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Film to X-rays?
erikred_at_csua asks: "A friend has his film X-rays on loan from the lab but needs to transfer them to digital format so he can take them for a second opinion. What's a reliable (and inexpensive) method of doing this without sacrificing image quality (and thereby rendering the exercise worthless)? Would the old lamp and scanner trick work here, or would there be too many flaws to make it worthwhile? Where could one find a list of places that would do this on the cheap? Since this is to document the progress of arthritis in his back, the level of detail must remain high."
If they are his xrays, they should be part of his medical record, which means he owns them. You can keep them as long as you like (they are signed out to you right? dont get some poor clerk in trouble), or return them and your other doc can request them.
At least, thats the way it worked in the radiology dept. I worked in for a while about 10 years ago.
Don't blame me, I voted for Kodos
Can't he just take the ones on loan?
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Why the hell can't he just talk to his primary doctor, and ask him how medical professionals share x-rays with each other?
What kind of fucking moron with absolutely no radiology experience whatsoever thinks he can just scan a fucking x-ray and get something acceptable to a radiologist?
Do they have the technology to make digital copies of the X-rays? Maybe they've even made some already?
Maybe Walmart can make digital copies, if you get signed permission from the copyright owner (the lab).
I must take a pill to keep me alive, but I don't like paying the $15 copay every month. Could someone on /. tell me how to syntheize it at home?
I'm willing to exchange my plans for making an MRI out of iPod earplugs.
Conformity is the jailer of freedom and enemy of growth. -JFK
I would strongly recommend *not* screwing around with any homebrew methods when his health depends on it.
What I'm listening to now on Pandora...
How do I remove the engine from my car?
As I type this, my mechanic is replacing the brakes on my car. He said he could change the oil at the same time, but it would cost an extra $25. I called my friend bob, and he said that he could change my oil for only $10!!!
So, as long as the car is up on the lift anyhow, I think I'll just remove the engine from the car and take it to my friend bob's house, so he can change the oil for me. Then, I'll bring the engine back to the shop and re-install it in the car. After all, there's only one engine, so I should be able to get the engine removed and re-installed much faster than my mechanic can replace four brakes.
I once compiled my own linux kernel, so I figure engine removal should be easy to do. However, I'm hoping someone can point me at a good howto guide...
Doctors know how to get ahold of images, how to move them around, etc.
Let the 2nd opinion doctor tell him what to do. It won't involve using a lamp and scanning it, either. It might involve picking up a copy at the hopsital where the images were created. Or it might involve the other doctor just pulling up the image on that hospital's web site.
Again, there are systems and protocols that exist to give people who ought to have access to images access to them. Just don't get in the way, or make problems for the people who are going to do this.
That said, an X-Ray is nothing more than a special transparency as far as scanning goes (that's my theory). So if you don't have a scanner that can do transparencies, then you have two options as far as I can think. Option one is to put a piece of white paper behind when you scan it. The black area will stay black, the transparent area will be white. Shouldn't be a problem.
The second option is Kinkos or some other such place. They should know how to scan a transparency like that, or at least have a copier that can make you a copy so you can scan it yourself.
But I don't see why the "white paper" method shouldn't work.
Comment forecast: Bits of genius surrounded by a sea of mediocrity.
Most radiology practices have been moving to digital imaging, and have access to scanners that will convert your X-rays into a DICOM image. There are tools out there for converting DICOM to JPEG. And yes these are diagnostic-quality images. I've set up some facilities that don't even go to film anymore unless the patient asks specifically for a film copy. All diagnosis is done on screen.
There are still some stone age practitioners who refuse to move into the digital age. Before getting radiology work done, you might call around to see if the practice is on a "PACS" system. And furthermore, will they give you the images in DICOM format?
One of the hospitals I set up sent every patient home with a CD-R that had a royalty-free DICOM image viewer and the full study of their X-Rays, CT scan, MRI, etc. This way they could pop the CD into a Windows computer and see everything the doctor sees (sort of... some of the advanced image manipulation isn't there) and take the CD to their primary care practitioner for followup.
Ask the lab for a copy. They can do this, you know.
