For the Win-Win: Improved Image Quality and Accelerated Workflow with Digital Radiography (DR)

Helen Titus

Helen Titus, Marketing Director, Digital Capture Solutions, Carestream

It’s pretty safe to say that we are all going to be happier and better off when we find solutions that work for all parties involved. Even in healthcare, the focus needs to be on win-win situations.

At RSNA this year, a group presented the findings of a study conducted at Massachusetts General Hospital. After collecting 80 chest images of ICU patients, researchers concluded that DR images can be of similar or better quality while improving turnaround time and workflow.

According to Dr. Vogl and Dr. Lehnert of Klinikum of the Johann Wolfgang Goethe Universität, the DRX-Revolution Mobile X-ray System accomplishes just that, improving both facility performance and patient experience. Their facility is based in the center of Frankfurt and performs between 200,000 and 250,000 exams each year. After adding a DRX-Revolution, they have seen vast improvements in both image quality and workflow in their bedside imaging exams.

Based on the study, our conversation with Dr. Vogl and Dr. Lehnert, and other customer proven results, it’s becoming clear that the adoption of DR in health facilities means two very important things. First, processes involving patients are being completed in a shorter amount of time. Second, their images are going to be of a higher quality while less radiation dose is administered.

The result – improved healthcare.

Watch our interview with Dr. Vogl and Dr. Lehnert of Klinikum  from RSNA 2012:


Innovative Tools To Improve Clinical Quality: Montage Signal

At RSNA 2012 there was a subtle shift in emphasis from radiologist productivity to clinical quality, no doubt driven by greater quality reporting and pay-for-performance requirements.  Shown as a prototype in the Carestream booth, Montage Healthcare Solutions demonstrated Montage Signal™, a new software capability that flags report inconsistencies during radiology report dictation and identifies errors in real-time that can degrade clinical quality and reduce reimbursement.

Montage selected Carestream Vue Reporting as a proven radiologist workflow platform for demonstrating Signal. Signal is an extension of the Montage search-driven radiology business intelligence and clinical quality analytics tools that help practices understand and improve productivity and clinical quality. Visitors to the Carestream booth saw Montage Signal flag reports containing laterality and gender errors, critical test results and incomplete billing documentation—all before report finalization.

Montage search provides access to the unstructured clinical information in radiology reports, enabling radiologists to answer complex clinical questions without disrupting reading workflow. The result is clinical quality improvement and continuous learning because report creation can now occur in the context of prior clinical findings.

Woojin Kim, M.D.,  Interim Chief of Division of Musculoskeletel Imaging at the Hospital of the University of Pennsylvania and  Co-founder of Montage Healthcare Solutions, stopped by our social media broadcast lounge at RSNA to share his thoughts on the next step in clinical quality improvements and the importance of integrating tools into the reading workflow:

What other ways can we prevent errors before they come part of the clinical record?  What analytic innovations did you see at RSNA? 

Healthcare Reform Opens Doors for Mobile Screening Mammography Services

The 2012 RSNA meeting marked the 30th anniversary of the show from which Debora Wright’s mobile mammography screening business, Inner Images, was born. Three decades later, the current healthcare climate set a different at the meeting, but for Debora and Inner Images,  reform has opened doors and growth.

In this video, we speak with Debora from RSNA 2012 about how the move to digital mammography has helped her business’ productivity through this growth period.

Are you excited about the direction mammography is heading? What changes or benefits do you think we might see at next year’s RSNA?

Reflections on RSNA 2012 and the Progress in Intelligent Information Systems

On the last day of RSNA 2012, Dr. Eliot Siegel, Professor and Vice Chair University of Maryland School of Medicine Department of Diagnostic Radiology and Nuclear Medicine, Chief of Imaging at VA Maryland Healthcare System in Baltimore, and a member of Carestream’s Advisory Group, a collective of medical professionals that advises the company on healthcare IT trends, stopped by the Carestream booth to reflect on the focus on imaging informatics at this year’s event. Dr. Siegel comments on the opportunity to use information systems to empower and educate patients,  to make radiology more visible in patient care, and to drive the future of radiology.

What IT innovations caught your attention at RSNA? 

RSNA Scientific Session: Improve the Detection of Lung Nodules and Pneumothorax

Zhimin Huo, Carestream

If you left RSNA early, you may have missed a presentation today titled, “Rib Suppression Technique for an Enhanced Interpretation of Chest Radiographs.”

Don’t worry, though – you can read a summary of it here:

Chest radiographs are the most commonly used exam by clinicians for screening and diagnosing lung diseases. Studies have shown that rib suppression improved the detection rate of lung nodules, so Carestream developed a rib suppression technique that works well for portable chest radiographs including AP chest images. This can potentially improve the detection of both lung nodules and pneumothorax, especially for portable AP images.

Overall, the initial assessment of the rib suppressed images showed that current rib detection is sufficient for our suppression techniques. The rib suppressed images will be evaluated visually in terms of an increased visibility on lung nodules and pneumothorax by a group of radiologists.

The presentation concluded that the rib suppression technique can potentially improve the detection of both lung nodules and pneumothorax, especially for portable AP images.

