From time to time we have clients in our teleradiology service request to send digitized images of film radiographs. These phone calls are always difficult to respond to. On the one hand we are happy that we have new clients interested in our service and (as radiologists) we are always interested when veterinarians are searching for a teleradiology provider. On the other hand, digitizing film radiographs is easier said than done.
There are two primary methods of digitizing film radiographs that are used by veterinarians.
Method 1: Using a digital camera to photograph a radiograph. Photographing images for teleradiology is suboptimal. As a general comment, we don’t accept these types of images in our teleradiology service. Some vets find this interesting as there is research stating that photographing radiographs is acceptable and photographing radiographs has been used in the past.
I am aware of two peer reviewed veterinary journal articles that state that photographing radiographs is acceptable. These studies were performed at universities by (presumably) clinicians that were experienced at photographing radiographs. I also assume that the original radiographic images were perfectly exposed. In that situation, photographing radiographs can probably be successfully applied to teleradiology in some situations.
In our experience, however, the "real world" results obtained with photographed radiographs are largely unpredictable. Radiographs are generally not perfectly exposed and any radiographic faults present in the images will be accentuated in the photograph. The environmental conditions and user training in photographing radiographs is usually not ideal. As such, marginal images (that are OK with a hotlight in person) become disasters when photographed. Poor images become nondiagnostic.
Our rule ot thung to image assessment is “if this was our mother’s dog, would we interpret these images?” More often than not, with photographed radiographs, the answer is “no.”
Method 2: Using a dedicated radiographic film scanner: Dedicated medical grade laser film scanners do a great job of digitizing radiographs. The information on the film radiograph is effectively transferred to the digital image and there is a minimal loss of information during the image transfer process. Very poor images don’t transfer as well but, overall, dedicated film scanners perform well and are highly recommended.
Many veterinary referral hospitals digitize their images to include referring veterinarian images in the referral hospital PACS. This is an excellent application of radiographic film scanners.
Used film scanners cost between $3000-10,000.00. Vidar Scanners, Radlink scanners, and Cobra Scanners have all been effectively utilized in veterinary medicine.
When shopping for a dedicated film scanner, be sure to evaluate the software that comes with the scanner. Some software on the used scanners is outdated or very clunky. Other software requires a PACS system in order to send images for teleradiology. Fortunately, 3rd party software is usually available for these scanners. Also be sure to understand who will fix your scanner and what service costs might run. These can be expensive to service.
Here are a few ideas to get you started shopping for a dedicated film scanner:
- DOTMED– a classified listing for medical equipment. Search for VIDAR scanners. There are always some available.
- Ebay – Good old Ebay. Search for VIDAR or Radlink. You can usually find something
- Contact your local x-ray distributor. They usually have access to film scanners.
The following are a few third party software programs you can use to run your scanner or add teleradiology functionality to your scanner.
- PACS Gear PACS SCAN – we have used this successfully.
- Vendors if you have software that does this, let me know and I will add you to the list