• Naomi Customer

Joined: Wed Jun 24, 2009 3:44 pmPosts: 12 My Naomi sensor is a NX super High GradeI use a 5 years old Summit X ray generator working very fine with xray films (green)I precheck and calibrate the Naomi unit following EXACTLY the instuctions in the manual with 7.4.0 software the only one working with my unit … (Problem not solved at this time).

The images are very pale with no contrast at all and almost every time i see squares and /or parallel vertical lines on it WHY ?
I suppose it is a bad way to calibrate but what to do ?
I tried with or without a grid no difference the squares and the lines are here.And, i repeat, i cannot precheck and calibrate with 60 inches IT IS IMPOSSIBLE, the maximum distance i have between the sensor and the tube is 40″

Thank you for your help
Dr.  ****** DVM

• Mike  Post subject: Re: Very pale images, parallel lines or squares why ?Posted: Mon Dec 14, 2009 11:57 am Naomi Tech

Joined: Tue Jun 09, 2009 6:31 pmPosts: 31Location: Lincoln NE I’m sorry to hear that you are having problems with getting your Naomi High Grade to calibrate. If I understand this right, you have the Naomi sensor under a table top and the tube will only move 40″ away from the top of the table?
If this is so, there are a couple things you can do to try to get to the minimum 60″:
1. Take the Naomi sensor out of the table and hold it, in a upright position, at the end of the table. (if there is a wall next to your table its better to lean it against it so the Naomi sensor doesn’t move while calibrating) Then move your tube to the opposite side of the table, rotate and lower the tube so that it is facing the Naomi sensor and is aligned with the center. Make sure to measure the distance before running a calibration.
2. If your table has nothing under the Naomi sensor, put the Naomi sensor as low as it can be placed below your table. Some tables do not have a hollow base, so this might not work for you. Again be sure to measure the distance before running a calibration.
Please let us know if you are not able to do this, or if this worked for you.
_________________

IMPOSSIBLE to do that Why did NAOMI wrote in the LAST manual that it is possible to calibrate IF X RAYS COVER the entire sensor, which is the case with my installation ?

• Mike  Post subject: Re: Very pale images, parallel lines or squares why ?Posted: Thu Dec 17, 2009 11:47 am Naomi Tech

• It is possible to calibrate at the 40″ but you will only be able to use the 8″ x 10″ image setting. Anything bigger then that will not be calibrated properly to display a good quality image. If you want I can explain to you how to calibrate at 40″ in the 8″ x 10″ mode.

• NO i need to use the ENTIRE sensorI have to move the entire RX system away from a wall to have the good distance, it is quite heavy and not practical at all but if it is the only way to do it we will do it.So give me the procedure to calibrate my entire system, if i move the RX system i will have about 70″ between the generator and the wall.thx Dennis

• So we prechecked and calibrated the sensor last sunday using this method______________________________________________________________________To run a pre-check (and rest of calibration):1) Have your tube as far away, from the Naomi unit, as possible. (ideal 72″ away, minimum 60″)2) Set your factors to 72kVp, 100mA, 1/20th of a second, 5mAs.3) Collimate fully open. (the light on your tube has to be at least to past the silver border)——————————————————————————————–We moved the xray generator in another place in the xray room so we had 80′ horizontaly between the tube and the Naomi Unit.

• Everything went fine and after a succesfull calibration we put back the Naomi unit under the table ( so now there is 40′ between the tube and the unit)

• Our images are now almost every time very fine using the chart we had with our old films. BUT lines and squares are sometimes still here, sometimes on the entire image, sometimes only in some places, sometimes only on the edges of the image This is very anoying…

Can you explain me why this happen and the way to avoid it ?have we to leave the collimate full open for every xray image ?Have we to increase the KV? the Mas? Both ?
THX for your help
Denis DVM

• I’m not sure whats the problem is without taking a look at the bad images that you are getting. It might be just a simple technique issue. I would suggest setting up a time that we could remote into your computer and take a look at the images that you are getting. Let me know when would work best for you.

and on and on and on and on………..is this worth saving 5-10K??

There are approximately 150 of them in the United States, but Chiropractic Radiologists are little known to most people in Medical Imaging.

Mention Chiropractic Radiology on an online message board or to a group of Medical Radiologists, and you’ll likely be met with questioning looks. But Doctors of Chiropractic (DCs) regularly use imaging technologies in their practices.

