Research: Impact of Weight-bearing Images in Orthopaedic Imaging

Study favors weight-bearing images for orthopaedic patellofemoral diagnosis and surgery

In clinical orthopedics advanced imaging like computed axial tomography (CT) scanning, has become invaluable to the evaluation and management of patients with musculoskeletal disease. Bone detail is much better visualized with 2D and 3D CT renderings of patients with problems like glenoid fracture, failed shoulder instability surgery, and meniscal root avulsions.

Conventional CT technology requires subject in supine position

High-quality images provide multiplanar 2D and 3D visualization for practitioners who think and work in three dimensions. However, a significant limitation of CT technology has been that it forces image acquisition with the subject in a supine, relaxed position. When imaging an injured knee, for example, the leg is in full extension and the muscles relaxed.

The conventional measures of patellofemoral alignment include the congruence angle, patellar tilt angle, and tibial tubercletrochlear groove offset distance. There are clearly defined limits of normal use for each of these measures, and they are used by surgeons to plan corrective operations on the patellofemoral joint. The degree of knee flexion and activity of the quadriceps are known to influence patellar tracking on the trochlea, but these factors are removed when images are taken with the patient supine.

Some have tried to simulate weight bearing in a CT scanner by custom designing a rig to apply longitudinal  load  through  the  patient  for  imaging  of  the  spine or  lower  extremity. These  methods  are  at worst,  a  poor depiction  of  functional  anatomy;  and  at  best , a cumbersome  and a less-than-accurate simulation of function.

Jacobs School of Medicine and Biomedical Sciences at the University at Buffalo undertake study

Myself and other researchers from the Jacobs School of Medicine and Biomedical Sciences at the University at Buffalo are currently performing research on a new  cone  beam CT scanner,  the  CARESTREAM OnSight  3D  Extremity  System,  developed by Carestream Health. The system is designed to offer high-quality, portable,  low-dose  3D  point-of­ care imaging by orthopaedic and sports medicine practices, hospitals, imaging centers, urgent care facilities, and other healthcare providers.

We have been performing institutional IRB-approved clinical trials and basic sciences studies with the prototype model. These studies are being carried out at the Erie County Medical Center, Buffalo’s regional orthopedic tertiary care facility. Based on early data, we are convinced that many imaging studies should be acquired with subjects in positions that represent true human function, such as weight bearing on the lower extremities.

Comparing Carestream OnSight 3D Extremity System to predicate devices

We compared the 2D imaging performance of the CARESTREAM OnSight 3D  Extremity System to the predicate CARESTREAM DRX-1 Detector used with the CARESTREAM DRX-Evolution System. We compared the 3D volumetric imaging performance of the OnSight system to a multiple detector computed  tomography (MDCT) scanner  (“predicate device”). The purpose of the study was to demonstrate equivalent diagnostic  image quality between the investigational and predicate devices, using a Radlex subjective quality rating scale.

The evaluation was performed on equal numbers of knees, ankles, feet, elbows, and hands from 33 cadaveric human specimens and 13 living human subjects. Four independent, board-certified radiologists of varying general reading experience performed evaluations of the images/exams captured using both the investigational and predicate devices.

Results: OnSight 3D Extremity System produced 2D images with equivalent diagnostic image quality to predicate system

In summary, the CBCT system produced 2D images with equivalent diagnostic image quality to the predicate system for a range of exams, and 3D images were rated equal or better when compared to the predicate device for a range of exams on cadaveric specimens and human subjects.

  • More than 80% of all the 2D images were rated diagnostic or exemplary, whereas approximately 98% of all 3D images were rated diagnostic or exemplary.
  • More than 75% of all Radlex rating responses counted for all 2D images were rated equivalent or favored the investigational device.
  • Approximately 85% of the Radlex rating responses counted for the 3D images were rated equivalent or favored the investigational device.

Examples of representative scans are seen below.

2D and 3D orthopaedic renderings generated by the CBCT scanner

Figure 5: 2D and 3D renderings generated by the CBCT scanner

Our conclusion from this study is that for cases of patella instability, it may be desirable to obtain images while the patient is weight bearing on a flexed knee with their quadriceps muscles active. Improvement in objective measures of patella alignment should lead to improved clinical and surgical care of patients with this condition.

New study: comparing measures of ankle stability

A second clinical study is currently under way to take advantage of the unit’s ability to obtain images in weight bearing. The research will compare measures of ankle stability from the investigational weight-bearing cone beam computed tomography scanner to the same measures on gravity stress X-ray in patients who have supination-external rotation ankle fractures.

