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Why Brandywine Imaging?

Brandywine Imaging offers a diverse selection of equipment, services, and consumables. We offer equipement and consumables based on our customers needs, not our own. We have no exclusive ties to any one dealer or have salesman that work on commission. Our service, in conjunction with sales, is based on how we can best help our customers fill their needs.

 


 

What is digital x-ray?

Digital X-ray is equipment that takes the place of a conventional x-ray film processor and produces x-rays on a monitor instead of film. There are (3) standard equipment types used in producing digital x-ray images. CR (Computed Radiography) equipment, DR (Direct Radiography) and CCD (Type of Digital Camera) are the three basic types of equipment used to capture images

 

Computed Radiography

(CR) uses very similar equipment to conventional radiology except that in place of a film to create the image, an imaging plate (IP) made of photostimulable phosphor- is used. The imaging plate housed in a special cassette and placed under the body part or object to be examined and the x-ray exposure is made. Hence, instead of taking an exposed film into a darkroom for developing in chemical tanks or an automatic film processor, the imaging plate is run through a special laser scanner, or CR reader, that reads and digitizes the image. The digital image can then be viewed and enhanced using software that has functions very similar to other conventional digital image-processing software, such as contrast, brightness, filtration and zoom.

Differences from Direct Radiography


Computed radiography (CR) is often distinguished from Direct Radiography (DR). CR and DR have many similarities. Both CR and DR use a medium to capture x-ray energy and both produce a digital image that can be enhanced for soft copy diagnosis or further review. Both CR and DR can also present an image within seconds of exposure. CR generally involves the use of a cassette that houses the imaging plate, similar to traditional film-screen systems, to record the image whereas DR typically captures the image directly onto a flat panel detector without the use of a cassette. Image processing or enhancement can be applied on DR images as well as CR images due to the digital format of each. There are many different types of DR detectors in use in medicine and industry. Each type has its own merits and distinctions and may be applied to certain imaging requirements based on these attributes.
CR and DR should not be confused with Fluoroscopy, where there is a continuous beam of radiation, and the images appear on the screen like on a TV. This is the system many people are familiar with, where the image of the article being x-rayed is viewed in real time on a monitor or display. Many people think airports use Fluoroscopes for baggage inspection, when in fact LDA's (Linear Diode Arrays) are universally used to generate static images of luggage content. LDA's are also used in a wide variety of other screening and imaging applications, and are also presented in a digital format. Modern fluorosopes use a device called an image intensifier to enhance the analog output of the real time x-ray image, where it is picked up by either a video or CCD camera and digitally enhanced to reduce the noise inherent in the system
Imaging plate
The CR imaging plate (IP) contains photostimulable storage phosphors, which store the radiation level received at each point in local electron energies. When the plate is put through the scanner, the scanning laser beam causes the electrons to relax to lower energy levels, emitting light that is detected by a photo-multiplier tube, which is then converted to an electronic signal. The electronic signal is then converted to discrete (digital) values and placed into the image processor pixel map.
Imaging plates can theoretically be re-used thousands of times if they are handled carefully. IP handling under industrial conditions, however, may result in damage after a few hundred uses. An image can be erased by simply exposing the plate to a room-level fluorescent light. Most laser scanners automatically erase the image plate after laser scanning is complete. The imaging plate can then be re-used. Reusable phosphor plates are environmentally safe but need to be disposed of according to local regulations.
Medical applications
Computed Radiography systems are the most common in medical applications because they have proven reliability over more than two decades, flexibility to address a variety of clinical applications and lower costs to take multiple exam rooms digital. DR in the form of a portable detector starts at around $150,000.00, while a basic low volume CR can start as low as $30,000.00 (but higher volume, hospital-grade applications can be higher.) DR systems are generally sold as a full x-ray room replacements and tied to a single x-ray generator. CR IPs can be retrofitted to existing exam rooms and used in multiple x-ray sites since IPs are processed through a CR reader (scanner) that can be shared between multiple exam rooms.
Advantages

