ACA App
Annals of Cardiac Anaesthesia Annals of Cardiac Anaesthesia Annals of Cardiac Anaesthesia
Home | About us | Editorial Board | Search | Ahead of print | Current Issue | Archives | Submission | Subscribe | Advertise | Contact | Login 
Users online: 580 Small font size Default font size Increase font size Print this article Email this article Bookmark this page
 


 

 
     
    Advanced search
 

 
 
     
  
    Similar in PUBMED
   Search Pubmed for
   Search in Google Scholar for
    Email Alert *
    Add to My List *
* Registration required (free)  


    References
    Article Figures

 Article Access Statistics
    Viewed38    
    Printed0    
    Emailed0    
    PDF Downloaded8    
    Comments [Add]    

Recommend this journal

 


 
Table of Contents
LETTERS TO EDITOR  
Year : 2019  |  Volume : 22  |  Issue : 3  |  Page : 344-345
Digital X-ray: Not so indefectible!


Department of Anaesthesiology, SGPGIMS, Lucknow, Uttar Pradesh, India

Click here for correspondence address and email

Date of Web Publication4-Jul-2019
 

How to cite this article:
Dixit A, Sharan S. Digital X-ray: Not so indefectible!. Ann Card Anaesth 2019;22:344-5

How to cite this URL:
Dixit A, Sharan S. Digital X-ray: Not so indefectible!. Ann Card Anaesth [serial online] 2019 [cited 2019 Jul 19];22:344-5. Available from: http://www.annals.in/text.asp?2019/22/3/344/262095




Digital X-ray has taken over and replaced conventional radiography in a huge way. There are several advantages of digital radiography including reduced radiation exposure (effective doses for direct digital radiography are up to 29% lower than those for screen-film radiography),[1] better X-ray image quality,[2] image enhancement is possible like the exposure of each image can be adjusted, and enlargement of images is possible. It has also eliminated the need to file and store hard-copy radiographic images and there is less likelihood of losing digital data. No dealing with harmful developing chemicals and fixing solutions for developing film is required. X-ray images are instantly stored and ready to view on computer, and these images can also be electronically distributed to numerous locations.[3]

However, amidst all the advantages lies the major disadvantage of the ease with which electronic images can be modified. It arouses the suspicion that they could be adulterated either purposefully or by mistake very easily. We report one such incidence of post-acquisition modification of the X-ray film that could have changed the diagnosis of the patient altogether. A 23-year old female patient was referred to our institute, a case of situs inversus dextrocardia with ostium secundum atrial septal defect (OS-ASD), for closure of ASD. The patient had a conventional chest radiograph film taken elsewhere showing situs inversus dextrocardia. Patient underwent routine blood investigations in our institute along with digital chest radiograph. This chest radiograph was inverted digitally, and print was given to the patient which showed situs solitus levocardia [Figure 1]. After the patient underwent echocardiography, the diagnosis was confirmed to be dextrocardia with situs solitus and chest X-ray was repeated with clear instruction to keep marker while taking the film [Figure 2].
Figure 1: Post modification X-ray film

Click here to view
Figure 2: Repeat chest X-ray film with the marker without modification

Click here to view


This is one example of how digitalization has its limitations and disadvantages as well. Not only it adds confusion for the diagnosis of a patient, but it also has legal implications if such modifications are used for medical malpractice.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.



 
   References Top

1.
Compagnone G, Baleni MC, Pagan L, Calzolaio F, Barozzi L, Bergamini C. Comparison of radiation doses to patients undergoing standard radiographic examinations with conventional screen–film radiography, computed radiography and direct digital radiography. Br J Radiol 2006;79:899-904.  Back to cited text no. 1
    
2.
Ozcete E, Boydak B, Ersel M, Kiyan S, Uz I, Cevrim O. Comparison of conventional radiography and digital computerized radiography in patients presenting to emergency department. Turk J Emerg Med 2015;15:8-12.  Back to cited text no. 2
    
3.
Willis CE. Computed radiography: A higher dose? Pediatr Radiol 2002;32:745-50.  Back to cited text no. 3
    

Top
Correspondence Address:
Aanchal Dixit
Department of Anaesthesiology, SGPGIMS, Lucknow - 226 014, Uttar Pradesh
India
Login to access the Email id

Source of Support: None, Conflict of Interest: None


DOI: 10.4103/aca.ACA_202_18

Rights and Permissions


    Figures

  [Figure 1], [Figure 2]



 

Top