These and future studies may validate the value of the OnSight 3D Extremity System. Potential benefits include better quality images with a lower radiation dose than conventional computed tomography. The unit is proposed for use in orthopedic offices, but it might have applications to the operating room or at athletic competition sites. The unit is less expensive than a traditional in-hospital or radiology center CT scanner, and can be used with existing electrical systems (220V). Most important however, is the potential to acquire images while bearing weight and in more functionally relevant positions.

Editor’s note: The CARESTREAM OnSight 3D Extremity System received FDA 510(k) clearance in September 2016 and is available for order in the United States.

Dr. John Marzo, UBMD

Dr. John Marzo is a physician with UBMD Orthopaedics & Sports Medicine, Associate Professor of Clinical Orthopaedics, Jacobs School  of  Medicine  and  Biomedical  Sciences,  University at Buffalo and  former  Medical  Director,  Buffalo Bills. He is also a member of Carestream’s Advisory Group, a collective of medical professionals that advises the company on healthcare IT trends.

Columbus Regional Health Gets Creative When 3 RAD Rooms are Eliminated

Reliability, redundancy and mobility help provider keep pace with imaging needs

Many radiology departments are feeling the pressure of “doing more with less”. For Columbus Regional Health in Indiana, the pressure was literal: the medical provider had to eliminate three RAD rooms yet maintain the same Bill-Algee-Columbus-Regional-Healththroughput. The hospital is meeting the challenge by transitioning to DR and adding mobility to the modality mix.

The provider started by converting its CR mobile X-ray equipment to DR with Carestream’s mobile retrofit kit. That retrofit was followed by the purchase of a Carestream mobile DRX-Revolution.

“Mobility is essential to bringing imaging to where we need it,” said Bill Algee, Radiology Manager at Columbus Regional Health. “Our staff drove it around for a little bit and fell in love with the product.”

Next, the hospital outfitted its imaging room in the emergency department with a DRX-Evolution Plus. The product’s high level of reliability is critical to meeting the needs of the busy ED, which was relocated a considerable distance away from the imaging department.

“It absolutely has to be reliable because it’s the only imaging solution in that area of the hospital,” said Algee. “The reliability factor was really important to us.”

Also, the product’s extended tube column and wall stand provide make it flexible enough to meet the varying imaging needs of patients coming in to the ED.

The hospital has an added level of support from Carestream’s DR Detectors. The wireless DR detector can be used with imaging systems throughout the facility.

“Having uniform detectors gives us an added layer of redundancy. If a cassette goes down in emergency, we can replace it with one from diagnostics,” explained Algee. “And the software is always the same no matter what room we go in to. The technologist doesn’t have to take the time to figure out what to do in different rooms.”

The combination of retrofitting existing equipment and purchasing new products helped Columbus Regional Health transition from CR to DR to meet the U.S. Consolidated Appropriations Act at their own pace.

“We kind of took it in baby steps and that worked well for us. Our staff didn’t feel overwhelmed,” said Algee. “Carestream was the right partner to help us through it; they had the right methodology.”

Watch the video interview with Bill Algee to learn more about Columbus Regional Health’s transition to DR. #radiology #AHRA2016

Erica Carnevale

 

Erica Carnevale is a marketing manager at Carestream Health in the United States and Canada Region.

How is Carestream Supporting Efficient Utilization of Dose?

Imaging Products and Technologies That Can Help Reduce Dose

How is Carestream Supporting Efficient Utilization of Radiation Dose?

DRX-Revolution Mobile X-ray Unit

At Carestream we are doing our part to help minimize radiation dose by delivering high-performance image capture systems and specialized software that can help minimize dose while maintaining high image quality. Here are five of Carestream’s dose-related initiatives:

  • Deliver DR detectors with high detective quantum efficiency

Carestream’s DRX Plus 3543C, DRX-1C and DRX 2530C cesium iodide detectors deliver high detective quantum efficiency (DQE), which can produce a higher quality image (defined in terms of signal-to-noise ratio) than a device with lower DQE. Higher DQE can also deliver the same image quality at a lower exposure, which reduces patient dose. Cesium iodide detectors are particularly important for pediatric imaging applications since children’s sensitivity to dose is substantially higher than adults.

