The next time you get an X-ray, don’t be surprised if you are not handed a giant piece of photographic film to carry back to your doctor for a “stat” reading.

That’s because there may be no film to carry. The same revolution that has hit consumer cameras is invading the medical X-ray market with a vengeance.

There’s a pitched battle ranging for the hearts, minds and money of medical radiologists.

And home base for the guerrilla warriors is a stone’s throw from the Calgary International Airport.

File photo by Mike Sturk, Business Edge
Imaging Dynamics CEO Darryl Stein, left, and chief technical officer Robin Winsor with the technology to digitalize X-rays onto the computer screen.

The headquarters of Imaging Dynamics Company Ltd. (IDC) doesn’t look like much from the street – just another high-tech strip mall hopeful trying to find its wings on the aptly named Pegasus Way.

Walking in doesn’t inspire much more confidence – the receptionist’s post is deserted and I have to go hunting for president and CEO Darryl Stein by asking random employees.

Ah, but what employees they are! I recognize Arunas, a genius-level software developer who also has a reputation around town as a math guru.

I meet Pavel, who is cheerfully soldering together a piece of equipment that he claims will cut hours off the calibration of the company’s equipment.

Finally, I locate Stein, the man who was brought in five years ago to help save a company that had great technical ideas but, in his own words, “went public prematurely.”

“Robin Winsor, our chief technical officer, was working on digital radiography 12 years ago,” says Stein, “and he had the foresight to file some patents.”

It took almost a decade to turn Winsor’s ideas into a salable product, but IDC now boasts clients ranging from the St. Elizabeth Medical Centre in Boston to Prince George Regional Hospital in B.C.

There are real common-sense advantages to digital X-rays. Studies show that eight to 10 per cent of conventional X-ray films simply get lost, either misfiled in a cavernous hospital file room or in weird places such as people’s basements, where some of my old snowboarding injuries are on display. As Stein says, “can you imagine your bank losing eight to 10 per cent of your transactions?”

Another great advantage of digital X-rays is that you can store, retrieve, distribute and even e-mail them. So it’s not unreasonable to think of a doctor bringing up a patient’s X-ray on a bedside terminal. Or even a cruise ship sending a sick passenger’s digital images to a shore-based radiologist. “Often they have to turn a ship around, at a cost of hundreds of thousands of dollars, if a patient is ill,” Stein says. This technology could help the patient and protect the cruise line from lawsuits.

While it’s true a lot of IDC’s work centres around designing and making hardware, Stein points out that a big part of their product is user-friendly software that, in his words, “make images look great.”

You can delve through the various shades of gray, looking for that small fracture or first signs of a tumor. The day may even come when artificial intelligence programs help to read X-rays. Researchers at Staffordshire University have used neutral networks to piece together X-rays of a human thigh.

Stein notes that in the last five years, many medical experts have moved from skepticism about digital X-rays to enthusiastic support. “They’re now saying it’s not a question of ‘if’ but ‘when’ X-rays will go digital,” he says.

The big boys in hospital X-ray gear, like Siemens, GE and Phillips, are not asleep at the switch. They’re all offering digital X-ray products too. But they have some problems in economics and technology that IDC is hoping to exploit.

Generally, these industry leaders want to sell a complete, integrated system, so it can cost in the range of half a million dollars to re-do an X-ray room. Stein figures he can do it for a third to a half of that cost, largely because he replaces only the components that need changing.

The IDC XPlorer product replaces the film carrier with a CCD-array, kind of a high-end version of the guts of your digital camera. The difference, says Winsor, is that his CCDs have a much higher resolution (14-bit digitization and spatial resolution of 4.6 line pairs per millimetre; for the techies in the crowd.) They’re also super-reliable, he says, noting that they are used in the Hubble Space Telescope, where it’s kind of hard to go make a service call. The company also offers a five-year warranty, while the industry standard is 12 months, Stein observes. In a cost-conscious health-care system, this can make a real difference. Stein says the market is huge, because there are about 250,000 general X-ray rooms in the world, and only 10 per cent of them have gone digital. It’s also not lost on him that there are non-medical applications for the technology he’s sitting on, ranging from non-destructive testing to security systems. But, he says, “we’ve spent no time on those,” preferring to focus on grabbing a toehold in the medical X-ray market. But it’s not easy. “The way U.S. hospitals buy is incredibly complex,” says Stein.

“There are group purchasing arrangements that bring together from 50 to 1,800 hospitals. There are IHNs, IDNs, HMOs, public, private, you name it. I have a full-time person who just focuses on HMOs (health maintenance organizations).” He says the private imaging market is starting to “get legs” in Canada, and that he’s currently negotiating to sell a system to a private X-ray centre in Calgary.

The Prince George Regional Hospital was one of the pioneers in using the Imaging Dynamics digital X-ray system, having installed it two years ago. Chief technologist Karen Eldridge says they are pleased with its performance for chests and abdomens, though they are using different technology for other types of X-rays.

“The Northern Health Authority takes in a huge area,” she notes, “almost two-thirds of British Columbia’s landscape. We are very interested in using this type of technology to bring quality health care to remote communities through tele-radiology.”

Of course, technology is not perfect. Anyone who’s had a digital camera for more than a month has probably pushed the “erase all pictures” button by accident.

Can that happen to digital X-rays? Stein laughs, and points to the redundant digital backup for the images.

“You’re a lot more likely to lose a film X-ray,” he says. I guess my rec room display proves he’s right.

Web watch:

www.imagingdynamics.com
www2.dcs.hull.ac.uk/NEAT/dnd/papers/cscs12.pdf

(Tom Keenan is a professor at the University of Calgary and an expert on technology and its social implications. He can be reached at keenan@businessedge.ca)