From smaller footprints to higher-resolution output, radiology teams are demanding printers that suit their work setting and their specialty. Manufacturers are providing a speedy response with high-speed solutions.
Medical printers and imagers have many capabilities, numerous new features, and different approaches to address varied needs—from high-volume, high-resolution output required in more developed countries to compact, low-cost systems preferred in less developed regions. Although each manufacturer stresses their product’s unique attributes, the desired features boil down to a familiar blend of distinctions: speed, reliability, image quality, flexibility, convenience, and, of course, low cost.
According to Kurt Seestrum, product manager for digital output, Carestream Health, Rochester, NY, “Some facilities use printers to output selected images, or all images, from digital imaging systems such as CR and DR, MRI, CT, ultrasound, nuclear medicine, PET, etc. It’s important to have a printer that can print from all modalities in the size and format needed. This allows high-quality images to be sent for diagnosis or referral in a timely manner.
“Sometimes a central networked printer serves all modalities or printers,” said Seestrum. “They can be located throughout a facility so that films can be output where they are needed, such as the wing of a hospital, specialty area, outpatient imaging center, or breast center, for example.”
But the fact is that capabilities vary. Speed ranges from 50 to 230 films per hour; resolution from 320 to 650 pixels per square inch; film sizes can be 8×10, 10×12, 11×14, 14×14, or 14×17. Then there are a host of other features such as multiple film drawers and sorters that sort by modality. Today’s array of offerings mean image centers and hospitals must do their due diligence before investing.
Options for Every Specialty
“Features that meet the need for image quality are a key factor in decision-making by users,” Seestrum said. “For example, mammography images require the highest resolution and are strictly governed by standards in the United States and around the world. While some units print at only 508 pixels per inch, the Kodak DryView 8900 Laser imager outputs all imaging studies including mammography at 650 pixels per inch.”
But resolution issues aside, since medical image requests are often queued like print requests for networked document printers in an office, the sorter saves a technologist from having to go through a stack of film to find out where one study ends and another begins.
|Fujifilm’s DRYPIX 5000 produces 240 films per hour.|
Randy Sprinkle, administrative director of radiology, imaging services at Piedmont Hospital, Atlanta, agrees with Seestrum’s assessment. Using Kodak’s DryView 8800 and 8900 printers, he applauds the unit’s sorting capabilities for saving time and money. “Sorting is a big deal,” said Sprinkle. “With multiple film sizes, and modalities, units that can sort output efficiently are much more cost-effective.”
Tim Jablonski, vice president of marketing at Codonics, Middleburg Heights, Ohio, thinks versatility is the key. He notes that the current trend of PACS to completely digitize the radiology environment is going too far, and the industry still requires a variety of output formats. “Sites well entrenched in the implementation stages of PACS commonly find the need for occasional film print while using grayscale and color paper to help market their specialty applications like multislice CT images or digital long films for long bone or scoliosis applications,” said Jablonski. “Codonics’ Horizon system allows one to print occasional film, specialty films, low-cost paper prints, and color prints as the situation demands.
“Codonics Horizon imagers are used as an integral part of sites that are planning to go to PACs, are implementing PACS, or are in post-PACS implementation,” Jablonski noted. “There is also a marketing angle: The ability to print output in various sizes and formats to serve different presentation needs is an effective way to build referrals.”
|“Sorting is a big deal. With multiple film sizes, and modalities, units that can sort output efficiently are much more cost-effective.”|
| —Randy Sprinkle, Piedmont
“The thing I love most about the Horizon Ci printer is the ability to print several different types of media,” said Becky Lamberth, director of radiology, Plaza Medical Center of Fort Worth, Tex. “We can print color paper, 8×10 black and white paper, 14×17 paper, and film if needed. The printer does not limit us in any way, and we can give our referring physicians exactly what they want. The burner allows us to burn CDs or DVDs, and the colorful labels are eye-grabbing,” she said.
Lamberth also emphasizes the importance of flexible output. “We had some push-back from some of our referring doctors when we made the transition from film to PACS,” said Lamberth. “Many of them still wanted a hard copy to show patients, and as a facility, we wanted to eliminate that expense. For those doctors who insist on a hard copy, the paper printer was a great solution. When we find it necessary to print out certain exams (such as extremities), we can print on 8×10 paper. It saves us money, and the doctors love it because it fits nicely into the patient’s chart. No need for them to have storage for x-rays.
“The paper output has also provided us with a great marketing tool,” Lamberth noted. “We perform CCTA procedures and are able to print 3D reconstructions of the heart on the glossy color paper. With this capability, we can provide impressive copies to both the referring doctors and the patient.”