  • No silver based film or chemicals are required to process film.
  • Reduced film storage costs because images can be stored digitally.
  • Computed radiography often requires fewer retakes due to under- or over-exposure which results in lower overall dose to the patient.
  • Image acquisition is much faster - image previews can be available in less than 15 seconds.
  • By adjusting image brightness and/or contrast, a wide range of thicknesses may be examined in one exposure, unlike conventional film based radiography, which may require a different exposure or multiple film speeds in one exposure to cover wide thickness range in a component.
  • Images can be enhanced digitally to aid in interpretation.
  • Images can be stored on disk or transmitted for off-site review.
  • Ever growing technology makes the CR more affordable than ever today. With Chemicals, dark room storage and staff to organize them, you could own a CR for the same monthly cost while being environmentally conscious, depending upon the size of the Radiographic Operation.

Disadvantages

  • In medical applications, manual handling of the cassette housing the IP is considered a disadvantage versus DR but it also offers more flexibility for patient positioning.
  • CR is still not an approved method for higher quality radiologic applications (aerospace), due to the possibility of digital manipulation to the captured image, the inherent geometric unsharpness and resultant lower spatial resolution as compared to film (radiographic) images, SNR (signal vs. noise)issues and sensitivity to scattered radiation, and the general lack of procedural consensus among primes and OEM's.
  • There also are no quality (image resolution) standards for general radiography, only for mammography (21 CFR 900.12 (e)), however, competition among manufacturers has raised the bar and newer CR technologies with increased detective quantum efficiency (DQE) and higher spatial resolution have emerged.
  • Imaging plates (IPs) are expensive and can be damaged if the system being used requires manual handling of the IPs. Theoretically, IPs may be reused thousands of times, but constant use will always result in damage to the IP and image artifacts, eventually to the point of necessary replacement. Konica (unlike Fuji, Carestream and most other manufacturers) does not come in contact with IP. Most manufacturers remove IP by feeding through rollers to be scanned and then reinserted into cassette.

Terms of Interest:
In medical imaging, "electronic picture archiving and communication systems (PACS) have been developed in an attempt to provide economical storage, rapid retrieval of images, access to images acquired with multiple modalities, and simultaneous access at multiple sites". Electronic images and reports are transmitted digitally via PACS; this eliminates the need to manually file, retrieve, or transport film jackets. The universal format for PACS image storage and transfer is DICOM (Digital Imaging and Communications in Medicine), Non-image data, such as scanned documents, may be incorporated using consumer industry standard formats like PDF (Portable Document Format), once encapsulated in DICOM. A PACS consists of four major components: the imaging modalities such as CT and MRI, a secured network for the transmission of patient information, workstations for interpreting and reviewing images, and archives for the storage and retrieval of images and reports. Combined with available and emerging Web technology, PACS has the ability to deliver timely and efficient access to images, interpretations, and related data. PACS breaks down the physical and time barriers associated with traditional film-based image retrieval, distribution, and display.
PACS has four main uses:

  • Hard copy replacement: PACS replaces hard-copied based means of managing medical images, such as film archives. With the decreasing price of digital storage, PACSs provide a growing cost and space advantage over film archives in addition to the instant access to prior images at the same institution. Digital copies are referred to as Soft-copy.
  • Remote access: It expands on the possibilities of conventional systems by providing capabilities of off-site viewing and reporting (Distance education, telediagnosis) It enables practitioners in different physical locations to access the same information simultaneously for Teleradiology
  • Electronic image integration platform: PACS provides the electronic platform for radiology images interfacing with other medical automation systems such as Hospital Information System, (HIS), Electronic Medical Records (EMR), Practice Management Software, and Radiology Information System (RIS)
  • Radiology Workflow Management: PACS is used by radiology personnel to manage the workflow of patient exams.

PACS is offered by virtually all the major medical imaging equipment manufacturers, medical IT companies and many independent software companies. Basic PACS software can be found free on the Internet.

 

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