Money Matters

Obviously, as mentioned previously, the biggest advantage of CR over DR is the cost. One of the biggest challenges of investing in a DR system is having the appropriate infrastructure to install it. In many cases, an existing room has to be renovated to accommodate a new system.


DR typically requires purchasing entirely new X-ray equipment, and new X-ray equipment almost always requires remodeling of the radiography room, which can add anywhere from $50,000 to $200,000 to the project, depending on the existing infrastructure, regulatory requirements, and back-up clinical needs during the remodel.

Because of the equipment and infrastructure requirements, a DR system can be three to five times the cost of CR. The list price on a high-quality CR system today can be as low as in the $60,000 range, while for DR, you're typically looking at $350,000-plus with the new equipment.

Stephen Spearing, Administrative Director of Imaging Services at Lewistown Hospital in Pennsylvania did an extensive evaluation of CR and DR before deciding on DR for mammography and CR for their other imaging needs. He cites cost as being the major factor.

"We are a small rural hospital of 139 beds so to get into DR you need to buy a piece of equipment for each room, and that's roughly $300,000 per unit, 6-7 rooms, so you're looking at nearly $2.1 million," he says. "It didn't cost that to put CR in. It was a financial decision and strategy. If we had all the money we wanted, we would go with DR everywhere but that's not the real world. We looked at how to do it effectively, quality wise and cost efficient and that's what we did."

Economic Uncertainty

Burkhart explains that after first coming into the market, CR grew to $500 million in volume but with many users converting to DR over the years, especially as it has gotten cheaper, that number is gradually decreasing.

"We see the market going down 5% to 10% a year," Burkhart says. "It's hanging in there very well given the significant advantages of DR but it's still a very substantial part of the market and probably will be for some time. In terms of unit sales, we're seeing 60% DR, 40% CR. If you want to talk about patients, it's probably about 70% DR and 30% CR."

There has been a bit of a slowdown within the industry as many hospitals and health facilities are contemplating if this economic climate is really the best time to invest in new equipment to go digital.

Because of that, Ji says Cannon has thrown their energy behind upgrades and retrofits, which will not cost as much as a new system.

"About half of our business is dedicated to upgrades and retrofits. A lot of manufacturers are coming up with that now because of the way technology is going," she says. "We hear 'we don't have money for DR because of the way the economy is going' but we are able to work with them and help them with the upgrade."

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