DR vs CR for Your Digital X-Ray System

Jul 22, 2022 9:50:26 AM / by Melissa Schwab

When looking at upgrading to a digital x-ray system, there are a few options to replace film and retrofit a system to be digital. Today we will talk about why you should choose a DR vs a CR system when considering a digital x-ray system. 

What is CR? 

First, let's discuss what a CR system is. CR stands for computed radiography. With CR, special cassettes use a flexible phosphor imaging plate (IP) to capture the X-ray image, replacing traditional X-ray film. Once the x-ray is shot, the CR cassette goes into a CR reader to convert the data into a digital image. This digital image is then sent to a computer with image acquisition software. From here the image can be viewed and enhanced with the software tools. Once the image has been digitized, the CR reader erases the IP and the cassette can be reused for additional images. 

What is DR?

In a recent post, I discussed what a DR panel is and how they work. DR (direct radiography) panels also replace film and contain a crystal layer inside known as a scintillator that absorbs the x-rays and converts them into digital signals that are instantly sent over to a computer with image acquisition software. The entire process from the x-ray being shot to the image showing up on the screen is a matter of seconds. From here the clinician can use the image acquisition software to enhance or manipulate the image as desired. The DR panel can immediately be reused as it does not have to be erased. 

Key advantages that DR has over CR: 

  • Newer technology
  • Saves time
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Newer technology

As an industry, digital x-ray technology is advancing and has shifted more towards the continued development and improvement of DR technology vs CR systems. While you can still purchase CR systems, they are becoming less popular as the industry continues shifting towards DR panels. With wireless DR panels offering more portability and many DR panels using cesium iodide (CsI) versus gadolinium oxysulfide (GOS) as the scintillators, which allow for extremely high-quality digital images, there are now even more reasons to adopt the newer technology of DR panels. With CR technology, the image quality can deteriorate if there are issues with the IP not being fully erased by the CR reader or if debris gets into the cassette. 

Saves Time

DR technology saves time. As mentioned before, there are much fewer steps in the process to take images with a wireless or tethered DR panel vs using a CR system. With a DR panel, in many cases you never have to move it (unless you have a wireless panel that maybe you move between a wall stand and a table). It’s ready to go immediately and the image is sent directly to the image acquisition software that is usually right there in the x-ray room with the patient. You can see the image within seconds.  

With CR, you have to load a blank CR cassette into the tray before each image. After the image is taken you have to remove the CR cassette, load it into the CR reader, and then once the image is digitized it has to be erased before the cassette can be reused. The CR reader may be in a different location than the imaging room and the cassette would have to be transported to be read. This all increases the processing time and adds to the overall time it takes from shooting the image and being able to read it. In most cases, you want to make sure the image quality is acceptable before you end the patient’s appointment in case additional images need to be taken, thus the patient must wait longer with CR. Using CR also adds additional throughput time for staff as they navigate these additional steps in the process.

Better Dose Efficiency

DR panels have been shown to have significantly better dose efficiency than CR systems. Dose efficiency is measured in DQE or detective quantum efficiency. Gadolinium Oxysulfide (GOS) DR panels have a DQE of 35%, which is better than CR with a DQE of 25%. Cesium Iodide (CsI) DR panels are two to three times more efficient than CR with a DQE of 70%. This equates to less radiation exposure to both the patient and the clinician with the same image quality.

As DR technology developed over the years, the one advantage that CR seemed to have over DR was cost. However, now that DR panels have become more popular and it has become the gold standard for digital imaging, the price gap between the two has significantly diminished and you now can get a high quality DR panel for a similar price as a CR system (maybe even less depending on the system you choose). 

To sum it up, DR technology has improved greatly in recent years. There are several advantages to choosing a DR panel system vs a CR system.  For a comparable price, DR panels systems offer newer technology with improved image quality, lower dose efficiency and can save you and your patients time. 

If you have questions about your digital x-ray needs we’d love to hear from you. You can email us at sales@mavenimaging.com or call (800) 949-8015. We look forward to hearing from you!


Melissa Schwab

Written by Melissa Schwab