Digital X-Ray: CR vs. DR Flat Panels

By now, pretty much everybody in the radiology field knows that old-school, analog image acquisition and processing via film are about as inefficient as it gets. Most people also know that there is more than one way to take your imaging into the digital age.

Of course, as is usually the case any time one is offered options, there are pros and cons to each. Below, we'll break down the advantages and challenges posed by both computed radiography (CR) and digital radiography (DR) panels.

CR Reader

If you choose to use CR, your analog system takes X-ray exposures in the usual way but uses a CR-specific cassette in place of a traditional film cassette. After the exposure is taken, the cassette is run through a CR reader where the image is scanned into a digital format. The cassette can then be cleared and reused for future scans. 

Pros

Once the CR cassette is inserted in the reader, most units will have the image rendered digitally in under a minute. This is exponentially faster than film processing.

Once an image is digitized, storage and transfer are far simpler and more space-efficient than film.

CR units have compatibility with other X-ray devices aside from a traditional rad room. A single CR reader can serve to “digitize” multiple analog units in a single facility.

NOTE: mammo-compatible CR readers have stricter quality guidelines than readers for other X-ray modalities. A mammo CR reader will work for all X-ray modalities, but not all CR readers will work for mammo.

Installation of a CR is less labor-intensive than a fixed DR panel and about the same as a tethered or wireless panel. Once the reader is positioned and connected to the facility network, the rest of the installation is software-based.

Cons

Though it is much faster than film, CR is much slower than a DR panel. The time it takes to remove the cassette from the bucky tray, take it to the reader, read it, clear it, and replace it into the bucky can add up to several minutes.

There is no validation of image quality with a CR until after the time has already been spent to process the cassette. Other conversion methods can show the image on the spot.

For U.S users, reimbursements for studies digitized with a CR reader will be cut starting in 2018. At 7%, the cuts will be relatively modest compared to the 20% cuts that will be hitting film processing in 2017, but over time they will still add up to a significant dollar loss.

Digital Radiography Flat Panel

Another way to go digital with your X-ray equipment is to update your analog system with a DR detector panel. Whether you choose to use a fixed panel, a tethered panel, or a wireless panel, there are options to accommodate a variety of both preferences and budgets.

Pros

Because a DR panel spends most of its time in your X-ray system's bucky tray, you won't require any additional space for it. The workstation that comes with your panel can be wall-mounted or can live in about two feet of counter space. A CR reader is only about the size of an office copier, but is far bulkier than a DR panel setup.

The average DR room will have an image captured and rendered in about 5 seconds. This speed is far ahead of both film and CR.

Like a CR reader, a DR panel can be shared across multiple systems and/or modalities.

While the up-front cost may be higher, the overall cost of ownership of a DR panel is lower than that of a CR reader. Because a CR reader has many moving parts, it is more likely to require a regular on-site maintenance plan and replacement parts.

Cons

The sole con to choosing a DR panel over a CR reader is the potential to pay more up front. As we mentioned earlier, however, the lower service costs compensate for this over time.

See Current Average Pricing for DR Flat Panels

The Takeaway

We'll all be scanning with digital equipment sooner or later. At present, however, facilities considering this transition around the world will need to evaluate the up-front capital expenditure they're capable of in the immediate future. U.S. users will want to think twice about investing in a CR reader at all.

If you'd like more information to help along the way, we're happy to offer it. Contact us directly with your questions or request a DR panel demonstration to learn more in the comfort of your own facility.

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Picture of Tony Baggett

Tony Baggett

Tony Baggett is an X-Ray Product Manager at Block Imaging. Tony assists imaging centers, hospitals, and orthopedic centers in their purchases of x-ray equipment. When he’s not serving customers, Tony can be found hunting, fishing, and camping with his wife, son, and daughter.