In most states, plain Film Radiography is within a chiropractor’s scope of practice, and many states allow a chiropractor to order and even interpret advanced imaging if they have the proper training and credentials, according to American Chiropractic College of Radiology (ACCR) President J. Todd Knudsen, DC, DACBR. Some larger chiropractic offices, especially those integrated with other healthcare professionals, may have diagnostic ultrasound or other imaging modalities available for their patients.

Though laws vary by state, chiropractors are often free to order advanced studies such as CT, MRI, or ultrasound, according to Gary A. Longmuir, MAppSc, DC, DACBR, of Diagnostic X-Ray Consultation Services in Arizona.

Many chiropractors rely on a Chiropractic Radiologist such as Longmuir to read and interpret films for them. According to the ACCR, there are approximately 150 Chiropractic Radiologists in the United States, with another 50 outside this country.

Chiropractic Radiology is a specialized branch of chiropractic healthcare. Similar to medicine, there are generalists and specialists in chiropractic, according to Knudsen. Most chiropractors are generalists, and most specialties in the field require additional training in the form of postgraduate seminars or full-time residencies—as is required with Chiropractic Radiology—and then board certification examinations to earn diplomate status. In the case of Chiropractic Radiologists, the examining board is the American Chiropractic Board of Radiology (ACBR), widely considered the most stringent of the specialty boards in chiropractic. Chiropractors who pass this certification process and maintain their continuing education requirements may use the designation of diplomate of the ACBR (DACBR).

According to Knudsen, Chiropractic Radiology consists of interpreting, and sometimes performing, imaging exams such as plain radiographs, MRI, CT, and diagnostic ultrasound. Chiropractic radiologists are chiropractors who may own and operate consulting practices, treating practices, and/or imaging centers or teach in chiropractic or other colleges.

“The main difference between Chiropractic Radiology and Medical Radiology is in the areas of emphasis,” says Knudsen. “Chiropractic Radiologists are more like neuromusculoskeletal radiologists, and most Medical Radiologists are generalists. Another obvious difference is the fact that we are chiropractors and they are medical doctors.”

Chiropractors complete 300 to 400 hours of training in chiropractic school to learn about acquiring and interpreting plain film radiography, with some rudimentary training in advanced imaging—more for the recognition of imaging type and to have a better understanding of reports they may get from a radiologist, according to Knudsen. Chiropractic radiologists complete approximately 4,000 hours of training in practical and didactic training during their three- to four-year full-time residencies, and they are certified by the ACBR, an autonomous examining agency not affiliated with the American Chiropractic Association Council on Diagnostic Imaging or the College of Radiology. This way there is no conflict of interest or undue influence, according to Longmuir.

Chiropractic radiology residencies are conducted by schools accredited by the Council on Chiropractic Education (CCE). “The residencies themselves are not currently accredited; however, CCE has been discussing this possibility for years,” says Knudsen.

“The chiropractic community has stayed current with imaging technology and is fluent in our ability to do the interpretation,” says Longmuir. “Medical doctors in patient practice are exposed to diagnostic imaging as part of their undergraduate curriculum and do rotations in diagnostic imaging as part of their internship and residency. Radiologists in a medical community must do a four-year specialized residency in diagnostic imaging and then have to sit for a series of qualifying examinations. It is the same for Chiropractic Radiologists.”

Chiropractic undergraduates take classes in pathology, soft tissue x-ray, bone x-ray and pathology, MRI, CT, and sonography. If they want to become certified in radiology, that residency lasts for three or four years. For the duration of the residency, those training for this career must learn radiation health safety, bone pathology, chest imaging, gastrointestinal imaging, genitourinary imaging, and MRI.

The certification exam consists of several days of testing before candidates are admitted to the ACBR and permitted to use the initials DACBR after their name.

“I know of a number of DACBRs who have gone to medical school in addition to all the training I’ve just discussed,” says Longmuir. “These individuals have gone on to become medical radiologists or into specialized occupations in internal medicine, including a number of state radiation regulatory agencies.

“Chiropractic Radiologists are diagnostic in nature,” he continues. “We interpret plain film, CT, and MRI just the way medical physicians do. We are, however, predominantly bone and joint radiologists. We do read chest films and do gastrointestinal studies as well, but overall our forte is musculoskeletal studies.”

Longmuir has a full-time practice and a large number of doctors, including chiropractic, medical, and osteopathic physicians, for whom he reads studies. Typically a courier picks up and drops off imaging studies to his office that have been taken at chiropractic clinics in and around his area. He also has film studies sent by mail and DICOM files sent via the Internet or on CDs.