  • Offer systems that help optimize radiation dose efficiency

Carestream products offer sophisticated multi-frequency image processing algorithms as well as the flexibility to adjust image processing techniques through the modality’s Continue reading

X-rays and Mom — Case Study into the State of Imaging Technology

Reposted from Imaging Technology News (ITN) with permission.

While I write a lot about medical imaging technology and how new technology can and should work, it is not often that I get to experience how things actually work in the real world. This past Thanksgiving I received a call from a paramedic explaining that my mom had fractured her leg and I should stop working on the turkey and fixings and rush to the emergency department (ED) at Edward Hospital in Naperville, Ill. She had been walking her dog on wet grass and leaves in a park when her dog took off after another dog and pulled her down. She was whipped around and the change in weight caused her to dislocate her ankle (the bottom of her shoe was facing her when she looked at her feet) and caused a spiral fracture to her fibula.

ImagingTechnologyNews December-2015 X-ray_Fractured_fibula_with_permission_of_patient_MF

A bedside screen shot of a Carestream DRX mobile X-ray in the ED of the fractured fibula.

When I got there my mom was already heavily sedated due to the pain and because the ED staff had already put her ankle back in place. The ED doctor ordered a digital radiograph (DR) of her leg to see the extent of damage. They wheeled in a new Carestream DRX mobile X-ray system and I had a live demonstration of how fast these types of systems can snap the pictures. It called up the images immediately on the machine’s screen. The image of the Pott’s fracture with fragments was really interesting as someone who covers radiology, but I also realized from a non-clinical standpoint she was really messed up and in pain. Additionally, she would need reconstructive surgery to put her Humpty Dumpty leg back together again. She was way up the creek without a paddle with it being Thanksgiving and there were no orthopedic surgeons in staff due to the holiday. The day after Thanksgiving was not much better, as we found, since most physicians were out through the following Monday. So the ER splinted the leg, wrapped it in ace bandages and sent her home with heavy pain killers.

Compounding her mobility issues was the fact that she has bilateral knee replacements. Due to the trauma, broken bone and knowing she had these implants that further limited her ability to move around, she was prescribed a prophylactic anticoagulant.

Knowing we would need the images for a surgeon to review, I had the ED burn a CD. However, I was happy to find

ITN NEWS Orthopedic_Surgery_repair_of_Broken_fibula_with_permission_of_patient_MF_0

The post-surgical X-ray showing the bone repair, which was accessed and copied by the patient using a patient portal.

Edward is among the growing number of hospitals to grant patients access to their health records via a DR Systems Internet image/results distribution system. This technology pulls images and reports from the hospitals’ Epic EMR (electronic medical record) system and makes them available for remote viewing by clinicians outside of the hospital’s picture archiving and communication system (PACS). She also was given login instructions at discharge for a patient portal so she could access her records and images herself on a home computer or smartphone.

We managed to find one orthopedic surgeon in their office on the Friday after Thanksgiving. They thought it was great that we had a CD, but before attempting to open it, they asked which hospital she had been at. Edward was already in a health information exchange, so outlying offices such as this one from a different medical group could access her records remotely in less than a minute. They were able to call up her images and see what meds she was prescribed, which made the office visit go much faster.

She had surgery on Dec. 1, the Tuesday of RSNA 2015. The orthopedic surgeon practiced at Elmhurst Hospital in Elmhurst, Ill., across the county from Naperville. But, thanks to the remote image viewing system, they could get the ED images for reference and planning. The surgeon’s post-surgery DR image showing the reconstruction of the fibula also was available via my mom’s patient portal.

She did what most patients today do with this type of access and posted her X-rays on Facebook. Leveraging the Facebook form of patient engagement, the result was lots of sympathy, flowers and friends volunteering to help her with things around the house and groceries since she cannot walk or drive for at least two months.

While an unfortunate incident and a horrible thing to have happen to my mom, from a professional standpoint, I was happy to see the technology I cover working in the real world as it was intended. The speed in workflow efficiency, speed and ease of access to her imaging at the point of care and remotely, and access to a patient portal are all examples of how the healthcare system should work. In this case, the technology and imaging integration was flawless.

David_FDave Fornell, ITN Editor

Dave Fornell is the editor of Diagnostic & Interventional Cardiology magazine and assistant editor for Imaging Technology News magazine.

 


Imaging Case Study: Carestream Mobile DRX-Revolution

 

To learn more about the CARESTREAM DRX-Revolution, click here.