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"You are not remembered for doing what is expected of you." - Atul Chitnis
It's sad that patients have to jump through hoops to get their medical records. In contrast, when I needed some tests done recently, I drove down to Mexico and got X-rays and a CT scan for about half what I would have paid in the U.S. (and I'm talking cash over the barrel, no insurance). The doctor handed me the X-rays in a folder - I still have them. And the CT scan results were burned to a CD with a handy little viewer app, so I can cruise through my abdominal cavity a la "Fantastic Voyage" whenever I please. Sure beats pleading with the lab to see the results that you PAID for.
Soylent Green is peoplicious!
http://www.epson.com/cgi-bin/Store/consumer/consDe tail.jsp?BV_UseBVCookie=yes&oid=53540925
There may be other less-expensive models w/ a similar adapter, and you may also be able to find one used.
If you need high quality images from a nageitve, use a scanner that's equipped to handle negatives. Many scanners do this. Cheap ones will only scan small sections of negatives, but you can stitch them together later.
You might find that Kinkos or a local print shop has the capability to copy the film to CD as well. Look around.
I don't think you're going to be able to do this job on the cheap and well at the same time.
-Adam
X-Ray scanners cost in excess of $10,000 for usage in simple day surgery situations. There is a good reason why they cost that much. Domestic scanners don't even come close to the resolution needed by radiologists. When they look at a minute dot on an X-Ray which to you and me looks the same as any other minute dot, they know the difference. The FDA makes a distinction between images which can be used for diagnostic purposes and images which can't.
Task Mangler
Check his website. He really does have plans for for making an MRI out of iPod earplugs. And it works too! How else do you think he found out that he had back pain?
I am not a doctor, however, you can always go to a pro photo lab and have a high quality drum scan, or maybe a high quality sigma scan done.
Photos.
Check out http://www.microsoft.com/business/executivecircle/ content/casestudydetail.aspx?csID=14967. I work for a largish health system in the midwest. We're currently piloting the Azyxxi image system.
:P
Just today, I had the opportunity to talk with a doc who saw the system for the first time. He about crapped himself with glee. Since the image viewing component is a set of crApctiveX controls, it seems likely that we'll be rolling out a patient-viewable feature in the next year.
Get your doc as a client and push things like this on him. You know what his clients want because YOU ARE A CLIENT!
These activex components work in WINE, so don't whine about IE only
The poster is asking about scanning an X-ray.
In many ways, it's essentially a negative by the time it's delivered to you. I know my scanner can scan negatives, but only in 35mm format.
Is a scan of an X-ray somehow innacurate, or likely to introduce errors? Or will it come out with sufficiently good resolution to be accurate at the scanned resolution? Obviously, you can't meaningfully zoom beyond the resolution of the X-ray, but would a scan result in something of comparable resolution?
[ I have no background in either imaging or X-rays, so it's a real question. Supercifially it sounds obvious, but I'd rather have someone chime in who really knows this stuff and can speak to the technical limitations, I'd love to see a reasoned explaination as to why you wouldn't simply scan it ]
Lost at C:>. Found at C.
Homebrew methods for something so important seems a bit risky.
I got one of my wife's CT for $3.50 from the hospital radiology department. I just asked for a DICOM-format dump of the CT series (OK, so I used to work in radiology software - they don't get many requests but are happy to help). Open source software is readily available to view it (I either used Madena X or OsiriX at the time).
My God, it's Full of Source!
OUTSIDE_IP=$(dig +short my.ip @outsideip.net)
Yes the "lamp and scanner trick" works. Just scan the original to digital and p-shop on a tumor shadow in the shape of a crying Jesus. Have OPhoto print the result to a large transparency, and sell it on EBay to pay for your operation.
That was easy. Go ahead and ask me another one.
Ask your xray place to supply you with your xrays in cdrom format. Demand it!
Only 'flamers' flame!
