Revolutionizing critical care radiography: A cost-effective retrofitted digital radiography solution

Background: Portable radiography is essential in critical care management, but traditional computed radiography (CR) systems in the Indian subcontinent face significant delays in image processing, hindering timely interventions. This study evaluates a cost-effective solution: retrofitting portable X-ray units with digital radiography (DR) capabilities.

Objectives: To compare the diagnostic performance, turnaround time, workflow efficiency, and clinical impact of retrofitted DR systems versus conventional CR in critical care settings.

Methods: A comparative study was conducted at Ruby Hall Clinic, Pune, India, from July to September 2016. We analyzed 1,000 portable chest X-ray examinations (500 CR, 500 DR) performed by two experienced radiographers. Key performance indicators included preparation, imaging upload, and treatment response time. Statistical analysis was performed using unpaired t-tests with significance set at p < 0.05.

Results: The retrofitted DR system demonstrated significant improvements across all metrics. Examination duration decreased from 51.02 minutes (CR) to 15.2 minutes (DR). Preparation time was reduced from 9.9 to 6.8 minutes, and post-acquisition processing time from 25.3 to 4 minutes (p < 0.0001). Treatment response time improved from 14.7 to 3 minutes. Overall workflow productivity increased by 96%. Additional benefits included reduced radiation exposure, decreased retake need, and substantial cost savings through reduced film usage and optimized resource utilization.

Conclusion: Retrofitting existing radiography systems with DR capabilities presents a viable, cost-effective solution for improving critical care imaging in resource-constrained settings. This approach significantly enhances workflow efficiency, reduces treatment response time, and improves patient outcomes while maintaining image quality and safety standards. The successful implementation of this technology could revolutionize critical care imaging practices in developing regions.