Digital X-ray is Vision and Reality
Image courtesy of Imaging Dynamics 

At RSNA 2007, vendors are offering the best features from DR and CR to help users get the most bang for their buck, whether those users are large medical centers or small physician practices. Systems that offer higher throughput and flexibility allow healthcare organizations a wider choice than ever before of x-ray equipment that can be tailored to their specific needs. Technological advances continue to mean lower dose, higher image quality and longer equipment life.

Vendors know that space, time and budgets are all being squeezed—so look for more compact, affordable equipment that offers flexible positioning, speedier throughput and further improvements in image quality. Look for more housings and attachments for easy integration into other diagnostic systems and other capabilities for better communication between systems and clinicians. User-friendly software, touchscreens and preview technology are just some of the features designed to let technologists get their job done while staying with the patient as much as possible.
RSNA 2007 promises a plethora of choices for anyone seeking cost-effective digital radiography equipment that considers the specific needs of facilities—from flexibility to space to throughput.


Agfa HealthCare (Booth 4106) is showcasing its computed radiography systems, featuring new portfolio additions. All Agfa HealthCare digitizers offer the NX touch-screen interface user station, the radiographer’s image identification and quality control tool, and seamlessly integrate with PACS, RIS and HIS that comply to current medical imaging standards. MUSICA2, Agfa Healthcare’s latest automated digital radiography image processing software, is now available for its entire CR solutions range.

Agfa’s multi-application, desktop CR 30-X provides clinicians with a high quality, efficient and economical analog to digital solution. Agfa HealthCare’s CR 35-X is a compact, highly versatile digitizer designed for decentralized CR environments.

The CR 35-X has three different image resolution modes. In combination with application-specific plates and cassettes, the CR 35-X supports a broad range of applications. Agfa HealthCare’s CR 85-X is a multi-user digitizer, featuring a unique 10 cassette drop-and-go buffer that eliminates waiting times and maximizes productivity. The system can support the imaging needs of at least three x-ray rooms, supporting efficiencies on both a cost and flexibility level. 

Agfa HealthCare’s advanced DX-S solution is a CR system with image quality, speed and flexibility that exceeds traditional CR solutions. The DX-S offers increased image quality and potential for x-ray patient dose reduction through the DirectriX needle-based detector technology.

Canon Medical Systems (Booth 3311) is showcasing its full line of DR sensors integrated with a wide range of x-ray systems. The Canon CXDI-50G DR system is light-weight and has a large imaging area (14-inches by 17-inches). This DR system is being shown integrated with the RadPro 40kw Mobile X-Ray System and GE AMX-4 Portable X-ray System, making it appropriate for bedside or post-operative procedures. Canon also is showing a Field Deployable Digital Radiography System (FDDRS) integrated with Canon’s CXDI-50G, and the RadPro Overhead Tube integrated with Canon’s full-size CXDI-40EG detector.

The Canon CXDI-40EG General DR system provides a large imaging area of 17-inches by 17-inches, and lets users capture desired anatomical views for both large and small format x-rays in portrait or landscape orientation without having to rotate the detector unit. This system can be retrofitted onto almost any new or existing bucky table, upright tilting wall stand, universal or ceiling suspended multi-positioning unit, according to the company.

Carestream Health (Booth 2513) is debuting two new computed radiography systems: the Kodak Directview Classic and Elite CR systems. These compact, floor-standing, single-cassette CR systems can help improve workflow, productivity and patient throughput. The systems offer a modular design, are significantly smaller than other Directview single-cassette systems and incorporate the latest generation of CR software from Carestream.

The company also is showing its newest DR platform, the Kodak Directview DR 9500 that has a ceiling-mounted U-arm that contains both a tube and detector to deliver unprecedented mobility and operational flexibility. This system easily moves around the patient to facilitate patient positioning and to enhance technologist convenience and productivity. The system is designed for a wide variety of general radiography procedures and offers enhanced speed and comfort to patients with limited mobility. 

