April 2015

X-ray Rules Armamentarium of Diagnostic Imaging

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Dr (Col) Dinesh Kapoor

Dr (Col) Dinesh Kapoor,
Radiology, Fortis Hospital, Noida

Spectacular progress has been made and continues to be made in the field of radiology. Introduction of new imaging modalities and constant improvements in the available modalities has outpaced most other advances in healthcare. Nowadays, there are computed radiography (CRs) and digital radiography (DRs), computed tomography in its multi-slice form, DSA PET, SPECT, and MRI but can we do away with Xray machines. In any size of healthcare institution, in any role that institution plans to play, primary, secondary or tertiary radiology forms an integral part and stands out as backbone of diagnostics. Therefore more development is required in technology to get faster and better results.

In our own scenario in India there has been multifold rise in the X-ray equipment market as elsewhere in the world. Digitisation has revolutionised the way X-rays were produced and viewed. Credit goes to the digital images and development in PACs and fast speed of data transfers images can be almost seen as soon as they are acquired wherever the radiologist or the consultant desires across the globe. The digital X-ray market is booming in India. Referring physicians literally demand to see images in digital formats considering the ease and convenience of viewing. DR systems though expensive are fast catching on but CR thrives even in the smallest of clinics.

Digital imaging provides rapid and convenient flow of diagnostic information. Images are available within seconds and can be beamed across the continents using the technologies available either web based or even on hand held devices such as mobiles and tablets. WhatsApp and other social sites are a great boon to humanity in this regard. Not only the quality of imaging is better, it also helps plan appropriate exposures to reduce the radiation dose.

However, the cost and maintenance of such systems is a deterrent considering the economy requirements. Paying capacity of our general population is less than the developed nations. Also not many can afford insurance, nor is there a social security system. Hence, penetration of this technology is slow in rural belts and even in II and III tier towns. Multiple factors are to be considered. There are areas where even adequate power back up is not available. Overall growth in healthcare spending does augur well but once again budget allocation has not been adequate. Both government and private players need to come together to address these issues and help bring costs down to affordable levels. Vendors must also ensure proper maintenance and supply backup so that the centres in far flung areas do not suffer long downtimes due to equipment or supply failure.

There has been a paradigm shift with gradual replacement of film based systems to DR systems and improved viewing displays combined with state of art workstations. However, both government and corporate apathy on loosening their purse strings the radiologist has to make do with whatever is provided. Various hospitals that I have had opportunity to work will not invest in very high-end conventional radiology systems and more so in good viewing monitors and PACs leading to some frustration at times. Rising standard of awareness and demands of quality standards are very strongly influencing the type of equipment especially in metropolis townships. Budgets are of course a constraint in this recession period globally. Atomic Energy Regulatory Board has very rightly stepped in to ensure registration of all X-ray based equipment through eLORA. This also must be ensured at the vendor end as is the case with ultrasound equipment. The market is poised for a giant leap in the coming years and more and more PPP projects will help providing the breakthrough.

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