TechNation keeps readers updated on the latest in technology when it comes to medical devices. We recently reached out to digital radiography experts to gather their insights on the state of this imaging technology. We also asked for their tips on finding training and the ideal device.
The digital radiography experts participating in the roundtable include AMX Solutions CEO Bill Bentley, Mindray’s International Marketing Director for Digital Radiography Systems Jason Li, Multi Diagnostic Imaging Solutions Chief Operating Officer Dan Moretti and Carestream’s Worldwide Marketing Director for X-ray Solutions and Ultrasound Helen Titus.
Q: What are the latest advances or significant changes in digital radiography in the past year?
Bentley: AED (Automatic Exposure Detection) Technology wireless DR detectors are significantly lighter than the current tethered detectors and are much easier to use. Some AED detectors offer more features such as storing the last 100 images and indicating over/under exposure. Also, costs are reducing significantly due to the number of detector options available.
Li: The conversion from conventional film radiography to the no-film digital radiography has enabled Mindray to move forward by introducing higher quality detectors that improve images, reduce operational expenses significantly and speed workflow, while reducing radiation dosages for patients.
Moretti: In the last year, we have seen a greater presence of wireless DRs as well as improvements to DR technologies for the enhancement of image quality, reliability, decreased weight, ease of installation, use and support.
Titus: The markets for both CR and DR systems have expanded, so customers today have more choices than ever before. Affordable systems are available for providers that capture 150 images a day — or 150 images a month. Facilities can now upgrade from film to CR/DR, from CR to DR or to expand their DR systems — easily and affordably.
Q: How will those changes impact the digital radiography market in the future?
Bentley: More customers can afford DR since the costs are more favorable. The same detector can be used with the portable and in the rad room. The GE AMX-4 Plus portable can now be used with the customer’s choice of detector and software giving the customer more flexibility to choose the product they like the best.
Li: The advancements in digital radiography have already enabled several benefits. Digital radiography can lead to better diagnosis and more treatment options for the patient.
Moretti: The constant improvements will aid in providing better image analysis, improved workflow, increase patient throughput and greater customer satisfaction.
Titus: The market for digital radiography will expand and extend to smaller facilities/specialty offices that can now afford these systems. We will see new software features and workflow enhancements in addition to equipment advances.
Q: How can a facility with a limited budget meet its digital radiography needs?
Bentley: They can purchase a DR ready GE AMX-4 Plus portable that comes with everything except the software and detector at a very affordable price and select an affordable detector/software package to fit their needs. There are a lot of options available in today’s market.
Li: Much attention has been given not only to the acquisition costs, but also to the operational costs. Those operational costs are of course impacted most positively by the transition from film to digital. However, operational costs are also impacted by ease of installation (impacting start-up costs), ease of use (reducing training and expertise requirements), system reliability (long term cost-of-ownership), and overall system flexibility and expandability.
Moretti: DR pricing is falling at a dramatic rate, so being able to afford a DR system these days is not entirely out of the question for facilities with a limited budget. I always calculate overall cost of ownership when I quote DR. With all things factored, DR typically costs less to own over a 3-5 year period than CR or film/chemistry systems.
Titus: The market’s broad range of CR and DR systems allows film users to upgrade to digital technology and equips CR users to upgrade to DR. Facilities can retrofit existing film or CR systems with DRX detectors that enable immediate access to high-quality images without replacing existing room or portable X-ray systems.
Q: What else do you think TechNation readers need to know about purchasing and servicing digital radiography?
Bentley: OEMs aren’t always the answer. Customers should get to know the company with whom they are working, obtain references and make sure they are comparing apples to apples. They should know if the company offers affordable training and proper support after the sale.
Moretti: It is very important that someone looking to purchase a DR system does his or her homework. There are different technologies, applications (radiology, chiro, vet, podiatry, etc.) and many brands to choose from. When choosing what DR to purchase, some things to consider should be image quality (the best patient care should lead the decision), reliability, support, ease of use, etc. Regarding service, DRs are typically not field serviceable. If a hardware failure transpires, a loner is generally sent out while the failed DR is repaired. What can be done in the field are calibrations of the DR panel. It is recommended to perform periodic calibrations of the DR in order to get the very best image quality from it.