Mobile Radiology: Accessible to All in the Future

Carestream DRX-1 System

La versión española de este post se puede leer aquí.

We know that technology can work miracles, but does it really matter when such technology is only available to a few, and not all?

In relation to today’s world, Roentgen certainly could not have imagined that capturing X-rays would contribute to the birth of one of the most important inventions in radiology.

The most useful of medical specialties. 

Today, medical students worldwide are taught to provide a majority of their patients with a radiological examination because of how critical a role the images play in the diagnosis and treatment of diseases. The unfortunate reality is that many patients live in rural areas, far away from hospitals or imaging clinics where they can receive such exams.

Therefore, it is important to develop and scale mobile digital diagnostic equipment to ensure accessibility for people living in rural, isolated or under-developed geographic areas.

Development is to provide care to the majority of the population. 

The World Health Organization (WHO) estimates that more than 2/3 of the world population has no access to radiological tests. Today, one of the primary goals of WHO is to ensure accessibility, because any acute pathology requires emergency radiographs.

It is necessary to leave the hospital environment and bring radiology to where the patient is located. For example, portable digital detectors, apart from being mobile, have low power consumption, and are provided with a longer range. Being digital allows for the capability of sending the image to be viewed by other doctors for a second diagnosis.

Equipment capable of cruising the world’s environments to meet the patients.

A portable X-ray detector can bring medical technology to unimaginable places and thereby bring care to impervious areas of the world for use in various humanitarian missions. The issue of time is important in medical imaging, and early diagnosis makes a difference in fractures or in detecting metallic foreign bodies caused by external trauma. This method of radiology gives access to faster information and delivers it with a speed that is often not available.

The use of mobile and transportable radiology systems has not only proven useful in military and humanitarian missions, but also in expeditions and athletics. In his quest across the Antarctic, Ranulph Fiennes’s team brought a portable scanner, and the technology is also used in professional sports to diagnose player injuries quickly.

Mobile and transportable systems have also expanded into public hospitals with X-ray rooms, because this equipment becomes necessary when a patient cannot be transported safely to the room due to illness, possible infection or because of a patient quarantine.

The technology, as it is used more often, is proving to be a success in radiology field. Radiologists believe in the efficiency of the technology, and by improving efficiency without compromising image quality, imaging professionals can be sure they are providing the best care to the patients.

FernandezRafael Fernández Navarro is the Iberia X-ray Solutions Business Manager & Iberia Service Sales Specialist for Carestream

 

Radiología portátil, Accesible Para Todos en el Futuro

Carestream DRX-1 System

The English version of this post can be read here.

Sabemos que la tecnología hace milagros, pero ¿qué importa todo eso cuando esta solo al alcance de unos pocos?, Seguramente  Roentgen  no podría  ni imaginar  que  al descubrir los   “rayos x”  estaba contribuyendo al  nacimiento de una de las ramas más importantes de la medicina.

LA ESPECIALIDAD MÉDICA MÁS ÚTIL

Hoy en día a los estudiantes de medicina de todo el mundo se les enseña que habrá que someter a la mayoría de sus futuros pacientes a exámenes radiológicos, porque se ha convertido en algo crucial  en el diagnostico y tratamiento de  enfermedades.  Pero  la triste  realidad es que cuando ejerzan  a menudo tendrán que hacerlo en medios rurales, lejos de hospitales donde pueden recibir los exámenes radiológicos.

Por ello es importante el desarrollo  y la envergadura de losequipos de diagnostico portátiles digitales  para asegurar la accesibilidad de los habitantes que viven en zonas rurales, desprovistas o aisladas por cuestiones geográficas.

 EL DESARROLLO ES QUE SE LLEGUE A LA MAYOR PARTE DE LA POBLACIÓN

La OMS calcula  que más de 2/3 de la población mundial no tiene acceso a pruebas radiológicas.Hoy, Uno de los objetivos principales de la OMS es asegurar  la accesibilidad, ya que cualquier patología aguda requiere un estudio radiológico de urgencias.

Por ello es necesario salir del ámbito hospitalario y llevar la radiología allí donde se encuentran los paciente., por ejemplo, detectores digitales portátiles , aparte de ser móvil, tener un bajo consumo, y estar provisto de larga autonomía.Al ser digital, cuenta con la ventaja  de poder enviar la imagen para que sea vista por otros médicos y que puedan dar un segundo diagnóstico, supone entrar de lleno en el concepto de la telerradiología llevando la sanidad  donde sea necesario.

