Digital Radiography: Features and How DR Fits in Your Practice

This is the third part of series explaining digital radiography systems and their different components, features, types, and uses. Read Part 1 and Part 2 for more information.

Features

There are many standard and optional features for DR systems. Knowing what’s available makes selecting the right DR system easier and more cost-effective. The features vary based on make and model, but some of the most common ones are listed below.

• DR Panel Type: CCD, Cesium, GadOx or Selenium are the most common available.
• Tethered or Wireless: Most DRs are tethered with a cable to generator or operator workstation, however in recent years more and more wireless models have come on the market.
• Image Quality: DRs generally have excellent image quality with some variation between the models and manufacturers.
• DICOM Store Compatibility: This option allows the DR to send images to viewing workstations, PACS servers and other destinations based on DICOM standards.
  • Multi-destination: This allows the DR to send to multiple destinations. (Example: daytime reading radiologist or nighttime reading radiologist)
  • Auto-send: When an x-ray study is completed it can be automatically sent to a destination.
• DICOM Print Compatibility: If physical films are required, a DR can print directly to a digital DICOM film printer. These printers must be purchased separately.
• Modality Worklist Compatibility: This feature allows a DR system to connect to a RIS, EMR or HIS generated modality worklist. Note that in order for this feature to work modality worklist has be enabled and active on an electronic medical record system.
• CD/DVD Burning: A common method of distributing DR images is on a CD or a DVD. Often these include burned-in viewing software.
• Quality Control Software: This allows the technologist or doctor to fine tune the quality of the image, add markers or notes, and more before finalizing the image for interpretation.
• Touch Screen or Mouse/Keyboard Controls: DR systems often give the option of a touch screen or mouse and keyboard control. It is mostly a matter of workspace size, user preference and price.
• Mini-PACS and/or built-in Web Viewer: Generally designed for smaller providers, this works as an “all-in-one” option for storage and web viewing. It is not widely available from all manufacturers, but can be very cost effective in certain circumstances.

How DR Fits in Your Practice

What DR system you should buy varies between practices. Below we’ll take a look at some common scenarios for different types of practices.

General Medicine

With general medicine practices such as urgent cares, family practices, orthopedists and other healthcare operations that take x-rays of a wide variety of body parts it’s important to make sure that the DR you select has the ability to work with both an x-ray table and a wall stand. For this you have two options 1 panel that can be moved from table to wall stand or 2 panels both the wall stand the table.

• One DR Panel Option: It is important to make sure that you select a DR panel that can be quickly and easily removed from either the wall stand or table and then replaced in the other. CCDs are often too large and bulky to make this feasible, so it is best to take a look at Cesium, GadOx or Selenium. Also, look for models that have handles because a dropped and broken panel means downtime. Wireless DR panels, although more expensive, are worth looking at as well.
• Two DR Panel Option: When using two DR panels you can select from the full array of DR options because the panel won’t be removed from the wall stand or x-ray table regularly. The drawback with this option is that it will cost more because you’re buying two panels instead of one.

Chiropractic

Most of the shots taken in chiropractic environments are done standing or sitting in front of a wall stand. The DR panel can stay fixed in the wall stand for the majority of the time. If this is the case, then there is little need to make sure that a panel has handles or is easily accessible and panels can be evaluated based on quality and price.

Mobile X-Ray

Until recently DR panels were difficult to use in mobile x-ray because of the size of the panels and the cost associated with them. Tethered panels can be wired directly into portable x-ray machines and controlled from a tablet PC also mounted on the x-ray machine. This can be a huge benefit to mobile x-ray providers because there is no going back and forth between the patient and the CR reader in the vehicle. It is important to make sure that the panel is light-weight and has a handle. CCD panels are generally not a good option for this. It is best to look for panels that conform to standard cassette sizes such as 14 x 17 and 10 x 12.