The ACR and others have done many studies on that question, and there is still no right answer for everyone. Let's start with the various types of facilities, and look at the practicalities.
If you are a small imaging center or a mobile company, the answer is probably Computed Radiography, or CR. CR is a system that simply replaces existing film cassettes with a cassette containing a phosphorus coated plate. Instead of the rays penetrating the film, they stimulate the phosphorus to varying degrees. The cassette is placed in a reader, the image is acquired from the plate, and the plate is erased using a bright light, preparing it for the next shoot. The advantages here are that the systems are much less expensive initially, and there is no need to refit the x-ray room. For mobile companies, that means you can continue to use your existing cameras; for imaging centers and small hospitals, the CR cassettes fit into the same bucky as your film cassettes, and with a little adjustment in technique you are ready to go.
We have looked far and wide for an inexpensive DR system, and thus far the systems we have seen that are truly affordable produce poor quality images. DR technologies vary in some cases, but most of them are CCD-based (similar to the way handheld digital cameras work), and the inexpensive DRs produce far too many artifacts to be usable in a diagnostic read. The better systems offer superior quality images, but generally require a complete room retrofit or replacement and can be quite expensive.
If your facility does a large amount of trauma treatment and seconds count to a severely injured patient, they are certainly worth the cost. On the other hand, if you are doing non-trauma studies, we believe that CR offers a lot more "bang for the buck" at the present. However, as the technology becomes more widely disseminated, the prices on DR systems will decrease, making them the better choice in the years ahead. Radical Radiology offers the complete line of AGFA CR and DR units as well as the Carestream/Kodak Point-of-Care line of CR units. Affordable prices, full integration, the best in support.
