Progress in Diagnostic Imaging

The latest generation of wireless DR detectors with automatic beam detection achieves the traditional use case of both CR and film, with additional benefits of much higher throughput and improved dose efficiency.

The world of radiology has evolved astoundingly since X-rays were first discovered in 1895. Since then, there have been many twists and turns along the way, as imaging technologies evolved with the times. Constant breakthroughs in X-ray usage have led to increased accuracy of radiology, all while decreasing potential harm to medical professionals and patients alike. Manufacturers are giving particular attention to ways of improving contrast, sharpness, and real-time inspection capability.

Technical developments in X-ray imaging aim to improve diagnostic certainty or reduce the radiation dose, or both. During the digital revolution in radiology, the development of flat-panel X-ray detectors both improved image sharpness and reduced graininess. This increased the diagnostic value of the imaging, while making it possible to reduce the radiation dose compared with that required in the first available digital X-ray imaging procedure.

Indian Market Dynamics
The X-ray equipment market is growing exponentially with an increase in the number of imaging centers. The growth in the analog segment is stagnant, while the digital radiography systems acquire market share due to wider adaptability.

The market players are expanding their product portfolio keeping in mind the price constraints in the adoption of DR systems. The latest generation of X-ray detectors and radiography-cum-fluoroscopy systems are gaining traction. The demand for indigenous systems and refurbished systems is steadily growing. With the Make in India initiative providing the requisite impetus, the indigenous players are keen to match safety features and offer competitive price points.

2016 saw a unique teleradiology public–private partnership. Fujifilm India Private Limited signed a contract with KRSNAA Diagnostics Pvt. Ltd., to install 1000 CRs across India. This enables converting X-ray setups from analog to digital and patients getting immediate reporting through teleradiology, especially in remote areas, where senior doctors are not always present. This installation reduces reporting time and delivers enhanced image quality, aiding in better diagnosis. This is a two-year project and FujiFilm will supply and install 1000 units of FCR Prima and 1200 units of DRYPIX imager. The first phase covers all the districts of Assam, followed by Telengana.

Global Market Dynamics
The global X-ray equipment market is projected to reach USD 11.92 billion by the end of 2021, growing with a CAGR of 5.0 percent from 2016 to 2021, estimates Infinium Global Research. The global X-ray equipment is dominated by CR systems as they are relatively less expensive than DR systems and entail less retraining of medical practitioners. The market for digital X-ray equipment will grow impressively at a CAGR of over 13 percent by 2020.

In terms of geography, the North American region remains the major market followed by Europe in the actual period. The APAC region will witness strong growth driven by countries such as India and China. While developed regions will continue to dominate the market in terms of revenue, emerging nations are expected to respond to the market optimistically due to the developing healthcare infrastructure, leading to increase in hospitals and rising focus on healthcare among the growing middle-align population.

Adding Edge to Technology
The X-ray equipment market is flooded with the key players bringing in the best-possible digital radiography systems offering cutting-edge digital enhancements. The healthcare providers want to leverage their existing imaging investments yet generate higher-quality images with the potential for lower radiation dose. Some of the newest systems have focused on improving productivity and workflow for more efficient operation and cost control.

Recent studies have revealed that a sheet of graphene can be used to generate surface waves known as plasmons when struck with photons from a laser beam. Plasmons can further release a sharp pulse of radiation that can be tuned to uniform X-ray wavelengths. This radiation is said to be relatively safer, as it can result in lower-dose X-ray systems being built in the future.

Industry vendors have been working to provide solutions, and 2016 witnessed the introduction of several new products designed to aid the transition from analog to digital in different ways:

New wireless detectors. The latest generation of wireless DR detectors with automatic beam detection achieves the traditional use case of both CR and film, but with the benefits of much higher throughput and improved dose efficiency. Automatic beam detection capability enables a simple path to digital retrofits, since no integration with the X-ray generator is required. State-of-the-art DR panels are now equipped with a data-processing engine and carry their own calibration files, which allows the images to be corrected on the panel. With the calibration data stored on the panel, the DR cassettes are more portable between the equipment and the rooms.

Dose efficiency. Both GOS (gadolinium oxysulfide) and CsI (cesium iodide)-based DR detectors have higher dose efficiency than CR. With increased dose utilization, DR can produce the same image quality as CR at a lower dose and can produce higher-contrast resolution images than CR using the same dose. The cesium-based detectors feature automatic exposure detection for easy install without connecting to a generator interface cable.

Sharing equipment. Using Bluetooth, the most advanced detectors are designed to connect automatically to equipment that controls the X-ray tube and generator. Installation is accomplished with a wireless access point through which images can be sent for display or storage, image processing software, and a display screen. Auto detect features are staples in new products and can be used to control detectors and other X-ray components at multiple locations in a facility.

Road Ahead
Keeping in line with continuous innovation, more progress is slated for the future. The industry envisions a future with more advanced software applications bringing faster and higher-quality imaging. Continuous evolution of physical characteristics of the flat panels, availability of different sizes and shapes of DR panels, along with fused or hybrid imaging is also expected in the coming years. As these technological innovations enter the market, X-rays will find new avenues of clinical usefulness.