in early detection, diagnosis and treatment of common diseases and conditions such as cancer, neurological disorders or injuries of the locomotor apparatus. The most common use of MRI - to examine the spine and central nervous system. The method allows to accurately assess the structure of the bodies, identify disease, tumors, traumatic changes, and so on. In addition, MRI is widely used in Angiology, oncology, urology and other fields of medicine.

Head of the laboratory of social and economic risk analysis HNIZ, Chairman of the Working Group of Cardiology of young Russian Scientific Society of Cardiologists End AV said that an MRI - is a modern high-tech diagnostic method, which allows you to look inside the human body and identify a range of diseases, including cancer. Most importantly, this method can be applied at the earliest stages of the disease when treatment is effective.

In addition to the study of internal organs and soft tissues, this method allows non-invasive diagnosis - that is, without intervention - to investigate organ function: measure the speed of current of cerebrospinal fluid, blood flow, determine the level of Diffusion in the tissues, to track the activation of the cerebral cortex, and much more. It turns out that for one MRI can clarify several aspects of human health. During the passage of an MRI patient in a horizontal position is placed in a narrow tunnel (pipe) with a strong magnetic field for about 15-20 minutes, depending on the type of research. The patient must maintain complete immobility of the body parts which are subject to inspection.

The procedure is painless, but is accompanied by a loud noise, to reduce the discomfort that patients are often offered headphones. By the way, in order to pass magnetic resonance imaging, the patient does not need special training. He can continue to use any drugs, do not limit themselves in eating and drinking, as well as other medical procedures take place. Only the examination of the pelvic organs to take care of filling the bladder. But before examining the head, women's better not to apply make-up, as the shadow, mascara and other cosmetics may interfere with obtaining high-quality images, and thereby reduce the accuracy of the procedure. In addition, the patient is important to provide all the previous data on the ultrasound and MRI studies - then the specialist will be easy to trace the dynamics of change.

Contraindications for using MRI

But, unfortunately, not all patients can use this method of diagnosis, since there are a number of absolute and relative contraindications. For example, a completely non-pass magnetic resonance imaging in the presence of the established pacemaker, metal implants and various metal fragments in the body. At the same time relative contraindications are insulin pumps, nerve stimulators, various non-ferromagnetic implants and prostheses, pregnancy, claustrophobia and the need for physiological monitoring.

If we talk about patients with pacemakers, the MRI would be very useful for them in terms of studying the state. On doctors' estimates, about 50-75% of patients worldwide were living with implanted pacemakers, one way or another in need of an MRI scan during the lifetime of the device. Thus in 2010 appeared the first and only worldwide pacemaker manufactured by Medtronic with a unique technology that allows the passage of magnetic resonance imaging. This was achieved through the modification and improvement of the internal circuitry system and reduce the number of ferromagnetic components. To date, the new pacemaker can already run a full examination by MRI more than 13 000 patients worldwide, and in June 2011 announced the release of this system is pacing the Russian market.

With regard to pregnant women, to date, experts gathered insufficient evidence that MRI is completely safe for the fetus. But, doctors say, is preferable to MRI imaging and computed tomography, and yields more information than by ultrasound. In addition, the relative restriction to the passage of magnetic resonance imaging may be the presence of tattoos, made with pigments containing metal compounds, including compounds based on titanium (eg titanium dioxide), though in itself is not ferromagnetic titanium and virtually safe MRI.

There is also a psychological problem due to the fact that the procedure takes place in a narrow space, people with even a mild form of claustrophobia, may experience severe discomfort. However, today there is less bulky machines MRI with a wider aperture, and the time of the procedure is reduced. Also, there are open sets and apparatus in which a patient can undergo research standing. But, experts say, the quality of the results obtained is inferior to traditional methods. So, sometimes for the full and effective investigation used a local or full anesthesia, especially for infants and young children who can not remain immobile during the procedure.

Kidney Lymphoma and the Importance of Computed Tomography (CT)