 APARATOS CAPACES DE CRUZAR MEDIO MUNDO PARA ENCONTRAR A LOS PACIENTES

Un aparato portátil con un detector de rayos X permite llevar la tecnología médica a lugares inimaginables y con ello poder llevar la salud a zonas impenetrables del mundo para utilizarlo en diferentes misiones humanitarias.La cuestión del tiempo es importante en el diagnóstico por la imagen, y un diagnostico precoz marca la diferencia en  fracturas o en la  detección de  cuerpos extraños metálicos provocado por traumatismos externos. La radiología es el acceso a la información  de la manera más rápida y proporciona la velocidad que a veces no se dispone.

Esta tendencia necesaria y vital  no solo ha llegado a uso militar, o a misiones humanitarias , también a expediciones. En la expedición atraves del Antártico, el equipo de Ranulph Fiennes llevó un escáner portátily esta tecnología se usa en el  deporte de elite, diagnosticando las lesiones de los jugadores rápidamente.

Los equipos portátiles  se han expandido  en hospitales públicos dotados de sala de rayos, ya que  a veces son necesarios equipos portátiles cuando un paciente no se puede trasportar de forma segura a la sala, debido a una enfermedad, por posibles contagios o porque este se encuentra en cuarentena.

La tecnología, como se utiliza más frecuentemente, está demostrando ser todo un éxito en el campo de la radiología. Los radiólogos creen en la eficacia de la tecnología, y en la mejora eficiente sin comprometer la calidad de imagen, los profesionales del diagnostico por la imagen pueden asegurarse de que están proporcionando el mejor cuidado a los pacientes.

FernandezRafael Fernández Navarro es el especialista de Iberia de rayos X Soluciones de Business Manager Iberia y Servicio de Ventas de Carestream

 

Implementing Effective Ways to Reduce and Track Radiation Dose for X-ray Exams

DRX-Revolution Mobile X-ray Unit

El Camino uses two DRX-Revolutions as part of its conversion to DR technology.

El Camino Hospital has made dramatic decreases in patient dose in recent years. We use Bayer Radimetrics dose management software to track dose for all CT exams and we are now starting to collect dose for our room and portable X-ray exams and for fluoroscopy and interventional radiography procedures. We are especially proud of our accomplishments in the area of portable imaging, where we have made a significant reduction in dose.

We have lowered dose by replacing CR with DR technology—and by implementing software that enhances visualization and reduces the need for repeat exams.

We installed three new wireless DR portable systems that are used for imaging of critical care patients in our neonatal ICU, ER and OR as well as bedside exams for our main Mountain View campus. We have two Carestream DRX-Revolution portables and have retrofitted two existing mobile imaging systems with DR detectors to perform ER, OR and bedside exams at our Los Gatos campus.

Since critical care patients require more images than other patients, they benefit most from dose reduction as well as the enhanced image quality we are now able to provide to our physicians. We use grids for 90 percent of adult exams and our new imaging software lines up the grid with the tube head. This makes it much easier for technologists to achieve an excellent quality image and reduces the need for repeat exams. The grid improves details in the chest and abdomen as well as thicker body parts and provides better diagnostic data for physicians.

We now use a cesium iodide DR detector that fits into the incubator tray to image fragile neonatal ICU patients. This enables us to produce excellent quality images at a very low dose. Our imaging software includes pediatric settings that help technologists use the correct technique for each patient.

Both adult and pediatric critical care patients benefit from imaging software that helps enhance visualization of pneumothorax as well as tubes and lines by producing an image that is optimized to display the chest and tubes/lines from the original image. This also eliminates repeat exams and reduces dose.

Patient care is also improved by the higher power generators offered by modern portable X-ray systems. These generators enable us to image heavy or obese patients at a lower dose and provide better quality images at a lower dose for all our patients.

Have you converted all your X-ray imaging systems from CR to DR? As part of this transition, are you retrofitting existing systems, purchasing new DR systems or both?

Howard Sanford, El Camino Hospital

 

Howard Sanford, R (MR), is the imaging operations manager at El Camino Hospital.

Four Radiology Department Improvements Unlocked by the DRX-Revolution

Don Thompson, Digital Capture Solutions, Marketing Manager, Carestream U.S. & Canada

Don Thompson, Marketing Manager, Carestream U.S. & Canada

Patient experience. Cost containment. Clinical Quality. Physician alignment.

