Which is better in the ICU: Wireless direct or computed radiography?

Chest radiography is the most commonly performed imaging technique in diagnostic radiology. In the intensive care unit (ICU), the need for an efficient way to acquire high-quality images for rapid interpretation is particularly important.

Researchers compared image quality; visibility of anatomic landmarks, tubes and lines; and other significant findings on portable chest radiographs acquired with wireless direct radiography (DRw) and computed radiography (CR). 

Craig R. Audin, MD, with Massachusetts General Hospital’s department of radiology in Boston led the study, which was published in the November issue of Current Problems in Diagnostic Radiology.

Audin and colleagues gathered radiographs from 75 ICU patients at a tertiary academic medical center. Participants were 37 percent female with a mean age of 60.7 years old. Seven thoracic radiologists compared the images using a five-point scale. Results showed:

  • No radiologist reported improved visibility on CR images compared to DRw.
  • Three of seven found DRw “significantly” better for visualizing anatomic landmarks.
  • Six of seven found DRw images better or clearly better for position of tubes and lines. Those images were also helpful for evaluating central venous catheters and esophageal tubes.
  • None of the experts found CR images superior for seeing clinically significant findings.

“…our data show that DRw did not compromise image quality or visualization of anatomic landmarks, clinically significant findings, or position of tubes and lines compared to the CR system,” the authors concluded. “Therefore, we believe that DRw can be used in the ICU setting for chest radiography in place of CR.”

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Matt joined Chicago’s TriMed team in 2018 covering all areas of health imaging after two years reporting on the hospital field. He holds a bachelor’s in English from UIC, and enjoys a good cup of coffee and an interesting documentary.

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