67% more exams per day… 3285 more patients each year… 8.16 minutes time savings per exam… up to 50% dose reduction… The numbers are impressive, tempting – and real!

These are actual results experienced by one of our customers when migrating from CR to DR 

[1]. Combined with decreasing cost and rapid ROI, benefits such as these are making DR an increasingly attractive investment for hospitals and imaging environments.

At ECR 2018, our experts will be on hand to walk you through the technology and the move. Plus, we have put together a downloadable white paper with plenty of clear information. To get you started along the path, here are a few practical considerations.

GOS and CsI

Both CR and DR use phosphor technology to convert X-ray energy into light. With DR, you have a choice between Gadolinium Oxysulfide/GOS (powder) or Cesium Iodide/CsI (needle). The needle phosphor technology enables higher X-ray absorption, resulting in lower dose and better image quality.

Fill factor (FF)

Each pixel in a DR detector has an active sensing area. The “fill factor” (FF) is the percentage of the pixel that makes up the active sensing area. Lower FF in a panel means less efficiency, higher image noise and lower overall image quality.

Pixel size = resolution

Smaller pixel sizes mean higher resolution, but larger pixel sizes usually have a higher fill factor, for a higher collection efficiency and lower quantum noise. You need to pick the right pixel size for the exams you are doing: using a pixel size that is smaller than the resolution needed could actually increase the noise in the image!

Image processing software: what to look for

Studies have demonstrated that image processing can significantly affect perceived image quality at reduced dose. Choose one that provides consistent performance, for all body types and patient ages, and that is ‘low dose-friendly’. You want few artifacts and tolerance of over- and underexposure. And it should reduce – not increase! – work for your imaging staff.

Anti-scatter grids and grid line suppression

Improper grid selection may result in image artifacts, so make sure you follow the manufacturer’s recommendations when selecting a grid. The pixel pitch of the panel, the grid type and the lines per inch can all influence the appearance of grid lines. Grid line suppression software such as Agfa’s GLS automatically identifies repeating patterns caused by the grid-panel interference, and removes them, for improved viewing conditions and workflow options.

In addition, when selecting anti-scatter grids, consider factors such as grid alignment, focal range, grid line orientation and “non-grid” scatter suppression software – which reduces the need for a grid, for example with bedside chest imaging.

Dynamic range

DR has a smaller dynamic range than CR, so pay close attention to exposure accuracy in order to prevent image saturation and overexposure. The International Electrotechnical Commission (IEC) has an index offering a methodology for monitoring exposure consistency, and providing a standard way to measure the exposure to a digital detector.


X-ray collimation reduces the exposed area, lowering patient dose and reducing the influence of X-ray scattering. Proper X-ray collimation significantly impacts dose and image quality with DR. Done correctly, it automatically detects the area of interest, requiring minimal manual cropping. In fact, manual cropping or masking after exposure should be the exception, not the rule.

Control your DR repeat rates

Reduced repeats are a potential advantage of DR, so take care not to negate these benefits unnecessarily! It is so quick and easy to modify the patient’s position, for example, this can actually encourage more repeats. Be vigilant.


As you can see, moving from CR to DR can offer you plenty of efficiency and patient care benefits, as well as the potential for dose reduction. Let us help you make the choices that maximize your investment, and bring you the greatest benefits! Want to find out more? Visit our ECR booth.

Download the free White Paper here


[1] Results from Loma Linda University Medical Center with Agfa’s Fast Forward DR Upgrade Program