A recent Advisory Board blog post about the CXO perspective of imaging success reported that the C-Suite places more importance on these factors than volume growth.

It’s no surprise that provider priorities are changing. In response to this change imaging leaders are seizing the opportunity to adopt the broader system’s objectives and success measures.

This service line realignment becomes even more important during purchasing decisions. Radiology administrators must be able to demonstrate the impact of a new technology
investment on the right institutional objective.

Consider how the CARESTREAM DRX-Revolution helped these four DRX_Revolution_Image_09_Upright_Column
radiology departments:

  1. Clinical quality – “The DRX-Revolution helps our neonatologists improve care by delivering exceptional image quality and has also helped enable our staff to reduce dose by more than half. The ability to lower dose is especially important for pediatric patients due to the harmful effects of radiation on children and also because these very ill babies often require frequent X-ray exams. The DRX-Revolution automatically displays the previous technique so that we can ensure imaging consistency, which is especially important to help physicians detect changes in these very small patients. Physicians also report that being able to view images at the tubehead when they are inserting PICC lines and other devices is especially helpful because they no longer have to leave the bedside to verify correct placement. This speeds the process and reduces discomfort for these very fragile patients.” – Brad Hellwig, Director of Radiology, and Beth Wilson, Manager of Radiology, Crouse Hospital
  2. Cost containment – “We have reduced our fleet of portable imaging systems by one-third. Carestream’s DRX detectors can also be moved to another mobile imaging system. So if one of our existing portable systems goes down, we can move the detector to another unit,– Juanita Reader, RT(R), Manager of Diagnostic Radiology In-Patient and Informatics, OSF Saint Francis Medical Center
  3. Patient experience – “With the DRX detector, images are available over a wireless network in about five seconds, which can expedite diagnosis and treatment. This also eliminates the time-consuming process of transporting cassettes to a CR system for processing. The detector is light and it’s much easier for technologists to position correctly because the detector offers a full field of view. Detectors that are larger than the size of the image they capture are more difficult to work with.”  –  Tina Harvey, RT (R), Radiology Manager, Baylor University Medical Center
  4. Physician Alignment – “The DRX-Revolution also delivers process improvements for everyone involved in the imaging workflow—from technologists to physicians, radiologists and specialists. Since images from the portable systems are available in about five seconds, physicians can make rapid decisions that can improve patient care. The hospital’s technologists worked with radiologists to create new techniques for portable exams that lowered the dose while optimizing image quality. When Carestream’s consultant came to the site for training, she displayed four views of the same exposure so radiologists could select their preferred display preference. We didn’t even know it was possible to do this but it made our radiologists extremely happy.” – Chief Technologist Chris Vineyard, University Health System, San Antonio

Have you explored how a change in portable imaging strategy could contribute to your organizational goals?

Learn how one of American’s top hospitals – Indiana University Methodist Hospital –  converted from portable CR systems to DRX technology to improve physician satisfaction and boost staff morale here.

Van Damme vs. Bones: The Epic Splits

Heidi McIntosh, Marketing Manager, X-ray Solutions, Carestream

Heidi McIntosh, Marketing Manager, X-ray Solutions, Carestream

If you haven’t seen the Jean-Claude Van Damme Epic Split video by now, allow us to introduce you. Back in November, Volvo released a video featuring Van Damme atop two reversing trucks to demonstrate Volvo Dynamic Steering. The stunt was performed in one take and went viral quickly. What’s equally impressive is that the video racked up over 64 million views in just over a month. It’s kind of something you have to see to believe.

 

We thought it’d be fun to demonstrate the precision and directional stability of our DRX-Revolution mobile X-ray system in a similar manner, but on a much smaller scale. Our video features “Bones” performing an epic split between two reversing DRX-Revolutions. Without the fully automatic collapsible column, mobility wouldn’t be such a breeze. Check out our version below and let us know what you think!

 

Optimize Image Quality and Accelerate Work Processes with WLAN Systems

Guenther Hefler

Gunther Hefler, XRS Product Specialist, Europe, Carestream

The German translation of this post can be found following the English version.

At the 94th German Radiology Congress 2013 in Hamburg, I had the opportunity of giving a talk during X-ray technician training about technological advances. The subject of my talk was “WLAN in intensive care” and the feedback I received afterwards was very positive. Among other things, the aim was to present Carestream Health as an innovative manufacturer of WLAN-based systems, such as the newly launched DRX-Revolution.

