2024-03-27 12:51:52
Photo credit, CHRISTINE RO
Image caption,
Portable x-ray machines, like this one pictured, are becoming more widely used.
an hour ago
Portable X-ray machines “can literally mean the difference between life and death”, says radiographer Sam Pilkington.
For most of us, if we need to have an x-ray, the procedure takes place in a hospital. But for very sick patients or to fight infections, Ms Pilkington says portable devices are very useful.
In effect, “they take the burden of transportation off patients,” explains the final-year student at the University of the West of England in Bristol, who is also a member of the Institute of Physics. Instead, it is the X-ray machine that comes to them.
The benefits are obvious for remote locations including battlefields, roadsides and disaster areas.
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And with the increased availability – and capabilities – of these portable systems, their use is growing rapidly. With the coronavirus pandemic fueling this growth, the global portable X-ray market was valued at $7.1 billion (£5.6 billion) last year. This figure is expected to reach $14 billion by 2028.
Simply put, there are two types of portable x-ray machines: machines on wheels, usually referred to as “mobile”, and the lighter machines that can be carried by a single person. These are generally referred to as “ultraportable”.
Crédit photo, IDDS/STOP TB PARTNERSHIP
Image caption,
Portable X-ray machines now produce images of similar quality to large, fixed hospital machines.
The Orkney Islands in Scotland are a remote location that has tested ultraportable X-ray equipment. Before a trial there from November 2021 to January 2022, 73% of patients scheduled to have an X-ray did not show up for their appointments – largely due to the costs and time required to reach distant hospitals.
During the trial, a handheld device made by the Japanese company Fujifilm was taken to local clinics. Called the Fujifilm Xair, it weighs just 3.5kg and measures just 301mm (12 inches) wide and 144mm high.
Thanks to its use, the rate of absenteeism from x-ray appointments has been reduced to zero.
As one patient commented about the following report: “This is extremely beneficial for people on small islands. Much less upheaval for the most fragile patients. »
Another manufacturer of portable x-ray machines is the German company OR Technology. Tim Thrun, its commercial director, says he sees great interest from emerging markets. “There is a huge demand for health care to be accessible to the population,” he says.
Photo credit, OR TECHNOLOGY
Image caption,
This mockup shows how a portable x-ray machine could take photos at the scene of an accident.
In the Philippines, Nigeria and other developing countries, portable X-ray systems are transforming screening for tuberculosis (TB), which kills an estimated 1.3 million people a year despite being preventable and curable.
It has long been known that a chest X-ray is the best screening tool for TB, says Suvanand Sahu, deputy executive director of the Stop TB Partnership. This Switzerland-based organization represents more than 1,500 government and non-governmental organizations around the world.
But he says access to X-rays has always been hampered by a lack of hospitals. This was particularly true in remote areas and among isolated, nomadic and displaced groups.
Dr. Sahu says portable X-ray machines, which often include artificial intelligence software to quickly process images, are a powerful solution that allows detection to be carried out successfully in the field.
“About 10 years ago, if we had said ‘we can do an X-ray in the community, with the computer reading it,’ I think people would have jumped out of their seats. But it’s happened now.”
Dr Sahu adds that AI has enabled a “quantum leap” in the precision and speed of reading these X-rays.
Crédit photo, IDDS/STOP TB PARTNERSHIP
Image caption,
Portable X-ray machines are now used in countries such as the Philippines to screen for tuberculosis.
However, some worry about the radiation emitted by portable X-ray machines. These machines work in the same way as the large fixed machines in hospital radiology departments: the image is created by a targeted burst of ionizing radiation.
In hospitals, X-ray rooms are carefully designed to minimize exposure to radiation, for example with lead walls.
Thurn explains that with portable systems, this lack of protection is made up for by the larger space in which they are used, whether outdoors or in a field hospital. In those cases, he says, health care workers can stand much further away.
However, the issue of radiation needs to be clarified, because currently international radiation protection guidelines “are designed for the traditional fixed type of X-rays,” says Zhi Zhen Qin, digital health specialist at the Stop TB partnership.
The image quality of portable X-ray machines was also a concern. But Miss Pilkington says today’s machines rival fixed units in this regard: “The images taken on these machines are of a comparable diagnostic standard.”
However, there are obstacles to the size of the components in an x-ray system. If an x-ray detector is too small to capture a part of the body in a single exposure, additional images may need to be taken, which would increase radiation time and doses.
And units with limited battery life or data storage reduce the number of patients that can be photographed in a single session.
Meanwhile, some systems described as portable aren’t really lightweight and easy to transport, especially if they need other hardware to make them work like media or computing equipment.
However, Australian company Micro-X now makes much lighter ultraportable X-ray machines, thanks to its new technology capable of producing X-rays without creating heat. This eliminates the need for oil and motors for cooling, which add weight.
The high cost of portable x-ray machines is also a problem. Although they are cheaper than larger stationary machines, they are still very expensive.
The Stop TB partnership says the price of ultraportable machines is between $47,000 and $66,000. There are additional costs for warranties, installation and software.
Dr. Suvanand says that as more manufacturers enter this sector, “we hope that competition will drive prices down.”
Ultimately, his vision for the future is that “everyone who needs an x-ray should have access to this type of modern, digital, ultra-portable x-ray with AI capability.”
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