By MC Raflesia

Kidney lymphoma is most frequently observed along with multisystemic, dispersed lymphoma or as tumor reappearance. Kidney lymphoma might be observed in immunocompromised patients or, hardly ever, as primary disease as well.
With the kidneys being the most usually involved organs, extranodal spread of lymphoma frequently influences the genitourinary system.
The lymphoma can obstruct urine from leaving the kidney. This could cause kidney failure, which could lead to low urine output, weariness, loss of appetite, nausea, or swelling in the hands or feet. The lymphoma could obstruct feces as well moving by means of the bowel. This bowel stumbling block could lead to nausea, vomiting, and serious abdominal pain.
Lymphoma of the kidneys is detected at the time of autopsy in nearly one half of cases. It is seldom suspected on conventional urologic surveys like intravenous urography.
In the nonattendance of right clinical treatment, since involvement of the kidneys typically points to dispersed disease the prognosis is poor. The disease can present with progressive kidney failure. Survival is really poor in principal kidney lymphoma: in less than 1 year 75% of patients die. By early detection of the disease and by doing systemic chemotherapy the prognosis could be recovered.
Kidney lymphoma displays no racial predilection. Kidney lymphoma shows no sex predilection. Nonetheless, it is allegedly perceived more frequently in male patients. Kidney lymphoma takes place in every age group. The disease typically influences adults; but, kidney lymphoma has been reported in childhood as well.
For the detection, diagnosis, staging, and monitoring of kidney lymphoma, contrast material-enhanced computed tomography (CT) remains the modality of option. In patients in whom intravenous administration of iodinated contrast material is contraindicated, magnetic resonance (MR) imaging is principally helpful. Ultrasonography (US) is less sensitive than CT and MR imaging for identifying kidney lymphoma, though really useful for diagnosing lymphoma in the testis or epididymis.
However, in patients with suspected kidney lymphoma, the most sensitive, efficient, and complete examination for evaluation of the kidneys is computed tomography (CT). Helical CT especially recovers detection and characterization of lymphomatous kidney involvement by optimizing contrast dynamics and data acquisition. It is the present modality of option for precise staging of lymphoma.
If you want to get some excellent resources on kidney, please visit my site on You and Your Kidney [http://allaboutkidney.blogspot.com/] or Kidney Lymphoma [http://allaboutkidney.blogspot.com/2008/06/kidney-lymphoma-and-importance-of.html]

Breast Screening With the Aid of MRI

In the detection and assessment of breast cancer by MRI, gadolinium contrast agent is used to highlight lesions and their extent. Subtraction and fat suppression techniques are used to minimize loss of visibility.

The screening of the general population by MRI is not practical because of its high cost and limited availability. Although MRI screening is at least 10 times more expensive than mammographic screening, studies suggest that the use of MRI might be the most cost efficient screening modality, especially in cases with a high-risk probability of breast cancer. The MRI breast imaging is performed with the aid of specialty dedicated breast coils, usually a bilateral multichannel system. The MRI system can be a whole body scanner with a magnet of 1.0 T or more.

Such MRI Scanners feature a slice thickness of 2.5 mm or less and a plain resolution of 1.3 mm or less. A high end 1.5 T scanner can achieve a Voxel size of 2 mm or less.

MRI sensitivity for breast lesions is high, however its specificity is not adequate. Therefore MRI-guided biopsies are often performed for histological examinations. Two different MRI guided intervention methods are used:

1. The freehand technique which allows wire localization within 10?5 mm of the lesion
2. The stereotactic approach which features much better precision.

There are several biopsy devices on the market including: coaxial core needle system, stereotactic system, biopsy guidance device and vacuum assisted core biopsy gun. Standard whole body scanners can be used to perform breast MRI imaging, if the appropriate breast coils are available. These types of systems benefit from greater versatility in the radiology department.

Currently, dedicated machines are available. The advantage of these machines is that they are custom-designed for breast MRI, and patient comfort is therefore optimized. The staff working on these scanners will become specialized in the needs of this particular patient group.

Standard 1.5 T multi-purpose MRI scanners cost between 1.1?1.9 million dollars. Dedicated breast MRI scanners costs 1.4?1.8 million dollars.

All MRI scanners require investment in terms of physical space, running costs, maintenance and staffing. A dedicated breast scanner will require almost the same costs.

Magnetic Resonance Imaging (MRI) And Functional Computerized Tomography (4DCT) In Radiotherapy

Magnetic resonance imaging (MRI) is traditionally used in the diagnostic and staging parts of a patient's treatment pathway. More recently however, it has also been used to help determine the planning target volume (PTV). In many CNS patients their diagnostic MRI scan is fused with their radiotherapy planning CT scan. (REF) The oncologist is then able to outline the tumour mass on the MRI as a GTV, which can then be superimposed on the planning CT scan, to check the area for treatment and the margins to be used. This fusion of images, is advantages for two reasons. Firstly the MRI image shows far greater resolution in soft tissue, than the CT, and secondly because the CT scan is carried out post surgery following de-bulking, whilst the MRI is carried out prior to any clinical intervention. Therefore the oncologist is in effect, able to treat where the gross tumour was actually initially located.