Does slashdot hate my posts?
medical imagery typically requires highly specialized equipment (like the hdr displays they were yapping about in another article). to give the offeror of your second opinion a reasonable hope, you'd have to scan in at least 16bit and quite possibly 24bit gray scale at sufficient resolution to get a 16k x 16k image (these are the magic numbers i remember from my image processing class. i am not a medical professional, nor do i play one on tv. take my advice with a suitably large grain/pile/mine of salt. by reading this post, you agree not to sue me, etc.) do *not* compress the images or in any way dick around with them (contrast stretch, etc. --- just say no).
i seriously doubt that your scanner will be able to get sufficiently high quality to get a meaningful diagnosis. find the person you want the second opinion from, tell him/her about the existing imagery, let them deal with the paper work.
Yeah there are FOSS tools in the works various places, but the "free" viewer is MSWindows-only.
Seriously. You're not going to get an image that's good enough for medical work. I seem to remember that X ray scans need at least 12 bits of greyscale information to be useful. And then there's the question of resolution (which I don't know offhand). Do you have access to a scanner with that kind of capability? I very much doubt it ...
Don't dick around with your health. Don't try to do it yourself. You'll just screw it up, and it'll cost you more in the long run.
I get those discs all the time, and a majority of the time they're a pain in the butt. 1) They're in Windows format, 2) the interface is AWFUL - no instructions on how to view multiple images, how to scroll thru a CT scan, etc. Someone needs to come up with a better interface for those.
..........FULL STOP.
If this person cares about his health, (s)he should either borrow/sign out the films and send them to the other MD, or have the lab where he took them make him a copy and mail the actual films, if the lab is a non-PACS type of place.
They want a seconds opinion, but then want to send them some half-assed scanned images that he wants to make himself????? The second MD will be hamstrung by these images and might not be able to give a proper diagnosis, and you'll just waste their time.
..........FULL STOP.
The Hospital owns the X-rays - you are paying for the professional reading cost for the diagnosis, and the time and materials to make that diagnosis. EVERY hospital in America works that way - it's just the way it is. You may try to argue with them, but that's the reality of it.
..........FULL STOP.
Every patient that I have, has copies of their records - it's easy to get copies of you medical records here in the US. Pretty much every radiology dept will give you a copy of your images and report if you want. The artical poster is not complaining about any problems getting records - they're just asking about how to make a copy.
..........FULL STOP.
As far as your little theory goes - it's ok in concept, but fails miserably in it's application. A radiograph has many subtle shadings, that some homebrew scanner copying will not reproduce. I actually am an orthopaedic surgeon and have seen some images like that - I can't make anything, but the most basic of diagnoses off poor quality copies like that. This then wastes time for both of us, and would just annoy me as a consulted surgeon. At this point I might be thinking - if I have to operate on this guy - would he follow instructions, or would he try to cut corners, and say borrow his friends antibiotic which is the wrong kind and 2 years expired.
It's easy to have the lab loan out, or have copies made of the films - does your friend just not want to pay $10 to have a proper copy made? I get patients in my office every week with thick jackets of films from other hospitals, my staff just mails them back. Is something else going on here?
..........FULL STOP.
Since my wife the radiologist has the day off today, I swiveled my chair around and asked her. So here's a bullet list of relevant points combining my editorializing with her systems knowledge:
-Most medical stuff is regulated at a state level (in the US, anyway), not at a federal level, so exercise caution when saying 'it's the law'.
-Radiology films are 11"x17", so you would need a big (and expensive - my wife has a couple thousand old films from her research we'd like to digitize, so I've shopped) scanner to do this.
-Contrary to popular belief, you do not own your medical records; the physician who generated them does. You do, however, have the right to access them and the request a copy. You may be required to pay a fee for the copy, but it's usually something reasonable (e.g. $10). I realize this may raise a ruckus - this isn't flame bait or an ethical statement, it's a statement about the way it is. Deal with it.
-You may request a copy of your films to keep, rather than borrow. Again, there may be a fee.
-Many practices now use PACS systems to handle the images, and can burn a CD of the data that can be read by a radiologist; many even come with the reading software on the CD. As another poster pointed out, the image data will in all likelihood conform to the DICOM standard http://www.sph.sc.edu/comd/rorden/dicom.html , and can be shared with your other physicians readily. Because the CD systems are relatively new, many hospitals and imaging centers haven't yet implemented a policy of how to charge for them - so you may be able to get it for free. Or not.