CMT Medical Technologies (Booth 1917) is presenting advanced features for its SmartRAD DR and SmartSPOT PrimaX systems. DuoRAD, a two-in-one imaging technique, is now available for the SmartRAD family of DR solutions. DuoRAD enables acquisition of dual-energy images in a single x-ray exposure by using a combined DR-CR unique technique that provides significant dose reduction, while eliminating motion artifacts.

The DuoRAD, a patent-pending works in progress, benefits from the high Quantum Detective Efficiency (DQE) and Automatic Exposure Control (AEC) of DR imaging, along with tuning of the x-ray spectrum for improved contrast of the CR technique, combined in a single exposure. DuoRAD offers distinction between soft tissues and bones in the same image, detection of calcified lung nodules, better visualization of urinary tract stones, detection of small bone fractures, follow up on the healing process and bone mineral density for osteoporosis.

CMT also is showing a new, works-in-progress system based on dynamic FPD—the SmartSPOT PrimaX FPD-43. The newcomer to the SmartSPOT PrimaX family is a premium digital R/F and angiography imaging solution based on the state-of-the-art Pixium 4343 Flat Panel Detector by Trixell. The SmartSPOT PrimaX FPD-43 is equipped with a user-friendly graphic user interface and capable of performing all clinical R/F and DSA procedures. The system’s basic capabilities include patient registration, image acquisition, archiving, viewing, post processing and DICOM 3.0 connectivity.

Fluke Biomedical (Booth 6927) is unveiling a new x-ray maintenance, calibration and quality assurance tool for service and radiation management professionals. This compact, wireless device features simultaneous all-in-one exposure measurement, including HVL, and choice of custom readout device or laptop/PDA communication with dedicated Zigbee interface for fast and secure results display and archiving. Users also may expect an easily-positioned detector and industry-standard accuracy of results.

Fujifilm Medical Systems USA (Booth 1129) is highlighting the new Unity SpeedSuite, a works-in-progress U-Arm DR system designed with motorized, multi-position single detector flexibility. The Unity SpeedSuite is a cost-effective DR solution that is capable of performing a wide range of exams including both table-based and upright procedures. The innovative Unity DR system includes Fujifilm’s intuitive IIP workstation that offers image processing tools and delivers very high patient throughput. It is geared for many clinical applications including general radiography, emergency departments, dedicated chest rooms or even outpatient care facilities, such as an orthopedic office.

Fujifilm also is showcasing its newly expanded FCR line with two new CR systems. Fujifilm is launching new software at the technologist workstation that can benefit the radiologist.

GE Healthcare (Booth 1729) is showcasing the Definium 8000, its new DR system designed to streamline challenging exams with consistent and superior image quality. The Definium 8000 is available in a broad range of configurations, from a single wall stand to a comprehensive radiographic room. With full DICOM 3.0 connectivity, the Definium 8000 connects easily to hospital information systems, RIS or PACS. The user interface for the new auto-positioning overhead tube suspension includes a touch-screen user interface, motorized 5-axis movements, and 90-degree rotating screen.

Auto Image Paste provides physicians with a single view of the human anatomy, particularly the spine and legs, without any visible seam lines. GE’s Auto Image Paste application is a new method of acquiring and processing images of anatomies that would not fit in the span of a traditional detector. Up to five image acquisitions can be acquired, with the system automatically moving between acquisitions.

Volume RAD provides physicians with multiple high-resolution slice images of the human anatomy, including the chest, abdomen, extremities, and spine, using an x-ray system. This advanced application is a method of acquiring a series of low-dose projection images during a single sweep of the x-ray tube over a limited angle. A computer then assembles the information to provide high-resolution slice images that can be reviewed by the radiologist at a computer workstation.

