Advancing the value of radiology in the COVID-19 era

By Konica Minolta Healthcare

August 24, 2020 -- Imaging centers and group practices that are reopening during the continued presence of COVID-19 and the partial lockdown are faced with new challenges regarding patient safety and care. Many patients postponed nonurgent imaging procedures, resulting in a backlog of imaging studies.

The most notable change for imaging facilities and staff is the need to balance adequate infection control with sufficient patient volume. The U.S. Centers for Medicare and Medicaid Services (CMS) and the American College of Radiology (ACR) both recommend new safety measures, such as health screening and temperature checks, patients' use of face coverings, implementation of social distancing in waiting rooms, the use of personal protective equipment to protect staff, and cleaning and decontaminating patient care areas and imaging equipment according to guidelines from the U.S. Centers for Disease Control and Prevention (CDC).1,2

To address the increased demand for imaging from patients, the ACR suggests extending hours of operation, implementing strategies to shorten imaging examinations and procedures, and modifying scheduling grids. Another solution is to maximize the usage of space with a compact digital radiography (DR) solution that can perform multiple types of imaging exams.

The KDR® Advanced U-arm (AU) X-ray System from Konica Minolta provides multiple capabilities in one simple-to-use U-arm system. An extremely versatile DR system, the KDR U-arm can perform general radiography as well as specialized orthopedic/musculoskeletal (MSK) and pulmonary imaging studies, including static, dynamic, and full-body imaging, without the need for expensive long-length detectors.

Konica Minolta
Konica Minolta's KDR Advanced U-arm X-Ray System.

Full-body imaging captures images from head to toe by moving the detector while rotating the tube to ensure alignment and reduce parallax. Dynamic Digital Radiography (DDR) provides a series of images acquired at high speed and low dose for up to 20 seconds to assess motion in the chest or joints.

Make better decisions, sooner

Designed to optimize workflow, increase staff efficiency, and improve outcomes, the compact and efficient KDR U-arm expedites the diagnostic process. The system fits under standard 8-ft ceilings and is automated to revolve around the patient and automatically swivel into position, saving time and elevating the patient experience.

Further streamlining the exam process is the ability to confirm the patient's information on the tube-mounted console. Information is instantly retrieved, prompting the system to move to a predetermined position and source-to-image distance to save time when positioning the patient. Images are displayed for on-screen review within three seconds of acquisition. The automated KDR System prepares for the next exam, minimizing the time between patients and providing the technologist with additional time to disinfect the system.

A state-of-the-art 17 x 17-inch high-resolution detector maximizes efficiency and image quality, delivering excellent bone and soft-tissue visualization from a single study exposure. The result is exceptional image quality to give radiologists the clarity to make confident diagnoses sooner.

MSK imaging with DDR

Dynamic Digital Radiography is a ground-breaking technology exclusive to Konica Minolta. DDR provides a series of individual digital images acquired at high speed and low dose, resulting in a cine loop for a diagnostic-quality view of anatomical motion. DDR is not fluoroscopy; it is x-ray that moves.

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Konica Minolta's DDR technology is x-ray that moves.

With DDR, orthopedists can view changes in the relationship of bones and other anatomical structures through the full range of motion to assess and monitor anatomic structures like joints, tendons and ligaments in areas such as the shoulder, knees, wrists, and spine.

"One of the really exciting capabilities of DDR is the ability to look at what is happening in a patient's joints in a way that we've never been able to see before," said Dr. Eric Wagner, MSc, an orthopedic surgeon at Emory Healthcare and assistant professor at Emory School of Medicine in Atlanta.

"With DDR, I can see every complex part of the joint that is allowing the patient to move in certain ways," he adds. "In patients with limited joint movement, I can see what is blocking that motion. This technology provides that insight into what is going on in the body without having to open them up surgically. This is very exciting because I can do more than just diagnose; I can also evaluate how to intervene with the patient in a way that I could never do before."

Pulmonary imaging with DDR

DDR is also an effective imaging solution for evaluating pulmonary disease. It has been well documented that COVID-19 patients can suffer from lung damage even after they recover from the virus.3,4 These patients will require continued monitoring of their pulmonary structures and function, which can be performed dynamically with DDR.

In one study evaluating the use of DDR to diagnose dyspnea, physicians at the Icahn School of Medicine at Mount Sinai in New York City found that chest DDR allows for a more comprehensive and streamlined assessment of pulmonary function and pulmonary mechanics than static chest x-ray.

According to the study's primary investigator, Dr. Mary M. O'Sullivan, associate professor of pulmonary medicine at the Icahn School of Medicine at Mount Sinai, "With improved clarity and less radiation than fluoroscopy or CT, and a more integrated assessment than ultrasound can provide, dynamic x-ray fosters a contextual understanding of not only dyspnea but also other pathophysiologic abnormalities of the entire chest that might contribute to it."5

Another study of DDR in patients with chronic obstructive pulmonary disease (COPD) conducted at the Icahn School of Medicine at Mount Sinai found that DDR may be a clinically relevant option to assess COPD severity in the acute setting and for patients who are unable to

perform pulmonary function tests. Co-author Dr. Alexander Somwaru, assistant professor of radiology at the Icahn School of Medicine at Mount Sinai believes that, "DDR may have the potential to expand the horizons of traditional radiography by providing biodynamic diagnostic imaging for disease evaluation and treatment."6

The future of x-ray is here

Beyond pulmonary and MSK imaging, DDR has the potential to perform many different exams, including scoliosis, prosthetics, whiplash, and gastrointestinal or swallowing studies. With DDR available on the KDR Advanced U-arm, facilities can increase the type of exams being performed and broaden the physician referral base.

Beyond increasing exam volume, the KDR System with DDR from Konica Minolta can help increase staff efficiency with automated operation that saves time and decreases patient inconvenience with a U-arm that can move from PA to lateral positions without moving the patient. Independent source-to-image distance control on the tube and detector support all other imaging views commonly required in radiology, including wheelchair and table work.

For centers seeking to safely resume medical imaging during COVID-19, the KDR Advanced U-arm with DDR is the ideal versatile imaging system, from general radiography to full-body imaging to advanced dynamic x-ray studies.

References

  1. Davenport MS, et al. ACR Statement on Safe Resumption of Routine Radiology Care During the Coronavirus Disease 2019 (COVID-19) Pandemic. J Am Coll Radiol. 2020;17:839-844.
  2. Centers for Medicare & Medicaid Services. Re-Opening America: What Patients Should Know About Seeking Healthcare.
  3. https://www.hopkinsmedicine.org/health/conditions-and-diseases/coronavirus/what-coronavirus-does-to-the-lungs.
  4. https://respiratory-research.biomedcentral.com/articles/10.1186/s12931-020-01429-6.
  5. 2019 ATS: Dynamic digital radiology technology enhances dyspnea diagnoses. Applied Radiology, June 14, 2019. Available at: https://appliedradiology.com/articles/2019-ats-dynamic-digital-radiology-technology-enhances-dyspnea-diagnoses.
  6. Results of Dyspnea Study Using Dynamic Digital Radiography to be Presented at ATS 2019. Available at: https://www.konicaminolta.com/medicalusa/news/press-releases-2019/.

 

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