RSNA 2012 Digital Radiography Discussions: AnMed Health

Kathy Hood, Director of Radiology, AnMed Health in Anderson, S.C, discusses the role of digital radiography in her department. Hood highlights the department’s acquisition of a CARESTREAM DRX-Evolution DR Room and the ability to share DRX wireless DR detectors between equipment. Hood is looking at new technology at RSNA and shares feedback on the DRX-Revolution and how the collapsible column would benefit her technologists. Hood also comments on her vision for the future of imaging sharing in the department:

What technology did you see at RSNA that you can’t wait to show your department? 

BCF Technologies, CARESTREAM Vita CR System and Arktos the Polar Bear

Walking the halls at RSNA you’ll come across some of the most amazing stories. One of our favorites came from Carestream partner BCF Technology in Scotland and their experience taking x-rays of Arktos the Polar Bear, who have suffering from a toothache.  The BCF Technology Blog has a great summary of “bear-side” imaging with the CARESTREAM Vita CR System and ImageSuite Software and amazing images that are a must read.

Gavin Mitchell of BCF Technology also sat down for an interview with us to offer advice to veterinary practices on how to evaluate new imaging technology:

What is the coolest story you’ve heard at RSNA? 

RSNA Hot Topics: Portable Imaging and Radiology’s Transformation

Todd Kranpitz, Executive Director of Radiology at Iowa Health, Des Moines, visited our social media broadcast center at RSNA to offer his thoughts on the transformation underway in radiology.  Kranpitz feels its important that the radiology professionals become educators and reach out to other specialties to ensure they understand ALL that diagnostic imaging can bring to the table throughout the care continuum.

Also, Kranpitz recently acquired a CARESTREAM DRX-Revolution Mobile X-Ray System and shares his feedback on the impact of the portable unit on technologist productivity. He also discusses how surgeons want the technology and he sees the potential to replace c-arm systems in the operating room with a DRX unit.

RSNA Presentation: Carestream’s DRX Improves Image Quality, Workflow and Turnaround

Jim Sehnert, Carestream

In case you missed it, a presentation at RSNA today was centered on the added benefits that digital radiography brings to healthcare facilities. If you weren’t able to make it, here are the main findings:

Recently, a study was conducted at Massachusetts General Hospital in which chest images of 80 ICU patients were collected. Radiologists compared CR images to images of the same patient taken with a Carestream DRX-Detector. The team found that the DR images were clearly better than CR images for visibility of tubes and lines, and the edge-enhanced DR images were helpful in evaluating the patients. They concluded that the use of wireless DR for chest radiography in the ICU can provide similar or better information compared to CR—while enabling quicker turnaround time and smoother workflow.

To learn more about CARESTREAM DRX technology and how it can benefit your facility, visit us at RSNA 2012 in South Hall, or visit

RSNA Session Recap: Improve Image Quality While Decreasing Dose

Jackie Whaley, Carestream

Three studies by Carestream R&D presented at RSNA this week featured some of  our latest work to reduce patient dose exposure:

First, “Maximizing Lesion Conspicuity in Chest Radiography: Application of Low-Energy X-rays with Rib-contrast Suppression” was presented on Monday.

The study evaluated the use of low-kVp imaging in combination with rib-contrast suppression (RCS) to improve and maximize the appearance of lesions in chest x-rays at the same patient dose. A cesium iodide Carestream DRX detector was used in the study, which concluded that anatomy contrast and lesion visualization can be maximized when lower kVp is used in combination with rib-contrast suppression. Low kVp with RCS can be used to maximize the diagnostic quality of chest X-rays while maintaining the same patient dose, or to reduce the patient dose while maintaining the same diagnostic quality.

Second, “Task-Specific Dose Reduction for Neonatal Chest Imaging Using a CsI Direct Radiographic (DR) Detector” was presented on Tuesday.  The study was designed to determine the dose reduction potential in neonatal ICU imaging using a Carestream cesium iodide DRX detector. Pediatric radiologists independently marked the location of three features in each image: carina, endotracheal tube tip (ETT), and largest pneumatocele. The study concluded that while currently neonatal patients receive an effective dose of 15-20 µSv for chest exams, employment of task-specific techniques such as a low-dose ETT study and a higher-dose lung parenchymal study could promote dose reduction without affecting diagnosis. These findings are important because of the challenges of acquiring diagnostic quality radiographs of neonatal patients at the lowest possible dose.

Also on Tuesday, “Neonatal and Pediatric, Portable, Digital-Radiographic AP Chest Imaging: Weight-specific kVp Selection to Optimize Effective Dose and Image Quality” was presented. Pediatric patients are particularly sensitive to X-ray dose. This study evaluated the ability for physicians to detect small lung nodules imaged with a wireless Carestream DRX cesium iodide detector. The goal was to evaluate overall imaging performance to identify the best kVp as a function of weight. Typically, neonatal patients of less than 3 kg are imaged at or above 60 kVp. This study presents evidence that they should be imaged a lower kVp to optimize imaging quality and effective dose.

To learn more about the Carestream cesium iodide detector and how your facility can decrease dose for your patients, visit us at RSNA 2012 in South Hall, or visit