X-ray: Medicine enters more transparent window of imaging

Nearly 115 years ago, Prof Wilhelm Roentgen invented a gadget that would revolutionise medicine.

In the middle of a cold December night in 1895, he pulled his wife out of bed and brought her to his laboratory, asking her to place her hand upon a photographic plate and aimed a machine at her hand.

A few minutes later, the world’s first X-ray was developed.

The tool that is now commonplace has proved unparalleled in service to the medical community was initially described as “mythical and unearthly”.

In fact, Mr Roentgen’s wife is said to have exclaimed “it makes me somehow feel that I’m looking at my own death!” upon seeing the bones in her hand.

Over a hundred years later, the X-ray is undergoing transformation thanks to technology.

For instance, ultrasounds have now moved to supplying 4D images.

“Expectant mothers can clearly see the features of the baby and it is also easier to catch abnormalities using 4D,” said Dr Saleem Malik, the chief radiographer at Aga Khan University Hospital.
According to new research from Frost & Sullivan entitled Strategic Analysis of the Medical Imaging Industry in Kenya, in 2007 the X-ray market earned revenues of Sh1.9 billion ($25 million) but is expected to reach Sh3.2 billion ($43 million) in 2014.

According to this report, the Kenyan medical imaging market will experience steady growth over the next five years, primarily driven by an aging population demanding greater access to the services and diagnostic procedures.

And while traditionally patients would be forced to carry big, stiff envelopes containing their x-rays to specialists, doctors can now send them digitally.

Today, most major hospitals, both private and public have advanced to digital x-ray machines that save the images on portable devices such as discs.

With digital machines, radiologists can manipulate images at the time of viewing and can improve contrast for a better picture.

By next year, the Aga Khan University Hospital will be among the first hospitals in Kenya to have the latest technology that will connect all its branches in Nairobi, Kisumu, Mombasa and others such that with the touch of a button, a doctor can access and compare images irrespective of where they are.

To draw a comparison, while other industries strive to push more of their functions onto computers and become paperless, the medical technology is moving to filmless images.

According to Frost & Sullivan health research analyst Jolize Gerber, growth in the x-ray market will be driven mainly by the installation of digital systems as well as the introduction of picture archiving communication systems (PACS) to the Kenyan market.

PACS facilitates digital communication, storing, processing and viewing of images and image-related information at the click of a button.

However, the high cost of digitisation in the medical industry is a major inhibiting factor that has especially affected public hospitals relying on government funding.

Unfortunately, the health sector receives about six per cent of the total national budget that can not accommodate acquiring new medical technology due to priority areas such as administration costs and medical supplies.

For instance, for Aga Khan to acquire PACS, the budget is estimated at Sh37 million ($0.5 million) on the lower side.

KNH is looking at Sh1.2 billion to digitise its entire operations.

In this year’s budget, KNH received Sh500 million, which has already been channelled to construction of a burns unit.

“PACS is very cost-effective since one does not have to print the images, therefore, patients take less time to receive results. It also saves on storage,” said Dr Jotham Micheni, KNH chief executive officer.

For instance, one MRI film can cost about Sh1,000.

However, saving it on a disc is only about Sh100.

KNH is also set to move to PACS next year.

It also saves time for both the patient and the radiographer due to instant access of historic images electronically stored in the system.

Already the national referral like many other private hospitals such as Nairobi, Karen and Aga Khan, is operating on multi-slice CT scanner acquired two year ago.

This means extraordinary fineness of detail in imaging can be achieved, enhancing precise diagnosis.

It also reduces repeat rate of imaging since it is to a large extent accurate, consequently lowering radiation dosage.

Moi Teaching and Referral Hospital is set to acquire its first digital CT scanner in two weeks time, which will enable it to diagnose a wide variety of conditions faster.

Skilled manpower

But going digital has its challenges beyond the cost factor: skilled man power to manage the transition from analogue.

Dr Wilson Aruasa of Moi Referral told Business Daily that since technology is evolving by the day, it is not taught in medical schools, leaving the burden to hospitals that must invest in staff growth and development inflating tits training budget.

But the biggest benefit of going digital is the back-up system, since images are stored electronically reducing chances of loss or longer retrieval.