Agfa Solutions for X-ray Digitizer

• [click] Radiological Imaging Technology (brief)

Hospital x-ray departments are transitioning to filmless solutions by purchasing DR or CR technology. Some hospitals are adopting CR or DR as their preferred solution for a filmless department, while others are transitioning towards a complete digital solution by upgrading their conventional x-ray units with CR before replacing their x-ray installed base with DR technology

Scanning and the elimination of paper-based medical records is the first step to implementing electronic medical records.

We provide accurate, rapid conversion services from paper charts and files to digital images and indexed data allowing you to focus on your clinical and business priorities.

Now, you can take full advantage of your Picture Archiving and Communications System (PACS) by freeing up precious space using our efficient and cost-effective x-ray film digitization service and storage that will allow you on demand access to the images you store with us.

Radiology Services Online can help you manage film and digital images in both your PACS and our web-based storage application. Through our cost-effective approach to converting analog films to digital images, you can:

- Improve radiologist productivity

- Increase accuracy of interpretations and conduct remote diagnosis

- Streamline workflow

- Reduce costs

- Avoid the high cost of equipment purchases, upgrades and maintenance

- Optimize your film management

- Free up valuable floor space for expanded revenue-generating opportunities.

Our application for storage is a showcase for those providers that either plan to implement or have recently implemented a PACS. We make it simple, fast and affordable to transition to today’s newest technologies for handling of images and patient health records.

Importing the data into the electronic medical records (EMP) or the electronic health record (EHR) efficiently is an integral aspect of effectively gaining access for the scanned images with the software. Oftentimes, a medical organization will want to preserve the physical paper for peace of mind. Solutions are offered to provide and secure medical record storage to archive your information for as long as it's needed.

Working from the convenience of a workstation in their office, group suite, or hospital department, specialists can:

Retrieve images from fundus cameras, slit lamps, ultrasound and other imaging modalities, film digitizers and any other modality anywhere on the network:

- Change contrast levels to more clearly define details.

- Zoom in with far greater accuracy.

- Share images with colleagues (= teleradiology)and referring physicians over intranets and internets.

- Output images to improve patient education and/or make presentations.

- Compare pre- and post-treatment images.

Radiology

The most prominent telemedical application is certainly teleradiology with over 1100 references in the scientific literature indexed on Medline (838 using the MeSH term “teleradiology”). This is not so surprising because in radiology, the basis of the diagnostic process is an artificially created image itself. Modern X-ray generate this image in digital form and with DICOM there is an agreed standard format for these digital radiographs. Since such images are captured digitally, it is a logical step forward to also transmit them over a network and DICOM – standing for “Digital Imaging and Communication in Medicine” – includes a component for standardised transmission of images. In many modern hospitals this technology is in fact used to transmit the image from the actual X-ray machine to the screen in the radiologist’s office. The transmission over a longer distance is only a logical consequence.

A second important consequence of the fact that the image itself is the basis for the diagnosis consists inof a very straightforward process of telemedicine in radiology. A transmission of the image in sufficient quality and time alone is enough for a tele-diagnosis and there is often no need to transmit additional data or perform additional examinations immediately. Thus, teleradiology lends itself to a separation of the patient and the specialist as all the specialist needs to see is the image of the patient. It is not surprising that teleradiology is the only application in telemedicine that is used on a larger scale.

While digital X-ray equipment is increasingly used in industrialized countries, the vast majority of X-ray machines in the developing world is conventional film-based equipment. Teleradiology based on film based images is also possible and involves either scanning of the film or digitization with a digital photo camera.

Film Digitizer

The Scanning Workbench from Agfa Systems is a high quality film digitization system for PACS applications. The system is a DICOM Storage SCU: it transmits DICOM secondary capture images using a selection of transfer syntaxes (different DICOM compression algorithms). It also supports DICOM modality worklist and print clients, includes a DICOM viewer and supports an HL-7 interface. Used with a DICOM printer, the system can also be used as a film copier, providing superior copies than those produced by conventional methods. The same PC controller can also be used to run Agfa's Capture Workbench, which is a frame grab solution and a DICOM Storage SCP. By combining The Scanning and Capture Workbenches, a single computer and network connection can be used to transmit film, frame grabbed (DICOM secondary capture) images and DICOM images application.

The improved patient proximity allows greater efficiency and workflow for the technologist, with more comfort and a shorter waiting time for the patient. There is no longer a need for the technologist to leave the patient to perform any ID or image quality control activities. The system is completely integrated with the X-ray system, there is no need to enter data into the X-ray console.

Solutions for Digital Radiography plays a significant role in the hospital’s goal of providing patient comfort and care and improving communications throughout the facility via a total integration of systems. It supports the latest evolutions of hospital integration philosophy for improved interoperability.

Delivering exact radiation doses through image-guided radiation therapy to specific areas of a tumour demands ever increasing accuracy from the radiotherapy solutions. Currently, this need for precision images is being met by Agfa’s Computed Radiography (CR) solution. A digital simulation and portal imaging system for both low- and high-dose applications, it handles low- and high-energy X-rays. It is capable of acquiring radiographic quality images in a radiotherapy environment using CR technology. This enables the acquisition of digital images, which, in comparison with conventional film, results in higher contrast images.

