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Tuesday, February 5, 2013

A New Toy....D-Rad!

Radiographs are an interesting thing.  Taking one is essentially like taking a photograph, but instead of light exposing the film, x-rays are.  This has been the case for well over 100 years, but like cameras have made the transition from film to digital, x-ray machines have also.

And I now have one!

First, a quick lesson with traditional x-ray films.  The film is kept in a special cartridge that is placed with the patient between the x-ray emitter and the film.  X-rays move through the patient or object with denser materials blocking more of the rays.  The top of the cartridge has special minerals that glow when hit by x-rays.  The more rays hit an area, the stronger the glow. The light exposes the film in the same way that it happens in older cameras.  The film then has to be developed in a darkroom just like camera film.  The developed film is what we're used to seeing as a radiograph.

The first practice I worked in as a vet had tanks where you had to dip the film in the developer to bring out the image and then a fixer to keep it from developing further when exposed to light.  This was back in 1997 and even then a hand-dip system was outdated.  Automatic processors had been around for a long time.  You put an exposed film in one end and it would do the developing, fixing, and rinsing in a couple of minutes, with a finished film emerging from the other end.  I simply could not convince the practice owner that an automatic processor was a huge time saver and gave less error than processing by hand.

Over my career digital x-ray equipment has become more common in veterinary and human medicine.  I was envious every time I saw digital radiography ("D-rad").  It solved so many of the problems seen with traditional film.  And while you can still get a great image with traditional radiology films, d-rad has significant advantages.

First, you get the image right away.  This is important because when you take a film you might have to adjust the patient's position or change the exposure settings.  With film you have to take it, wait several minutes to develop it, and then potentially get the patient back out and re-take it.  That makes taking radiographs a potentially lengthy process and can result in aggravated pets.  But with d-rad you get the image instantly and can make quick adjustments if needed.

Second, you can adjust the image.  Digital software allows you to manipulate the contrast, magnify an area, and otherwise alter your image.  When your exposure may not be exactly perfect, this allows you to see more in the image and can keep from having to retake views.  The adjustment and magnification can also make certain features stand out more than they might on film.

Third, sharing images is much easier.  When sending a client to a specialist for further testing or another opinion you often have to give the other doctor any radiographs you've taken.  With films you have to loan them to the client with the expectation that they will bring them back.  The films are part of the legal medical records and therefore do not belong to the client.  It's not uncommon for the films not to come back, which is a problem if there are any questions in the future as to what happened, or if the doctor just wants to compare images over time.  Copying x-ray films is difficult and not something that can be done in the practice.  But with digital radiography you can keep the original file and burn as many copies as you want to discs.

After years of asking for it, we finally got ours installed last week.  Needless to say, I'm incredibly excited!  There is a bit of a learning curve on the software, but I'm already seeing a huge benefit in our diagnostic ability.  And I finally feel like our practice is part of the 21st century!

This is an essential diagnostic tool and something that we use daily.  But I have to be honest and admit that it's also a cool new toy for a geek and doctor like myself!