"Digital upgrades are a significant market opportunity for remanufacturers and refurbishers of diagnostic X-ray units as they do not need the blessings of the OEMs to carry out the upgrades. There are literally thousands of units in the field that are waiting to jump on the digital bandwagon," he added.

Canon leads the rest of the pack in digital upgrades with their portable amorphous silicon flat panel DR detector. This is ideally suited for the workflow with the portable units. Exposure repeats are a big issue with conventional units and this detector eliminates repeats. Images are sent to the hospital PACS system once the portable units are connected to a PACS port.


Ramesh also noted that "Siemens and some other manufacturers have announced portable CR X-ray units. These units have integrated CR readers that eliminate the need for the technologist to run to a stationary CR reader after every
exposure."

Portables 101
The three configurations for portable X-ray machines are traditional film, CR and DR.

Film is the old standby approach that converts the x-ray beam to light that's captured on the film, requiring processing. CR, or computed radiography uses a plate inside a cassette. When the plate is irradiated, it changes the valance or charge. The technician takes the plate to a CR reader, which is a laser beam that scans it to release the image. Some units are selfpowered with batteries like the gold standard GE AMX IV(4). Others must be plugged in for use.

DR, for direct radiography, uses a rare earth element spread across an image receptor. Like a giant digital camera it captures the image directly and coverts it to a digital image right there at the detector. Canon is known for its DR portables but GE is coming out with one presently, the AMX V (5). DR units are heavier than CR and a bit harder for technicians to lug around.

Older equipment remains very popular and ISOs are known to stock parts while the OEMs may not for older units. "There seems to be a high demand for the older portables like the AMX 110 and the AMX III. I get requests for those all the time and they're after-life, according to GE...and the older units are cheaper," said Marc Todd, owner of Longevity LLC, Brooklyn, N.Y. The company provides used medical imaging equipment and parts to hospitals and other providers.

Hospitals often find buyers for their old equipment on DOTmed.com when they upgrade, or they buy used equipment to augment their portable fleet. Some charities buy the units since they take the place of a rad room in the medical mission hospitals.

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