Ukraine has such experience.
It is through this process that within 2000 – 2006 substitution of 30% of fluorography with preventive digital radiography became possible (Fig.4-5).
Today there are additional modernization options which make it possible not only to substitute fluorography with digital radiography,
but to exclude carrying out of fluoroscopy without X-ray II.
Today Ukraine produces both digital receptors (DR) for radiography and dynamic DR for radiography,
fluoroscopy and X-ray tomosynthesis (Fig.6-7)
If ca.
$50,000 is required to purchase a new digital fluorograph,
ca.
$100,000 – for a digital X-ray apparatus for radiography and ca.
$200,000 – for a remote-controlled tilting table for digital radiography and fluoroscopy,
modernization of the equipment in service requires considerably less money.
Calculations show that retrofitting of an X-ray apparatus with a digital receptor requires $20,000 and retrofitting of a tilting table with a dynamic DR – ca.
$30,000.
Even in-depth modernization of an X-ray apparatus with replacement of the whole X-ray part and control circuits of the stand-mounted devices will require less money comparing to the purchase of a new digital fluorograph.
Unlike the fact that not more than 20% of the total sum invested with the purchase of new X-ray equipment is allocated to the new digital X-ray imaging technology,
retrofitting of the working X-ray apparatuses with DR increases this index up to 80% [1].
In the event of intensive use of the digital X-ray equipment,
the self-cost of the digital radiography will be less of self-cost of fluorography,
that is withdrawing the only advantage of the latter [5].
Thus retrofitting of 1 500 analogous X-ray apparatuses with DR allows for handling several critical problems at a time:
- All film fluorographs should be put out of operation and digital radiography fully substitutes fluorography; in such case,
effective dose on the examined patients will reduce by times.
Furthermore,
in the event of abnormality detection,
the patient is examined in additional projections right then and there,
and no other X-ray examinations are needed.
Thereat collective effective dose for the population of Ukraine which makes up 48 650 man/Sv [2] reduces by more than 12 600 man/Sv,
in other words – by ca.
26%.
Thus,
the sum of 30.0 – 60.0 Mio USD invested in transferring of analogous X-ray apparatuses to the digital X-ray imaging technology allows reducing medical exposure on the population of the country by almost a third;
- Transferring to the digital technology of one X-ray apparatus allows saving not less than $3,000 annually on purchasing of X-ray film and chemical reagents,
and consequently allocating additional money to the renewal of X-ray diagnostic facilities;
- The option of prompt digital image sending via telecommunication networks allows optimizing the diagnostic information processing.
Retrofitting of another fifteen hundred tilting tables with dynamic digital receivers enables to reduce collective effective dose on the population of Ukraine by at least 4000.0 man/Sv,
i.e.
by 9.0%.
However,
this requires more than 45.0 Mio USD yet.
To implement the linear tomosynthesis mode retrofitting with high frequency X-ray generators with “pulse fluoro” mode and dynamic DR of two-station X-ray facilities is promising.