05/04/2013    Raymond Posa, MBA

RE: Purchasing a Digital X-Ray System (Michael Brody, DPM)

Regarding Dr. Brody’s post on digital x-ray
systems CR vs. DR, there are some erroneous
statements. First CR is not a “true” digital
system. Think of CR as a copy machine, we all
know as you copy originals, you lose quality. The
CR system is more closely related to traditional
film than it is to digital x-ray.

In a CR system, a x-ray sensitive plate is put
inside a standard x-ray cassette and exposed just
like a traditional piece of film would be. Then
the cassette is placed into a reader (some CR
systems require you to remove the plate from the
cassette and place it into a reader. The image is
then scanned off the plate and converted to a
digital image. The process is somewhat labor
intensive and slow.

In a DR system the image is taken directly from
the imager to the PC, thus eliminating the need
to handle cassettes and the need to convert an
analog picture to a digital image.

I ran a time motion study using a mid-range CR
system ($75,000) vs. a 21 megapixel DR system
($25,000) and the speed difference in both the
image acquisition and the positioning of the
patient and the handling of the cassettes
resulted in a 3 to 1 time savings by using DR.
The time motion study showed it took just over 6
minutes to take 3 images in a study, process them
and get them on the computer screen with the CR
unit, the DR only took 1 minute and 56 seconds.

In a busy office this productivity gain is
significant. As for cost, most companies are
dropping their CR products because they are
yesterday’s technology. As for cost, there are
some digital x-ray companies that do not charge
ongoing maintenance support for the unit or their
software.

I have seen many more CR plates damaged than any
DR plate. The CR plates typically cost $800 each
and you need to keep about 6 on hand to operate
efficiently. With all of the handling and the
lifting and the dropping and the banging, these
CR plates get damaged frequently. The CR plates
also have a limited life span (about 800 images)
the image quality also drops significantly as you
approach the end of life of the plate. With the
DR system, you are never lifting the imager,
rather you rotate it from a horizontal to a
vertical position and the unit never leave
contact with the ground.

Finally, ask your x-ray dealer about the section
179 and ADA tax credits available on the DR
units, they generally off set have of the cost of
the unit.

Raymond F. Posa, MBA – Farmingdale, NJ
rposa@themantagroup.com

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