The CARESTREAM DRX-Evolution is a fully automated, dual-detector DR suite.

Significant dose reduction, increased throughput, and seamless versatility are some of the clinical benefits that Houston Healthcare has experienced since converting its CR systems to DR detectors. Houston Healthcare, serving residents in Warner Robins, Centerville, Perry, and Houston County, Ga, is no stranger to DR systems. But when the decision was made to implement digital detectors on a wider scale, Houston Healthcare chose CARESTREAM’s modular DR detector technology to make it happen.

The health care system installed the CARESTREAM DRX systems in three phases over the course of 2011. First, they completely overhauled and expanded the hospital’s busiest imaging room, which handles ER patients and general radiology exams and installed the CARESTREAM DRX-Evolution, a fully automated, dual-detector DR suite. In the second phase, they also converted two existing portable imaging systems with wireless DRX detectors using the DRX-Mobile Retrofit Kit. This solution is a noninvasive, customized retrofit package, compatible with most mobile units. They also installed two DR detectors in general radiology rooms. The third phase included the installation of two additional DR detectors in existing x-ray systems in the busy Houston Healthcare Pavilion outpatient imaging center.

Tim Sisco, director of Cardiovascular and Imaging Services for Houston Healthcare, explained their initial reasons for choosing CARESTREAM technology, “What it came down to during our evaluation was the throughput and the technology that we saw with the CARESTREAM DRX-Evolution room. DR was what we were looking at for speed. The big challenge that we ran into in looking at DR systems is if it’s a fixed detector, then you are only stuck with the Bucky that the detector is associated with.”

The versatility of the CARESTREAM wireless DRX detector eliminated that concern. It fits standard wallstands and table Buckys, and can be used for tabletop shots, just like a CR cassette with no equipment modifications required. Images are immediately available at the system’s capture console and can be quickly forwarded to multiple network destinations. The wireless DR detector simply slides into existing x-ray equipment and can be used with imaging systems throughout a facility. Sisco elaborated that “With CARESTREAM, because these detectors are wireless and portable, we could actually take them out of a Bucky and put them on the patient if they are on the gurney. We could have DR detectors that were mobile, or could be moved from one Bucky to the other, or were able to be used on a tabletop…. I could move it to wherever it needed to go.”

One pleasant surprise to the clinicians at Houston Healthcare was the dose reduction they observed after installing the DRX units. “We lowered our doses by about 30% to 40% as we put the systems in. We realized that the increased sensitivity of the DR units compared to CR allowed us to reduce our doses. We were using our automatic exposure control systems, and the image was initially so dark, or overpenetrated, that we had to reduce the dose. We had to have the machines recalibrated to lower dose by about 30% to 40%. We did know that there would be a dose reduction. We just did not know to what degree. It wasn’t until we actually implemented it and realized how much of a recalibration we needed to do to our x-ray tubes to bring them down, that we really got a working knowledge of it. We really hit that understanding about dose reduction mid-year 2011.”

In addition to the standard DRX detector, CARESTREAM has a Low Dose DRX-1C Detector with a cesium iodide (CsI) scintillator, which is available for procedures in which minimal patient x-ray exposure is desired. The CARESTREAM DRX-1C detector’s high Modulation Transfer Function (MTF) and Detective Quantum Efficiency (DQE) make it an ideal fit for dose sensitive applications like pediatrics.

“I have been a clinical director for a long time, and diagnostic x-ray is one of those areas where technology has not historically progressed as fast as some of the other areas,” said Sisco. “This was a real satisfier for the department because the largest pool of our staff, the general diagnostic radiologic technologists, were finally able to get some new technology that allowed them to do their jobs better, and it raised morale. This was our opportunity to provide technology in general radiology that we have not seen for a while.”