Digital Discussion

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DIGITAL RADIOGRAPHY 101

DR or CR? Which is "best"?

There are basically two branches of "Digital Radiology". There is Direct Radiography (DR), where an image is digitized in real time with a sensor that replaces the film cassette. DR can either be "flat panel" or CCD, ( "charge coupled devices"). The "best" solution depends entirely on your application and budget.

DR offers:

	Fast digital imaging...6- 8 seconds typical
	Greater financial risk
	Higher radiation dose (with some exceptions)
	May or may not use your existing x-ray, depending on system
	The newest (Fuji D-Evo) flat panels are the size of a 14 x 17 cassette
	Wireless versions are available for fast substitution from table to upright image receptors

CR has been around for a number of years and is rock solid technology. And that is the reason you need to consider CR; economical and dependable performance.

CR offers:

	Most economical...typically thousands or tens of thousands of dollars less
	CR can generally be used with any x-ray system
	CR offers the best value in digital radiography
	Higher image quality
	Use your existing x-ray machine
	Typically half the dose as many (not all) DR systems

When the CR image plate is "read" in the reader, the image plate is erased and returned back in the cassette and is ready for immediate use again. CR is slower than DR, but the image begins to scroll up on the monitor within a few seconds generally confirming positioning. The entire image (14 x 17) completes on your screen in under one minute. CR will work with most x-ray machines without modification, however a 178 line grid may be a desirable upgrade.

Fuji CR systems provide very high quality images with more algorithms then their competition. Soft tissue or bone detail can be optimized from the same exposure. Because they are close to the dose used in a 400 speed film based system, x-ray tube life is significantly extended and scatter radiation is significantly reduced. Harborview Hospital, Seattle; Group Health of Washington, and The Mayo Clinic, all use Fuji CR. We have installed over 40 throughout the Northwest in the past couple of years.

All of our digital systems include workstations with the necessary hardware and software to perform digital radiology. A high resolution 2 mp monitor is included with the workstation, as is PACS viewing software. You will be amazed at the image quality available on the workstation. All have CD/DVD burners for archiving or providing to clients or referring physicians. Systems are generally set up to send images over the internet to radiologists or education centers and we set them up to automatically backup your images to an external hard drive. Many recent installations are using an iPad for showing clients in exam rooms. All you need is a wireless modem, the iPad and Osirix software. The iPad gives a very impressive image, along with magnification, leveling and measurements. The present cost for the Osirix program (available through the iStore APS) is $29.95. It is very easy to set up for showing Dicom images and sending jpeg versions through email. Although we do not sell the iPad or software we are pleased to discuss this exciting application.

—Roy Duncan 8/2511

Last Updated 5/17/2012