Titus: Healthcare providers should select systems that can evolve to meet changing needs. It’s also important to evaluate accident protection or extended maintenance agreements and choose a supplier that offers a variety of service options.
Q: What are the most important things to look for in a digital radiography system?
Bentley: Evaluate your requirements and what equipment is reliable. Purchasing new equipment isn’t always the answer. Tried and true equipment with a reputation for quality and a supplier who will stand behind the product they sell can be the answer.
Li: Because almost all of the digital radiography system information is provided through DICOM-compliant images, the primary focus should be first on the ease of acquisition and the quality of the images. Beyond these most important clinical aspects, the decision process should include a review of acquisition and implementation costs and overall longer term operational expenses.
Moretti: The best answer to give is, the correct DR. As previously mentioned, there are many DR system types to choose from ranging from Cesium, Gadox, Selenium, CCD to varying sizes and connectivity (wireless vs. tethered). The facility and X-ray type will determine the appropriate type of DR system to purchase. There are application specific DRs that would work well for one type of practice, but not for another practice type. It is crucial that all the bases are covered by the sales team throughout the sales process in order to provide the most appropriate DR for the respective facility.
Titus: Critical factors for selecting a digital imaging system are: image quality, flexibility (the system’s ability to meet current and future needs), and reliability. A supplier’s ability to deliver responsive service and support is also essential.
Q: How can purchasers ensure they are making a wise investment in a digital radiography system? How can they make sure they will receive the necessary literature and training tools?
Bentley: Work with a company with a proven reputation for delivering quality products and that doesn’t always mean “buy new.” There are a lot of companies in the secondary medical equipment market with proven reputations for delivering and standing behind quality products. Make sure they can get a good return on their investment from a supplier on which they can depend.
Li: A strong consideration in any decision process are the local references, not just the glossy literature. Beyond image quality and workflow support, does the system provide the flexibility needed? What has been the experience with reliability and support? No purchase is complete without full documentation and end-user training.
Moretti: I always recommend that customers get references from sites that are using the DRs they are interested in. It is always helpful to get feedback from the technicians using the DR as well as from the radiologists reading the images from the DR. The feedback, whether good or bad, will help make the decision process less arduous while aiding in a DR purchase that is the best fit for the facility. Most DR systems come with the appropriate literature or user manuals that the technician can use for reference. Applications training is vital when a facility purchases a DR system. Without the appropriate training, the staff will more than likely not be able to use the device as intended.
Titus: It’s always wise to look for a supplier with a strong sales, service and applications/training infrastructure, a large install base and a broad portfolio of innovative products. Users can also check with a provider’s reference sites prior to making a decision.
Q: What else would you like to add or do you think is important for biomeds to know about digital radiography?
Bentley: Get to know the company from whom you purchase. Get your IT department involved early. Establishing wireless DR can be compared to setting up one’s cellphone. You’ve got to eliminate “dead zones” where signals drop. Work with a company who understands the IT side of the product.
Li: In the future, more and more doctors will be using digital radiography to diagnose and treat, while patients will experience even more benefits. Biomedical staff can assist in the decision process with evaluation and consideration of installation, implementation, and operational expenses associated with service and maintenance.
Moretti: The DRs of today really minimize the interaction of the biomed staff to the DR because of the improvements in reliability and the fact that the DR hardware (the panel itself) is not field serviceable. Another reality is that most of the support applied to these systems is performed remotely. This is a huge convenience for the facility as it does not have to burden the already over-engaged day-to-day schedules of the biomed staff.
Titus: Major equipment suppliers provide specialized training for biomeds so they can evaluate and service their own equipment. Some OEMs offer management tools that equip biomeds or managers to verify the image quality and productivity of their CR and DR systems. These automated tools save time and enable a small staff to keep imaging systems running at peak performance.