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Film to X-rays? 71

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."
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Film to X-rays?

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  • Are they his xrays? (Score:5, Informative)

    by i.r.id10t ( 595143 ) on Tuesday November 01, 2005 @09:49PM (#13929298)
    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.
    • I agree with this: They are yours. Keep them.

      Doctors want you to think these things belong to them for purely selfish reasons: If they keep them, they force you to return to them alone for service. Think of your last eye prescription, did they write it down and give it to you? No? Well, they too will try to tell you that you can't have it. Hog wash.

      Take what little control over your over-priced health care that you can. Check out your records and keep them. At the very least, make copies.

  • Can't he just take the ones on loan?
  • Don't (Score:5, Insightful)

    by Karma Farmer ( 595141 ) on Tuesday November 01, 2005 @09:50PM (#13929305)
    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?
    • And anyway, if he has the damn xrays, just take them to the second doc to look at. It's not like having a second doc look at them destroys the things.
  • 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).
  • by duffbeer703 ( 177751 ) on Tuesday November 01, 2005 @09:56PM (#13929341)
    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.
  • Get copies (Score:3, Insightful)

    by Otter ( 3800 ) on Tuesday November 01, 2005 @09:58PM (#13929355) Journal
    Most likely he has the rights to the films, but I'd recommend leaving the originals in his record and getting copies made. That's a routine request, and not expensive even if his benefits don't cover it.

    I would strongly recommend *not* screwing around with any homebrew methods when his health depends on it.

  • by Karma Farmer ( 595141 ) on Tuesday November 01, 2005 @10:00PM (#13929366)
    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...
    • I'd normally suggest a good Hayne's manual for your car. However, the liquer that will be required each time your homebrew mechanic bashes his knucles on something will easily overtake the cost of doing the work yourself. This could be the worst ask Slashdot in the history of ask Slashdots. If your second opinion doctor cannot get the medical records, it's time to call a lawyer (or at least threaten to).

      This reminds me of the time I was at Bastille day last year, someone called a local bar to ask wher
  • 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 fo
  • OK. That is YOUR X-Ray (well, your friends). That doctor MUST give it to the doctor you ask for a second opinion from (I believe).

    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

    • That's how I did it when I wanted a gory image of my arm to x-ray to friends. Get an expensive piece of bright white glossy paper, and put it on top of the x-ray. Problem solved.

      However, asking your radiology department is easier, as I discovered afterwards that they'd have emailed the digital original to me if I'd asked.
    • That said, an X-Ray is nothing more than a special transparency as far as scanning goes (that's my theory).

      So much for the theory. In practice even slightest shadings and finest details that can get lost when transferring the image with sub-standard equipment can hide vital information from the doc examining the picture afterwards, especially if you are not trying to examine some bones but soft tissue structures like e.g. the lung.

      So yes, an x-ray image basically is just a special transparency, but you will
    • 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.

      However, the grey areas will become much darker than intended since the light has to pass twice through the film. If the difference between white and black is a factor 500 in light intensity, then you will need a scanner that can handle a dynamic range of 500*500=25,000. There are no scanners that can do that under practical circumstances. That is why scanners for negative

    • The fee his friend paid was for the professional reading to make the diagnosis, the hosp owns the x-ray.
      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 j
  • DICOM is your friend (Score:4, Interesting)

    by Yonder Way ( 603108 ) on Tuesday November 01, 2005 @10:05PM (#13929400)
    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.
  • Typical (Score:3, Interesting)

    by OldManAndTheC++ ( 723450 ) on Tuesday November 01, 2005 @10:06PM (#13929403)
    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" [imdb.com] whenever I please. Sure beats pleading with the lab to see the results that you PAID for.
    • Re:Typical (Score:3, Funny)

      by KingPrad ( 518495 )
      scan results were burned to a CD with a handy little viewer app

      torrent?
    • Sure beats pleading with the lab to see the results that you PAID for.

      Sure beats it, but the lab took the photo, they own the copyright. It's just like getting professional photos (or being inadvertently photographed by someone in the street). They own the copyright on the artwork. They can make money selling you copies and restricting your right to make copies, and damn it they will do that...

      • I'm not so sure that the lab owns the x-rays. It sounds like a work-for-hire situation. You hired them to take the x-rays; you own the copyright. The reason this isn't true in the typical situation when you hire a professional photographer is because you sign a contract that creates a special arrangment. You don't sign any such contract when you have x-rays taken.

