Sunday, December 04, 2005

Sunday Morning Rants:
Sour Fuji Apples, and Meditech Blues

Fuji Apple Photo Courtesy of New York Apple Association
© New York Apple Association

It's easy to find an image for Fuji, but I had to search far and wide for something to go with Meditech. Here is a Russian blood pressure cuff, and I could stand to have my BP checked about now.

For over a year, I have complained to our powers-that-be about our Fuji CR. The images show poor contrast and cannot be adequately adjusted on my workstation. Many are just barely of diagnostic quality, and some don't even make the "barely" category.

As usual with this sort of thing, there is much finger-pointing. Fuji says their system works, but the Amicas PACS is the culprit. Amicas, of course, says just the opposite. Numerous posts on AuntMinnie.com indicate that there are settings within the CR that make it work better with Synapse; these have to be enabled (or disabled or whatever) for the CR to work with other vendors.

After a year of whining, I am fed-up, and I am really frightened by the possibility that I'm missing things due to the poor image quality. Therefore, I recently had a tantrum and declared that if this thing isn't fixed by the end of 2005, it's outta here. By that, I mean forklift removal and full refund. Enough is enough, guys. We have had much better luck with our Agfa CR over at the Agfa hospital. Could that be due to the fact that we have Agfa PACS over there? Could be, but they may get the chance to show how well their CR works with Amicas PACS in the near future. In the meantime, I would suggest that anyone considering the purchase of Fuji CR put that idea ON HOLD until I can tell you that our problem has been resolved.

Meditech gives me a different set of frustrations. The IT types at our Amicas/Meditech hospital decided in their infinate wisdom to purchase the Magic HIS/RIS instead of the client-server version. They felt the latter was not stable. Naturally, we were told about the purchase after all decisions were made; why would anyone want input from the people who will be using the product? (We actually do use the client-server flavor at a little suburban place, and it works just fine, thanks.) Magic is anything but. Basically, it is a port of their very old dumb-terminal software. Only the shortest reports can be seen on one (minature) screen, and it takes several key-strokes to view an entire report. Basically, sign-off time is tripled or quadrupled because of this antiquated approach. Trying to find an old report is an exercise in agony.

So, all I want for Christmas (or Hanukkah) is (to keep) my two front teeth, and to replace the Fuji CR and the Meditech Magic systems. Do I need to ask Santa for all this? At least I could get a candy-cane with that approach.

ADDENDUM: After having my tantrum to our imaging director this morning, I come to find that Fuji had already "fixed" the system last week. It seems that numerous settings were incorrect, including an interesting situation of the CR trying to send 14-bit data into an 8-bit PACS display. That's the good news. The bad news is that a very significant portion of the 200 or so studies I read over the weekend were still pretty awful. We would have tried to work on this more today, but it seems that Fuji won't let us have any of the manuals. Oh well.

NEW ADDENDUM, 12/21/05: Fuji has been slaving away on this problem, and the CR images are tremendously improved to the point that I can remove my "ban". I do have to admit that the prettiest images I have seen to date are from the combination of Agfa CR and GE Centricity PACS. See? I do give credit where credit is due...

Fuji still seems to harbor thoughts of blaming Amicas for the problems. I think that would be somewhat of a mistake. First, Amicas does not post-process the data, and secondly, we displayed a Fuji CR through an eFilm viewer, and it looked just as bad. Add this to the fact that Fuji was able to effect some improvement, and I must conclude that the problems lie with Fuji alone. Sorry, folks.

1 comment:

PJC said...

I have the same problem with Fuji CR. I am told that Fuji CR is 10 bit and most others are 12 bit.

This could explain why Fuji CR seems "devoid" of information.

If you open up a Fuji cr image on eFilm the default window width is somewhere around 2060 on our system with the level being half that. It varies from case to case.

If you open up a full field digital image, Kodak CR, or a plain film scanned into the system for that matter the Widow Width is 4096 (12 bit) and the level half that at 2048. This never changes.

My contention is that Fuji CR does not contain the same info as all the others. Try window and leveling the Fuji cases...there is nothing there. I would rather read a plain film scanned into our system than a Fuji film!

The Fuji Window width would imply that there is 11 bits of data (as opposed to the 10 that I have been told from other vendors). That still is only one half the info that is available on a 12 bit image.

So what does that say when we are now looking at Fuji CR for mammo....yikes!!!!