FPD technology applied across all forms of general radiography is now allowing far greater customization of systems, evolving toward a truly modular market.

Health sector in India is growing at a tremendous rate with a large number of hospitals and diagnostic centers being set up. X-ray equipment being an indispensable part of most medical centers, the market is experiencing a steady demand.

At present, the market is experiencing a shift from analog to digital models owing to better imaging results of the latter as well as willingness of medical centers to improve their services. The growing target base of consumers will boost sales and the market is expected to exhibit steady growth in future.

Despite the market for medical devices being mostly dominated by multinational companies, in the case of X-ray equipment, there are a large number of both domestic and foreign companies operating in the market. The presence of a large number of players has ensured that there is a stiff competition in the market. Companies look to outdo one another by providing additional features in their products, or by providing products with similar features at a lower price. Products from foreign companies are generally priced higher than the products of Indian companies, and these products are mostly used by the top hospitals in large cities.

However, with medical centers in smaller cities and towns also striving to provide quality service, Indian companies are also experiencing a high demand for their products. Overall, the market for X-ray equipment is exhibiting steady growth and holds ample opportunities for the players operating in this market.

Technology Update

The fundamentals of static X-ray imaging have changed little in decades, prompting the majority of radiologists to pay scant attention to developments in this sector. However, the emergence and increasing use of flat-panel detector (FPD) technology is producing surprising results, improving workflow, image quality, cost of ownership, and patient safety.

Fixed-room X-ray. Fixed FPD X-ray rooms have become a mainstay of general radiography, offering near instant processing, lower dose, and near-seamless integration with healthcare IT solutions. While the initial cost of these systems caused many to question the benefits of FPD over analog and computed radiography (CR) X-ray, manufacturers have clearly established the long-term benefits in workflow and lifetime cost of ownership. The main beneficiaries of this shift to FPD have primarily been larger hospitals and imaging centers; reducing processing time across large scan volumes has significant benefits both in terms of efficiency and cost. More recently, projected adoption of automated multiplate systems and tables will further drive gains in efficiency, a positive outcome for many healthcare providers struggling in the current age of austerity.

Another notable trend has been the creation of a tiered FPD fixed-room market, providing more options in terms of configuration and panel type, allowing customization for the requirements of each unique user. Increased availability of lower priced fixed-room systems is also forecast to rapidly increase uptake of FPD systems in smaller institutions and emerging markets, particularly with panel prices continuing to decline year after year.

Mobile. The evolution of mobile X-ray equipment has also been heavily shaped by FPD technology, particularly with more widespread use of wireless FPD technology. Mobile X-ray has often been overlooked on account of the lower price of systems and relatively low utilization compared to fixed-room systems. However, digital mobile X-ray systems offer even greater rewards in terms of efficiency, workflow, and cost savings over the system's lifespan than fixed rooms.

A large portion of mobile X-ray use occurs with patients too unwell or critical to be taken to the fixed system, most commonly in the intensive care or emergency medicine scenarios. Using wireless FPD mobile X-ray, maneuverability of the detector is improved, thereby reducing risk for the patient. Near-instant processing and review achieved with FPD also removes the need for the user to return to central processing locations to check the image, cutting out any need for the radiographer to return later to redo the same scan.

Wireless FPD mobile X-ray further offers inherent flexibility for hospitals, allowing sharing of wireless panels between mobile systems, or even between fixed-room and mobile systems. While in many large healthcare institutions, equipment is in near-constant use, smaller facilities can make significant savings.

Retrofit. In terms of increasing accessibility to digital FPD X-ray, the development of retrofit FPD X-ray solutions could have the greatest impact of all. While onlookers may view retrofit upgrades as a short-term response to the current challenging economic climate, it may in fact bring FPD digital X-ray imaging within reach of those who need it most. In the wider Europe, Middle-East, and Africa (EMEA) regions, many parts of Eastern Europe, the Middle-East, and Africa remain critically underserved by aging analog X-ray systems. Assuming FPD prices continue to decline as has been observed in the past 5 years, retrofit FPD solutions could soon be affordable for users in these regions. Furthermore, an increasing number of vendor-neutral retrofit solutions are commercially available, allowing more flexibility and choice for users.

The changes discussed have all developed through product evolution of one technology, refining, and developing products based on the demands of users in today's challenging healthcare market. FPD technology applied across all forms of general radiography is now allowing far greater customization of systems, evolving toward a truly modular market. Yet at the same time, it is making real changes to the way X-ray imaging is conducted, increasing efficiency, saving money, and providing tangible opportunity for emerging markets to adopt 21st-century imaging.

Dr Ayesha Siddiqui, Sr. Consultant-Radiology, Saket City Hospital, New Delhi
Second Opinion
Technology at PoC

Nowadays, portable digital X-ray machine can take advantage of the latest innovations in medical imaging technology, which has not only shrunk in physical size, but in cost as well, while providing more capabilities and versatility than ever.

Compact mobile radiography units can produce diagnostic images in virtually any location. Some mobile radiographic machines are designed for transport by automobile or a van to nursing homes, extended care facilities, or other off-site locations requiring radiographic imaging services. Their folding design allows them to be stored and transported easily through standard doors and up and down the elevators. A built-in cassette storage area can accommodate several radiographic film cassettes. The latest portable X-ray units provide high-power state-of-the-art technology, system reliability, and low maintenance with a small footprint and light weight. Usually these units are 100 kV/30 mA, 3 kW systems that can reduce exposure times on difficult radiographic anatomical views, thereby minimizing problems related to patient motion and enhancing image quality.

A next-generation digital mobile X-ray system offers innovative digital imaging technology at the point-of-care (PoC). The technology is self-contained and battery-operated. At the core of this portable system is next-generation wireless digital detector. Radiology staff can achieve the same image-quality, productivity, and functionality, at the PoC as that of a radiography room.

The most recent advancements include advanced digital imaging, more power in a compact design, no boot-up requirement, 24×7 availability, automatic charging, and improved image storage.

Today these units are designed for high reliability and durability that will assure maximum up-time performance and low maintenance. The convenience of taking images at the bedside is now leading to additional advancements in power management and wireless capabilities of this mobile technology.

With these new mobile X-ray units, the near-instant access to the images at the patient side has healthcare providers asking for more. Mobility and diagnostic image quality are key enablers for this trend, while wireless connectivity and battery life are areas where most manufacturers of these units can improve.

Dr Ayesha Siddiqui
Sr. Consultant-Radiology,
Saket City Hospital, New Delhi

10 Diagnostic Imaging Trends for 2018



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