Functional MRI (fMRI) is a relatively new technology, which is used with the aim to try to determine precisely which part of the brain is handling which critical functions. This is called brain mapping and is used primarily during surgery before the patient comes for any radiotherapy. The use of fMRI has been extended more recently, as it has now also been used as tool, in order to monitor the growth and function of any remaining brain tumour following treatment.

Functional computerised tomography (4DCT) is a normal CT scanner with software incorporated, or hardware adaptations, which allow it to look at organ motion in relation to bony anatomy. These fall into three main categories; 1 Breath Hold, 2 Gating and 3 Tracking the movements of the tumour.

Another method, which can also be used to monitor and control organ motion linked to breathing, is a type of active breathing control device. An active breathing device allows imaging in only one specific part of the patient's breathing cycle. The benefit of this is that it allows for the scan to be constructed with the tumour in one position, and therefore hopefully not as effected by organ motion. The same active breathing device is then used each day while the patient is having their radiotherapy treatment, so the tumour is localised while the treatment machine is delivering dose. This technique does require much cooperation from the patient, and would only be suitable for patients whose thoracic tumours were not too severe to have caused severely laboured, or erratic breathing patterns.

Another type of tumour tracking device uses reference points that are actually attached to the patient's skin surface. These reference points are then tracked while the patient is being CT scanned to determine at which point in their breathing cycle they were at any given point during the scan. When the data from the CT scan is then being consolidated, this additional motion information is added allowing the actual specific motion of any tumour to be linked to each patient's own specific breathing cycle.


The 3rd 4DCT method effectively builds a margin around the GTV as it continually moves within the body. This technique aims to determine the true extent of each patient's actual tumour motion, so a personalised plan can be produced which gives a treatment dose to the GTV, even though it is moving throughout the treatment. The main problem with this technique is a large volume normally needs to be treated, if the tumour motion is of significance and is therefore not generally useful when using radical radiotherapy treatment techniques.

Investigative Radiology special edition on “Advances in CT technology”

According to the information of Investigative Radiology, there is a special issue on ‘Advances in CT technology’ scheduled for publication during the summer of 2010.

The focus of this special issue will be on recent technical developments of CT, including specifically dual source/ dual energy CT and multidetector CT with 128 or more detector rows. The special issue will include both basic and clinical research investigations. In terms of clinical studies, the focus will be on those providing evidence for improved clinical diagnosis by the use these CT techniques.

The deadline for submission is December 15, 2009. Scientists and clinicians who work in the area of preclinical CT are also encouraged to submit papers.

Medical Imaging Equipment Financing Tips

The huge advancements in the field of medical technology have resulted in great benefits to mankind. One such great advancement is the creation of medical imaging equipment.

Types of Medical Imaging Equipment

One of the most commonly used medical imaging machines is the CT scan machine. This machine is a result of a great breakthrough in medical science. It enables us to scan the different parts of the body and helps doctors see internal organs, muscles, blood vessels and tissues in a manner which they could not have imagined a few years ago. However, since these machines are immensely sophisticated, they come at a great cost. Thus, if you need to purchase medical imaging equipment, the best way is go for financing.

Radiology equipment like X-rays, tomography, radio waves, and ultrasound also come at a very great cost. However, in every hospital or clinic, it is highly essential to have these equipments so as to help doctors diagnose diseases promptly. There are many kinds of radiology equipment that are required by doctors for testing different parts of the body and different kinds of symptoms. Therefore, any healthcare institute must have all these equipments at hand if they want to ensure that the patients coming there for treatment are not deprived of good care. Since it is very difficult to buy all these equipments, the best way is to appeal for financing and then purchase these.

One of the most common equipment required by doctors is the X-Ray machine. In case of any kind bone injuries, it is important for the doctor to identify whether the injury is to the bone or the ligament. Also in case of pains, doctors need to find out the reason behind them and they usually want to see an X-Ray of the region of the body concerned. This has increased the importance of the X-Ray machine in modern medicine to a great extent.

An important medical equipment is the sonogram, which is widely used for getting images of the important internal organs in order to identify diseases of the veins, muscles and arteries. Especially in cases of tumor, the sonogram is required. Being an immensely expensive yet essential equipment, there are many finances available for the sonogram.

Other equipment that are required in hospitals and health clinics include the endoscope and the x-ray film processor. The endoscope is used for taking high resolution pictures of internal organs that reveal minute details of the organ. The x-ray film processor is an equipment that prints the images that the x-ray machine takes. The ultrasound equipment is yet another important medical imaging equipment that helps in identifying the problems of internal organs. It is especially used to monitor the growth of the fetus during pregnancy.