These breakthrough applications complement GE’s exclusive Dual Energy Subtraction, an advanced clinical technique that eliminates bone or soft tissue obstruction from chest or abdominal images.
GE also is showing the Definium 5000, a U-arm-based system suited for radiology and orthopedic clinics where space is a premium. It incorporates GE’s digital flat-panel detector technology along with the U-arm that can fit into smaller rooms without the need of ceiling support structures for x-ray tube suspensions. The Definium 5000 provides positioner operator controls at tableside, in the control room or via infrared remote control. The U-arm facilitates standing (weight bearing), stretcher or wheelchair patient imaging.  

iCRco (Booth 4754) is demonstrating its True Flat Scan Path technology for a new line of CR systems—iDR. This scanning technique enables very fast scanning and erasing of CR cassettes in one step, the company says. Delicate CR plates are encapsulated inside the iCRco digital cassettes and the plate is read without any contact to the scan head. This touchless reading technique guarantees that plates will last a lifetime, and image quality will never change over time, according to iCRco.

The iDR system is a sealed scanning DR system that generates high-resolution and superior quality images, fully processed and delivered to a review station in 30 seconds. This new DR system can be configured to wirelessly transmit an image over an internal network or internet connection and it can work over standard network connections.

IDC (Imaging Dynamics Company) (Booth 4729) is introducing its X-Series DR technology. The new X-Series CCD-based imaging detectors: X3G, X3C, and X4C represent digital alternatives to traditional film-based x-ray for any size of facility.

The new technology provides higher sensitivity and amplified dynamic range; anti-blooming for better image quality, reduced distortion and very low noise; lateral overflow drain to eliminate saturation artifacts; enhanced soft-tissue imaging without compromising bone detail; and significant increase in imaging performance.

The IDC X-Series, with low dose, high image quality and affordability, is designed to help facilitate a move to digital x-ray. Offerings like these have led the company to achieve over 600 percent growth globally in the past three years.

IMIX Americas Inc. (Booth 6547) is launching its IMIX insight line of full-featured, affordable DR products. The IMIX insight PanoRAD is a universal, full-function DR system with a small footprint and innovative stand design. The flexible, full-room PanoRAD includes a generator, detector head, and table, along with a fully motorized stand with remote control.

The IMIX insight NovoRAD offers a new approach to radiology room configuration as it is designed and engineered to provide the flexibility of a dual-detector room with just one detector. It includes a ceiling-mounted tube support, fixed four-way floating tabletop, and upright stand. The IMIX insight OrthoRAD, a partially motorized, straight-arm stand is specifically designed for the orthopedic market. The fully functional orthopedic solution features tools designed to address orthopedic imaging needs, such as a weight-bearing platform that allows imaging of patients’ feet while standing. Orthopedic software options also are available.

Konica Minolta Medical Imaging (Booth 2554) is introducing the REGIUS Nano CR, a single-bay CR system engineered to make DR more affordable in low-procedure volume facilities and ancillary departments. The REGIUS Nano CR offers customer maintenance features that help to reduce department downtime, including the cassette release handle for easy access to remove a trapped cassette; Optics Sweeper that enables the user to easily clean dust that may accumulate on the optical unit; and Konica Minolta’s patented rigid image plate technology for excellent image quality and durability.

The REGIUS Nano CR is available in two models. Nano CR—The Enterprise Solution utilizes the same easy-to-use interface as Konica Minolta’s flagship Xpress CR to provide sophisticated software tools for superior image quality and customization while requiring fewer steps to complete the exam. Nano CR—The Clinic Solution uses the same intelligent and automated software as the IQue CR, resulting in minimized user training requirements in addition to delivering consistently high quality images.

Konica Minolta also is showcasing its REGIUS 370 Upright DR, which features the most advanced phosphor detector available, Cesium Bromide (CsBR), to produce a high level of detective quantum efficiency (DQE) comparable to flat-panel DR systems. The REGIUS 370 is compatible with virtually any existing x-ray generator or tube, thereby reducing the cost of entry to DR. The REGIUS 370 Upright DR is capable of rapidly scanning an image at a rate of 210 exposures an hour.

