By Jane Ehrhardt
“It’s like the crème de la creme of x-ray machines,” says Jeffrey Cuomo, MD, orthopedic surgeon at Precision Sports Medicine & Orthopedics in Jasper. The practice became the first in the Southeast to acquire the state-of-art KDR Flex Overhead X-ray System in January.
The smart radiography system, made by Konica Minolta, delivers a host of innovations that enhance workflow, along with being Dynamic Digital Radiography (DDR) ready. DDR, a technology engineered by Konica Minolta in 2020, shows the images as if the body is in motion to enable orthopedic specialists to provide faster and more detailed diagnoses.
Composed of a table, wall stand, and overhead tube crane, Cuomo was impressed by the automation among the Flex’s components. “The tube is on a track, so it’s almost like it’s robotic,” he says. The movement of the overhead crane smoothly glides, tilts, rises, and swivels by itself to meet the needs of the image programming or the tech’s directions.
The most useful feature to Cuomo came from the Flex’s ability to automatically position itself and the settings for an array of specified images. “Certain knees need different strengths of the camera or penetrance. In this machine, that’s automated,” he says.
That automation also alleviates the usual differences inevitable with human handling because different techs have different positioning. “But this machine automatically positions itself so the views are very consistent,” Cuomo says. “That auto-positioning by the machine versus humans brings exacting consistency between initial images and ones taken over time during the healing process, even weeks or months later. So we don’t have to wonder if rotation was off.”
The overhead tube crane can track and align to both the table and wall stand. “We used to have to move the patient, then move the tube,” Cuomo says. “Now it’s a more streamlined, seamless process. And we get a good product every time, so we don’t have to do it multiple times.”
The table lowers from 36 to 21 inches to enable easier patient onboarding, and holds up to 770 pounds lifting weight. The wall stand adapts to allow for specialty wheelchairs, such as for scoliosis patients, along with long leg shots, with imaging by the overhead tube starting at the bottom to capture the ankle.
Those low shots of the ankle were not always possible with the previous x-ray machine. “The camera couldn’t get low enough, so the patients had to stand on a platform,” Cuomo says. “Some elderly patients were not able to get on that platform, so we couldn’t do that view.” Shoulder and spine patients also no longer need to position themselves into painful positions to capture certain views, since the Flex has such mobility.
Whether shooting from the stand or on the table, the Flex’s precision produces seamless and quick stitching. After shooting a series of images of the whole body, standing legs, or spine images, the system meshes those into a single, high-resolution image within 12 seconds. Pediatric stitching can include up to the three images.
Because the techs are not involved in trying to align the patient, the process avoids any parallax in motion. It also quickens the x-ray experience and reduces the patient’s exposure to radiation. “The less times they have to click that button, the less radiation that patient is getting,” Cuomo says. “Fewer x-rays also result from the clarity of these digital images. We don’t have to get two or three views. Now it’s more reliably a good picture every time.”
Transferring from manual to auto to semi-auto, only takes a touch. At any time, when the tech grabs the overhead crane, it automatically switches to manual motion with unlimited capabilities and can be moved anywhere in the room.
Cuomo estimates the clinic, part of Brookwood Baptist Health Specialty Care Network, with its four orthopedic surgeons and three physician assistants, uses their Flex system at least 100 times a week. He says it’s not unusual for patients to arrive from outlying clinics with their x-rays. “The views or the penetrance is terrible,” he says. “But with this machine, I know we will get a good image and the patient will not have to spend more money to get another one.”