Opt for Equipment Financing

There is a wide range of organs that are required to be checked by medical teams in order to properly identify the particular health problem of the individual. Thus, getting finances is a very important thing in this field. Thankfully, there are numerous organizations that help medical institutions purchase these equipment by financing.

X-Ray Technician Online

It is possible to complete studies in online schools for practicing as an X-ray Technician. Most courses can be completed and certification earned at your own pace from the comfort of your own home through an Online X-ray Technician program.

An X-ray Technician, or radiologic technologist, supports medical teams by managing x-ray imaging processes, transporting and preparing patients for x-ray, and providing information. X-ray Technicians are employed in private physicians' and chiropractic offices, medical and dental clinics, and sometimes in industry and government services. Hospitals, however, are where most X-ray Technicians will find placement.

An X-ray Technician is trained to use radiography to capture images of the body and to provide information for diagnosis. Information provided by X-ray Technicians will be used to repair broken bones and treat diseases. An X-ray Technician is trained to explain procedures to patients and operate x-ray machines. An X-ray Technician must also be educated in the safety issues related to radiology and materials used in the processes of imaging.

Most programs for an X-ray Technician will prepare the student with studies of patient care, medical terminology, anatomy, physiology, pathology, the uses of radiology, and necessary protection from excessive radiation. Additionally, students will be instructed in the proper positioning of patients for specific techniques, principles of imaging, and medical ethics. X-ray Technician programs take one to four years of study, depending on the program and the level of expertise the student chooses.

A curriculum emphasizes the development of effective techniques and preparation for state examinations for certification or licensing, as necessary. Most programs prepare X-ray Technicians to perform back office medical assistance, as well, which will increase job opportunities and vary job one's experience.

Computed Radiography Systems Can Improve Workflow and Save Money

Computed Radiography is a tried and true method of acquiring medical digital images for use as x-rays. Computed radiography systems are not only available for large hospitals, but also for small and medium-sized medical facilities, orthopedic offices and others. Now you can use exceptional CR systems, including AGFA CR, kodak CR, and Fuji CR units, to complement your existing digital radiography equipment and move it up to low-volume digital imagery at an affordable price.

CR systems can be used both in the office and off-site. With a CR unit, you also have more flexibility in taking patient images because the patient can be lying or sitting down. Reusable cassettes are used for the digital image capture, which is a cost savings over film and development chemicals that need to be replaced for every image taken.

The Kodak digital radiography systems offer an attractive group of digital imaging units. Several of the Kodak CR systems come with a mini-PACS system as well, so that you can archive and distribute your digital images quickly and easily.

The AGFA CR 30-X and 35-X systems are compact and produce high resolution digital medical images. The AGFA CR systems allow you to meet HIPPA requirements in terms of medical digital image archiving and storage. The CR30-X is a compact tabletop device that runs on standard electrical outlets, saving space as well as time in that it offers a simpler installation than other systems. The AGFA CR 35-X offers three unique image resolution modes for your convenience.

Fuji CR systems are available in XC-1 and XL-1 models. Both have a small footprint, making them suitable for use in exam rooms. They offer fast image previews in less than a minute, and offer imaging plates in a variety of sizes appropriate to your medical digital imaging tasks. The Fuji CR XL-1 can send digital images to your PACS system, where the images can be stored, and it will also enable you to print hard copies of your digital medical images to film. The fuji cr XC-1 can process 35 plates measuring 14X17 per hour, while the XL-1 can read 62 similar sized plates each hour, for improved workflow in your digital imaging department.

Computed radiography systems such as the AGFA, Fuji and Kodak CR units make a great choice for when you want to retrofit the radiology equipment that you already have in place. By upgrading your current equipment so that it produces digital medical images, you can also benefit by being able to use a PACS system for digital archiving both on and off-site, and can implement teleradiology to send and receive digital images.

Technology in Healthcare (How to Get the Most From Your Radiology Dollar)

The decisions are getting harder when we try and determine what our facility should invest in to provide the best patient care. 256 slice CTs, 3.0T MRIs, Digital Mammography, PACS Upgrade, EHR and so on....? We first try and determine our available budget or we are asked to submit a request for funds based upon current and future requirements, local competition and/or physician requirements. It is now necessary to take a long hard look at what is currently being utilized and determine how best to enhance capabilities. You probably begin to bring in vendors to discuss the capabilities of their new systems, as well as potential costs. If you are like many administrators, you immediately get a large blast of reality. You instantly know that you will be limited to one purchase or less and it's possible funding won't be available for several years. If you are experiencing growth, patient count is increasing, test procedures are on the increase, and available system time is becoming harder and harder to come by, then you know you will need to upgrade Radiology capacity.

