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Most consumers know the name Agfa for its camera film, but its products literally go skin-deep.

 Its Agfa Diagnostic Centre (ADC) Compact System for x-rays ironically uses no film. It relies instead on re-usable phosphorus plates and hi-tech scanner to produce digitised x-ray images on a workstation.

 ADC-generated x-rays can be enhanced on-screen for more accurate viewing and the images can be viewed at a networked computer within a hospital or sent through leased lines to another hospital.

 Agfa also claims that ADC's accuracy reduces the need for patients to undergo x-ray re-takes due to overexposed or underexposed film - reducing exposure to radiation.

 The system consists of a refrigerator-sized scanner, a Unix-based workstation running Agfa's Musica software, and an Agfa 21-inch, black-and-white monitor.

 A radiographer would insert an unexposed x-ray plate - in a plastic case - into a special reader on a standard Windows-based PC, then call up patient information entered by the admission desk.

 The radiographer would input data about the x-ray - such as the body area - and the information stored in a memory chip on the plate case.

 The phosphorus plate inside the casing is about 2 millimetres thick and has a layer of Agfa-patented coating that protects it from blood that otherwise would ruin the image. The plate also can be exposed to daylight without damage.

 To make the image, the plate is pressed against the patient and exposed using the traditional radiography x-ray. It is then inserted into the scanner which 'reads' the intensity of energy emitted from the plate. The scanner then digitises the image and sends to the workstation.

 The workstation picks up the image and sends it back to the Windows-based PC where the radiographer can check image quality to ensure another x-ray is not needed.

 Agfa's Musica software - which runs on Sun Microsystems' Solaris operating system - enables x-ray images to be enlarged, enhanced for detail or toned down.

 'The region behind the heart is hard to see,' said Benson Cheng, Agfa's regional application specialist, medical division. On an x-ray, the heart appears as a near-solid white, round object that obscures the bones behind it.

 With a few quick mouse clicks, Mr Cheng lightened the heart's image allowing the area behind it to be viewed on a large Agfa monitor which can display x-rays using 4,096 grey shades.

  Other x-ray imaging technology was available from Fuji and Kodak, but Musica software was more advanced in technology and had an easy-to-use interface, said Richard Klitsie, Agfa regional project manager, medical division.

 ADC is being used in a six-week trial at Hong Kong Baptist Hospital. X-ray technician Eric Leung said: 'Compared with the conventional system, it is very fast.' It also greatly reduced the amount x-ray retakes.

 Each x-ray image, which can be stored and archived in magneto optical disks or linear digital tape, takes up 11 MB of uncompressed storage. Compressing the images into a smaller file would compromise the quality, Mr Klitsie said.

 Developing technologies such as wavelength compression may enable ADC images to be reduced without loss of quality, he said.

  The ADC workstation can send x-ray images over intranet to another terminal, or to another hospital through a leased-line network, although most SAR hospitals presently lacked the IT infrastructure to enable such communications.

 According to the Hospital Authority, four hospitals have limited internal networks for storing and transferring images from the radiology section to a second department.

 Inter-hospital links between the Caritas Medical Centre and Kwong Wah Hospital exist for two-way transfer of computerised tomography images.

 Hospitals that adopt digital-based imaging systems need to establish networks and an archiving system for storing the images. This would represent a considerable investment, on top of the ADC System which costs between $1.5-$1.8 million.

  Mr Klitsie said ADC would pay for itself within three to four years, as costs such as labour, chemicals, and film would be reduced or eliminated.



Agfa shows way in x-rays