Direct digital radiography (DDR) portable x-ray systems enhance efficiency and work flow in comparison with conventional computed radiography (CR) systems, according to a study published online Nov. 1 in the Journal of Medical Imaging and Radiation Sciences. The study additionally found four defined key performance indicators that may aid in giving framework for measuring the performance of portable radiography in other institutions.

A vital tool for hospitals, portable radiography provides x-rays for critically ill or bedridden patients. For many years, conventional CR systems have been used to accomplish this task, requiring time-consuming off-site processing of CR cassettes. DDR portable x-ray systems have recently been conceived in Hong Kong, allowing for wireless transmission and immediate review of digital images.

Tsz-Lung Ngan, MSc, of the Hong Kong Sanatorium and Hospital, and colleagues designed a study aimed to quantitatively investigate the performance of portable radiography using the DDR portable x-ray system and the conventional-CR combination in terms of efficiency and work flow enhancement.

Each procedural step was timed for 190 portable x-ray exams using the conventional-CR combination and the DDR portable x-ray system. Ngan and colleagues designated four key performance indicators designed to measure the performance of portable radiography quantitatively. These include: examination duration, the time for the image to become available in PACS, postacquisition processing time, and manpower deployment time.

Results indicated that overall productivity was raised by 96 percent using the DDR portable x-ray system.

There was an improved performance of 46 percent in examination duration over the conventional system, with the shortest duration being four minutes for the DDR system and nine minutes for the conventional one.

Images became available in PACS significantly faster for the DDR than the conventional-CR system, with a 65 percent improvement in the DDR system. Postacquisition time for DDR was slightly longer than the conventional counterpart, but this difference was not statistically significant.

Lastly, the manpower deployment time of the DDR portable x-ray system was extended over the conventional, but the DDR was capable of performing 16 exams in one portable round. The conventional-CR system could perform a maximum of four examinations in one round.

Other benefits are derived from the use of the DDR system. Radiologists may be less susceptible to occupational injury when using DDR as they will not have to carry as many cassettes and less effort is needed to transport the machine to the patient. Additionally, the mobile x-ray could allow for a 50 percent reduction in radiation exposure.

“In a nutshell,” wrote Ngan and colleagues, “the use of the DDR portable x-ray system can provide effective, efficient, timely, patient-centered, and safe health care.”