1 Jun 2016
Developments in the world of imaging technology have brought big benefits to practice – both clinically and commercially. Here, Jon Mills makes the case for portable and CR X-ray.
Jon Mills
Job Title
Image: © chiyacat/Fotolia.
Recent advances in digital radiography have boosted the scope of veterinary practice incredibly and represent an undeniable move forward for the profession.
Digital radiography includes DR (direct or truly digital radiography) and CR (computed radiography).
Thanks to the versatility of modern CR, portable x-ray devices and the innovative nature of the technology, we are able to provide so much more for our clients and patients than we were ever able to before.
CR uses very similar equipment to conventional radiography, but instead of using a film to create the image, a sophisticated imaging plate housed in a special cassette is used. Being digital, the images are generated automatically and can be viewed and enhanced in ways that do not require a darkroom or volatile chemical tanks. The cassette is portable, and can be taken and positioned wherever it is required.
The ability to manipulate contrast and brightness allows image quality to be maximised if exposure settings are suboptimal.
In our practice, we use a portable, handheld x-ray or a standard wall-mounted x-ray generator in conjunction with our CR system for capturing all manner of images. Using this versatile system, patients can be in and out of the x-ray room in five minutes.
I would estimate we use our portable x-ray generator between five and 10 times a day for routine check-up x-rays on osteotomy cruciate ligament and fracture surgical cases.
With this technology we can complete the radiographs with no sedation necessary, while owners wait. Furthermore, we chose not to charge extra for these as it costs us very little – five minutes of time and a few pence of electricity.
Treatment planning and diagnoses are also made much easier.
Another significant benefit of using modern radiographic technology is in the intraoperative x-ray capability of some devices. In our practice we use our portable generator to acquire images during surgery when we need to check implant placement and want to do this without having to move the patient from theatre.
Handheld x-ray systems are also very effective for generating intraoperative radiographs for imaging extrahepatic portosystemic shunts in small dogs with positive contrast portal venography. Again, this saves moving a patient with an open abdomen from theatre to x-ray and back, which is definitely an added surgical risk we prefer to avoid.
Initially, I was a little apprehensive about using CR technology due to the health and safety considerations around horizontal-beam imaging.
To deal with this we made an L-shaped alcove out of two doors on castors and we lined this with 4mm roofer’s lead. This cost no more than £300 for materials and, as far as I know, is bigger and better than anything readily commercially available.
Systems such as the Nomad Pro, from Clark Dental, have a fail-safe feature in that once the system is “armed”, it switches back into standby mode if it hasn’t “fired” within about 10 seconds.
CR technology represents the next step in what is possible in veterinary radiology. Overall, the benefits of using this technology far outweigh any potential drawbacks and, by choosing to work with CR-based radiography, any veterinary practice will soon reap the rewards. After the initial outlay, which would be needed whichever platform you choose, the savings on time, money and hassle will be incredible and you will wonder how you ever worked without it.
