Special report: Radiography (and fluoroscopy) keep pace with market demands

by Loren Bonner, DOTmed News Online Editor | November 14, 2012
International Day of Radiology 2012
From the November 2012 issue of HealthCare Business News magazine

“Numerous studies, including AAP [American Association of Pediatrics] and SPR [Society for Pediatric Radiology] have concluded that neonates and children are the most vulnerable to the possible risks associated with radiation exposure,” says Joan Silverio, marketing manager for Kubtec. “In addition to the cumulative effects of X-ray exposure over a lifetime, a child’s rapid growth rate increases sensitivity.”

Kubtec received FDA approval last October for the portable DIGIVIEW 250 system for pediatrics, particularly those patients in the neonatal intensive care unit. The system uses a CMOS flat panel digital detector and works with existing portable X-ray systems.

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Other vendors, like Philips, incorporate default settings in the system based on a person’s date of birth.

In addition, depending on the DR detector technology, lower-dose can automatically be achieved. Experts say that DR technology, which consists of caesium iodide scintillator detectors, automatically bring dose back to what was achieved with regular film (CR has a higher dose than film).

“The gold standard is caesium iodide technology and this one is most effective in converting the radiation into a usable image,” says Ybarra.

Improved image processing is helping to achieve lower dose imaging—since improved processing can take lower-dose information and turn it into a crisp X-ray image. Most vendors have post-processing algorithms that improve quality, reduce noise and enhance detail.

Viola Fernandes, radiography product manager at Siemens, says they also have grid options (for pediatrics it’s important that they can be removable from the system) to help reduce scatter radiation and improve image quality. Low-dose filters can also be used to separate out soft radiation that is absorbed by the skin and doesn’t contribute to the image.

The rumors of fluoroscopy’s death have been greatly exaggerated
Despite some claims that fluoroscopy is dead, Siemens sees the market coming back in a positive way. At last year’s RSNA, the company was the only OEM that introduced a new system— the Luminos Agile—which they claim increases image quality by up to 116 percent compared with older systems.

Philips’ Helbig says fluoroscopy is still a large and stable market.

“It may look like image intensifiers are dying out, but in the end for standard GI work, speech work, and functional studies, often the temple resolution of an image intensifier is better than flat detector,” he says.

Siemens’ Niepel says he’s even seeing a new clinical focus for fluoroscopy opening up with bariatric surgery, which has become a popular weight-loss option among obese patients.

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