After the talk, several delegates came to our stand to see a demonstration of DRX-Revolution and during those two days we gave over 70 live demonstrations which, without exception, were very well received by customers.

Here is a brief summary of the talk:

In addition to their established use in existing conventional X-ray equipment and completely direct digital radiography systems, the market launch of mobile wireless WLAN detectors in cassette format in 2009 has created new and interesting possible applications in bedside X-ray diagnostics in intensive care.

The technical requirement for the efficient use of these detectors is two separate WLAN connections. Connection 1 guarantees CSH_Revolutionimage transmission and internal systems communication between the detector and the X-ray equipment console. Connection 2 takes over communication between the hospital’s network and the console. A DICOM modality work list is continually retrieved from RIS. This WLAN connection also allows previous images to be displayed through DICOM query/retrieve and up-to-date X-ray images to be despatched in PACS.

This approach ensures that the image is displayed directly at the bedside within a few seconds of the image being acquired. After the user carries out quality control and releases the image, it takes around 20 seconds for the up-to-date X-ray images to be available on the hospital network. As well as complete digital systems from leading manufactures, there are also digital retrofit solutions available for most analogue mobile equipment.

All in all, the clinical use of the WLAN links described leads to considerable improvement and acceleration in work processes in intensive care. The time between X-ray creation and their availability is reduced considerably in comparison with imaging plate technology. Further advantages include optimal image quality with a lower dose combined with a reduced workload for staff.

German Translation:

Anläßlich des 94. Deutschen Röntgenkongresses 2013 in Hamburg hatte ich die Möglichkeit als Referent im Rahmen der MTRA- Fortbildung im Bereich Technolgiefortschritte, einen Vortrag mit dem Thema „ WLAN auf Intensivstation zu halten. Die Resonanz auf meinen Beitrag war sehr positiv. Ziel war unter anderem Carestream Health als innovativen Hersteller von WLAN- basierten Systemen, wie zum Beispiel des neu markeingeführten DRX Revolution, darzustellen.

Sehr viele der Teilnehmer kamen nach diesem Vortrag auf unseren Stand, um sich unser DRX Revolution demonstrieren zu lassen. Wir hatten während der 2 Tage insgesamt mehr als 70 Live-Demonstrationen mit durchwegs beigeisterten Kunden.

Hier die  Kurzfassung des Vortrags:

Mit der Markteinführung mobiler kabelloser WLAN-Detektoren in Kassettenformat im Jahr 2009 haben sich neben dem etablierten Einsatz in bestehenden konventionellen Röntgenanlagen und voll digitalen Direktradiographiesystemen auch neue interessante Anwendungsmöglichkeiten im Bereich der bettseitigen Röntgendiagnostik auf Intensivstation ergeben. Technische Voraussetzung für den effizienten Einsatz dieser Detektoren sind zwei separate W-LAN Verbindungen. Verbindung 1 gewährleistet die Bildübertragung und interne Systemkommunikation zwischen Detektor und der am Röntgengerät befindlichen Konsole. Verbindung 2 übernimmt die Kommunikation zwischen Kliniknetzwerk und der Konsole. Über diese W-LAN Verbindung wird kontinuierlich eine DICOM Modality Worklist aus dem RIS abgerufen. Die Anzeige der Voraufnahmen über DICOM Query/Retrieve und der Versand der aktuellen Röntgenbilder ins PACS sind ebenfalls möglich. Diese Vorgehensweise gewährleistet die Bildanzeige direkt am Krankenbett innerhalb weniger Sekunden nach der Bildakquisition. Nach Durchführung der Qualitätskontrolle und der Freigabe des Bildes durch den Anwender stehen die aktuellen Röntgenbilder nach ca. 20 Sekunden im klinischen Netzwerk zur Verfügung. Neben digitalen Komplettsystemen der führenden Hersteller sind auch digitale Nachrüstlösungen für die meisten analogen Mobilgeräte verfügbar. In Summe führt der klinische Einsatz der  beschriebenen W-LAN Anbindungen zur einer deutlichen Verbesserung und Beschleunigung der Arbeitsabläufe auf Intensivstation. Die Zeitspanne zwischen Erstellung und Verfügbarkeit der Röntgenaufnahmen wird im Vergleich zur Speicherfolientechnologie deutlich verringert. Optimale Bildqualität bei geringerer Dosis in Verbindung mit reduzierter Arbeitsbelastung des Personals sind weitere Vorteile.