        • 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.
        • 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).
          • You generally do sign a contract when you're admitted to the hospital, though offhand I can't say if it contains a clause about ownership of image copyrights. However, in my experience you generally do not sign any such contract when you get x-rays or other tests as an outpatient.

            • in my experience you generally do not sign any such contract when you get x-rays or other tests as an outpatient.

              I had some medical images taken recently and they made me sign quite a long disclaimer, etc and it was just a simple ultrasound. The lab retained copyrights to the images (according to the piece of paper I signed), but I have the original prints that were made. They retain a digital copy and can reproduce them at any time if I need them.

              It really is a matter of asking. AFIK they aren't al

    • 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.
  • http://www.epson.com/cgi-bin/Store/consumer/consDe tail.jsp?BV_UseBVCookie=yes&oid=53540925 [epson.com]

    There may be other less-expensive models w/ a similar adapter, and you may also be able to find one used.
    • I have one of these (ok, not this model scanner, but an Epson with transparency). It's meant for slides, not full-sized x-rays.
    • X-Rays are typically 11"x17". No way it'd fit in any Epson scanner I've ever seen.

      At the hospital where we work we do have a Kodak scanner specifically designed for X-Rays, but of course it costs probably in the range of $10,000-$15,000.

      Of course this entire question is moronic. Go to the Radiology department, ask for a copy of your X-Rays to keep, and they'll charge you like $15. $15 is about two orders of magnitude cheaper than ANY method you could do yourself, and three orders of magnitude of any meth
  • by stienman ( 51024 ) <adavis@NOspaM.ubasics.com> on Tuesday November 01, 2005 @10:30PM (#13929511) Homepage Journal
    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 (Score:3, Informative)

    by Centurix ( 249778 ) <centurix@g m a i l . com> on Tuesday November 01, 2005 @10:34PM (#13929528) Homepage
    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.
    • Re:X-Ray scanners (Score:1, Insightful)

      by Anonymous Coward
      Right. You believe the human eye can discriminate beyond the 600 dpi minimum resolution that even the most inexpensive junk desktop scanners offer. So you are claiming that a human being can spot a significant feature on an xray that has a maximal width of less than 0.5mm.
      • I would imagine the difference is less in the resolution of the image as in the range of colours. Displays sold for Medical Imaging have mostely quite a large dynamic range to allow differentiation of miniscule details of shade.

        I am not sure if your inexpensive junk desktop scanner can handle the range that is needed.
      • It's not the resolution, it's the number of colour scales required. I've dealt with X-ray scanners which output DICOM images with a minimum of 4096 shades of grey.

        When you have to deal with full colour images the imaging equipment has to be colour calibrated regularly when it's used for diagnostics.
      • 600 dpi at what calibration for grayscale (ignoring colour options)?

        I have a 1200 dpi laser printer, I can see the dot scale on images because its black and white, not grayscale.

        Your scanner, even at 1200 or higher DPI won't be able to determine the exact difference in shade between point A and point B, it just does its best based on how well calibrated the bulb and sensors (and semi-reflective white material on the lid) is.

        Accuracy is pretty low on consumer scanners; good enough for most undiscerning peopl
  • 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.
  • 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 backgro
    • Most home and office scanners offer only 256 gradations in gray scale mode. Scanning the xray image under these conditions is going to seriously compress the midrange values and some of the subtle distinctions are going to be lost. Since the concern is with arithritic changes in bone density, this would be a very serious problem. Scanning in 24 bit color mode could get around this, but it would probably introduce color artifacts that could mislead a diagnostician even when the scan looked good. (A pixel tha

  • Whenever I needed my X-rays somewhere else, I either check the originals out and hand carry them - or I fill out a form my HMO sends 'em over.

    Homebrew methods for something so important seems a bit risky.

  • Ask for a CD (Score:4, Informative)

    by bill_mcgonigle ( 4333 ) * on Tuesday November 01, 2005 @11:38PM (#13929782) Homepage Journal
    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).
  • 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.
  • .. no seriously, my dr office gave me a copy of my xray on cdrom, and I just took that to the second opinion and all the other doctors that have asked for it. It is a windows, exe file that has my xrays scanned already. You can zoom in and out and doctors here love it!

    Ask your xray place to supply you with your xrays in cdrom format. Demand it!

  • 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
  • by jnedelka ( 457104 ) <janNO@SPAMnedelka.net> on Wednesday November 02, 2005 @08:22AM (#13931307) Homepage
    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 [sc.edu] , 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
  • 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
  • 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

  • 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.
  • As someone that is involved in authoring Breast Screening software that is now transitioning to digital mammography units, I can give a few points:

    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 sh

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