CR is Computed Radiography. CR utilizes special cassettes and imaging plates that are used in the same manner that cassettes and film are used. Cassettes with the plates are positioned inside the table or wall bucky and an exposure is made. The cassettes, are then inserted into the imaging reader. Inside the CR reader, the imaging plate is exposed to a series of laser lights that read the information on the plate and a radiograph appears on the computer monitor within 1 minute. The image can than be enhanced, read, manipulated and saved. Most CR readers will then automatically erase the plate once the image is accepted, so that the plate is ready to be used on another exposure.

Advantages of CR

• More affordable than DR
• Ability to retrofit into any existing radiographic equipment
  
• Easy to use for mobile or cross table radiography
  
• Capture process remains familiar to people accustomed to using a film and processor
• High reliability
• Excellent Image Quality

Disadvantages of CR

• Still must process an imaging plate
• Similar workflow to film. Time savings may be possible through decreased repeats.

DR is Direct Radiography. DR is an image detector that is incorporate into the x-ray system, or attached by a tethered cable to be mobile. No cassettes are used with DR. The patient is positioned, the x-ray is taken, and the image typically shows up onto the computer monitor within 10-15 seconds. There are no plates to erase, and the system is always ready to take a digital x-ray. There are two types of DR detectors; flat panel detectors and CCD (charge couple device) are affixed into the x-ray table.

Advantages of DR

• No processing time and immediate image acquisition
• No imaging plates or cassettes to handle
• Excellent Image Quality

Disadvantages of DR

• More expensive than CR
• Cannot perform cross table or mobile radiography (unless a wireless or tethered cable can be attached to the flat panel detector to make it mobile, like the FUJIFILM D-EVO)
• The imaging sensor is more expensive to replace than an imaging plate or cassette
  

DICOM (or Digital Imaging and Communications in Medicine) is a standard developed by the American College of Radiology and the National Electrical Manufacturers Association. The standard was established to meet the needs of manufacturers and users in the medical imaging equipment for the exchange of data on standard networks. Already accepted across all medical fields, DICOM simplified the development for all types of medical imaging. "DICOM-compatibility' simply means that different users of different imaging devices will be able to smoothly exchange information. More info at 'http://medical.nema.org'.

PACS (or Pictoral Archive and Communications System) is used by the radiology and diagnostic imaging industry to manage information and images electronically. The system is responsible for acquiring, transmitting, storing, retrieving, and displaying digital images and related patient information from a variety of imaging sources, and communicating the information over a network.

This will depend on your clinic set-up. If you have a multi-doctor clinic, or would like multiple viewing stations than it is best to have a PACS. Not only will the PACS help manage all of the patients' files, but it will also replace your filing room and act as you image storage facility.

You will need a network connection in your x-ray room for the "acquisition station'' computer. This computer needs to be networked into the "Virtual Viewbox" workstation computer. This can be done as an independent connection that does not link in with any other networking or it can be linked in with an existing network. The main goal is for the two computers to communicate without interruption.

Digital images shown on many comparisons may appear to be excellent, but the dose used to create the image should be considered. In many cases the dose is outside of normal levels. In an image quality comparison by an independent reporting service, DR has one of the lowest dose requirements in the industry.