With Digital Imaging, Future is Now in Radiology Department

By Jay Wolz

An accident victim is brought to the Emergency Department at Southeast Missouri Hospital.

Within moments of his arrival, multiple x-rays of his broken leg are simultaneously studied by an emergency physician in the trauma area and a radiologist elsewhere in the hospital. At the same time an orthopedic surgeon in his private office across town views the same x-rays as he works with the radiologist and emergency physician to care for the patient.

Meanwhile, an oncologist sitting at a computer screen shares three-dimensional PET (positron emission tomography) images with a colleague in California as they discuss treatment options for a cancer patient.

That same day, a woman takes copies of her MRI (magnetic resonance imaging) scans to her neurologist. But instead of handing him a bulky set of films, she gives him a CD-ROM disk filled with dozens of images of her brain and spine.

These three scenarios represent the future of health care. But thanks to digital radiology and Southeast Missouri Hospital’s new picture archiving and communications system (PACS), the future is now!


Digital x-rays and computer screens have replaced x-ray film and view boxes in Southeast Missouri Hospital’s Emergency Department. Here, emergency physician David R. Meece, M.D., studies a set of digital x-rays on one of the department’s new viewing stations. The computer monitors in the ER and Exexpress are used between 50 and 100 times a day to view digital x-rays.

Working with some of the world’s most advanced digital radiology development companies including Emageon and UltraVisual, Southeast has gone "filmless" and offers one of the first digital imaging and archiving systems in the area. Mark L. Gates, M.D., chief of radiology at Southeast, says "This new system facilitates rapid diagnosis and gives physicians some unique 3-D viewing capabilities. It allows us to see anatomy and pathology in ways we haven’t been able to before."

For instance, he says the three-dimensional images produced by the new digital system has made it much easier for physicians to identify certain organs, such as the appendix, which has facilitated the diagnosis of appendicitis in a number of cases.

The elimination of traditional x-ray film in Southeast’s Emergency Department has helped streamline patient care while maintaining high quality standards. "By eliminating steps associated with development of traditional x-rays, digital imaging speeds up patient care which makes us more efficient," comments Michael A. Kolda, M.D., medical director of emergency services at Southeast.

"Our new system has a number of other advantages over traditional x-rays including the quality of the images and the digital ‘tools’ available to enhance viewing," he notes. "Also, the radiologist and clinician can view and discuss the same images on remote screens simultaneously which is a significant advantage. Previously we would have to hand carry a film to the radiologist." This step saves precious minutes which, in emergency medicine, can save lives as well as time.
In addition to saving time and lives, the PACS system also saves space and money. In the past, Southeast Missouri Hospital produced enough x-ray film, MRI scans, CT images, mammograms, PET scans and other images over the course of a few years to fill a medium sized house. Thanks to the new filmless system, all those images can be stored on a few computer hard drives and backup storage systems.

Images can be loaded onto CD-ROM disks allowing patients to easily provide copies to consulting physicians. "Any study performed at Southeast after mid-February is available to be downloaded onto a CD-ROM and given to the patient," Dr. Gates notes. "No more bulky films or concern over losing the films, and since they’re digitally archived, an infinite number of copies can be made."

Dr. Gates adds that the National Institute of Health already makes digital copies of diagnostic images. "Soon, hospitals that have PACS systems will be able to communicate with each other and will be able to share studies electronically," he says. "This could eliminate the need for making copies altogether."

According to Southeast Radiology Director Tom Welch, the PACS system is helping the Hospital control costs by eliminating or reducing film, chemical and storage costs. In 2002, Southeast spent approximately $400,000 to produce "film" images. By next year that expense will be reduced by about 70 percent thanks to the new digital technology.


Did You Know…

  • X-rays were discovered by German physicist Wilhelm Roentgen. He also produced the first x-ray picture of the body (his wife’s hand) in 1895.
  • When radiology was in its infancy more than 100 years ago, a head x-ray could require up to 11 minutes of exposure time. Today, x-ray images are made in milliseconds and the x-ray dose currently used is as little as 2 percent of what was used a century ago.