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Decoding Your Digital Radiography Purchase: Considerations For Sound And BMV Panels

Comparing  Sound and BMV digital x-ray.

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Equipment purchases are a large but important investment for patient care and for the financial success of a veterinary practice.

While diagnostic imaging purchases may seem daunting, it helps to take the process step by step to figure out what’s best for your clinical needs and budget.

As a starting point, here are a few things to consider…

Sound and BMV Veterinary Equipment Companies

Sound and BMV are two widely used sources of digital radiography systems in veterinary medicine.

This includes options such as an entire x-ray system (equipment, software, and support), or having flat panel detectors retrofitted into your current equipment.

Sound claims their advantages are:

Veterinary digital radiography, and supporting vets since 1996.

Their software, MUSICA, which is highly regarded for excellent quality image processing, optimization, and consistency (across different species, users, and techniques), and includes features such as a 3D position assistant for readily available positioning guides for less common views.

 

Excellent quality images and equipment.

A strong focus on education and training so you can easily use your equipment and get the most out of it. Courses are available through the Sound Academy of Veterinary Imaging via board-certified instructors.

Long-term relationships with panel manufacturers—which is a good thing when it comes to long-term product support.

24/7 live phone support.

Headquartered in the US (Carlsbad, CA) with in-house production and repairs.

According to BMV, their advantages include…

Sharp, high-resolution images obtained in less than 5 seconds.

Availability of their patented Irradiated Side Sampling on Cesium panels, which raises the detection layer near the top of the scintillator crystals. This means the x-rays have less distance to travel, creating a sharp image at the lowest radiation dose on the market (see below for more information on scintillator layers).

BMV Web PACS advanced viewer, powered by AI for faster viewing and easy sharing, and with a reference image library to help clients see abnormal findings compared to a normal image.

Integration with practice management software.

24/7 support.

BMV telemedicine consultants.

An online learning center.

While BMV and Sound and two major players, there are other companies out there, too.

And of course, each company offers a variety of products, so you can find the technology and a price point that’s a good fit for your needs.

When making a purchase decision, do your research and ask plenty of questions to figure out what’s best for your practice.

The technology and terminology can be a little confusing for new and experienced practitioners alike, especially if this is your first big radiology purchase.

We can’t cover everything in the scope of one article, but here’s some information about common types of DR flat panel detectors…

Cesium, Gadox—What Does It All Mean?

Cesium and Gadox refer to two possible substances that could be used in the scintillator layer of an indirect flat-panel detector.

Now, that’s a mouthful, so here’s what it all means…

A flat panel detector is a panel or plate you use to capture digital images with your x-ray machine.

There are two types of flat-panel detectors: direct and indirect. In a nutshell, direct panels convert x-ray photons into an electric charge, while indirect panels first convert x-rays into light and then into an electric charge. Either way, the final image is read out by a detector layer that contains millions of pixels.

Within an indirect flat panel detector, the scintillator layer is the one that absorbs x-rays and converts them into visible light.

This scintillator layer is most commonly made of either cesium iodide (Cesium) or gadolinium oxysulfide (Gadox).

Gadox is produced by formulating a liquid that hardens into thin sheets.

Cesium, on the other hand, is a bit more complicated to produce in a uniform way because it is “grown.” Cesium is composed of crystals that grow upward (acting as “tubes” for light to pass through) after being formulated and heated.

That means sometimes the composition and quality of Cesium can vary, although reliable manufacturers generally have good quality flat panels whether they use Cesium or Gadox.

What’s Better—Cesium or Gadox?

Each substance is useful and can produce good quality x-ray images.

A major advantage of Cesium is its high sensitivity to the x-ray signal. In addition to producing a clear, detailed image, this also means that images can be produced at a lower x-ray exposure.

Gadox can also produce clear, detailed images—but it requires a slightly higher exposure (within 10% difference) dose.

It’s worth noting that the higher sensitivity of Cesium can also lead to higher noise in the image, but Cesium is generally considered to deliver excellent quality images.

Also important is the fact that the price varies between Cesium and Gadox. Because the process of producing Cesium is more complicated and less consistent than with Gadox (as described above), good quality Cesium flat panels cost more than standard Gadox.

Finally, there is a consideration of how and where the panel will be used. Some veterinarians state that Cesium is less reliable in temperature extremes, and thus they prefer Gadox for their large/equine practices and other mobile practice needs. But this preference may vary between individual veterinarians.

Additional Questions to Ask

As many veterinarians will tell you, your equipment and the initial investment is only part of the story.

It’s also important to calculate ongoing costs, such as renewing warranties, service costs, software updates, and support, and storage fees for digital images. And, is loaner equipment available if a repair is needed?

Another consideration is the expected lifespan of the equipment, and whether support may eventually be discontinued on older models or parts (asking about where the company obtains their equipment is one way to learn more, so you can research the manufacturer).

Before you buy, it’s also a good idea to look at a variety of images from the equipment you’d like to purchase—at the very least, compare a large dog abdomen and a small cat paw, to view details over a range of sizes.

You can ask for a demo from the equipment company or distributor, or ask for the names of colleagues in your area who have purchased the same equipment who could tell you about their experience.

Keeping all these things in mind will help you choose the best option for your veterinary practice, whether you’re considering BMV or Sound, Gadox or Cesium panels, or even CR or anything in between.