X-ray’s Long Courtship With Solid-State Detectors

Fifteen years ago, I was ready to bet the farm that X-ray, with its hundreds of thousands of systems installed worldwide, was ready to embrace the digital revolution. Every other modality had done so. PACS gurus lamented that X-ray’s intransigence was the main – if not the only – reason that PACS was not catching on. And their argument made sense. Radiographs alone accounted for about 70% of all radiologic images. Major suppliers, including Thales in Europe and Varian on this side of the Atlantic, had announced fabrication facilities capable of stoking the digital fire.

It was easy to conclude, therefore, that digital X-ray was a freight train on a radiological turntable ready to synch up with the rest of modern imaging. But it wasn’t…and it didn’t…at least, not the way I thought it would.

Rather than shiny new X-ray systems arriving on the loading docks of hospitals across America, computed radiography surged. Money made the difference. Flat panel detectors were just too expensive. In place of the digital X-ray revolution arose a plaintive “yes, but…” discourse that now, finally, may be at an end.

Flat panels have invaded the last bastion of radiography – mobile X-ray – with decreasing cost and increasing ease. Wireless technology is championing both.

At RSNA 2011, the big names in radiography were pitching wireless as the cornerstone for sharing detectors and, thereby, reducing capital equipment costs for going digital. By transmitting data wirelessly from detector to acquisition console, flat panels can be shared from table to upright chest stand and from radiography suite to the portables that image bedridden patients.

No system exemplifies this potential better than Fujfilm Medical Systems USA’s new FDR Go flex. When this system clears the FDA – it was shown as a work-in-progress at the RSNA meeting – owners of analog systems will be able to transition to digital through a simple three-step process. First, an electronics box will be placed into the cassette drawer of the radiography table, upright or mobile X-ray. Second, a specially designed laptop will be mounted on the analog system to acquire and process the data. Third, the newly digitalized system will be configured to connect with the company’s wireless D-EVO flat panel detector and the facility’s IT network.

Other vendors offer similar upgrade paths, each designed to make the transition from analog to digital as painless as possible, allowing facilities to change out as many analog platforms as they want over whatever time period makes financial sense.

Clearly, the long-awaited digital revolution in X-ray is at hand. It will have taken hold, when aging radiography suites and mobile X-ray units are finally scrapped in favor of products designed specifically for digital detectors…but this will happen decades later than I would have expected.