Formal reports are dictated in the same manner as medical radiologists complete theirs, according to Longmuir. “We then provide these to the referring doctor, make recommendations, and answer questions on the phone. I’d be hard-pressed to find differences between us and regular medical radiologists. It’s an integrated practice in which I interpret CT/MRI bone and joint radiology or musculoskeletal radiology, reading not just for Chiropractors or DOs, but also for some MDs or even the occasional Veterinarian in the area.”

A Chiropractic Radiologist’s scope of practice is the same as it is for every licensed chiropractor in each state. They have additional training in radiology, but they practice under a chiropractic license.

Each state’s law defines the scope of practice for any chiropractor licensed in that state. Chiropractors in all 50 states can take x-rays and may refer those exams for interpretation, according to Longmuir. The scope of practice also permits them to order advanced imaging studies; whether a third-party payer provides coverage is a separate matter.

Chiropractic radiologists are reimbursed by cash, lien, or insurance—like other chiropractors. “When it comes to billing, we can either bill for the primary read (the professional component of the x-ray services) or a second opinion,” says Knudsen.

Chiropractors who do not have imaging equipment in their offices order the exam to be performed at an imaging center. Longmuir notes that his office is located above an MRI clinic. He interprets spinal and appendicular MRI studies for the facility, along with MRI studies from outside sent via the Internet, including international studies from places such as France, India, and Mexico. Each week, Longmuir catches roughly two fractures and one tumor in his work.

“The best advertising you can have is your reputation,” says Longmuir. “If you are viewed by the referring doctor as a reliable source of diagnostic information, I think that is the best situation for someone in this field. This is what we all try to do.”

Still, there is some criticism from Medical Radiologists that films from a Chiropractor’s office are poor quality, usually because older machines are used. Tracy G. Hoyt, DC, DACBR, of Hoyt Chiropractic in Murrieta, California, believes the quality of chiropractic radiology film is improving, though there are still challenges.

“I feel if the insurance companies were to reimburse us a little better for such tests as this, it would go a long way for us,” says Hoyt. “We typically get $38 for the taking of an x-ray. How is a doctor going to keep his equipment updated with that amount?”

Asked how chiropractic radiologists may be viewed by the medical radiology community, Hoyt says, “I think medical radiologists don’t have concerns regarding chiropractic radiologists—mainly because I don’t think they know, for the most part, that we even exist. There are only about 200 of us. My guess would be that if those in medical radiology did have some concerns, it would be that we in chiropractic radiology would extend out beyond those areas that we are well versed in. But I don’t think that the medical profession at large knows that there is such a thing as chiropractic radiologists.”

That anonymity may change as chiropractic radiologists seek opportunities to share common ground with the medical radiology community in hospital and research space.

For example, Terry Yochum, DC, DACBR, FACCR, served as vice president and president of the ACBR for seven years. He is currently director of the Rocky Mountain Chiropractic Radiological Center in Denver and an adjunct radiology professor at Southern California University of Health Sciences, a chiropractic, acupuncture, and oriental medicine school. He has been on staff at the University of Colorado School of Medicine’s Radiology Department as a skeletal radiologist since January 1991.

Yochum says imaging centers to which chiropractors refer their patients often use chiropractic radiologists to assist them in interpreting studies along with the medical staff. He says it is beginning to happen around the country that a Chiropractic Radiologist may work in conjunction with a medical imaging center to assist in referrals and interpretation of exams for chiropractors. Still, it’s true that there simply aren’t that many chiropractic radiologists around.

In New York, Jean-Nicolas Poirier, DC, DACBR, and Chad Warshel, DC, DACBR, recently earned clinical teaching privileges in the Canandaigua VA Medical Center. They will teach radiology to chiropractic students and residents as part of the college’s master’s program in diagnostic imaging residency. They are the first doctors credentialed by the VA to do so. New York Chiropractic College interns and residents will be given the opportunity to view a broad variety of radiographs and advanced imaging of the VA’s chiropractic patients.

One question asked in the medical radiology community is how well can a chiropractic radiologist interpret images? While plain radiography of the spine is an established part of chiropractic practice, few studies have been done to indicate chiropractors’ ability to read plain radiographs.