-So, in a nutshell: If you are, for whatever reason, not willing to ask your physician to share the information (which is the best route - physicians are our partners in care, not our adversaries), then request a copy that you own; don't borrow. Present this data to the physician you are seeking a second opinion from. Good luck, and I hope he can treat the arthritis!
I had some x-rays I needed to send to a vet at Texas A&M. Rather than mailing them, I simply used my digital camera. The trick was the backlight. If you put a pure white screen (expand any picture making program) on your monitor, then place the xray in front. Luckily, I have a 24 inch crt (burning my eyes out at this moment) that has a bit of lip around the tube. The xrays would slip into the lip, and hold the xray in place. Then I put the camera on a stable surface.. and viola... perfect digital copies. The verdict? The xrays by my local vet were horrible, and I had to get them redone. Saved me quite a bit of cash.
If you think that you don't sign a contract when you enter a hospital, you haven't had medical treatment in a long time. The stuff you sign to get anything done nowadays is on par with the EULAs discussed recently on /.
Nonetheless, I would find it hard to believe that you couldn't request a copy be made made, or the originals loaned to a licensed doctor, for a small fee. (small is, of course, relative when you're talking the medical community).
Is it just my observation, or are there way too many stupid people in the world?
Someone said, "Every patient that I have, has copies of their records - it's easy to get copies of you medical records here in the US. Pretty much every radiology dept will give you a copy of your images and report if you want. The artical poster is not complaining about any problems getting records - they're just asking about how to make a copy." So it's clear hospitals don't act like professional photographers and claim they own the copyright. Read the comments you replied to on this thread and see what you are responding to.
I have an MS in medical physics from MDACC in diagnostic radiology.
of all the lame comments here -- no one seems to have made some of the most important points:
reading x-rays from a film and from a screen are completely different. radiologists still primarily read from film for very good reasons. (mostly contrast depth on film is 14 orders, where screens are at best 8 or 9 orders).
do not screw with the originals. the more you move and play with them without expereince,the higher the chance you'll scratch and damage the films. damaged films make bad diagnostic tools.
copying film is easy. you take the film in the dark room, open a new film, place them next to each other (flat agaist one another) and place them both on a bright lightbox, with original close to the light. cover and flash the light for about 15 seconds. the shadow goes through old film onto the new one. the copy is noticably lower quality, yet still better than reasing from a screen. radiology groups do this all the time.
scanning techs have come a long way since my degree. no comment there.
modern scanners can produce direct dumps to digital from an mri, pet or ct scanner. i've got software and images which show you what it does..try multislice RTP at http://yhs.sf.net/ ..has source for decoding images as well.
if you have only physical film then any good hospital or uni with a image engineering dept can copy it for you for a nominal fee ($2/film i believe). alternatively try going to a large photolab and they should be able to do it. you shouldnt try using a regular scanner since the bit depths in a CT or mri image are far more than normal scanners can aquire. usually 16 or 18 bit greyscale which translates to requiring a 48 bit color scanner to duplicate properly.
Interpreting xrays depends on really subtle shadows and things, and it will take some doing to get it right in digital form. Do the right thing and ask the hospital/doctor for reprints. If it's that important, it's worth doing right. Unless you're some sort of idiot.
No, make that a fucking idiot. Sheesh.
A couple of years ago I found myself in the emergency ward after stumbling in the dark (distracted by Jupiter...) and going head first in to a brick wall. They did a CAT scan, and when I asked if I could get reprints, they said sure. Come back at the end of the month and we'll run you off a set. Didn't cost me a dime.
...laura who actually does have a brain, and who has the pictures to prove it!
the cheapest way of getting a copy is to have it copied, by the radiology department. i think it cost less than anything else which give you a film.
1. Making a diagnosis from an image scanned into a digital system by even the best scans is generally not done. The Radiologist will typically want the original - and that's even when done with real equipment.
2. As others have mentioned, the tools to do this are very very specialised - including extermely hi-res monitors with very fine contrast ratios.
In short, keep the x-rays, carry them around. They have very high information density.
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