X-rays | Continuous technological advancements define the x-ray market

X-ray’s ability to non-invasively see through objects in high-definition detail is making science fiction an imminent reality.

Since its discovery, x-ray imaging has rapidly changed the face of diagnostics and treatment over the last century for a wide variety of health conditions. With recent advances, the ability to non-invasively see through objects in high-definition detail is making science fiction an imminent reality.

Some recent breakthroughs could change the face of radiography in the next few years.
Flexible x-ray imaging. Up until recently, most x-ray detector panels were flat and only capable of scanning x-rays in a 2D format. A large rotating gantry has allowed for 3D imaging to take place. However, due to the expense and equipment size, inventors have been looking for 3D imaging alternatives. One such alternative would be flexible imaging panels that curve around surfaces. In the last few years, several flexible panels have been invented that improve upon all currently available flat panels (direct and indirect types) used in medical imaging devices. Some of these new inventions can curve around surfaces and may even be worn by the patient for comfortable scanning of selective body regions. Unfortunately, these prototypes contain heavy metals such as lead, which is likely to increase any potential radio-toxic side effects.

Liquid nanocrystal imaging. In 2021, liquid nanocrystals were discovered that were capable of capturing x-rays better than currently available flat panel technology, allowing for optimal flexible x-ray imaging without heavy metal involvement. This technology also solves problems pertaining to irregular shapes, which often show up blurred in conventional radiographs. As of yet, these liquid crystal imaging devices are not able to convert high levels of radiation into images, suggesting the course of future innovations.

Portable x-ray imaging devices. With the invention of flexible panel detectors of all shapes and sizes, the possibility of portable x-ray devices is moving closer to becoming a reality. In tandem with flexibility, inventors have been working on making portable x-ray imaging devices and incorporating them into everyday gear, such as cellphones, cars, and glasses. As of 2022, an imaging plate the size of a square millimeter has been developed that can detect large quantities of photons on its minuscule surface area with a relatively high degree of accuracy. With more advancements such as these, x-ray imaging devices may become as small as thermometers and integrated into the diagnostic toolkit of any general practitioner. With more time and refinement, early detection of cancer and other tissue abnormalities could be part of an everyday standard check-up.

Improved computation. Advances in computer software have led to better imaging as well. Algorithms have been developed that improve the accuracy of x-ray-generated images, particularly through better recovery of blurred areas and other irregularities that tend to show up on the images. These improvements are more relevant to CT scanning. One recent development allows for flawless x-ray imaging of the heart by using an algorithm that incorporates the patient’s ECG results with the sensor. In this way, the scanner is able to capture more accurate x-ray images of the heart from multiple angles that are matched in time to the patient’s heartbeat, thereby enhancing the resolution of the final image.

As recently as December 2023, a new standard has been developed that is reaching out to be widely adopted by medical professionals. Developed by an international scientific team led by the University of Waterloo’s Karim S. Karim, associate vice-president of Commercialization and Entrepreneurship, this new standard for x-ray technology allows medical professionals to see more deeply and clearly than what they can see using traditional x-ray machines.

Based on new radiographic imaging technology pioneered at Waterloo, Karim created a portable, dual-energy x-ray screen that can be fitted to traditional x-ray machines, allowing them to discern between soft tissue and bone—something that, up until now, only a CT scan could do.

Now commercialized through Karim’s start-up company KA Imaging, this device enables early detection and treatment of disease and at a lower cost.

Standards allow for conformity in products. USB ports, for example, are standardized across devices globally. Product conformity benefits both manufacturers and customers. In the medical device industry, technicians seek devices with standardized technology to ensure they are using a trusted, quality product.

At the same time, engineers creating new devices seek standardization to increase consumer acceptance and to support the commercialization of their products. Despite the benefits of standardization, the process of creating a standard is often lengthy and complex.

“Developing a standard is in part a political exercise in democracy,” Karim says. “In order to have a technology standardized, you need to get the majority of the world to agree to it.”

The International Electrical Commission (IEC) sets standards for medical devices globally. To obtain the standard for the medical device, Karim collaborated with both the IEC and the Standards Council of Canada through its Innovation Initiative. His first step was to have his project team send a notice detailing the proposed standard to representatives in 150 countries, seeking their feedback. The team received unanimous approval from the 28 countries that responded.

Next, he led an international working group of technical experts from industry and academia in negotiating the technical specifications that would comprise the standard. For the standard to be approved, acceptance was required from two-thirds of the working group members. After almost three years of meetings and multiple rounds of negotiation, Karim and his team were able to attain unanimous approval.

“Now that the dual-energy x-ray device and the standard for it are complete, we need to raise awareness about them,” Karim explains. “Doing this will drive better health care outcomes globally and, ultimately, save human lives.”

Dynamic digital radiography. Technologies like CT and MRI can provide high resolution imaging of bony and soft tissue structures, but do not show the joint’s movement or take images of a patient in a natural upright position. The dynamic digital radiography (DDR) system can perform all standard x-rays, and images can be taken with the patient standing, seated or on a table.

DDR technique enables healthcare professionals to track the real-time functionality of organs, bones, and joints. This real-time insight proves invaluable in diagnosing and monitoring conditions such as musculoskeletal disorders, respiratory ailments, and gastrointestinal issues.

In less than a minute, DDR can acquire up to 15 sequential radiographs per second resulting in 20 seconds of motion and multiple single images. The radiation of a typical DDR exam is about equivalent to two standard x-rays.

However, high costs DDR equipment is expected to act as a significant restraint for growth. The 2023 recession has significantly impacted the dynamic digital radiography market share, and has created a challenging environment for the dynamic digital radiography market, hampering growth and hindering progress in the sector.

Teleradiology plays a pivotal role in addressing the shortage of radiologists and optimizing the available workforce, particularly in India where the ratio of radiologists to population is as low as 20,500 radiologists serve a population of 1.4 billion.

Along with newer technologies such as AI, teleradiology enables the efficient delivery of radiological services. However, there are knowledge gaps in the implementation and evaluation of AI in primary healthcare settings. Additionally, regulations surrounding data protection and secure image transfer need further development to ensure compliance and safeguard patient privacy.

As India moves toward establishing robust digital health ecosystems, insights from reviews like this can inform the planning and execution of initiatives such as the National Digital Health Mission, ultimately improving access to healthcare services for all.

To sum up, through manipulating the transference of energy, x-rays can be produced and captured, allowing for precise imaging of internal body compartments. x-ray imaging has progressed tremendously since its invention in the late 1800s, shifting towards digital radiography that makes use of advanced computation to process high-resolution images. Recent developments have improved upon the selectivity and sensitivity of the equipment, enabling it to generate near-perfect imagery even involving moving body parts. Breakthroughs in imaging technology predict the future use of smaller devices with a higher degree of flexibility that allow for accurate imaging of previously undetectable micro tissue problems. Future technology is expected to be less toxic as well due to lower radiation exposure and a safer material selection.