Innovations in X-ray imaging technology have come a long way, and with more hospitals adopting digital technology, the field will continue to benefit from improved image quality, reduced radiation dose, and a more efficient workflow.

The field of medical imaging has evolved. This shift in medical imaging has seen the emergence of flat panel detector (FPD) technology in everything from cardiology systems to portable X-ray equipment. Digital solutions have begun to revolutionize medical imaging by offering improved image quality, faster processing time, and dose reduction advantages over their analog predecessors.

Growing demand for refurbished and retrofitted devices, introduction of digital and portable X-ray systems, and increasing adoption rates of PACS in healthcare establishments as a cost-effective and technologically advanced alternative, are driving innovations in X-ray equipment.

Indian Market Dynamics

In 2015, the Indian X-ray equipment market saw an overall decline of 20 percent in value terms. The analog equipment market is continuing to see a decline, whereas the digital radiography (DR) systems are in demand. The fluoroscopy segment, which comprises analog, digital, and IITV contributed about 25 crore to this segment. Showing a continuous X-ray image on a monitor, much like an X-ray movie, this segment is preferred by the discerning customer.


The computed radiography (CR) equipment market in 2015-16 maintained its sales of 4100 numbers and was valued at 246 crore, similar to the 2014-15 level.

The procurement by government facilities continued to be for high-end equipment. The private sector was more prudent and opted for a mixed bag as per their requirement and budgets.

When comparing CR and DR, each type of system offers relative advantages, but DR may represent a better option for some facilities with a larger patient load due to the greater ease of use and elimination of cassette handling with DR, lower scan time, and less wear and tear on other key components of the equipment. A DR system is likely to have a similar footprint to an analog system and there will be a low probability of needing to remodel the X-ray space. However, purchasing a full DR system is far more expensive than adding a CR reader to the analog unit, which has deterred the buyers from switching to DR. This has spurred all the X-ray equipment vendors globally, to make an effort toward bringing the price of the DR systems down and maintaining the price for DR nearly twice that of a CR system.

Planning for Upgrades

x-ray-pieAfter the initial upfront investment in equipment, DR provides numerous advantages over CR, including better image quality, faster processing times, potentially lower radiation doses, and gains in productivity.

The most striking difference between CR and DR as imaging modalities is efficiency. Compared to previous X-ray methods that required the technologist to physically remove the film or cassette and carry it over to a processing area, DR technology captures the image directly onto a flat panel detector. DR images are available for review seconds after the image is taken. Being able to retrieve and render captured images on the spot allows for a more productive radiology workflow. DR reduces the processing time by anywhere from 90 to 95 percent. The quick turnaround increases workflow efficiency within the radiology department and results in time savings and as a result cost savings. With fast and efficient DR technology, facilities can see more patients. Higher utilization of their assets also translates into a higher reimbursement rate.

There are other benefits of DR. Not only does the technology eliminate the need for costly film-processing steps, it also carries the potential for radiation dose reduction. Imaging quality is also improved, with a wider dynamic range that makes it more forgiving for over- and under-exposure. Technologists can use DR system software to apply special image processing techniques that enhance overall display of the image, helping radiologists make better diagnostic decisions. One of the downhill effects could be a more satisfying patient experience, a metric that many facilities would like to improve.x-ray-pie

The benefits of DR are widely recognized by the medical imaging community, but adoption has been slow for some because of the challenge of finding cost-effective ways to upgrade or replace their existing technology.

Manufacturers of DR systems are responding to these challenges by creating attractive programs and product packages that help facilities make the transition to digital affordable and with minimal interruptions in workflow.

Because of budget cycles, most imaging facility administrators are currently in the planning stages of upgrades. One of the first considerations is the facility's current space. What needs replacing and what could remain for a few more years? Will the whole room need to be replaced? Some facilities will have one or two rooms to upgrade, while others will have dozens. For larger health delivery networks with multiple sites, putting together a strategic plan will help hospital administrators outline how to go forward. If those plans include construction, the room could be offline for several months. Organizational leaders may also need to consider changing the room's configuration to better accommodate workflow.

Replacing the entire X-ray room is not the only option, however. For some facilities, upgrading existing CR technology can allow them to make the shift to DR without major upfront costs.x-ray-pie

From a staff workflow perspective, converting to a new DR system poses few training hurdles, since many of the software platforms available are already familiar to technologists. Rather, the biggest challenge for most facilities is securing the capital funding to pay for the system, which manufacturers say they can offset by using customizable, vendor-neutral solutions. Agfa, for example, offers a program called Fast Forward DR that allows the company to provide a unique cost structure, such as monthly payments only marginally higher than those a hospital currently makes to maintain its prior CR technologies. The efficiencies gained by the new technology help the system pay for itself.

Innovations in X-ray imaging technology have come a long way, and with more hospitals adopting digital technology, the field will continue to benefit from improved image quality, reduced radiation dose to patients, and a more efficient workflow. Making the conversion to more efficient DR technology allows healthcare organizations to keep up with ever-changing healthcare regulations as well as maximize returns on their imaging investments.

Indian Market Dynamics is based on market research conducted by Medical Buyer in July 2016.

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