Philips Medical Systems (Booths 4165, 4129, 4048, 5117, 5664) is showcasing the Eleva Experience for all of its radiography and fluoroscopy systems. The standardized, intuitive user interface will be available in 2008 on MammoDiagnost DR, DigitalDiagnost, and Practix Convenio DR, and is already available on Philips CR, Essenta DR, EasyDiagnost, MultiDiagnost, and OmniDiagnost.

Philips also is showing its wireless flat-panel detector for instant image display on Eleva workspots. The detector is for Philips’ DR rooms (DigitalDiagnost) and portable x-ray unit, the Practix Convenio DR which is a works in progress. The detector is appropriate for all radiography applications where flexibility of projections is required.

The Practix Convenio DR, its wireless, digital, portable x-ray device designed for increased efficiency in the OR, ER and ICU thanks to instant image access (less than 8 seconds) and wireless connectivity. The system allows for complete workflow at Convenio's Eleva workspot (HIS/RIS connectivity) from patient request to image archiving.

The DRF room solution combines high-quality DR and fluoroscopy in one room for increased room utilization. It uses Philips’ UNIQUE image processing and DoseWise concept and allows for filmless and even cassette-less workflow for high throughput with Eleva Concept.

Quantum Medical Imaging (Booth 4771) is showcasing DR and CR products at RSNA, starting with the DiRex, a complete digital imaging solution. Quantum, in partnership with Agfa Healthcare, designed the DiRex system to use a specially configured Agfa DX-S CR system and Quantum radiographic system, integrated into a single room digital imaging solution.

The DiRex system features exclusive technologies: Quantum’s TechVision, which allows the technologist to modify exposure parameters and preview images from tube-side and the DX-S system which uses DirectriX needle point technology, providing images of exceptional detail at lower dose than typically found on CR or DR systems. In addition, the unique high-speed scanner performs line-by-line scanning for ultra fast results, providing images in seconds.

The DiRex System is available in three versions of room configurations: ceiling-mounted tube system, floor-mounted tube system and QV-800 Universal system.

Quantum also is highlighting its new QV-9000 Digital Universal Radiographic System, which offers automated positioning features. All positioning motions of this C-arm type system are fully motorized, and synchronized for maximum patient throughput. Once the exam is selected from either the modality worklist or directly by the technologist, the QV-9000 automatically moves itself into the position required to complete the examination. The system can be easily positioned from either the digital operators control monitor or from Quantum’s unique “TechVision.” The unit features a highly versatile C-arm design which maintains constant alignment between the x-ray tube and the image receptor, regardless of C-arm rotation position or image receptor angle. This allows for a great number of exam positions, for not only average patients, but also those who are disabled or physically restricted.

Also on display is the latest feature of TechVision—complete two-way generator integration and image preview. TechVision lets technologists easily view and set-up all exposure parameters at tube-side. Technologists are given the opportunity to remain by the patient for positioning or repositioning, yet also use the Operator Control Panel outside of the room, if patients are comfortable.

The ease of two-way generator communication via TechVision eliminates the back-and-forth from the Operator Control Panel to the patient, for the system set up for patient exams. The operator has complete control to adjust exposure parameters at the tube-side. Within 6 to 9 seconds, the technologist can preview the x-ray directly on the TechVision’s in-room touch-panel monitor, mounted on the tube head assembly, enabling the technologist to determine whether the exam needs to be repeated or the technologist can move on to the next view. With TechVision integrated with the DR system, the technologist obtains another incremental productivity gain in total digital workflow. This synchronized generator solution greatly streamlines the imaging process and decreases overall examination time, while allowing the technologist to remain close to the patient, for increased patient care.

Quantum also is demonstrating two new CR systems that were developed in partnership with Agfa. The CR30-SP+ is a table-top unit, capable of 60 plates per hour. The CR35-SP+ is an upright unit which does up to 73 plates per hour.

