X-Rays Poised To Be More Flexible

New technology means that X-ray detectors could one day effectively be printed onto any suitable surface and could be made curved to wrap around the part of the patient’s body being scanned to produce a much more accurate image.

1895 is a landmark year in the history of medicine for mankind for the discovery of X-rays that revolutionized the way medical fraternity looked at human anatomy and there has been no looking back. Today the X-ray technology has advanced to new horizons and is breaking newer barriers. From conventional wet radiography to computed radiography (CR systems) to digital radiography (DR systems) there has been a tremendous refinement in the processes for viewing the images of the human body from inside out. These developments enable to view X-ray images on computer screens, substituting the conventional films and making it possible to use digital image modification. One can get high-resolution images as soon as the technician hits the exposure button without wasting any moment in processing. These images can also be modified digitally as per the requirement of diagnosis.

In CR and DR newer trends are being witnessed. Latest flat panel detectors are being manufactured with the capability of faster and sharper acquisitions and transmission and viewing of images. A single wireless DR detector can be used universally for several machines thus lowering the cost of such detectors across the vendors. One of the best new features on the hardware side is expected to be the introduction of panels with automatic exposure detection (AED). Prior to AED, digital panels had to be interfaced to the X-ray system in one way or another to inform the panel when it is time to integrate the X-ray exposure and to inform the X-ray system when the digital system is ready for acquisition. Now digital panels detect when exposure begins on its own. AED panels are ideal replacements for the outgoing CR technology. On the software side, image processing continues to advance. One example would be image stitching. Radiation dose limitation is also being taken care of in all latest advances.

FDA updates radiation control regulations for manufacturers
A new draft guidance published by the US FDA in December 2018, aims to clarify the agency’s policies concerning the production of diagnostic X-ray systems. The guidance, Clarification of Radiation Control Regulations for Manufacturers of Diagnostic X-Ray Equipment, once finalized, would replace the FDA’s previous guidance on this issue from 1989. Device manufacturers, according to the document, are required to ensure all equipment complies with applicable standards, permanently apply certification and identification labels, provide adequate assembly and installation instructions and provide documentation that describes specific technical specifications of the equipment and any necessary radiological safety precautions and procedures which may be necessary. The guidance also covers several specific topics of importance for manufacturers of these devices, including certification, labeling, measurements, and more.

Flexible detectors – X-rays could be about to change
Since its discovery at the end of the 19th century, the radiation has provided a window into the inner workings of the body. But the technology has remained in principle the same, the rays are fired through whatever object is being inspected onto a fixed, rigid and usually small detector that can produce the desired image. But X-rays could be much more flexible in the future!

New technology means that X-ray detectors could one day effectively be printed onto any suitable surface. So they could be made curved to wrap around the part of the patient’s body being scanned to produce a much more accurate image. And this future is now a step closer thanks to recent advances and several researches that are taking place in the market. Today, many X-ray images are created by firing the rays onto a digital detector rather than photographic film. These detectors convert the X-rays into electrical charges and a computer converts these into a digital image. Many industries have benefitted from this massive leap from X-ray film because it has enabled the creation of more detailed images that can be viewed in real time. But the solid detectors are also rigid and flat and so limited. By contrast, the human body naturally consists of curved surfaces. And firing X-rays through a curved object onto a flat detector can cause errors. This can lead to a cancer misdiagnosis or a patient being given the wrong dose of radiotherapy. Overexposing someone to X-rays can also cause tissue damage and even the growth of secondary tumors.

All these applications would benefit from the creation of more flexible digital X-ray detectors. And it looks as if there might finally be a solution. Researchers are now demonstrating one of the world’s first curved plastic X-ray imager. Some have also developed a way to create detectors using a special ink that can be deposited on a surface to create an X-ray sensitive film. The ink contains nanoparticles that can stop the incoming X-rays and generate an electrical charge and organic material that carries the charge to a set of electrodes. It can be coated or printed onto any suitable surface of any size and only needs to be several micrometers thick, less than a sheet of paper. As a result, it is now possible to create large, flexible X-ray detectors powered using only a couple of coin cell batteries.

Alternatively, manufacturers could create portable X-ray detectors that, coupled with portable X-ray sources, could fit into ambulances and be used to make diagnoses on the road and not just in hospitals. And improving the resolution of the images could allow the technology to be used for detecting cancer. Researchers are also working to create detectors that can work with lower X-ray doses, to minimize the amount of radiation that patients and operators are exposed to. This will require identifying materials that are more sensitive to X-rays so that a better response can be achieved with a lower dose. This technology has such exciting potential to revolutionize current imaging techniques and where this would take the industry is only limited by imagination.

Outlook
In 1895, few could imagine the significant inroads that advanced radiology would make! Today, it is difficult to imagine the inroads that clinical radiology will make going forward. While the technology has grown ever-more precise, the fundamental principle of harnessing X-rays to produce images for human analysis has largely stayed the same. However, the quality of medical images will continue to improve, providing greater detail than ever before. Greater detail means that more anatomic information will be available to clinicians. This information will prove easier to access with software developments like enterprise imaging. The industry is on the precipice of a new medical imaging revolution, one that puts the X factor back in the X-ray!