You now are probably asking yourself why you are faced with this growth. The first thing you may remember is that those people called baby boomers are becoming elderly and generally with age, comes increased health care. Secondly, the Deficit Reduction Act (DRA) reduced reimbursements to imaging centers, putting a number of facilities out of business and moving those patients to fewer remaining facilities. And, of course our Government is becoming close to adding more than 47 million uninsured Americans on to the rolls of public health insurance which is sure to increase radiology test requirements significantly everywhere in the country. Now that you are pretty much convinced you need to expand capability, usually with a limited budget, just what do you do?

You first may want to take a close look at what you are utilizing today and determine what is adequate and what needs to be replaced. If you are using a 4-slice CT or less, if your MRI is 1.0T or less, if x-ray, R/F and mammography systems are analog output (film) instead of digital, then you have important issues to resolve. Now, if you have an available budget of around 3 Million dollars you should be able to purchase new replacement systems that will work very well -- a 32 slice CT, a 1.5T short bore MRI, x-ray and R/F systems with DR and a digital mammography system.

Let's assume for a moment that you don't have a budget of 3 million dollars but you do require upgrades. Here's what you might consider: Upgrade the CT with a late model 16 slice CT, refurbished, installed and warranted for about $200,000. Also, bring in a late model 1.5T short bore MRI system for about $400,000. Purchase one new high volume CR system to convert x-rays for about $70,000. Add a refurbished fluoro DR system to the R/F room for about $45,000 ( or a new one for $65,000). And finally, purchase a Mammo CR system for about $90,000. Now for just over $800,000 you have nearly the same results as if you had replaced and purchased new except you will saved nearly 2.2 million dollars.

How do I know this? We do this every day. We enable health care facilities to upgrade with high quality, high performance late model systems for a fraction of the cost of new. This business of diagnostic imaging is all about taking pictures, and as long as the pictures are high quality, very little emphasis should be focused on whether or not the system that took the pictures are new. Remember, once that new system has been operated once, it becomes a used piece of equipment!

Using Radiology For Health Prevention is a Great Lifesaver

There are four main types of radiology: diagnostic, interventional, nuclear medicine and radiation therapy. The diagnostic radiological procedure includes common preventative medicine practices like MRIs, mammograms, ultrasounds, X-rays and angiography. Doctors check the various systems of the body to determine if anything is wrong. This is the best health prevention method, aside from the standard healthy diet and exercise.

The interventional radiological method is an alternative to surgery that includes biopsies, cancer treatments, angioplasty, embolization, vertebroplasty, nerve blocks and varicose vein treatments. Nuclear medicine is a way of assessing damage done to the heart, lungs, thyroid, liver, gallbladder and bones.

The physiological damage and progression of tumors can be monitored using this method. Lastly, radiation therapy is used to treat brain tumors and cancers, such as breast, colorectal, head, neck, lung and prostate.

Radiological methods can be used within three hours of a person's stroke symptoms. Strokes are typically caused by blood clots to the brain, so the standard procedure dissolves blood clots through an intravenously injected tissue plasminogen activator. If it has been more than three hours, but less than six, then an intra-arterial thrombolysis treatment may be performed, which places the clot-busting drug right at the site and will mechanically break up the clot.

With this amazing minimally invasive procedure, most stroke patients can regain full functionality and return to every day life. Health experts say the main challenge with stroke radiology is having enough stroke teams ready to handle patients within the three-hour timeframe.

One of the most common uses of radiology is for angioplasty, or the opening of clogged arteries, which benefits patients who are at risk for heart attacks or strokes. In this procedure, inflated balloons are passed through catheters to the trouble spots to increase blood flow to the brain, kidneys and legs.

Often, chemicals are placed in clogged locations to dissolve the plaque or the clots, which are then mechanically broken up. Another related radiological technique is stent grafting, where a synthetic tube is placed in large blood vessels to prevent an aneurysm or fatal bleeding.

Those concerned with senior health favor the non-invasive methods especially. Many people are in and out during the same day and continue to live productive lives afterward.

The use of radiology for health prevention and testing is one of the biggest lifesavers, health experts say. Ultrasound, magnetic resonance imaging and mammograms have the ability to help patients who would have otherwise died to live an extra 20+ years.

As for interventional radiological procedures, the benefits are numerous. It requires less anesthesia, less trauma to the body, shortens the hospital stay and recovery period, as well as causing minimal discomfort.

Digital Radiography - Electronic X-Ray - When, Why and How?

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.