Gastrointestinal imaging: A systems analysis comparing digital and conventional techniques

OBJECTIVE, The purpose of this study was to compare digital and conventiona l methods of gastrointestinal imaging based on the cost of image storage an d estimated overall costs, radiation exposure to the patient, and duration of the examination. MATERIALS AND METHODS. Our study sample consisted of 128 patients who under went conventional gastrointestinal studies (64 double-contrast upper gastro intestinal examinations and 64 double-contrast barium enemas) and 139 patie nts who underwent digital gastrointestinal studies (66 double-contrast uppe r gastrointestinal examinations and 73 double-contrast barium enemas). The number of images and films for each study was recorded, and the mean cost o f image storage and the estimated overall costs for digital versus conventi onal studies were calculated. Both the duration of fluoroscopy and the lime from start to completion of the study were obtained from our radiology inf ormation system. From these data, we calculated mean radiation exposure to the patient and the duration of the examination. Finally, referring physici ans completed a questionnaire about their level of satisfaction with paper prints generated from digital gastrointestinal studies. RESULTS. When digital studies were compared with conventional studies, the mean cost of image storage decreased by 45% and the estimated overall 10-ye ar costs decreased by 8%. The mean number of spot images increased by 8% fo r upper gastrointestinal examinations and by 25% for barium enema examinati ons, whereas the mean duration of fluoroscopy decreased by 4% and by 10%, r espectively As a result, radiation exposure to patients increased by only 2 %, a difference that did not approach statistical significance. Finally, th e mean duration of examinations decreased by 24% for upper gastrointestinal examinations and by 33% for barium enemas. Approximately 85% of the physic ians who completed the questionnaires indicated that they reviewed the pape r prints generated from digital studies and that they would like to continu e receiving them. CONCLUSION. Digital gastrointestinal imaging systems are associated with hi gher initial costs than conventional systems, but the long-term costs of th ese digital imaging systems are slightly less because of the lower cost of image storage, and radiation exposure to patients is comparable. The shorte r duration of digital examinations is a potential benefit of this technolog y, allowing improved patient throughput. Finally, referring physicians have a high level of satisfaction with paper prints generated from digital imag ing.