Carestream, Fuji seek greater growth through DR innovations

Last year's digital radiography unveiling by Carestream Health will be this year's commercial headliner. The wireless detector is being framed by promoters as an economical godsend to sites wanting to transition from film to digital. The 8.5-pound flat panel, dubbed DRX-1, has rolled into its first installations, among them an outpatient clinic at Tuft's New England Medical Center, which Carestream execs are setting up to be a lightning rod for interest by prospective customers at this year's meeting.

“It has overachieved my expectations,” said Michael P. Foley, director of radiology services at Tufts Medical Center in Boston. “I didn't think I would get this much bang for my buck.”

Fujifilm Medical Systems USA is hoping to be in a position to promote its AcSelerate DR product at RSNA 2009. The company is pushing to get the turnkey radiography system, based on an amorphous selenium flat-panel detector, through the FDA. As it pursued this 510(k) clearance, Fuji sought an investigational review board (IRB) clearance to install a system at Swedish Covenant Hospital in Chicago. One goal was to acquire clinical images that could be shown in Fuji's RSNA booth.

“The claim we're making is that amorphous selenium provides superior detail and contrast resolution with reduced dose [compared with other flat-panel technologies],” said Penny Maier, director of marketing for imaging systems at Fujifilm Medical Systems USA.

With its FDA clearance in hand since spring, Carestream has been hawking the DRX-1 for its ability to fit neatly into a standard bucky, offering a quick and clean upgrade to digital for any standard film-based radiography system. The detector can serve under a patient table or in a wall stand. Or it can be placed on the tabletop for laterals and to capture images from otherwise hard-to-reach angles.

Fuji is showcasing its AcSelerate. Its unusually thick layer of amorphous selenium provides higher sensitivity and better conversion efficiency than competing flat-panel detectors, according to Fuji, potentially reducing dose and improving image quality..

Neither the Carestream nor the Fuji technology is novel. The DRX-1 was preceded to market by a wireless detector from x-ray components supplier Trixell, whose Pixium 3543pR weighs in at 10.6 pounds. Similarly, Direct Radiography, bought by Hologic a decade ago, was the first to base digital detectors on amorphous selenium. The technology platform today serves as the cornerstone for Hologic's full-field digital mammography system, called Selenia.

In the retrofit marketplace, Canon Medical USA has been providing wired flat-panel detectors designed to upgrade film-based radiography systems to digital since 2001.The ranks for such competitors will expand this year when Fuji introduces a flat-panel detector for the retrofit market.

Like such Canon products, the still-unnamed work-in-progress requires no modification to integrate with most existing wall stands and table buckys. Scheduled to debut at RSNA 2009, it will be differentiated primarily by its integration with image processing software developed by Fuji and evolved over decades of use in computed radiography (CR).

Notably, the amorphous selenium detector crafted by Fuji marks a significant diversion from its decades' long trajectory involving CR. The eventual commercialization of AcSelerate will strengthen Fuji's hand in competitions for sales to customers who want a flat-panel answer to the digital x-ray question, just as its still experimental flat-panel retrofit promises to extend the company's reach in a market traditionally addressed by Fuji CR.

Carestream is homing in on this retrofit twist of the digital question. With the DRX-1, sites with tight budgets that need to go digital can do so for a fraction of the cost of buying a DR system. Retrofits of installed radiography systems take only a few hours, according to Carestream, and cost only about $125,000, as the wireless nature of the DRX-1 offers ease-of-handling advantages over wired competitors.

In this, the DRX-1 stands out. Other high-profile wireless detectors are being built into turnkey products that have either recently been commercialized or are nearing the marketplace.