Frequently Asked Questions.....
- What is the difference between CR and DR?
If your office currently uses CR, or Computer Radiography, you take your exposures in the traditional way of film-based x-ray but use a specific type of cassette that is inserted into a CR reader, rather than a film processor. This cassette is then erased and used again. This method takes slightly less time than a film processor setup would, without the hassle and cost of film and chemistry. The films are stored on digital media and easily transferred from site to site. New CR systems have mostly been discontinued from manufacturers as the cost is about the same as a DR setup. You may find a few Used systems still in operation, but parts are very limited.
If your office currently uses the more modern DR, or Direct Radiography, your x-ray machine will shoot directly onto a DR panel. This panel can either be fixed to the wall stand or table, or moved between wall and table buckys. These portable panels connect to the aquisition computer via a tethered or wireless connection. Most images are aquired within 3-10 seconds of the initial exposure. Retakes can happen within seconds, reducing exam time even further. The manufacturing techniques and technology make DR more expensive than most CR solutions, but the quality of the images and the time required to complete an exam makes it a valuable component of your x-ray room. Recently passed House Bill H.R. 2550 dictates Medicare reimbursement cuts of film and CR studies, soon making DR the only fully approved method of acquiring images.
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- How does DR work?
An x-ray generator procduces x-rays, which strikes the Scintillator. This Scintillator is usually made of Gadolinium oxysulfide (Gadox) or Cesium Iodide (Csl). Cesium usually requires a 10% lower dose to yield the same results as Gadox. This Scintillator converts the x-rays to light which passes on to the Thin Film Transistor (TFT) grid. Each pixel of this grid contains a photodiode which generates an electrical charge proportional to the amount of light produced by the Scintillator. These signals are captured and sent to the translation electronics and passed on to the acquisition computer for display and storage.
Why should I go digital?
Many practices contact us with an interest in transitioning from film-based x-ray to digital. In order to figure out if making this transition is for your practice, you must ask yourself a few questions...
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How long do I plan on staying in practice?
If the answer is more than a few years, digital may be a wise investment. With the rising cost of film and chemistry supplies, digital x-ray is becoming a more common image acquisition media. Remember 35mm film? you once found film in every drug-store. Now, since the mass production of digital cameras, camera film is very hard to come by. The same thing is slowly happening to x-ray film. Eventually, if you plan to take x-rays, you may have no other choice but to convert to digital. Wouldn't you rather do it on your terms?
On the other hand, if you plan on selling your practice soon, having a digital x-ray setup adds value to your facility. Most practices that have digital x-ray are seen as "modern" and up-to-date.
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Should I choose CR or DR for my practice?
CR and DR systems can both produce quality x-ray images. In order to answer this question, you must first ask yourself how many images you plan on taking each day. This number may differ from your current intake. The way I describe CR is that it is basically a chemical-less processor that puts your image on a computer. Most CR units can process 40-80 plates per hour. If you only plan on taking x-rays on 3-5 patients each day, this may be the most cost effective way to go. Another point to consider with CR, is that all CR units have many moving parts inside. It is important to maintain these units and replace worn parts as needed. Keeping the area around the CR free of debris is very important. Prices on new CR units are generally half of the cost of a DR unit.
DR systems are best used when image processing time and image quality are factors. A good DR panel can produce a full-resolution image in just seconds, where most CR units take a few minutes to complete the cycle. DR panels have no moving parts and can be cleaned with a damp cloth. Most issues that a DR setup can experience can be resolved remotely, rather than waiting for a tech to arrive. The image quality of a good DR setup is far superior to most CR systems. Each pixel of data within the DR panel is read, rather than a linear scan of a plate as a CR does. This reduces the chance of artifacts in your image and does not allow the media to become contaminated with light or debris. The DR panel is generally ready to take another image within seconds of obtaining the first image.
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I'm confused with all the different models of DR panels. Which one is for me?
DR setups come in many different flavors. A DR panel can be wireless, or tethered (wired). Most vet and chiropractic offices choose the wired panel. These panels usually stay in the bucky and are not easily removed. Wireless panels are best used in applications where the panel will be moved from a wall stand to a table, such as a medical facility or chiropractic office.
Next you must decide what size panel is best for your practice. Central Alabama X-Ray offers DR panels in three sizes.
10" x 12" , 14" x 17", and 17" x 17"
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Most podiatrists use the 10" x 12" panels. Most fixed, but not all tethered panels are 17" x 17". The square size of the panel allows the user to capture the full image without having to rotate a 14" x 17" panel. This is helpful if a patient is wider or taller than your panel acquisition area. Most wireless panels are 14" x 17", but a few companies, such as Rayence, manufacture 17" x 17" wireless DR panels. These panels are the ultimate in wireless DR panel systems, as they can obtain an image at the maximum size of the bucky.
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The last decision to be made is whether to choose Cesium or Gadox. Cesium usually requires a 10% lower dose to yield the same results as Gadox. This means that you can use a lower exposure technique with your x-ray generator and get the same results. A majority of the DR panels we sell are Cesium, although the Gadox panels still give similar results.
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