CR: Radiology's Workhorse at Work

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hiit040705aComputed radiography (CR) has emerged as an important alternative to traditional plain film by offering access to electronic capture and management of imaging studies. It is a less expensive option than digital radiography and therefore proves an attractive option for smaller institutions and those with budgetary constraints. As image quality has improved in CR, many facilities and departments have selected this approach to meet their digital imaging needs.

CR as the backbone of imaging

Sally Grady, RT(R), director of imaging services for Florida Hospital Celebration Health in Celebration, Fla., explains that their multi-institution network performs close to 1 million imaging studies, with approximately 400,000 to 500,000 of those exams accomplished by their 60 Agfa CR units. 

“Our radiologists are very particular about the quality of the image, but they don’t care how the image was acquired,” she explains. “Whether it took me 10 seconds with a DR or 12 seconds with CR, they don’t care so long as the end product has a certain quality.” They have now installed the new Agfa DX-S, with MUSICA2 as the latest image processing software.  The resulting images are captured more quickly with better image quality than before, Grady says. 

They installed one of the units in their Emergency Department where they anticipate having more than 55,000 patient visits this year. Eventually, they plan to replace all existing CR units in the hospital with the DX-S computed radiography systems.

Max Grady, RT(R) is the manager of imaging information systems at Florida Hospital Celebration Health, and he explains that the DX-S scan head is much faster than other systems. He says that with traditional CR, the scan is accomplished line-by-line in a registered pattern where a thin laser beam scans point by point across one row, up one line and across the next row. The  DX-S scan head is engineered to read the entire row at the one time, so it scans down the whole plate in a single motion. This capability, coupled with a new “needlepoint phosphor” image plate, offers a much higher spatial resolution and produces a very sharp image, he says.

Another benefit to this system is the small footprint (approximately 2 feet by 2 feet) that can go into the x-ray room. The cassette reader can be placed either in the x-ray room or outside the room. He says this device functions to produce an image almost as fast as DR. 

Sally Grady says, “On the expense side, capital gets more difficult every year, so for me to spend $400K on a DR system when I could outfit four or five rooms with CR that will give me almost identical productivity, it doesn’t make financial sense…And we have 55 radiologists to please.”

Improved efficiency & reliability important

Michael Walker, RT(R)(CT)(NM), manager of Robinson Imaging Center of Kent in Ohio, describes their center as a division of Robinson Hospital, which is about 15 minutes away from this outpatient campus that opened in January 2006. They offer several imaging modalities, including diagnostic x-ray with a Fuji FCR Carbon XL CR system, a 16-slice CT and open MRI plus a PET scanner. Since they do not have a radiologist on site, they send all of their images to the primary radiology department in the hospital to be read.

“The biggest thing that CR has done for us is to enable us to be an extension of the radiology department because we can send images so easily,” he explains. They have improved their turnaround time for reports dramatically, now down to 24 hours, which they use in marketing their services. Walker says they have a single load FCR cassette reader, because their workload does not require additional capabilities.

Troy D. Todd, RT(R), PACS administrator for Alliance Community Hospital in Alliance, Ohio, reports that their Fuji Carbon XL is dedicated to their Emergency Department, “Anyone who comes through the ER and who needs any kind of imaging exam, it’s done in the room with the Carbon XL.”

One feature they find helpful is the compact size and ergonomic design. With the monitor at eye level and the cassettes waist-high, everything functions without the operator needing to bend. Secondly, they consider this an extremely reliable system with no plate jams or down time since the “go-live” date in January. Todd says the cassettes are very durable and the user interface is easy to navigate.

“Another reason we chose this system is that you can easily track statistics, such as re-take analysis per technologist,”