Imaging in the ICU: Comparing wireless direct, computed radiography

Considering the urgency in the intensive care unit (ICU), physicians need an efficient means of gathering high-quality chest images. Portable radiographs can be taken by digital or computed radiography (CR).

Researchers compared image quality, visibility of landmarks and tubes, and other significant findings on chest radiography acquired by wireless direct radiography (DRw) and CR.

The study—led by Craig R. Audin, MD, with the department of radiology at Massachusetts General Hospital in Boston—was published online Oct. 17 in Current Problems in Diagnostic Radiology.

Findings were based on radiographs gathered from 80 ICU patients over a three-week period at a tertiary academic medical center. Patients were 37 percent women with a mean age of 60.7 years old. Seven board-certified radiologists participated in a joint training session. Findings included:

• None of the radiologists reported better visibility on CR images.
• Three found DRw images were significantly better to see anatomic landmarks.
• Six of seven found DRw images better than CR images for position of tubes and lines. DRw images were especially helpful in seeing central venous catheters and esophageal tubes.
• None said CR images were superior for clinically significant findings.

“Critical care chest radiography with a portable DRw system can provide similar or superior information compared to a CR system regarding clinically significant findings and position of tubes and lines,” Audin et al. said.

While the imaging results are similar, the investment related to such systems should merit consideration.

“We believe that DRw can be used in the ICU setting for chest radiography in place of CR. On the other hand, DRw systems require a substantial initial investment in order to replace or upgrade the existing CR systems, which can limit its appeal and cost-effectiveness even for high throughput departments,” Audin said.