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Comparison of radiation dose, workflow, patient comfort and financial break-even of standard digital radiography and a novel biplanar low-dose X-ray system for upright full-length lower limb and whole spine radiography

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Abstract

Objective

To compare the radiation dose, workflow, patient comfort, and financial break-even of a standard digital radiography and a biplanar low-dose X-ray system.

Materials and methods

A standard digital radiography system (Ysio, Siemens Healthcare, Erlangen, Germany) was compared with a biplanar X-ray unit (EOS, EOS imaging, Paris, France) consisting of two X-ray tubes and slot-scanning detectors, arranged at an angle of 90° allowing simultaneous vertical biplanar linear scanning in the upright patient position. We compared data of standing full-length lower limb radiographs and whole spine radiographs of both X-ray systems.

Results

Dose–area product was significantly lower for radiographs of the biplanar X-ray system than for the standard digital radiography system (e.g. whole spine radiographs; standard digital radiography system: 392.2 ± 231.7 cGy*cm2 versus biplanar X-ray system: 158.4 ± 103.8 cGy*cm2). The mean examination time was significantly shorter for biplanar radiographs compared with standard digital radiographs (e.g. whole spine radiographs: 449 s vs 248 s). Patients’ comfort regarding noise was significantly higher for the standard digital radiography system. The financial break-even point was 2,602 radiographs/year for the standard digital radiography system compared with 4,077 radiographs/year for the biplanar X-ray unit.

Conclusion

The biplanar X-ray unit reduces radiation exposure and increases subjective noise exposure to patients. The biplanar X-ray unit demands a higher number of examinations per year for the financial break-even point, despite the lower labour cost per examination due to the shorter examination time.

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Conflict of interests

The authors declare that they have no conflict of interest.

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Authors and Affiliations

  1. Department of Radiology, Orthopedic University Hospital Balgrist, Forchstrasse 340, 8008, Zurich, Switzerland

    Tobias J. Dietrich, Christian W. A. Pfirrmann, Katja Pankalla & Florian M. Buck

  2. University of Zurich, Zurich, Switzerland

    Tobias J. Dietrich, Christian W. A. Pfirrmann, Alexander Schwab, Katja Pankalla & Florian M. Buck

  3. Department of Finances, Orthopedic University Hospital Balgrist, 8008, Zurich, Switzerland

    Alexander Schwab

Authors
  1. Tobias J. Dietrich
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  2. Christian W. A. Pfirrmann
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  3. Alexander Schwab
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  4. Katja Pankalla
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  5. Florian M. Buck
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Correspondence to Tobias J. Dietrich.

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Dietrich, T.J., Pfirrmann, C.W.A., Schwab, A. et al. Comparison of radiation dose, workflow, patient comfort and financial break-even of standard digital radiography and a novel biplanar low-dose X-ray system for upright full-length lower limb and whole spine radiography. Skeletal Radiol 42, 959–967 (2013). https://doi.org/10.1007/s00256-013-1600-0

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  • DOI: https://doi.org/10.1007/s00256-013-1600-0

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