A cost-analysis of computed radiography and picture archiving and communication systems in portable radiography

A comparative cost analysis of picture archiving and communications systems (PACS) versus conventional radiology in the private sector

Background: Radiology is rapidly advancing, with a global transition to digital imaging technology to improve productivity and enhance communication. The major challenge confronting radiology practices is to demonstrate cost savings and productivity gains when a picture archiving and communication system (PACS) is established.Aim: To undertake an incremental cost analysis of PACS compared with conventional radiology to determine productivity gains, if any, at two private hospitals in Durban.Method: An incremental cost analysis for chest radiographs, computed tomography and magnetic resonance imaging brain scans with and without contrast were performed. The overall incremental cost for PACS in comparison with a conventional radiology site was determined. The net present value was also determined to evaluate the capital budgeting requirements for both systems.Results: The incremental cost of both capital and the radiology information system for installing PACS shows an expected increase. The incremental PACS image cost shows a reduction.Conclusion: The study provides a benchmark for the cost incurred when implementing PACS. It also provides a decision framework for radiology departments that plan to introduce PACS and helps to determine the feasibility of its introduction.

Enterprise-wide CR implementation: the Shands Healthcare System experience

Major healthcare systems are comprised of hospitals and clinics of different sizes and locations. Many such enterprises are already using picture archiving and communication systems (PACS) and computed radiography (CR) in their main hospitals. The integration of other hospitals and clinics into PACS is a more complex problem. The introduction of CR in remote facilities presents problems, as patient populations, department sizes, and work flow patterns may differ among facilities, and inadequate implementation programs may lead to disruption of patient care services. Although the University of Florida has had an operating PACS for years, facilities affiliated with the Shands Healthcare System (SHS) had not been incorporated into PACS until recently. This article presents the 5-year process to convert all film-screen radiological services to CR in the main hospital, five affiliated community hospitals, and four clinics. The article shows the importance of leadership by the medical physicist from inception of the project through installation and clinical implementation.

Support line and tube visibility in chest examinations using computed radiography

The visibility of support lines and tubes was compared in computed radiography (CR) and screen-film adult chest radiographs. Parameters investigated were radiation dose, image minification, and the use of unsharp mask enhancement. Five radiologists rated the visibility of support lines and tubes on a five-point scale ranging from 1 (entire course of line visible) to 5 (line not visible or only small portion seen). These CR results were compared with the visibility of support lines and tubes as assessed by the same readers for conventional screen-film radiographs (600 speed). Support line and tube visibility improved with image enhancement, image minification, and increasing radiation dose. At the same radiation exposure, support line and tube visibility of the screen-film combination was superior to that of standard CR images. Application of an unsharp mask enhancement algorithm to CR images, however, significantly improved support line and tube visibility in comparison to that obtained with the screen-film combination. It was concluded that unsharp mask processing is a valuable tool for improving the visibility of support lines and tubes in CR chest radiographs.

Comparison of a photostimulable phosphor system with film for dental radiology

This study compared the imaging performance of a photostimulable phosphor system with E speed film for dental radiography. The response of each imaging system was measured as a function of radiation exposure. Measurements were also made of imaging performance in terms of the limiting spatial resolution and low contrast detectability. Photostimulable phosphors had a wider dynamic range in comparison with film. The limiting spatial resolution of the photostimulable phosphor was approximately 6.5 lp/mm and independent of image magnification. For film, the limiting spatial resolution was in the range 11 to 20 lp/mm depending on image magnification. At the same radiation exposure, low contrast detectability of the photostimulable phosphor was superior to that of film. Major benefits of photostimulable phosphor systems include the elimination of chemical processing and an improved low contrast detectability performance.