Choosing the Right Radiography System

A radiography system uses X-rays to acquire 2D images of various structures in the human body. Differences in tissue density allow these X-rays to be absorbed to a greater or lesser extent, causing a contrast gradient on the X-ray image and enabling certain types of tissue to be differentiated.

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What are the main features to consider?
When choosing a radiography system, six main characteristics should be considered: application areas, power and technology, size, price, number of daily examinations, and system components (modularity).
- Applications: There are different types of systems, each dedicated to a particular application, such as mammography systems, angiography systems, bone/lung X-ray systems, dental X-ray systems, and so on. There are also multi-purpose and portable systems, intended for field medicine or veterinary applications, etc.
- Power and technology: It’s important to check whether the system is digital (computed radiography (CR) or direct radiography (DR) or analog (film)). The main difference between digital and conventional analog systems lies in the way X-rays are detected after passing through the body. Two main types of digital radiology systems are currently available:
  - CR (computed radiography) systems or systems equipped with photostimulable screens. These use cassettes capable of storing a latent image which is then revealed and digitized during a reading stage.
  - DR (direct radiography) systems or flat-panel detectors. These allow digital images to be formed directly, without any intermediate steps, in just a few seconds.
- Size: Before purchasing, it is essential to estimate the space available (surface/height) in the examination room. This may help you decide on one model over another.
- Price: You need to take into account not only the cost of purchasing the equipment but also depreciation and maintenance costs.
- Number of daily examinations: You may prefer one model over another depending on the number of X-rays that need to be processed per day.
- System components: An X-ray system is often made up of several components that can be configured in a variety of ways. These may include a movable or non-movable table, a ceiling or floor-mounted or pivoting tube column, floor-mounted or wall-mounted bucky, etc.
  
  An X-ray system with a ceiling-mounted tube holder from Siemens Healthineers
What are the main types of installations available?
There are three main types of installations for X-ray systems: floor-mounted, ceiling-mounted, and portable.
- Floor-mounted systems: These are the standard systems used in most hospitals and healthcare establishments. Compared with portable units, floor-mounted X-ray machines can be used for a wider variety of procedures. In particular, they use more powerful generators than portable systems.
- Systems with a bucky wall/ceiling suspension: Whether bucky wall-mounted or ceiling-mounted, this type of system is highly versatile, allowing a greater variety of applications than fixed or portable systems. They often require larger rooms and are often more expensive than floor-mounted or portable systems, particularly because of the costs involved in installing and configuring the room.
- Portable systems These systems should not be confused with mobile radiography units. Portable X-ray systems are the least powerful of the three types of installations mentioned here. They’re easy to operate and maneuver and are at the lower end of the cost scale. They are used for special applications in field hospitals, medical practices, stables (for veterinary systems), etc.
  
  Canon Medical Systems floor-mounted radiography system
What are the differences between analog and digital systems?
- Analog (film) systems:
  - Advantages:
    - Installation is often simpler
    - More economical solution (excluding consumables)
  - Disadvantages:
    - Ecological impact (film systems require chemicals to develop the images)
- Digital systems (CR and DR sensors):
  - Advantages:
    - Superior image quality
    - Lower X-ray dose required per image
    - Reduced time per exam
    - Easy to process and share images after examination
    - Easy storage of images (in DICOM format)
  - Disadvantages:
    - Require a computer workstation for processing images
    - Ecological impact (electronic systems pollute when manufactured)
      
      Perlove Medical digital radiography system
What accessories or options should I consider?
In addition to the technology used (analog or digital), there are several other options to consider when purchasing a radiography system:
- Bucky: The number of bucky available, bucky types (wall, floor or ceiling mounted), etc.
- Table: Mobile or fixed table, tilting, adjustable height, etc.
- Tube-holding column: Ceiling-mounted, wall-mounted, free-standing, swivel-mounted, etc.
- Detectors: Detector size, technology, etc.
- Generator: Generator power
  
  Examion radiography system with a pivoting detector/tube holder column