Both systems include MUSICA2 Image Processing Software from Agfa that tweaks both bone and soft-tissue detail simultaneously. MUSICA2 analyzes the image data before applying optimal contrast, brightness and sharpness to all details within the image. The CR30-SP+ and CR35-SP+ packages come standard with a 19-inch touch screen, NX-2 Workstation, four cassettes (with two-year warranty), Advanced Annotations and Measurements tools software, and CD burning capability.

Radlink (Booth 4711) is introducing three distinct CR Pro machines that follow up on the company’s highly regarded CR Pro that uses sealed fiber-optic laser technology to obtain high-resolution, higher-quality digital x-ray images at a low cost.

The CR Pro 2000 features a top-quality CR reader that is specifically designed for two markets: the OEM market, for use as a CR appliance with digital radiography, as well as distributed applications for end-users with smaller budgets. The CR Pro 2000 is engineered with an upgrade path that provides all of the capabilities of the entire Radlink family of imaging systems.

The CR Pro 2100 is Radlink’s core CR product, based on a proprietary “sealed fiber optics” design that maximizes transfer efficiency in private physician offices where low-power x-ray equipment is common.

The CR Pro 2200 is designed for multiple physician practices where all digital images must be stored in a secure, HIPAA-compliant database for future access. The CR Pro 2200 bundles a robust PACS with up to 10 Terabytes of secure storage inside a self-contained Radlink CR system with image quality and speed that equals any other CR system available.

RTI Electronics (Booth 4125) is highlighting new features of its x-ray multimeter Piranha, including a light detector and mAs probes. The Piranha measures kV, time, dose, dose rate, dose/pulse, pulse rate, HVL, and total filtration. The new detectors add capability to measure mA, mAs, lx and cd/m2.

The new light probe measures both luminance to check monitors and illuminance to check the ambient light. Two different mAs probes are available, one invasive and one non-invasive. The non-invasive mAs probe allows mA and mAs to be measured without any need for electrical connections to the x-ray generator.

The Piranha is designed as a truly self-contained, all-in-one, multi-function meter that fits in the palm of the hand. Communication is made very easy by built-in Bluetooth and USB. The Auto Compensation pioneered by RTI, available on all existing multi-function meters, corrects for any added filtration on the fly. Measured data and waveforms are captured and are instantly shown on a PDA or a PC.

Siemens Medical Solutions (Booths 8313, 7713, and 8320) is showcasing image quality and workflow enhancements for the Axiom Artis interventional angiography systems. Siemens also is highlighting the 3D cross-sectional imaging application, syngo DynaCT, which allows soft-tissue imaging in the angiography suite and virtually eliminates the need to transfer patients to other modalities for follow-up procedures, Siemens says.

Also being highlighted is the Axiom Aristos FX Plus ceiling-mounted digital angiography system; the Axiom Luminos TF, a conventional fluoroscopy system with a table limit of 600 pounds; the Axiom Aristos VX Plus, a single-detector radiography system with a 17-inch by 17-inch flat-panel digital detector; and the Mobilett XP digital portable x-ray system.

The company's special systems division is highlighting enhancements to its Arcadis line of C-arms, including an improved and ergonomic trolley that facilitates maneuverability and reduces space requirements. These include the Arcadis Avantic, a mobile C-arm with a 13-inch image intensifier, and Arcadis Orbic and Arcadis Orbic 3D, a family of C-arms with an isocentric design and 190° of orbital movement.

Swissray International (Booth 7162) is unveiling a new dual-detector DR line of products incorporating portable x-ray detector technology. This new design allows for greater positioning flexibility and advanced applications.

Swissray is showcasing its newest DR system, the ddRCompact, offering state-of-the-art technology at the most competitive pricing in its segment. The system incorporates the new digital High Definition Silicon Solid State detector with Micro Lens Technology, delivering outstanding spatial resolution at low radiation dose. With an active detector area of over 17 inches (44cm), the system satisfies all large-field imaging requirements. The ddRCompact performs all DR applications on recumbent, standing and sitting patients including off-detector and off-center applications. All system movements are fully motorized and remote controlled.

