FAQ’s – Digital vs Conventional

Why Go Digital ?

There many reasons to consider going to digital radiography solution. Here are some of the reason why you should consider it:

  • Bring your practice up to the latest technology
  • Eliminates the need for X-Ray Film
  • Reduced repeat films – Eliminating the unnecessary radiation to patient an the operator
  • No darkroom required
  • Meets all current environmental requirements
  • Capable of sending images via electronic transfer
  • No more lost films
  • No need for film processor
  • No Chemistry required
  • DICOM compatible (for more info on DICOM, what is and what it means go to the Terminology page)
  • WH&S risk significantly reduced

Return On Investment

Once you have made a decision to look invest in a digital x-ray system, before you get to the next step of selecting equipment, it worth working out how you are going to justify a return on your investment.

A typical question we ask is how many x-rays do you do per week. If you go down the digital path, typically you will increase how many x-rays you do in your first round because it is easier, consistent quality, and you will get better diagnostic result every time. There is nothing like an over or under exposed film to put you off taking more to get the same result.

Once you are digital, you will also typically take more follow up x-rays for the same reasons.

So there are many ways you can justify it but it have found an app for Android (still looking apple versions) that is really useful to calculate repayments and even if you are going to fund it as a direct purchase, it is useful to evaluate it on the basis of a 5 year term or similar.

Go to Google Play Store and download Simple Loan Calculator. This app will allow you to put in a down payment if you want to do an upfront deposit, a residual payment, interest rate and more. Get an indicative interest rate from your chosen financiers, then once you hit the “Calculate” button, if you get a schedule of payments over your selected period with a monthly payment. Multiply that by 12 and divide by 52 and you have a weekly figure and you can then look at what you charge currently in you practice and see how many x-rays you need to cover the ongoing cost of a system.

Which Option ?

There so many choices to choose from and this question comes up again and again. We will try here and give an overview of the different technologies available and how to break it in modules for consideration of what is the best fit for each of those sections.

We would break this into modules as follows:

1. Image Acquisition

This is where you either x-ray, ultrasound, CT Scan, Endoscope or other form of image acquisition. These should be DICOM compliant in there own right and able to be separated from the storage systems. This is typically called this an imaging modality.

Most people consider the “digital imaging” to be their x-ray system, but the truth is there is more than one form of imaging that can be acquired and stored for useful benefits later on such as ultrasound, endoscopy and other forms of data

Firstly, you need to look at what you currently have in the way of x-ray equipment, is it a portable x-ray machine on a stand or is it a full floor mounted x-ray table and generator. If you are looking to upgrade from a portable x-ray to full room, then

Then what technology will you apply to acquire your x-ray images. There are several options available to you.

CR vs DR Systems

There are two broad classes of digital radiography systems:

CR – computed radiography – imaging plates and a plate reader are used to generate an image

DR – direct radiography or direct digital radiography – imaging plates are not used and the images are available immediately (within 2-10 seconds and ready for next shot in 5-15 seconds typically) without a processing step

A brief overview:

CR Advantages

  1. Less expensive than DR
  2. Can perform cross table or mobile radiography (unless you have a wireless or moveable DR Flat Panel)
  3. CR cassettes are much lower cost to replace than an imaging sensor is more expensive to replace than an imaging plate or cassette
  4. Very good image quality
DR Advantages

  1. Almost no processing time and immediate image acquisition
  2. No imaging plates or cassettes to hassle with
  3. Excellent image quality

There is no right or wrong with either, just what is a best fit for your practice. We will try and help you wade through the options as offer all solutions. Below is a diagram that will help you understand where these options fit together:

CR Systems

CR Systems are well proven evergreen technology that is highly flexible. Improvements are still being made to this technology and it allows some views to be done that DR Systems just can’t do as easily or with as low a risk. The trade off is that CR plates have to be process

With CR Systems you have multiple plates, with DR you have just one plate. Hence CR spreads the risk of damaged plates whereas DR locks this risk into one or two plates at best. And the investment required for DR for equivalent image quality is usually 2 to 3 times.

The nice part with most solutions now is that there is vet specific software and the DICOM Standard now supports the veterinary industry with specific tags, projection views, breeds etc. Make sure that the solution you are looking at has proper DICOM Compliance for the vet specific parts. If you don’t, exporting to a 3rd party becomes a challenge.

For more on CR click here to go our Digital Imaging Terminology page and scroll down to Computed Radiography
DR Systems

There are several different types of DR Systems available, CCD DR’s and Flat Panel DR’s. Within the Flat Panel DR Systems there several different choices

Medical

CCD DR

Go to the Digital Imaging Terminology page, as there is a detail description of the technology there under Direct Radiology

Flat Panel Detectors

Go to the Digital Imaging Terminology page, as there is a detail description of the technology there under Direct Radiology

If you want some more reading as you do your homework, there is a good article about the varying technologies, there is a very good article here. It is heavy going but also very neutral in what it presents an extremely good overview of the differing technologies.

Another good article is downloadable here: ARO PL DR-CR Comparison Article 120621. This article again, can be a bit heavy but you are looking at making a significant spend, so your research is well worthwhile. This article also is not sponsored by anyone so it is very neutral, it is simply

2. Storage System

This is where your images are stored for the long term, It should be able to grow with you over time and be upgraded as you grow. There are “Mini-PACS” solutions, which tend to be all in one solutions from one vendor such as the Carestream Image Suite or a separate storage solution such as VET-WEBX.

Either way any solution should store its images as per the DICOM Standard (Part 10). If you don’t have this as a minimum, you will limit your ability to move at later stage, especially if it is propriety solution.

3. Image Viewing

This where you view your results and can do specialist workup measurements. It is typical available on 2 platforms with a 3rd starting to come into play. This is “Thick Client” as in and installed application, usually limited by license seats, either single or limited concurrent seats, “Thin Client” that is web client based, either limited seats or unlimited seats.

4. Output devices

In veterinary practices this is rarely a requirement but DICOM printer for true size printing are available or you can print to a normal windows printer on paper. There is also available automated CD/DVD Robots available. Another method of output is to email results, either secure or unsecure. Security is not the same issue in veterinary practices as medical but remains a serious consideration.