Computed RadiographyDigital Radiography

LeeAnn Pack DVM

Diplomate ACVR

Computed Radiography (CR)

• Been around since 1980-81

• Uses same radiographic equipment– No change in X-ray machine

• Uses an imaging plate– Contains a photostimulator phosphor

• Need a cassette reader

• Images can be sent to a PACS

CT System

CR cons

• Still need imaging plates

• Cost of plates is expensive

• Same amount of time to produce the image as with film

• Processing time

• Increased exposure when compared to film and DR

DR

• Works like a digital camera– Images are seen immediately

• Two options– CCD– Digital flat plate detector

• Can be sent to PACS• Small decrease in tech time/time to

development when compared to CR

DR• No film costs• No darkroom space• No processor to maintain• No films to search for or file• No expense for film jackets• Increased productivity• Decreased retakes• Decreased exposure (Eklin)

Digital Flat Plate Detectors

• Expensive ($80,000-120,000)• Can retrofit into existing X-ray machines• Eklin

– Exposure is decreased thus improving radiation safety

• Do not use grid but use image software

• IDEXX• Sound Technologies

DR Portable System - EKLIN

DR – Portable with Carrier

DR Portable System - IDEXX

CCD

• Is sold with an X-ray machine

• Camera is placed in machine before install – fits underneath the table

• Less expensive than the Flat Plate Detector

• Cause increase in exposure by 2 times– Double the mAs

Potential Cost Savings• Film• Space

– Wont need the darkroom space

• Processor– Maintenance

• Less technician time– Decreased repeats and no developing

• Time lost looking for films

Images

• Ability to window exposures– Works like CT– Wider latitude for exposures

• Less retakes

– Better soft tissue – Image consistency

PACS

• Picture – viewing at workstations• Archiving – images short/long term• Communication –local or wide area

networks • System – use with HIS, other equip. ect.• Method that allows storing, retrieving,

distributing throughout your hospital or the internet

PACS

• Once an image is made – it is sent to the local PACS – a copy is also sent somewhere else (in house server, off site server)

• Then the image can be pulled up and viewed– Multiple sites throughout the hospital

EKLIN

DICOM

• Digital Imaging and Communications in Medicine

• Imaging standard that allows multiple pieces of medical equipment to communicate

• Essentially all PACS and almost all equipment speak DICOM now

• DICOM does not effect image quality

Computer Monitors

• Bigger really is better– Small monitor can not see entire image

• Some choose grey scale monitors– More expensive (3MP)

• Some choose the Dell monitor – Less costly (2MP)

Dell 2407 HC

Image Back Up

• Must have a way to back up copies of images in case your computer crashes

• Time to “keep” images varies by province/state

• 3 options– On site server– Off site server– Fingers crossed storage

Teleradiology

• Can send your images to a radiologist for interpretation– Should be of diagnostic quality

• Buy machine they add in contract with radiologists– Be careful

Hospital Integration

• Can integrate the images you take into the patients hospital record– If hospital is automated

• Referral veterinarians can view images you have made and also receive reports

• Images used in this presentation from– www.eklin.com– www.idexx.com– www.dell.com