by Cat Vasko

· Digital Radiography Strides Forward
· Tech Zoom: HD Camera System from Smith & Nephew

Digital Radiography Strides Forward

At the 2007 meeting of the American Healthcare Radiology Administrators (AHRA), Sudbury, Mass, held in July in Kissimmee, Fla, there was a new DR on the block: the Directview DR 9500 from Carestream Health, Rochester, NY. The DR 9500 distinguishes itself from many of its forebears, both analog and digital, via an innovative configuration in which tube and detector are fixed opposite each other on the arms of the U-arm device. To learn more about the strides DR technology has taken, Medical Imaging spoke with Helen Titus, product line manager for DR at Carestream.

Helen Titus
Helen Titus

MI: To begin with, what makes the DR 9500 different from its predecessors?

Titus: The overall design itself. With its U-arm configuration, you really get the flexibility of a dual-detector system with a wall stand and a table. You get that kind of flexibility in a single-detector design. It’s very easy to manipulate the system around the patient, so particularly with patients who are elderly, or in emergency situations, you don’t have to move them. The system has a lot of freedom of motion around the patient. There’s really no other system like it out there.

MI: What are some of the workflow enhancements that have been added?

Titus: There’s a touch-screen interface on the system so that you can see what exam you’re going to do. You can change technique right on the system itself without going back into the control room. We have movement controls, both motorized and manual, at multiple places on the system, so if the tech happens to be working at the back of the system, she can still control it from multiple work zones. We paid a lot of attention to the way techs work, and had a lot of customer input on where those buttons should be. We’re really saving steps and time.

MI: Were other modifications made based on technologist workflow?

Titus: The software we have on the operator console itself was really designed to facilitate workflow. We paid attention to the different ways techs work in order to streamline their button pushes.

The Directview DR 9500 (above and below) from Carestream features an innovative configuration.

MI: Is that just a matter of anticipating their next step?

Titus: Exactly. The software has multiple ways to get into different screens. It anticipates what the next logical move will be and makes it easy to go from one exam to the next. That’s not unique to the DR 9500; all of our Carestream CRs and DRs have that same user interface. Once a facility learns our system, they can very easily go between different products that we have. We’ve gotten very good feedback on that.

MI: I understand the detector-tube design deviates from the usual setup.

Titus: What makes the detector unique is—because the device is on this U-arm design—the x-ray tube and the detector are always aligned. They’re parallel to each other. There is no extra manipulation by the tech. This deviates from the traditional systems where you have an overhead tube and a wall stand, and they’re two separate entities. You can move the detector on the wall stand to any vertical location, but that doesn’t mean your tube will be directly parallel automatically. That’s what techs normally learn on. Most DR systems are this overhead tube/wall stand configuration. This system is different, so you have to overcome your initial apprehension. But in a very limited time, they come to love the way it works. Once you learn the system, you don’t have to take these extra steps.

MI: It seems like a pretty intuitive way to position the detector. Why wasn’t it done sooner?

Titus: Early analog systems were this way, so people made DR systems to follow the analog design. We have a DR 9000—the previous iteration—which is built on this same concept. The systems are out there. We just took it to the next level and made it that much easier for the user.

MI: What’s next for DR?

Titus: Some of the things we’re hearing and seeing is the desire by facilities to extend their DR rooms even further in terms of what they’re able to do. The desire to do more exams in the DR room plays into the DR 9500 concept. It’s so easy to get both sides of the patient. People want to use the DR in new ways. They want to do long bone exams. They want to do standing seat. Detectors are becoming available that have real-time fluoroscopy capabilities, so the idea is to combine rooms and have one room do everything. Now that people have DR, they want to do everything with DR. That takes some advances on the detector side, and some on the accessory side.

MI: Have you observed any other trends?

Titus: The desire for dose reduction. Europe has always led that effort, in Germany and other countries, but we’re really seeing it worldwide now. That requires higher-sensitivity detectors and software features to help facilities manage dose. We have software that tracks which types of exams had how many rejects. [Facilities] use it as a learning tool so they can reduce their numbers of rejects. It was easy in the film days, when they had a bin to keep the rejected film. They lost that with DR, and we recognized that and built this software. We’re finding that as dose becomes more critical, they need these tools to help keep the dose low and the rejects low.

MI: How can hardware help modulate dosage?

Titus: Most of it is in the detector itself. If your detector is more sensitive, you can get the same quality image by reducing the dose. And when your image processing software is good, you can filter out the noise and enhance the image, and that also lowers dosage.

MI: You mentioned that you are seeing a high level of demand for the technology.

Titus: People are truly ordering more and more DR systems. It’s no longer just for the big hospitals. It’s for the medium and small hospitals, the imaging centers. We continue to broaden our portfolio so we can really meet the needs of these various facilities. Budgets vary, room size varies, what type of exam they do varies. We’re set up very well to meet the needs as more and more people go to DR.

Tech Zoom:

HD Camera System from Smith & Nephew

New from the Endoscopy Division of Smith & Nephew, Andover, Mass, is the 560 Series 3-CCD High Definition (HD) Camera System, a surgical camera system designed to capture and display broadcast-quality HD images in arthroscopic and other minimally invasive surgeries. The 560 Series maintains high-definition resolution throughout the entire image chain, from the video arthroscope or laparoscope through the camera head and control unit and onto the monitor.

Smith & Nephew’s new 560 Series surgical camera for arthroscopic and minimally invasive procedures.

“Clearer images may result in better diagnostics, reduced OR time, and improved procedure outcomes,” noted Stephen M. Desio, MD, orthopedic surgeon at St Vincent’s Hospital, Worcester, Mass. “Smith & Nephew’s 560 Series Camera System has set a new standard for arthroscopic and endoscopic visualization. The picture detail, color, and field depth are outstanding.”

The 560 series is designed to interface with Smith & Nephew’s CONDOR Control System as well as the company’s 660HD Image Management System for Digital Operating Rooms. The CONDOR Control System enables medical staff to manage the operative environment from a single control panel; the 660HD IMS enables facilities to capture and store high-definition surgical images for archival with the patient’s medical history.

“The 560 Series was designed in partnership with broadcast technology experts to deliver superior image quality—not just for arthroscopy, but for all endoscopic specialties,” said Jerry Goodman, senior vice president and general manager of Smith & Nephew’s Capital Equipment business unit.

—Cat Vasko