Economic Problems of the X-ray Laboratory

Abstract

With the discovery that X-ray waves would change the silver in a photographic emulsion, the users of X-ray equipment naturally made use of the photographic plates which were commercially available. The size and shape of these photographic plates had been determined from the pictorial standpoint for landscapes and groups. With the exception of the special oblong plates which were made for Dr. Charles Lester Leonard for kidney examinations, we can find no record that any attempt has been made to study the requirements of the roentgenologist in regard to the sizes and shapes of X-ray plates and X-ray films appropriate for diagnosis. As a result there is at the present time a great economic waste in X-ray laboratories, a situation which it is one of the purposes of the present paper to discuss. A presentation of the problem seems quite timely, inasmuch as the manufacturers are at present engaged in studying the situation in regard to photographic films and photographic paper. Recently there have been many changes in the size of films and paper calculated to result in a standardization which will be an economic gain to the professional photographer. In every X-ray examination of the adult chest the present size 0 f 14 by 17 film is the one which is universally used. A careful study of a large number of chest films shows a waste due to the fact that the lower part of the average chest film is blank. The German economists have recognized this waste and have suggested making two exposures on the present 14 by 17 film, using a mat which will allow one of the exposures to be made of the apices, while the rest of the film can be used according to our present ideas. Such a system of double exposures, however, is inconvenient and oftentimes not needed. The greater number of chest examinations could be made on a 14 by 14 film. The writer has calculated that in a laboratory where, say, 6,600 chest examinations are made during the year, using 13,200 14 by 17 films, there is an economic loss of considerable moment. If acetate of cellulose films are used, with a trade discount of 20 per cent, which may be taken as the average trade discount allowed to many of the laboratories, the money value of the 42 square inches of unused film is $1,716. If, in these 13,200 films, nitrate of cellulose is employed, with an average trade discount of 20 per cent, the value of the 42 square inches of film which is wasted is $1,452. In other words, in an X-ray laboratory where 6,000 chest examinations are made a year, there would be a saving of $1,700 a year if 14 by 14 films were used in place of 14 by 17. There would be a corresponding saving in developer and fixing bath. This is an economic waste which goes on year after year and on a ten-year basis the loss would, of course, be about $17,000 —money which should be diverted from the commercial trade to the treasury of the hospital or laboratory.