The new ddRCompact Series also comes with Swissray’s APS–Automated Positioning System, which streamlines the radiography workflow process by automating all positioning and image acquisition requirements. Swissray’s imaging systems more than double the patient throughput compared with other DR technology. The ddRCompact also comes with AutoStitching, a function that automatically combines up to four images and allows the viewing of a single image of long bones with one push of a button.

Toshiba America Medical Systems (Booth 7130) is displaying its DR system offerings, including the T.Rad-PLUS Digital and Kalare systems. Designed for maximum productivity, the T.Rad universal C-arm design facilitates shorter exam times and greater diagnostic confidence. The Kalare R&F system incorporates a portable DR panel, creating a 100 percent filmless system allowing a single system to work like two. Both systems allow clinicians the flexibility to obtain images from virtually any position without moving the patient.

Toshiba is introducing its low contrast imaging feature as a works in progress that will be available on all of Toshiba’s Infinix products. This new feature will allow soft-tissue imaging in the angio suite and the technique will provide CT-like imaging at the point of treatment, as opposed to having to transfer a patient to a CT scanner. Toshiba’s low contrast imaging technique for the Infinix line will be available to customers in December. 

Toshiba also is showcasing its biplane x-ray system—the Infinix VF-i/BP. This system combines a versatile multi-axis floor mounted positioner that allows head-to-toe and fingertip-to-fingertip coverage and a ceiling suspended omega C-arm featuring variable iso-center. This combination allows unprecedented clinician access and anatomical coverage of the patient. High-resolution imaging is achieved with two flat-panel detectors—a 12-inch by 16-inch FPD on the multi-axis position and an 8-by-8-inch' FPD on the ceiling suspended omega C-arm. All of these features allow the maximum flexibility needed for complex vascular and neuro interventional procedures with high-resolution imaging at the lowest dose. 

Unfors Instruments (Booth 2109) is unveiling a new edition of its Unfors Xi system for multi-parameter measurements of all imaging modalities. The new Unfors Xi Platinum edition includes improved features such as longer waveform memory and the addition of a survey detector for measurements of leakage and scatter radiation.

The Unfors Xi Survey Detector is designed based on solid-state sensors with clear benefits in size, sensitivity and durability. The dose rate range is from 10 µGy/h to more than 1 Gy/h and is suitable for usage in the energy range from 17 keV to more than 120 keV. The handheld scatter probe is easy to use and has, in addition to the measured values in the display, a buzzer with a frequency corresponding to the dose rate. Data can be stored in the internal memory or exported to Unfors Xi View via serial or Bluetooth communication.

Varian Medical Systems (Booth 1358) is introducing two new PaxScan products—the PaxScan 4336R and the PaxScan 4343R. The PaxScan 4336R adds a 14-inch by 17-inch detector to Varian’s line of flat-panel products and is specifically designed for use in radiographic applications. At 17-inches by 17-inches, the PaxScan 4343R is Varian’s largest flat-panel x-ray image detector. Both panels incorporate identical detector arrays and readout electronics. Image data and control signals, which are based upon an industry standard Gigabit Ethernet interface, can be passed to and from these detectors using standard network interface cards. Images are transmitted instantaneously to the image processor for display and diagnosis. Housings and cable attachments are designed for simple integration into any diagnostic imaging system.  

Both of these panels come bundled with VIVA software, a system design and development application for image acquisition and viewing on a workstation running Microsoft Windows. This software package provides an easy way for the original equipment manufacturer or system integrator to quickly begin image analysis and system design. Also included with VIVA is a complete Dynamic Link Library (DLL) to facilitate simple software development. Sample code is provided to ease the design of detector set-up and calibration, image acquisition, and image optimization.