How it Works

An X-ray image is recorded onto Agfa’s unique image plate, which is held in a dust-proof cassette. This image plate is coated with a phosphor layer that is sensitive to stimulation by incoming X-ray photons. Following exposure, the cassette is inserted into the Agfa CR 25.0 digitiser, which reads the information via a laser beam. This activates the phosphor grains on the image plate to release energy in the form of light. This light is then collected as a digital image and processed – with Agfa’s patented MusicaTM image processing software – to obtain an exact digital image for display. The digital image can then be adjusted or reprocessed using Agfa’s CR Quality System (QS), a dedicated software package to enhance the imaging quality procedures within the department – something that has, until now, only been available in more expensive radiotherapy application areas. Once any adjustments have been made, the images can be made available on any hospital network via Digital Imaging and Communications in Medicine (DICOM) or by printing onto film using Agfa’s DRYSTARTM 5300.

Dedicated Plates and Cassettes

At the heart of the newly designed CR Radiotherapy Solution are cassettes that have been thoroughly evaluated in radiotherapy departments around the world. These cassettes, with their tungsten internal filter – a system patented by Agfa – provide significantly enhanced detection, while the lighter weight of the casing makes them more ergonomic and, therefore, more flexible for image manipulation when compared with others currently on the market. The CR radiotherapy high-dose cassettes offer optimal image quality at an extremely wide dose response of greater than 400 monitor units and are available for both high- and low-dosage applications. The CR RT low-dose cassettes for low-dose CR portal imaging provide excellent image quality in the low-dose range.

MUSICA² Advanced Image Processing

For intelligent digital X-ray image processing, Agfa HealthCare’s MUSICA²™ (Multi-Scale Image Contrast Amplification) offers even better image visualization and greater autonomy and robustness than its predecessor, the market’s gold standard, the original MUSICA image processing software.

The Multi-scale Image Contrast Amplification algorithm, MUSICA, composes the digital image in a number of different frequency ranges (or detail sizes) and modulates the signal amplitudes (or contrast) within each of these ranges. This results in an exceptional perceptibility, enhancing details. Making use of 1 dimension: the frequency, MUSICA is still today's market golden standard and is included in NX, Agfa's operator workstation for digital imaging.

MUSICA² however takes image processing even further with 2-dimensional image processing, for both frequency and density (or grey levels). This delivers even more detailed image quality.

Agfa has, and is developing, a significant number of products that make use of the DICOM standard for communication. It is our intention that each product can be connected to other DICOM products, either Agfa own or third party.

Therefore, a need exists to ensure that the products are conform to the DICOM standard in a way appropiate to their function. The Agfa DICOM Validation Tool (ADVT) has been developed to test our own products internally.

Agfa is a leader in both traditional imaging and Picture Archiving and Communications Systems (PACS) with systems deployed in radiology departments, specialty departments, clinics and group practices worldwide.

Computed Radiography (CR) uses very similar equipment to conventional radiography except that in place of a film to create the image, an imaging plate (IP) made of photostimulable phosphor is used. The imaging plate housed in a special cassette and placed under the body part or object to be examined and the x-ray exposure is made. Hence, instead of taking an exposed film into a darkroom for developing in chemical tanks or an automatic film processor, the imaging plate is run through a special laser scanner, or CR reader, that reads and digitizes the image. The digital image can then be viewed and enhanced using software that has functions very similar to other conventional digital image-processing software, such as contrast, brightness, filtration and zoom.

Differences from Digital Radiography

Computed radiography (CR) is often distinguished from Digital Radiography (DR). CR and DR have many similarities. Both CR and DR use a medium to capture x-ray energy and both produce a digital image that can be enhanced for soft copy diagnosis or further review. Both CR and DR can also present an image within seconds of exposure. CR generally involves the use of a cassette that houses the imaging plate, similar to traditional film-screen systems, to record the image whereas DR typically captures the image directly onto a flat panel detector without the use of a cassette. Image processing or enhancement can be applied on DR images as well as CR images due to the digital format of each. There are many different types of DR detectors in use in medicine and industry. Each type has its own merits and distinctions and may be applied to certain imaging requirements based on these attributes.

Imaging plate

The CR imaging plate (IP) contains photostimulable storage phosphors, which store the radiation level received at each point in local electron energies. When the plate is put through the scanner, the scanning laser beam causes the electrons to relax to lower energy levels, emitting light that is detected by a photo-multiplier tube, which is then converted to an electronic signal. The electronic signal is then converted to discrete (digital) values and placed into the image processor pixel map. Imaging plates can theoretically be re-used thousands of times if they are handled carefully. IP handling under industrial conditions, however, may result in damage after a few hundred uses. An image can be erased by simply exposing the plate to a room-level fluorescent light. Most laser scanners automatically erase the image plate after laser scanning is complete. The imaging plate can then be re-used. Reusable phosphor plates are environmentally safe but need to be disposed of according to local regulations.

• [click] Agfa Digital Imager

• [click] Agfa CR Digitizers

• [click] Agfa NX Workstation

• [click] Fuji Digital Radiography