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Life Chiropractic College West >> Life West Departments >> Digital Imaging Center >> Articles >> Radiography 101 |
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“Digital Radiography
101” In 1895, Conrad Roentgen brought the concept of x-ray to the world. A little over a century later, his concepts have been improved, refined, enhanced and taken around the globe. In 2003, the chiropractic profession caught up with some of the latest developments in x-ray with the implementation of digital radiography in the Health Center and curriculum of Life Chiropractic College West. In the 1950s, the concept of altering the “image capture” method involved in health-related applications of x-ray was first presented. The idea was simple. Instead of exposing photographic film in the cassette, could an image be captured through activation of a digital plate held in the cassette? The answer was yes, and the answer represented the birth of digital radiography. You might ask, “why bother?” You’ve got your technique chart down. You are comfortable using film and you are not particularly computer literate. If this sounds like a characterization of your thoughts, let’s look at it another way. With digital radiography (DR), you will never need to do any of the following tasks:
This litany hasn’t even begun to touch on the issues of increased patient safety, decreased radiation exposure, easier film interpretation/reading, enhanced clinical utility of x-ray images and ease of management of x-ray images in general. DR is a great advance in x-ray and it is within reach of the chiropractic office—technically and economically. How Does It Work? Let’s start from the beginning. As far as your x-ray machine is concerned, there are no changes in the system needed to convert to DR. The changes begin in how the image is captured. Presently, most chiropractors use the cassette-intensifying screen-film combination. The film is then developed, fixed and dried. In the DR environment, the cassette is the same, but instead of the intensifying screen-film contents, there is a digital card that records the image. Once the patient is exposed, the old technology took us to the darkroom and then through the development process. In the DR approach, we step to another room, open the cassette, take out the digital plate and send it through a “reader”. The reader is similar in appearance to a fax machine or a photocopier. In about 45 seconds for an 8” x 10”, or 55 seconds for a 14” x 17” plate, we have “captured” the data from the digital card and the data is being converted into an image at a computer workstation. In about 10 seconds, after passing through the reader, an image appears on the computer monitor. Now What? This is where the fun begins! The digital image is labeled and saved. This is the base image that we will use, as we need, from this point forward. But, unlike film where “what you see is what you get”, with DR, what you see is just the beginning of what you’ll get. At this point, perhaps it is better to think of the DR image as a digital photograph. You’ve seen how you can enlarge, rotate, change contrast, change color, etc. with a digital photograph. Imagine being able to do all of those things with your DR image. If the contrast on the DR base image isn’t the best, the software will modify it to your desires. If one area of the image is underexposed, and another overexposed, you can correct both. Enhanced images can be saved—by the dozens. You can play with the image until it is perfect at C1-C2, then save that enhancement, return to the base image, enhance it at C7-T1 and save that image. Let’s say you’ve found a fracture. It is discernable to the trained eye, but perhaps not to the layman. Simple—magnify the fracture until that baby looks like the Grand Canyon if you wish! Images can be reversed, structures can be measured with computer-generated measurements and, no matter how you magnify or reduce the image, the measurements remain accurate! Let’s Go Back to Image Management Today, you take a film, develop it, mark it, read it and store it. If someone wants a copy of it, you either have an x-ray copier and make a copy or you give them your original film. In the DR format, you can make an unlimited number of copies that are absolute clones of the original and/or enhanced images. When someone wants a copy of a DR image, your next question is “would you like me to email it to you, print it to paper, or burn it to a CD?” Sixty seconds later at a maximum cost to you of 50 cents, they have their copy! Suppose you’ve taken the film, adjusted the patient, and a year—or ten passes and the patient comes back. You pack a lunch, include extra water and send someone to begin the search in your film storage area. In the DR realm, you do a computer search by date or name and, in 30 seconds, you have your images again. Let’s say you’re caring for a patient who has been involved in an auto accident. You are called to testify in court. Instead of schlepping in a viewbox, putting up your film and pointing to things that can only be seen 12” away from the viewbox, you turn on your laptop and you project your images on an 8’ x 8’ screen in the courtroom and when you are questioned about a given finding or structure, you are three clicks away from making that osteophyte look like a gargoyle on Notre Dame! “I’m Not Ready to Convert to DR, But I Do Have Some Cases That Would Be Great to See in this Format—Can you help?” Thanks for asking! Of course we can help—that’s our job! We can help as much or as little as you would like. Here is how it could happen:
None of this is pie-in-the-sky. Every bit of this is available to you for any reason you feel is necessary—personal injury defense, workers’ compensation hearing or malpractice defense. For the first time in your career as a chiropractor, we can make your films more than they ever were before and we can put more information in a more dramatic form at your fingertips than you ever dreamed was possible. If you would like more information about DR technology for your office, visit www.lifewest.edu and click on “Digital Radiography Update”. If you would like information on utilizing the College’s over-read services, image enhancement services, or report generating services, call 510-780-4500, x2242 You’ll never look at an x-ray the same again in your career!
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