1. Why do I need teleradiology?

Teleradiology allows x-ray images to be transmitted from remote locations to a central receiving site. This means a radiologist's time can be utilized fully, whilst providing an optimum service to referring practitioners at the remote site.

It also allows two sites to be linked in such a way that a radiologist can spend half of their available time at one site doing procedures etc (usually done by appointment), and half at the other, whilst still providing equal service for general work at each. This is great for smaller communities without the population to sustain a radiologist full-time. They can get big-city service even in fairly remote areas.

Digitizing is also used for PACS systems for image archiving, and a range of new software technologies will soon be available which will utilize digitization in ways not seen before.

2. I've seen teleradiology systems years ago, and the image quality was not very good - how good is it now?

Earlier systems used resolutions of around 1k or less - that's 75dpi. Gross pathology could be seen, but fine fractures etc were virtually invisible. In addition, the optical density range (that is the range of light to dark) was limited, so that films with extremes of optical density could not be scanned properly.

The iCRco digitizers can scan at resolutions up to 9k - that's more than 80 times the resolution of a 1k scan! In fact 4k is sufficient to pick up the tiniest flake fractures, and with extended optical density ranges up to 3.6, you get all the information with all the detail.

3. What type of digitizer do I need?

A good place to start your needs evaluation is with the ACR's Standard for Teleradiology (downloadable from their website at www.acr.org. While you're there, grab a copy of their Standard for Communication: Diagnostic Radiology. This discusses what should be covered in the diagnostic radiology report).

The ACR basically suggests that you digitize at 2K x 2K (they word it a bit differently) with a spatial resolution of 2.5 lines/mm. They don't really offer meaningful guidelines on the grayscale resolution that you need. Normal x-ray film has a dynamic range of from about 0.1 to 3.5 OD.Minimal detectable contrast levels are generally reported as being +/- 5%. These are the basic parameters that you would be looking for in a digitizer. However, you need to also ask yourself whether physicians routinely put a magnifying device on an x-ray. If so, and if the magnifier is a x2 magnification, you would want to be able to accommodate a "4K scan" in some manner or other. The requirements for the digitizer would clearly be to support 4K. A 4k-capable digitizer also allows areas such as scaphoid or fine flake fractures to be scanned at high resolution - the benefit being you can magnify it to full screen size with little or no loss of detail i.e. pixelating.

Once you have determined the specifications that you need in the digitizer, you can evaluate the actual performance of the different brands available to you. One method is by means of standard test targets. We would suggest however that you get a collection of your favorite films together, and see whether the features you want to see on the film are able to be demonstrated on the digitized image - and that's when you'll find that there is no product better than a iCRco digitizer.

4. Which is better - CCD or Laser?

We have a page devoted especially to this topic - CCD versus Laser.You should also read the scientific findings presented at RSNA '98.

DICOM is a widely-used standard for digital image formats and data transfer in radiology. If the data created is DICOM-conformant, you will probably be able to use it for as far into the future as you like. If you use a proprietary format for your data, you will very likely face a huge problem in exporting your data for use with future programs and equipment.Most digitizers will have some way of creating and transmitting DICOM format data, although the method of doing so may not be provided by the manufacturers themselves. Make sure that the features that you have decided to use in the digitizer you select are supported by the application that you use to create the DICOM data. iCRco's Xscan32 program includes support for DICOM 3.0 image transfer as well as modem and network transfers.