Work Settings, Space Constraints
Other users emphasize the importance of different features for their particular needs and work setting. Denise Rioux, manager of diagnostic radiology, Eastern Connecticut Health Network, Manchester, Conn, says she likes Codonics’ small footprint and user-friendly format. “It’s ideal for teaching,” said Rioux. “And because we deal with various interested parties, such as the legal profession, flexible and usable output is important. I’m happy with Codonics, but, of course, we look forward to higher speed and even smaller design in the future.”
“Today our radiology printers, like the FilmStation, are used to provide hard-copy film images of diagnostic radiology studies, primarily CT and MR. But the product is used for CR, DR, ultrasound, and other modalities as well,” says George Santanello, director of marketing for the Sony Medical Systems, Park Ridge, NJ. “Film printers, more specifically, dry film imagers like the FilmStation, offer a tremendous advantage in cost, serviceability, and environmental friendliness over ?wet’ chemical processors of the past. The fact that they are much smaller than wet processors, or even some of the earlier dry film imagers, is also a tremendous advantage in that the printers can be placed in the same room as the workstation to eliminate extra steps to a central printing room.
“One significant feature of the FilmStation is the ability to install it vertically, which can mean under a counter, rather than on top, thus freeing up lots of floor space,” said Santanello. “Another interesting advantage of our UP-DF500 model is that a second FilmStation may be linked with the first unit with a simple USB cable, nearly doubling the throughput with the need for a second IP connection. Our UP-DF550 model also supports three different sizes of film (in addition to 14×17), including 11×14, 10×12, and 8×10, responding to different modality requirements or physician preference.”
Another key feature of medical printers is the ability to convert non-DICOM data to DICOM. Being able to translate non-DICOM images into the industry standard printing format ensures acceptable image quality and allows older modalities that do not support DICOM to send images over the network to the printer. Without the DICOM conversion, the print files cannot be printed on a networked printer and would require a dedicated printer at each imaging system.
Quality and Service Features
Although the trend in medical printers is toward smaller footprints and lower costs, radiologists will not accept a reduction in quality. “Producing the required image quality on various film sizes (depending on the type of exam) is key,” said Seestrum. “Other features can be added to make the printer more productive such as speed and sorters.”
Jablonski emphasizes service features, including Horizon’s “Smart Card” technology, which retains the existing programming. “When needed, the old imager’s power cord, data cable, and replaceable Smart Card can be removed and put into the replacement unit and you are up and running instantly,” he said.
“I think it really all comes down to the quality of the image and the reliability of the product,” said Santanello. “Hospitals and imaging centers can not afford to have a printer down nor can they send substandard films to a referring physician.”
“In the United States, Europe, Canada, and other developed countries, the current trend is for printers to provide high image resolution, time-saving features, and rapid throughput,” said Seestrum. “Yet, images from multiple digital modalities are being printed on networked printers, and only selected images are being printed in many cases since image review is often taking place on workstations linked to PACS or the modality.”
However, printers are still used to produce film output for referring physicians in many cases, although CD and DVD are popular formats as well. In less developed countries, images are being produced by printers for both the initial diagnosis and for referring physicians. “These facilities are looking for low-cost, compact printers that have the ability to generate high- resolution output for all modalities,” said Seestrum.
Options abound. As Denise Rioux noted, “Medical imaging has changed a lot over the last 10 years.” Printers are keeping pace with rapid industry change and increased innovation. The next generation of printers is apt to surprise us with features we have yet to imagine.
James Markland is a contributing writer for Medical Imaging. For more information, contact .
Some Popular Medical Printers…
And Key Features
Kodak Dryview 8900 Laser Imager System
- High throughput— up to 200 films per hour
- Up to three film sizes online
- Flexible printing— five film sizes
- Edge-to-edge printing capability
- Prints all images at 650 dpi
Codonics’ Horizon Ci Multimedia Dry Imager
- Up to 100 films per hour
- 320-dpi resolution
- Compact footprint
- Automatic calibration using built-in densitometer
- Compatible with many industry-standard protocols including DICOM and Windows
Sony Filmstation Dry Film Imager
- Provides choice of horizontal or vertical installation
- 320-dpi thermal head technology
- Built-in DICOM compatibility
- Holds up to 1,112 images with 7 gigs of HD for image spooling
Fuijifilm Drypix 5000
- Provides outstanding image quality necessary for mammography
- Produces 240 films per hour
- 50-micron resolution and 3.6 density capabilities
- FDA approved for use with all Full Field Digital Mammography (FFDM) devices