Many radiology departments, imaging centers and clinics have adopted PACS for the promise of cost-savings enabled by eliminating film. While that goal requires modification when specialists and referring physicians continue to request film, the use of high-quality laser imagers has enabled radiology practices to meet that demand.
Bill Fitzgerald, chief operating officer for Multi Imager Service, an authorized service contractor for Agfa, Kodak and other OEMs notes the changing trends that maximize the effectiveness of print activities. They are seeing much more reliable systems in the marketplace, coupled with many OEM service contracts that have decreased in price for routine maintenance activities.
"There are maintenance schedules with a film odometer that measures the number of films that has run through the unit," he notes. Typically preventive maintenance activities are required every 10,000 prints. "The machines are becoming much more reliable than they were 10 years ago" - a scenario reminiscent of the lonely Maytag repair man.
"Historically, you had a printer in the nuke med department, one in ultrasound, one in CT and one in MR," he says. "Now we're seeing one centralized printer with increased speed, sorters and multiple film sizes per laser." Since the overall number of prints has decreased with the advent of PACS, remaining hard copies must be produced efficiently and with an eye on cost.
Depending on the physical dimensions and requirements of the radiology practice, administrators must select the appropriate printer configuration to meet their needs.
Dispersed on a network
John C. Litchney, administrator for the department of regional radiology at the Cleveland Clinic Foundation, discusses the rationale for deploying a dozen plus Codonics Horizon imagers throughout their extensive department.
The small footprint (less than two square feet) of these tabletop printers, and the efficiency they afford the technologists who can print films in proximity to the imaging modalities where they are performing exams is appreciated. While film in ultrasound is not used, their laser imager configuration includes having one printer paired with one CT and one MR scanner, and no more than three modalities on any one printer. All of their archiving of images is accomplished electronically via PACS.
"Codonics offers color printing on paper," explains Litchney. "That, combined with the advent of 16-row CT scanners that can produce color 3D images in post processing, that's where we find ourselves using this product." Most of their referring physicians have appreciated the versatility of these imagers, capable of printing on film or paper.
One of the other benefits of printing on Codonics DirectVista paper is a reduction in cost compared to printing on film. For example, with traditional film, a 14-by-17-inch sheet could be as much as a 60 percent lower using paper. Many referring physicians prefer to place the paper print into their patient charts. Color printing proves useful in ultrasound, nuclear medicine, MR fiber tracking, multislice 3D and orthopedic applications as well as fused images produced by modalities such as PET/CT.
Litchney describes their use of a mobile PET/CT unit, where they place most imaging studies on CD disks. "The Codonics Horizon is on that mobile unit, and while we don't use it for most things, we do use it for color printing. It can do 80 to 90 sheets per hour."
They began using the imagers in 1999 and have needed to replace only one unit to date. Codonics offers a service program where they "swap" a new printer unit for one that has malfunctioned. A new machine is shipped to the department, personnel remove a "smart card" with set up information for the original machine, place it into the new one, and the imager is ready for use immediately. They return the original machine to the company.
The Sony FilmStation 14X17 Dry Film imager is another compact desktop imager that is capable of printing a film in less than a minute, according to Andrew Osiason, MD, co-director of New Century Imaging in Oradell, N.J. He considers this a plug-and-play system that is easy to install, and describes it as DICOM compliant. The imager can be installed in either a horizontal or vertical position and has casters for mobility with a LCD front panel and simple system for loading film.
By combining the newly developed print head with Sony's blue thermal film, the FilmStation is designed to produce an increased level