Sooner or later, the filmless hospital will leave the realm of science fiction to enter the everyday world of clinical practice. The medical imaging routine in various X-ray departments is bound to be submitted to advanced digitization technologies. One of the latest developments in this prominent area constitutes a new flatly shaped digital detector which was showcased in world premiere last November to the professional visitors of the MEDICA 98 Fair. The European Union, together with its United States' counterpart, has financially supported the development of the innovative device. As the prime advantage, the detector has the ability to largely reduce the radiation dose to which the patient is exposed during the X-ray procedure.
The pending commercialization of the "flat detector" semi-conductor system could signify a very important breakthrough for the European medical technology industry. The radiography departments grow nearer to filmless X-ray efficiency through the use of digitized radiographic imaging. Similar developments are observed in the United States where a group of engineers successfully integrated a comparable sensor into a non-film X-ray device. The clinical introduction of these two designs would no doubt enhance the patient throughput rate since repeated action caused by inadequate use can be avoided. The best news however relates to the patient for whom the radiation dose is lowered to a more than acceptable level.
Surprisingly, hospitals have been familiar with digital technology for about ten years now. Intensive care wards have systematically been converted to reusable image-capturing luminous films. This useful technology has been available to the market for quite some time and practically has succeeded in waving good-bye to failed X-rays. Before the arrival of this digital application the radiologist was forced to repeat nearly one out of four X-ray sessions due to incorrect exposure levels. The digital techniques on the contrary present a much wider fault tolerance, whereas possible difficulties originating from the film development are inexistent.
The luminous image-capturing technology however was unable to reduce the patient's radiation dose. Its radiation uptake of about 25 percent was far too low to meet this requirement since three-quarters of the X-ray energy simply was not being applied to the actual imaging. The innovative flat detector has been especially designed to tackle this issue. As a result, 65 percent of the X-ray radiation energy is used by the device to generate the image. Thus, the patient is being exposed to only a very small amount of radiation dose. This constitutes an ideal situation for hospital departments in which considerable amounts of X-rays are produced.
In fact, the leading-edge low-dose technology needs a specifically equipped X-ray environment to obtain maximum efficiency and cost-effectiveness. The hospitals have to be willing to largely invest in digital X-ray technology since its implementation requires the establishment of a whole new infrastructure, consisting of electronic imaging workstations and networks. Image capture, transmission and archival methods will have to be revised. Lots of time and money will be necessary to turn X-ray images into a digital form to be viewed on a monitor and stored in opto-electronic databases.
The German hospitals each year are still producing nearly 16 million square metres of X-ray film for a total amount of over DM400 million. It will require some patience before the filmless hospital eventually will take the stage. For more news on the subject, we refer to the VMW article Digital imaging replaces traditional X-ray films in Dutch hospital in the November 1998 issue.