A glimpse of whats new in digital radiography
Ironically, SIIM University Section 1 opened with a slide titled “Fractured Fairy Tales” and an image of a fracture. J. Anthony Seibert, PhD, University of California-Davis Medical Center, who was to be in attendance at SIIM 2007 in Providence, R.I., yesterday to give the talk, unfortunately had recently been in a bike accident and unable to attend. Filling in for Seibert was Charles E. Willis, PhD, University of Texas MD Anderson Cancer Center.

The set of learning objectives included a discussion of the latest commercially available digital radiography (DR) and fluoroscopy equipment; a review of new clinical image acquisitions and data extraction schemes; an illustration of research applications and prospects for digital detector technology; and advancement of standards of DR practice.

Using Siebert’s PowerPoint presentation, Willis reviewed the current DR detectors and their technologies that are cassette-based and cassette-less. The common themes in DR are: separation of acquisition, display and archive, wide dynamic range, variable detector exposure operation and appropriate SNR and image processing, which are crucial for image optimization.

What’s new in clinical equipment? Among the highlights, CR mammography has been approved by the FDA. Following suit after Fuji won approval in late 2006 the number of CR vendors for mammography is likely to increase within the year. With that, digital mammography will be pushed fast and further. Many CR readers can provide conventional and mammography readout capabilities, with a few limitations.

Other developments include dual-side CR readout, line-stimulation CR readout, and line-scan CR systems. Also, Wireless Blue Tooth-enabled flat-panel detectors are under development. Flat panel detectors (FPD) are now replacing image intensifiers. In comparing flat panel versus II image quality, Seibert’s presentation supported that flat panels are significantly better at high exposures and not as good at lowest exposures.

Digital imaging at point of care is growing. Portable radiography systems with built-in CR reader and cassette or DR detector are being used.

Willis noted that clinical acquisition schemes and protocols advances include dual energy radiography, digital tomosynthesis and 3D rotational angiography.

The road to the future for DR includes: hybrid detectors (indirect/direct); new direct x-ray converters; flexible substrates and detectors geometries; and standards.

On behalf of Seibert, Willis emphasized the need for standardization of practice for the industry. He said as new technology develops, the standards should address DICOM issues, integrating the healthcare enterprise, and quality control.

With the advancement of technology, “physicists, technologists, informatics and radiologists must maintain awareness of changes and be able to provide informed assessment and impact on clinical operations” noted Seibert’s final summary statement.