Cost, flexibility help CR maintain digital beachhead

Like Mark Twain’s famously false obituary, rumors of computed radiography’s imminent demise have been greatly exaggerated. In fact, CR is defying expectations that it would fade away once digital radiography emerged from research and development.

CR continues to appeal to buyers who are interested in making the leap to digital x-ray but are unable to afford pricey flat-panel systems. Vendors also cite the flexibility of CR over digital for portable x-ray and low-volume environments.

”We’re seeing more interest in high-throughput, cassetteless systems. And even though CR is considered an older technology, it still plays an important role in digital radiography,” said Penny Donati, manager of CR at Fuji Medical Systems, the company credited with promoting standard CR in the mid-1980s. “That’s due to the flexibility it offers a department, as well as cost.”

In the past year, the introduction of new digital radiographic products and a heightened marketing campaign have increased awareness among buyers of the pros and cons of digital technologies, said Gary Reed, president of Integration Resources, a Lebanon, NJ, consulting firm specializing in PACS and RIS technologies.

”By the time (end users) come to us, they have an opinion about what they want,” Reed said. “We’re seeing much more interest in CR. But people are starting to think and talk about DR. And they are starting to put DR into their budgets.”

Reed expects that CR and DR will coexist for years to come.

”DR is not going to take over the whole market,” he said. “You are not going to put expensive plates in mobile units when you’ve got technologists drag racing portables down the hall.”

CR’s primary advantage-besides cost-is its effectiveness in portable x-ray, agreed Tim Stevener, director of digital radiography business for Philips Medical Systems, which offers both CR and DR products.

”There are some things that are not impossible, but definitely more difficult, with DR,” he said.

Current flat-panel technology limits the ability of DR devices to image patients who are unable to get out of bed, for example. Because it replicates the size and flexibility of film-based portable systems, CR has no such limitations.

”And you have the added benefit (over conventional film) of digitizing the image, which means you have greater control over processing it,” Stevener said. “Customers say that the biggest advantage of CR for portable x-ray is the reduced number of retakes compared to standard film and cassettes. That’s a big issue when you are x-raying the sickest patients in the hospital, which is usually the case in the mobile x-ray environment.”

As a result, CR is expected to be the digital device of choice for years to come, at least in the realms of portable x-ray, emergency rooms, trauma rooms, and pediatrics, Stevener said. That prediction is supported by statistics compiled by IMV Medical Information Division (formerly TMG), a market research firm in Des Plaines, IL. In a survey of 2225 sites with CR, IMV found that the most popular areas for CR applications included the ICU/CCU (64%), ER/trauma (53%), and other bedside portables (26%). Stevener believes that flat-panel technology will eventually be made suitable for portable environments, but that today’s devices aren’t ready yet.

”There’s not really a good DR solution at the moment, although I believe it will happen,” Stevener said.

While such development work continues, the immediate needs of radiology departments still need to be met. And cost is an issue. The price of DR is expected to decrease over time, but this equipment is still too expensive for many sites to consider. Flat-panel systems cost nearly three times as much as CR systems, which average $100,000 for a basic configuration and extend the lifetime of already installed equipment.

”Today the practical matter is the cost of DR versus CR, and in this environment, there are people who will purchase CR for some time to come,” Stevener said. “It doesn’t give you the same productivity as DR systems, but if the drive is to be digital, it becomes a choice of what you can afford: CR or DR. And CR is more cost-effective today.”