What to Look for in a Veterinary DR System: The Top 8 Questions to Ask

No veterinarian wants to spend $60,000 or more on a digital radiography (DR) system just to find out later that they overpaid for underperformance. In the same vein, you wouldn’t want to purchase a system for $15,000 or $20,000 only to discover that it uses outdated technology and will need to be replaced in three to five years.

The secret to getting the most value and highest returns from your DR system is to view the purchase as a long-term investment. Don’t assume that if it works the first year, it will work in the third or fourth year. What you need to look for is product quality and image quality.

Below are a few questions you should ask when evaluating a veterinary DR system:

  • Can I See a Live Demo of the DR Unit on a Very Small Animal and a Large Animal?
  • Can You Put Me in Touch with Veterinarians Who Use This DR System?
  • How Much Training Is Required? Can a New Tech Learn How to Use the DR Quickly?
  • How Long Has the Distributor Been Working with the Plate Manufacturer?
  • How Easy Is It to Share the X-Rays with Radiologists?
  • How Easy Is It to Share the X-Rays with Clients?
  • Who Manufactured the Panel?
  • Are the Scintillators Made of Cesium or Gadox?
  1. Can I See a Live Demo of the DR Unit on a Very Small Animal and a Large Animal?

It goes without saying that image quality is an important factor to consider when purchasing a DR system. But some sales reps only show post-processed X-rays that do not accurately portray the system’s usual image quality. This is why a live demo is so important.

Any sales rep can show you post-processed radiographs that look like the Sistine Chapel, but what you really need to know is how the images will look on a daily basis.  Most DR systems can produce a decent image when an animal weighs 15 to 50 pounds, but some may struggle when a patient’s weight falls outside of that spectrum. This is because small animals and exotics usually have a lot of bone and virtually no target organs or soft-tissue, and larger animals have a lot of mass to shoot through. There are terms such as spatial resolution and dynamic range that you should get more familiar with, but live image acquisitions on demonstration day should convince you of the image quality.

But don’t just shoot the typical 35 lb dog. It would be embarrassing if the image quality on the perfect patient wasn’t presentable. Insist on demo x-ray imaging of smaller cats and larger dogs so that you can see consistency in image quality. Also take note of any modifications the rep may have to make in order for that image to look perfect. The more advanced DR systems have smart algorithms to adjust for the wide variety of exposure levels with the ability to segment and independently adjust the contrast layers to display a finely-tuned image every time. Some of the older (or less sophisticated) systems require manual tuning that puts your consistency at risk to variations in technique among the multiple technicians in your clinic that take radiographs on a daily basis. One quick, but illustrative test is to magnify the images, especially of small patients/body parts. Inferior systems easily show image degradation when zoomed.

  1. Can You Put Me in Touch with Veterinarians Who Use This DR System?

There are two reasons why you’ll want to reach out to veterinarians who use the system. The first is to find out if they are satisfied with its performance and whether they would recommend it. Ask your sales rep to put you in contact with DVMs who purchased the DR unit one to two years ago, as well as those who made the purchase three to five years ago. Is the system just as reliable and satisfactory in year five as it was in year one?

The second reason is to evaluate some actual X-rays taken by veterinarians who are using the same DR system to determine if the image quality is just as clear as the images that the sales rep showed you?

  1. How Much Training Is Required? Can a New Tech Learn How to Use the DR Quickly?

Ask your sales rep about the training that comes standard with your DR system. How difficult would it be to train a new technician to use the DR unit? Obviously any rep’s quick answer would be “sooo easy”, but put that to the test. After watching the rep walk through the workflow once or twice, take the wheel yourself to see if you can reproduce “how easy that was”. Clearly there may be some complex customizations that you may not be able to re-enact, but an intuitive interface should enable you to get through your day-to-day workflow with little-to-no guidance.

And when you do need help, where do you go? Make the sales rep show you the tutorial videos available (whether they live on the acquisition device itself or on some web-portal) so you can determine for yourself if they are organized well enough and sufficiently useful for your needs.

  1. How Long Has the Distributor Been Working with the Plate Manufacturer?

A lot of DR distributors jump from manufacturer to manufacturer every three to four years. If you purchase a DR system and your distributor stops working with the plate manufacturer, you might be forced to upgrade because the distributor will most likely discontinue servicing and supporting your unit.

That’s an area you can’t really see on the front-end, but it’s where a lot of clinics get burned. The most expensive and important component is obviously the plate, but there are other hardware components to consider, such as acquisition computers and electrical connections. Software changes occur as well (hopefully in the form of upgrades), and they’re usually not as big of an issue as not having the hardware supported, but still, if a distributor loses rights to sell/support software, that will certainly cause some troubles down the line.

  1. How Easy Is It to Share the X-Rays with Radiologists?

Your DR system should make it easy to send X-rays to radiologists and other specialists either from the Cloud or directly from the DR unit. If your techs need to send you an image while you’re at a conference, you should be able to pull up the X-rays on your smartphone, iPad, or tablet. And when you need to send off to a radiologist, there should not be a need to open a third-party software or email large attachments. Digital image storage (via PACS servers) organizes and streamlines this process, but your DR system needs to seamlessly integrate with it to get the most efficient workflow.

  1. How Easy Is It to Share the X-Rays with Clients?

Beyond sharing X-rays with referring specialists, it is equally important (and perhaps more so) to be able to share the X-rays with clients. It should be easy to show them the X-rays in the exam room so they have a visual representation of what you did or what you’re recommending, so they have a good idea where their money is going (even if the X-ray was negative). Aside from being more convenient, it helps the client understand the value of the service you provided.

  1. Who Manufactured the Panel?

 The veterinary market, being very unregulated, often turns into the Wild Wild West where manufactures don’t have to pass through the tight FDA regulations, and so can cut corners. As such, the DR market is flooded with low-cost panels from overseas that produce distorted images, break easily, and cannot match the performance of more sophisticated panels. It is exceedingly important that even though you may be dealing with a well-known veterinary distributor, that you find out who the panel manufacturer is and make sure it is someone who is consistently in the top tier of the human market as well. Reputable manufactures include Varex, Canon, Samsung, GE, Toshiba, Philips, and Siemens.

  1. Are the Scintillators Made of Cesium or Gadox?

The chemical compounds used as scintillators in the two main DR panel-types are gadolinium oxysulfide (Gadox) and cesium iodide (CsI). CsI is more expensive than Gadox, but requires slightly less radiation produce the same image quality. That said, with the slightly higher dose on a GadOx panel, you get less overall noise in the image. We are talking about a ~10% difference of dose, which in the human pediatric world makes a very big difference over the lifetime of a patient. In the veterinary space though, our patients don’t live long enough for radiation exposure to manifest into biological effects, and this minor difference in dose has exponentially less affect (because of the distance) on the scatter to our staff. Still, less dose means shorter exposure and so less chance of motion artifact in the final image.

Conclusion
A DR system is a major purchase for any practice, but it is important that you look beyond the upfront price to find out what you’re getting for your investment in the long run.

Evaluate the image quality by requesting a live demo on a very small animal and a large animal. Reach out to veterinarians who are currently using the system to find out if they are satisfied with its performance, and to determine if the actual image quality is on par with the X-rays that the sales rep showed you.

Don’t buy a system if there’s a good chance that you’ll be forced to upgrade in three to five years. Find out how long the distributor has been selling the DR system and working with the panel manufacturer.

If you would like more information about Digital Radiography, call SOUND® at 800-268-5354. You can learn more about SOUND®’s Digital Radiography systems by clicking here