The State of Wireless Digital Radiography: Our Perspectives

Before the introduction of wireless detectors, facilities implementing digital radiographic technologies had to choose between the lower cost of computed radiography (CR) and the preferred image quality of digital radiography (DR) (For a guide to CR and DR technology and an explanation of the terminology, see the following Health Devices articles: Digital X-ray Systems—Part 1 August 2001, Digital X-ray Systems—Part 2 November 2001, and Cassetteless Digital X-ray Systems March 2004). Not only was DR more expensive, but most DR detectors had to be built into gantries, making DR systems less adaptable to the needs of all patients and cumbersome to use. To help, some DR detectors had a wired (tethered) connector so that they could be freely handled and positioned. However, the size of the detectors was not standardized, so expensive modifications to x-ray tables and wall stands were necessary regardless of whether a detector had to be built in or could be freely handled. The introduction of wireless DR detectors whose electronics are built into cassettes identical in size to CR and film cassettes changed the DR landscape.

The introduction of wireless detectors brought certain obvious benefits—for example, eliminating the cord meant that technologists were no longer constrained by cumbersome equipment. Additional advantages were quickly recognized; for instance, the detectors could be easily shared between radiographic systems and were easy to use in sterile environments. However, there were some unanswered questions, such as how the new technology would affect image quality, whether the high cost (around $100,000 per detector) could be justified, how the high risk of accidental damage (e.g., from being dropped) would be addressed, and whether Wi-Fi issues would occur. ECRI Institute has closely watched the development of wireless DR detectors since their introduction in 2009. Here are some of the things we've observed during the course of our Evaluations:

Image quality is not compromised. If anything, image quality has improved when compared to similar fixed detectors, due to developments in detector technology and image processing. Most facilities are choosing the higher-cost cesium iodide (CsI) option over the gadolinium oxysulfide (GOS) option. CsI enables the best available image...