A new white paper can help you select the right printer features for your organization?s needs.

Sony offers a comprehensive line of imagers and color printers for CT, MR, CR, DR, ultrasound, and digital mammography printing.

You may have questioned whether maintaining a printer for hard-copy image output makes sense in today’s paperless digital era. This is a smart question to ask when faced with the increasing economic and efficiency demands of a busy and dynamic clinical environment. However, an even more critical question is not whether to print, but when and how printing should be conducted. With different health care printing requirements and as many printer technologies in the marketplace to address them, what your organization needs now more than ever before is a print plan.

Sony Medical recently released a white paper, “Printing in the Digital Age,” to specifically address this question and to help medical professionals plan appropriate purchases. The paper also provides examples of printers from Sony’s own extensive product line that meet the criteria for each specific application.

This comprehensive white paper puts forth several reasons why printed images are still in demand in our digitally focused health care environment. Here is the rationale: “Communication with other medical specialists ? who look at images only occasionally and have no training in digital reading, [they] often find working with electronic data unnecessarily complex and time-consuming. Moreover, hardcopy output helps avoid the all-too-common incompatibilities among PACS solutions. When it comes to radiologists, some also prefer film after years of hardcopy reading. And, of course, printed diagnostic images often are the easiest to provide to patients.”

Streamlining the printing process is key if providing hard-copy images is to be cost-effective and efficient. A print plan basically means that practices and hospitals should not assume that there is one all-purpose printer to meet their diverse printing needs or that a hard-copy image is always required. According to the white paper, “While lower in volume, today’s printing needs are more diverse than ever before with an expanded range of diagnostic imaging modalities.? Most medical facilities will realize greater efficiencies and cost-savings by purchasing various printers fine-tuned to their specific needs than by opting for one of today’s all-purpose printers that typically provides many options a site will never need.”

Therefore, when identifying your printing needs for applications where diagnostic accuracy is critical, such as in radiology and related diagnostic imaging, it is essential to understand several important requirements. The white paper describes a number of key factors that must be considered such as printing resolution, support for the DICOM format, FDA 510(k) premarket clearance, and whether a printer meets required safety and performance criteria to be considered a medical grade device. It is obvious from this evaluation that printing requirements vary widely between the different medical imaging procedures and that one printer cannot and should not be used to address all these printing needs.

Matching Modalities to Printers

The CARESTREAM DRYVIEW CHROMA imager will reproduce color or grayscale images from CT, CT/PET, MRI, nuclear medicine, ultrasound, CR, DR, and radiation therapy planning to paper or medical film. It is scheduled for availability in June.

The white paper provides a detailed breakdown of the printer requirements for various imaging procedures. With CR/DR, CT, and MRI images, the printer output is on monochrome film and requires a DICOM printer. The white paper explains that “Because film format varies with the anatomy involved, a DICOM printer should accommodate a variety of film sizes—from 11×14-inch to 14×17-inch for CR and DR to 10×12-inch for MRI reconstructions to 14×17-inch for multiple slices of MRI and CT. Because these multi-slice images are typically printed several on a page, image layout and therefore film size also involve physician preference.”

When it comes to full-field digital mammography (FFDM), there is no question as to whether printing is required. MQSA (Mammography Quality Standards Act) regulations require that all imaging sites be capable of meeting a patient’s request for a printed hard-copy version of their mammograms. For FFDM, printing is highly regulated and providers must use a special FFDM high-resolution DICOM device. Although it is not absolutely required that mammography printers have specific 510(k) clearance, they must still meet the FDA’s specific, standardized guidelines for mandatory Q/C procedures on cleared devices. Since many mammography printers do have 510(k) clearance, the white paper concludes that selecting a mammography printer that is specifically optimized for these time-consuming weekly or sometimes daily Q/C checks is critically important.

Fujifilm?s DryPix 4000 is a dry laser imager that combines high quality and performance with a compact design. It can print 110 to 160 films per hour at 50-micron resolution.