On their websites, many DCs refer to a study by de Zoete published in Spine Journal in 2002 and conducted at the radiology department at the Medical Center Alkmaar in the Netherlands. Five chiropractors, three chiropractic radiologists, and five medical radiologists read a set of 300 blinded lumbosacral radiographs, 50 of which showed an abnormality. The researchers found “small differences with little clinical relevance. All the professional groups could adequately detect contraindications to Chiropractic treatment on radiographs. For this indication, there is no reason to restrict interpretation of radiographs to medical radiologists. Good professional relationships between the professions are recommended to facilitate inter-professional consultation in case of doubt by the chiropractors.”

Stephen Perle, DC, a professor of clinical sciences at the University of Bridgeport College of Chiropractic in Connecticut, is the ethics columnist for Dynamic Chiropractic and the American Chiropractic Association’s ACANews. On his blog, he wrote, “Lindsay Rowe, DC, MD, DACBR, taught me this ‘technique’ to deal with medical prejudice towards chiropractors. He said that to many MDs you are stupid until proven intelligent if they know you are a chiropractor. So prove you are intelligent and then let them know you are a chiropractor. I’ve used it often to great effect.”

nsive, many medical facilities, especially smaller ones, have held onto that film equipment because the cost of upgrading to a Digital X-ray System has been too cost prohibitive.

All of that has changed, however, with the prices of all types of electronic and computer technology dropping in recent years. Because of this, many small and mid-sized medical offices can now consider adding Chiropractic X-ray in a digital format. It is also possible to take digital imaging equipment and use it to retrofit your existing film X-ray Equipment, turning it into a digital unit, and thus saving your office money on purchase costs.

Chiropractic DR Digital Imaging Systems are popular for several reasons. This form of Digital Imaging offers the highest resolution of all types of Digital Images currently available, and they produce the images in the shortest amount of time. Furthermore, they expose patients and physicians to the least amount of radiation as compared to other types of imaging systems. For these reasons, many medical offices, including chiropractic centers, turn to DR Imaging Systems.

For added features and flexibility in use, many chiropractic offices use their DR Image Acquisition systems with other Digital Imaging components, which can include a PACS system. The PACS is a software and hardware appliance that allows you to view, distribute and store your Digital Medical Images on a personal computer. You will likely also want to invest in a diagnostic monitor, which is a high-end graphics monitor suitable for use with medical digital images.

A PACS system can also be used as a router. What this means is that if you are connected to an online local area network, wide area network or even a virtual private network, you will have several physicians utilizing several clinical workstations at several different facilities. The router allows multiple users of the system to send and receive images, and the appliance will make sure that everything goes where it needs to go quickly and efficiently, and it enables the simultaneous use of the system by multiple users as well, so you only need one PACS system for numerous locales to benefit.

You can visit a medical Digital Imaging distributor’s such as DR Medical for more information about Chiropractic Digital X-ray solutions that will work well for your specific medical office’s needs.

What is Flat Panel Digital X-Ray? published by FlatPanelDR.com

Flat Panel Digital X-ray detectors can be divided into two classes. They either use a direct technique (direct-conversion detectors) or an indirect technique (indirect-conversion detectors) for converting X-rays into an electric charge.

• Direct-conversion detectors have an X-ray photoconductor, such as amorphous selenium, that directly converts X-ray photons into an electric charge.
• Indirect-conversion detectors have a scintillator that first converts X-rays into visible light. That light is then converted into an electric charge by means of photodetectors such as amorphous silicon photodiode arrays or CCDs. Thin-film transistor (TFT) arrays may be used in both direct- and indirect-conversion detectors

• Direct-conversion flat panel detectors based on amorphous selenium

The selenium-based technology uses an amorphous selenium-coated thin-film-transistor (TFT) array to capture and convert X-ray energy directly into digital signals. It is a direct-conversion technology that converts X-ray beams into electric charges directly. No light-emitting materials as with CR systems, no intermediate steps or additional processes as with silicon-based systems or CCD systems are required to capture and convert the incident X-ray energy. Under a bias voltage applied across the detector structure, incident X-rays directly generate electron-hole pairs in the selenium layer. These charges are collected by individual storage capacitors associated with each detector element for readout by customized electronics within the array.

