CT-MRI

Diagnostic X-Ray Technology

Implementing PACS with HIS along with digital radiography detector helps in ensuring superb work flow

In today's diagnostic world, X-Ray based diagnosis place a pivotal role in medical technology. Its benefits and applications are well-known and applied for normal routine radiography, fluoroscopy, angiography and CT scanners. While the benefits are enormous, we need to note the fact that any X-Ray based system has its own harmful side effects to the living beings. Taking into consideration AERB has made some excellent guidelines and rules regarding radiation safety. If properly followed and adhered to, the hazards can be minimised to a large extent. Among the various aspects of harmful X-rays, the key important point ascertains to the subject called 'Soft X-Rays' or 'large wavelength X-Rays or skin dose. The soft X-Rays are the ones human body absorbs especially the skin very easily creating harmful effects to human body. This is created by either scattering from human body and also from X-Ray tube. The ones generated from X-Ray tube are limited to a large extent by the aluminum equivalent filters used in the X-Ray tube ray-port. The other important aspect is the availability of the high-frequency inverter X-Ray generators. These generators have to a large extent reduced the amount of soft X-Rays generated from the X-Ray tube. World over has switched to this technology and have found it very useful in terms of safety and consistency. We as a nation should take steps to move towards this technology in a phased manner eliminating the use of 2 pulse X-Ray generators.

Collimators

Scattered radiation is minimised to a large extent by the use of collimators. Collimators are used to limit the beam to the area of investigation. This prevents the unnecessary area from being X-rayed and limits scatter. In India, we unfortunately call the light beam shutter diaphragm- the collimator. We use these devices to limit the beam. This results in creating penumbra image spread and disturbs the doctor reading the film. Also the image spread means an increased area of radiation even though small is not acceptable by any standards. Around the developed world Collimator means multi-leaf collimator, which uses three sets of leaves in each direction for limiting the beam. This has ensured the radiation exactly to the area defined and eliminates 'Penumbra' to a large extent. Almost every manufacturer in India has these devices with them either outsourced or manufactured and approved. We in India need to ensure that we move to this technology and ensure phasing out of shutter diaphragms, as soon as practically possible.

By following the AERB rules and regulations in a strict manner and following the principles of All Exposures kept As Low as Reasonably Achievable (ALARA) in every aspect of X-Ray based system. We are fulfilling an important duty and social responsibility as a citizen of this country. The second issue we need to look into is the work flow issue with the present generation X-Ray equipment. While in equipment like CT scanners and angiography, various automatic techniques have evolved and implemented, the techniques similarly evolved for the diagnostic X-Ray, unfortunately has not percolated down to the Indian users to large extent.

We need to look into the stressful environment the X-Ray technician works, especially in a crowded X-Ray centre day in and out. We need to help him or her out to ensure smooth work flow with lesser stress and ensure that they can concentrate on ALARA and quality of image. Various solutions have evolved and implemented in the developed world.

• Use of Ceiling supported X-Ray tube system.
• Auto-tracking.
• Auto-positioning.

We at Shimadzu with long history in X-Ray manufacturing (The first Roentgenograms was taken by us in 1896. Roentgen invented X-Rays in 1895. The first medical X-Ray machine was built by us in 1909 in Japan ) focus on all the above and ensure that we maintain all the above safety measures in the systems manufactured by us as we are concerned with the environment and the society that we live in.