Although radiologists usually depend on specialized digital workstations to interpret PET, nuclear medicine (NM), and PET/CT images, they are sometimes also provided in hard-copy format to nonradiologists. The white paper explains that these images require a color DICOM printer with output ranging from 8×10 inches to 14×17 inches. The output is lower in resolution for PET and NM images, whereas PET/CT include higher resolution CT images and therefore require higher resolution printers.

Similarly, ultrasound images are typically read on digital displays in real time and are not printed. However, as the white paper notes, there are situations where the radiologist or other specialist involved in the preliminary evaluation is not present at the exam and must depend on a hard-copy printout of the ultrasound image. Ultrasound printers are often compact, portable devices dedicated to one ultrasound device. Therefore, as the white paper states, “Ultrasound printers should be selected with the specific ultrasound system and exam in mind.” The wide variety of ultrasound devices and procedures then translates into a correspondingly varied list of requirements. For example, an analog video printer is required for most video-based ultrasound systems, whereas a digital interface would be required for printers dedicated to digital systems. And DICOM printers are also becoming more necessary as ultrasound devices start to support DICOM.

When not used for clinical diagnosis, high-resolution prints are not usually required. Hard-copy images may be used for reference by other physicians involved in the case or for patient records and education. In these circumstances, your print plan should focus on cost-effectiveness as well as meeting the requirements of the referring physician. According to the white paper, “?as part of their marketing efforts, many imaging sites [should] provide referring physicians with attractive, easy-to-read images in the referrer’s preferred formats. This is a sound marketing practice in today’s competitive health care environment, and printer choice plays a key role.”

The paper also dives into the different printing technologies that define the devices that are currently on the market. Printers are divided into four categories: Dye Sublimation, Direct Thermal, Laser, and Ink Jet printers. The first two types of printers are best suited for printing medical images and can produce high-quality prints. The latter two are more suited for office printing rather than for providing diagnostic quality images.

Key Features to Keep in Mind

Printer features that can improve, simplify, and streamline the printing process are critical to purchasing decisions. The white paper covers practical and time-saving features such as compact printer size, front controls and front paper loading, automatic calibration, fast printing speed, and the ability to accommodate several print media at one time with multiple trays. The importance of printer communication is emphasized with features such as a built-in network interface card, built-in wireless connectivity (WiFi) and Bluetooth connectivity, and the ability to support multiple signal inputs (analog, digital, standard, and high definition). Cost-saving features include having a stand-by mode and edge-to-edge printing capability. In addition, features that can affect the quality of the hard-copy output, such as color management systems, HD printing capability (1920 x 1080 lines of resolution), and the ability to accommodate special laminated water- and fingerprint-resistant media, are addressed in the paper.

Codonics Horizon Ci Multi-media Imager prints multiple sizes of diagnostic film, color paper, and grayscale paper all-in-one.

One often forgotten, but much appreciated feature is the ability to save an image to a USB device for image transfer to a PC or directly into PowerPoint presentations. Last but not least, the white paper emphasizes the importance of special features that help to market a medical facility such as flexible page layouts, text and graphics combination, easy-to-file media formats, and the ability to add your logo to every printed page.

Medical images are still being printed and provided to health care professionals on a regular basis, either for diagnostic purposes or for reference. Printers of all types are found in every medical facility and are depended upon for various jobs, big and small. An important question to ask is whether your current printers and printing infrastructure are supporting or sabotaging your facility’s goals of providing high-quality diagnostic images in an efficient and cost-effective manner. Do your hard-copy images represent your facility and the high quality of service that you provide? Sony Medical’s white paper provides insight into how diverse a facility’s printing requirements may be and how critical it is to review your current printing situation to ensure that it is designed to meet your organization’s needs and the expectations of your patients and referring physicians.

To view the entire white paper by Sony Medical, visit www.sony.com/medical and click on “Additional Resources.” Download and print it!

Carol Dawson is a contributing writer for Axis Imaging News.