• Indirect-conversion flat panel detectors based on amorphous silicon

A second type of Digital Imaging Sensor is based on amorphous silicon. This type of flat-panel sensor uses thin films of silicon integrated with arrays of photodiodes. These photodiodes are coated with a crystalline cesium iodide scintillator or a rare-earth scintillator (Terbium-doped Gadolinium dioxide sulfide). When these scintillators are struck by X-rays, visible light is emitted proportional to the incident X-ray energy. The light photons are then converted into an electric charge by the photodiode arrays. Unlike the selenium-based system, this type of indirect-conversion detector technology requires a two-step process for X-ray detection, i.e. the scintillator converts the X-ray beams into visible light, and light is then converted into an electric charge by photo-detectors, such as amorphous silicon photodiodes.

• Indirect-conversion CCD detectors

The oldest indirect-conversion DR system is based on charge-coupled devices (CCDs). These arrays record light created by the impact of X-rays on a scintillation material, such as photostimulable phosphors. The most salient characteristic of CCDs is that they are relatively small – typically 2-4 cm2, which is much smaller than typical projected X-ray areas. Because of this, CCD-based systems require optical coupling to reduce the size of the projected visible light image and transfer the image to the face of one or more CCDs. Although CCD-based detectors require optical coupling and image demagnification, they are attractive because they are both widely available and relatively low in cost

Today DR Medical Services has installed the Newest Digital X-Ray technology. Flat Panel X Ray Detectors are the most revolutionary product that has hit the Veterinary Radiography market in years. The new Flat Panel Detector will allow the staff to obtain a radiograph in about 6 seconds!! This cuts their time down from the previous CR (Computed Radiography) based system which took almost 2-3 minutes to acquire your image. The image quality is simply amazing when compared to a Film or a CR based Radiography system.

By converting from CR to DR Animal Emergency Hospital will be able to provide a faster diagnosis in the time of your pets emergency. In Emergency care whether Human or Veterinary every second counts.

Please stop by the beautiful Veterinary Emergency Hospital in Bel Air, Maryland at 807 Bel Air Rd. and see the most cutting edge Digital X-Ray System to care for your pets.

The plaintiff alleged that the defendant Chiropractor negligently left her alone on a Spinal Decompression Table without giving her the switch to stop the machine. The plaintiff claimed that she fell through the center opening of the table and sustained injury. The defendant argued that the incident could not have possibility occurred as alleged by the plaintiff.

The plaintiff testified that she had a history of cervical and lumbar disc herniations and began treatment with the defendant PA Chiropractor including a mechanical traction program. On December 14,  the defendant placed the plaintiff on a Spinal Decompression table which is designed to gently move up and down to cause Axial distraction of the spine.

The plaintiff testified that, on prior occasions, the defendant handed her the control switch to turn off the table; but on this occasion he did not do so before leaving the room. The plaintiff testified that the Decompression Table malfunctioned and overextended her spine, causing her to fall through the opening in the center of the table. The plaintiff, who was in her mid- 50s, claimed a Thoracic disc herniation as a result of the incident.

The defendant contended that the maximum width of the opening in the center of the decompression table is eight inches and that the plaintiff was properly secured to the machine with Velcro straps, making it physically impossible for her to have fallen through as alleged. The defendant testified that he laid the control switch next to the plaintiff, which is the accepted standard for him to do so.

The defendant testified that he was in the next room when he heard the plaintiff yell out. The defendant claimed that, when the decompression table rode up slightly, the plaintiff panicked. Evidence showed that the plaintiff had been on anti-anxiety medication for some 17 years. The defendant’s neurosurgeon testified that the plaintiff’s thoracic condition was related to her preexisting degenerative arthritis and not the alleged fall.

• The jury found that the Chiropractor was Not negligent.

If you think you Medical Equipment may just need a Tune up or a simple Face Lift,  DR Medical Services is your one stop shop for Medical Table and Chair Refurbishing in the North East United States. We have saved many  local Medical Practices thousands off their bottom line buy providing Repairs and Re upholstery Services.

DR Medical Services LLC specializes in refurbished Chiropractic Tables, Physical Therapy Equipment, Massage Tables, Surgical Tables and much more . All refurbished equipment is subjected to our extensive process resulting in like-new appearance, performance and reliability at a fraction of the cost of new equipment.

If purchasing new or refurbished products is not in your budget, consider having DR Medical Services refurbish and/or update your existing Medical Equipment. What you’ll receive in return is your machine, table, or chair restored to OEM specifications or updated to reflect the improvements that the OEM offers in their latest equipment.

All refurbished equipment comes with Warranties.

Whether you’re in the market for additional equipment, or are considering updating your existing equipment, we have a cost effective solution to fit your budget. Give us a call today!

1 866 997 9449